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If you factor in collapse of medical services -- Italy ran out of ventilators / ICU beds--the gap becomes clearer. You have to look at over 60 as more likely to

If you factor in collapse of medical services -- Italy ran out of ventilators / ICU beds--the gap becomes clearer. You have to look at over 60 as more likely to be hospitalized, putting strain on medical system.

zaroth 7y ago
This doesn’t account for it because South Korea didn’t even have the number of serious cases that Italy has. The real answer is simply that the number of tests is not equal to the number of cases. The number of positive tests is a factor of the number of tests done, and how selective the testing was allowed to be. It is only loosely related to the number of infected people (technically it is the lower bound).
- fnord123 7y ago
  >The real answer is simply that the number of tests is not equal to the number of cases. Ye olde "3.6 roentgens. Not great but not terrible" factor. https://m.youtube.com/watch?v=Mg5HOnq7zD0 https://m.youtube.com/watch?v=Mg5HOnq7zD0
- skmurphy 7y ago
  My comment was directed at age structure of population accounting for difference in mortality, complicated by effective collapse of medical care in certain regions of Italy that meant severe cases that could have been managed because critical and then fatal without ventilation support.
- RobertoG 7y ago
  >>"The real answer is simply that the number of tests is not equal to the number of cases." I think you are right, but, assuming all the deaths are reported, the obvious implication is that the mortality rate is a lot lower than 3% If fact, looking to Germany, I would say that it's around 0.2, 0.3 % That would be the good news, the bad news is that it's extremely contagious, probably because nobody is immune to this thing. Of course, I'm only a random guy in the Internet, so take it with a grain of salt.
  - gpderetta 7y ago
    I think the current most credible estimate is 0.8%-1%. That's what the UK government has been planning for, for example.
    - RobertoG 7y ago
      Makes sense, it's difficult to calculate without knowing the number of tests that are being done in every country.
T-A 7y ago
As far as I can tell from the media, Italy has not run out of intensive care units yet. See e.g. this: https://www.washingtonpost.com/world/europe/italy-coronavirus-patients-lombardy-hospitals/2020/03/12/36041dc6-63ce-11ea-8a8e-5c5336b32760_story.html https://www.washingtonpost.com/world/europe/italy-coronaviru...
- skmurphy 7y ago
  Here are two reports that would indicate that the standard of care has been substantially reduced https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/ https://www.theatlantic.com/ideas/archive/2020/03/who-gets-h... "Doctors and nurses are unable to tend to everybody. They lack machines to ventilate all those gasping for air." ---- https://www.euronews.com/2020/03/12/coronavirus-italy-doctors-forced-to-prioritise-icu-care-for-patients-with-best-chance-of-s https://www.euronews.com/2020/03/12/coronavirus-italy-doctor... "Another nurse working in Lombardy, the Italian region the worst hit by COVID-19, told Euronews the situation was "dire" and far worse than it is being portrayed in the media. Speaking to Euronews on the condition of anonymity, she said: "We have hundreds of cases in our hospital. Half of our operating block has been dedicated to COVID-19 patients. The situation is dire. Anesthetists – despite them playing it down a little bit on the media – have to choose who they attach to the machine for ventilation, and who they won’t attach to the machines" --- A first person report from Seattle ICU doctor https://www.facebook.com/marie.e.will/posts/10163071254245156 https://www.facebook.com/marie.e.will/posts/1016307125424515... "Remdesivir might work, some hosps have seen improvement with it quite rapidly, marked improvement in 1-3 days. ARDS trajectory is impressive with it, pts improve much more rapidly than expected in usual ARDS. Recommended course is 10d, but due to scarcity all hosps have stopped it when pt clinically out of the woods - none have continued >5d. I decode this as they have half the amount of Remdesivir they need, only treating for 5 days when recommended course is 10. The other thing that appears to be going on, and it's also hinted at in report from Seattle, is that old patients are being moved to hospice or "comfort care" who would not have been three months ago because of lack of supplies/personnel/equipment.
  - T-A 7y ago
    Going through your links: #1 provides no numbers and no details beyond a claim that "They lack machines to ventilate all those gasping for air." #2 does not even go that far: it speaks of "a huge turnover issue and leaving hospitals at near capacity" (near, not above, contradicting #1) #3 is from an intensivist in Seattle, Washington, not from Italy. I chose the Washington Post link because it provides numbers: "Lombardy has just 737 intensive-care beds available for coronavirus patients. More than 600 are filled. [...] The region is racing to bring more beds online; it added 127 on Thursday." (Lombardy is the region with most cases.) This is consistent with the claim in your link #2 that hospitals are near capacity (and not above it, as suggested by your link #1). The point of all this pedantry is simply that I don't think saturation can be invoked yet to explain the high Italian mortality rate. Addition: Here's a slightly older Italian source (March 11) which puts nation-wide ICU capacity in Italy at 5090, with 887 in use: https://www.linkiesta.it/it/article/2020/03/11/italia-coronavirus-ultime-notizie-posti-letto-intensiva/45767/ https://www.linkiesta.it/it/article/2020/03/11/italia-corona...

zaroth 7y ago

This doesn’t account for it because South Korea didn’t even have the number of serious cases that Italy has. The real answer is simply that the number of tests is not equal to the number of cases. The number of positive tests is a factor of the number of tests done, and how selective the testing was allowed to be. It is only loosely related to the number of infected people (technically it is the lower bound).

fnord123 7y ago
>The real answer is simply that the number of tests is not equal to the number of cases. Ye olde "3.6 roentgens. Not great but not terrible" factor. https://m.youtube.com/watch?v=Mg5HOnq7zD0 https://m.youtube.com/watch?v=Mg5HOnq7zD0
skmurphy 7y ago
My comment was directed at age structure of population accounting for difference in mortality, complicated by effective collapse of medical care in certain regions of Italy that meant severe cases that could have been managed because critical and then fatal without ventilation support.
RobertoG 7y ago
>>"The real answer is simply that the number of tests is not equal to the number of cases." I think you are right, but, assuming all the deaths are reported, the obvious implication is that the mortality rate is a lot lower than 3% If fact, looking to Germany, I would say that it's around 0.2, 0.3 % That would be the good news, the bad news is that it's extremely contagious, probably because nobody is immune to this thing. Of course, I'm only a random guy in the Internet, so take it with a grain of salt.
- gpderetta 7y ago
  I think the current most credible estimate is 0.8%-1%. That's what the UK government has been planning for, for example.
  - RobertoG 7y ago
    Makes sense, it's difficult to calculate without knowing the number of tests that are being done in every country.

T-A 7y ago

As far as I can tell from the media, Italy has not run out of intensive care units yet. See e.g. this: https://www.washingtonpost.com/world/europe/italy-coronavirus-patients-lombardy-hospitals/2020/03/12/36041dc6-63ce-11ea-8a8e-5c5336b32760_story.html https://www.washingtonpost.com/world/europe/italy-coronaviru...

skmurphy 7y ago
Here are two reports that would indicate that the standard of care has been substantially reduced https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/ https://www.theatlantic.com/ideas/archive/2020/03/who-gets-h... "Doctors and nurses are unable to tend to everybody. They lack machines to ventilate all those gasping for air." ---- https://www.euronews.com/2020/03/12/coronavirus-italy-doctors-forced-to-prioritise-icu-care-for-patients-with-best-chance-of-s https://www.euronews.com/2020/03/12/coronavirus-italy-doctor... "Another nurse working in Lombardy, the Italian region the worst hit by COVID-19, told Euronews the situation was "dire" and far worse than it is being portrayed in the media. Speaking to Euronews on the condition of anonymity, she said: "We have hundreds of cases in our hospital. Half of our operating block has been dedicated to COVID-19 patients. The situation is dire. Anesthetists – despite them playing it down a little bit on the media – have to choose who they attach to the machine for ventilation, and who they won’t attach to the machines" --- A first person report from Seattle ICU doctor https://www.facebook.com/marie.e.will/posts/10163071254245156 https://www.facebook.com/marie.e.will/posts/1016307125424515... "Remdesivir might work, some hosps have seen improvement with it quite rapidly, marked improvement in 1-3 days. ARDS trajectory is impressive with it, pts improve much more rapidly than expected in usual ARDS. Recommended course is 10d, but due to scarcity all hosps have stopped it when pt clinically out of the woods - none have continued >5d. I decode this as they have half the amount of Remdesivir they need, only treating for 5 days when recommended course is 10. The other thing that appears to be going on, and it's also hinted at in report from Seattle, is that old patients are being moved to hospice or "comfort care" who would not have been three months ago because of lack of supplies/personnel/equipment.
- T-A 7y ago
  Going through your links: #1 provides no numbers and no details beyond a claim that "They lack machines to ventilate all those gasping for air." #2 does not even go that far: it speaks of "a huge turnover issue and leaving hospitals at near capacity" (near, not above, contradicting #1) #3 is from an intensivist in Seattle, Washington, not from Italy. I chose the Washington Post link because it provides numbers: "Lombardy has just 737 intensive-care beds available for coronavirus patients. More than 600 are filled. [...] The region is racing to bring more beds online; it added 127 on Thursday." (Lombardy is the region with most cases.) This is consistent with the claim in your link #2 that hospitals are near capacity (and not above it, as suggested by your link #1). The point of all this pedantry is simply that I don't think saturation can be invoked yet to explain the high Italian mortality rate. Addition: Here's a slightly older Italian source (March 11) which puts nation-wide ICU capacity in Italy at 5090, with 887 in use: https://www.linkiesta.it/it/article/2020/03/11/italia-coronavirus-ultime-notizie-posti-letto-intensiva/45767/ https://www.linkiesta.it/it/article/2020/03/11/italia-corona...