4 ms·
This article does a better job than most, but I think still only half-asses the thought process necessary to logically reason about COVID. The naive or “known”
by zaroth 7y ago
This article does a better job than most, but I think still only half-asses the thought process necessary to logically reason about COVID.
The naive or “known” CFR is the fatality rate to-date divided by the number of positive tests to date.
For example, China at one point decided to consider a large number of people as positive cases based on purely clinical symptoms because they didn’t have the test capacity or specificity to definitively diagnose them. Which is why their case count gapped up one day.
The CFR after all cases have concluded is an upper bound on the IFR. There seems to be no true consensus on the percentage of asymptomatic or very mild cases which would not seek treatment or even testing. This number (which is basically unknowable during an outbreak) is a multiplier on the case count, and acts to reduce the true IFR.
Lastly, as we’ve seen quite clearly... How bad it is depends almost entirely upon the person, or at a higher level, the demographics of the people who are infected.
Italy as of March 11;
> Of the patients who died, 42·2% were aged 80–89 years, 32·4% were aged 70–79 years, 8·4% were aged 60–69 years, and 2·8% were aged 50–59 years (those aged >90 years made up 14·1%). The male to female ratio is 80% to 20% with an older median age for women (83·4 years for women vs 79·9 years for men).
Likewise, the outbreak in a WA nursing home was devastating to an elderly population where they would see 5-10 patients die in an average month.
IMO the path forward is either successful containment—which seems extremely unlikely given the transmission characteristics, but apparently China was able to do it? But where you constantly have to be watching for pockets of reemergence and clamp them down.
Or, if we can keep the virus away from high-risk populations while it spreads “like a flu” through the majority of the population, then you will see herd immunity kick in which ultimately works like a vaccinated population to prevent further outbreak and protect the at-risk population from ever becoming infected.
[1] - https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30627-9/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
- empath75 7y agoChina’s method of containment was to scan pretty much the entire population for fever and quarantine everyone who might have been infected immediately and involuntarily, including taking children from parents. Needless to say, that will never happen in the us or Europe.
- zaroth 7y agoAnd what’s your thought for explaining South Korea?
- empath75 7y agoThey did extensive testing and containment but that won’t matter eventually. It will break out into unchecked community spread eventually unless they implement a similar quarantine.
- alfiedotwtf 7y ago> taking children from parents. Needless to say, that will never happen in the US They separated Native American and immigrant families in the recent past, why stop now
- Fjolsvith 7y agoDon't know about the Native Americans, but the immigrants who broke the law by entering illegally had as much right to remain with their children as a US Citizen arrested for a DUI - i.e. none until released from custody.
- pmoriarty 7y ago"How bad it is depends almost entirely upon the person, or at a higher level, the demographics of the people who are infected." There are other important factors to consider. There will be a percentage of infected individuals who otherwise would have survived had they had access to respiratory assistance by trained medical staff at a hospital. But as medical staff get overwhelmed, get sick, or die, as free room in Intensive Care Units is used up, as respiratory assistance technology becomes unavailable because it's busy supporting other patients, the death rate will rise beyond what looking at the demographic data alone might lead one to believe. In addition, there are likely to be extra deaths from other, completely unrelated diseases and conditions for which people can no longer get treatment as hospitals and medical staff get overwhelmed, and as we run in to medicine and medical equipment shortages from lack of supply in China (and, I expect before long, from India and other countries on which the US medical system relies). To make matters worse, the people sick with COVID-19 will likely infect a lot of vulnerable patients in the hospitals they go to, as most hospitals just simply aren't equipped to effectively contain such infections, especially when there are so many of them. This will increase the death toll even further. There are many group living facilities such as prisons and nursing homes which will likely be affected by this as well. They will be especially vulnerable because the people there tend to already not be in the healthiest shape and have weakened immune systems.