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> We are very likely on the brink of a collapse of the ability of our health care system to take care of the most vulnerable, with a death toll that will dwarf

> We are very likely on the brink of a collapse of the ability of our health care system to take care of the most vulnerable, with a death toll that will dwarf in American casualties any war the US has been in and the direst of economic consequences if the pandemic is not slowed to a manageable level. This seems over the top. I thought the death rates are insignificant for those younger than 60, and those who succumb to it already have pre-existing health/respiratory issues. Doesn't influenza cause thousands of deaths per year? I am mostly playing devil's advocate, I am genuinely curious to hear why you have so much fear.

grecy 7y ago
Even the best-case estimates right now have US deaths at 2 million. i.e. 70% of people infected (230mil), 1% of those people die (2.3mil). 1% death rate is extremely low, it will more likely be 3 or 4 or 5. It's very possible 10 million people in the US are going to die (5% of infected).
- solidasparagus 7y ago
  This is blatantly untrue. Worst case scenario is currently believed to be 1.7 million deaths. https://thehill.com/homenews/sunday-talk-shows/487652-fauci-offers-updates-on-coronavirus-mitigation-as-administration https://thehill.com/homenews/sunday-talk-shows/487652-fauci-...
  - crooked-v 7y ago
    That only holds if all of the people suffering severe cases can get enough medical care, which becomes much less likely if hospitals get overwhelmed. That's why 'flattening the curve' is extremely important.
    - solidasparagus 7y ago
      What are you basing that statement on? The worst case-scenario is based on a scenario where no effort is made to protect against the spread of Coronavirus and I'd imagine the CDC considered the impact of overwhelmed hospitals when doing their analysis.
  - pmoriarty 7y ago
    From a Penn State epidemiologist (note that the quote below speaks of the "infection fatality rate", which is different from the "case fatality rate", the difference is explained in the article)[1]: "Scientists working at the London School of Hygiene and Tropical Medicine, Imperial College London and the Institute for Disease Modeling have used these approaches to estimate the infection fatality rate. Currently, these estimates range from 0.5% to 0.94% indicating that COVID-19 is about 10 to 20 times as deadly as seasonal influenza. Evidence coming in from genomics and large-scale testing of fevers is consistent with these conclusions. The only potentially good news is that the epidemic in Korea may ultimately show a lower CFR than the epidemic in China. ... "On balance, it is reasonable to guess that COVID-19 will infect as many Americans over the next year as influenza does in a typical winter -- somewhere between 25 million and 115 million. Maybe a bit more if the virus turns out to be more contagious than we thought. Maybe a bit less if we put restrictions in place that minimize our travel and our social and professional contacts. "The bad news is, of course, that these infection numbers translate to 350,000 to 660,000 people dying in the U.S., with an uncertainty range that goes from 50,000 deaths to 5 million deaths. The good news is that this is not a weather forecast. The size of the epidemic, i.e., the total number of infections, is something we can reduce if we decrease our contact patterns and improve our hygiene. If the total number of infections decreases, the total number of deaths will also decrease." This analysis is a little old, however (from March 9th, six days ago), and assumes that the rate of infection of COVID-19 is comparable to seasonal influenza. A recent This Week in Virology podcast[2] had another epidemiologist, Ralph Baric, of the University of North Carolina Chapel Hill, who had this to say: "The R0, or the number of people who become infected from an infected individual, is estimated somewhere between 2.5 and 3.2. That's actually quite high. That means that for every case there is two and a half to three additional cases. Contemporary flu is much closer to 2 or 1.8, 1.6. So this is very explosive spread and rapid transmission. It's even more explosive because you have rare individuals or maybe not so rare individuals who are superspreaders, who can infect 15, 20 people just passing through a room."[3] "In Canada there was one example of a superspreader who simply walked through an emergency room that was packed that was fairly packed with individuals and infected 19 people in the less than the 15 seconds they were in the emergency room as they walked through it."[4] With such explosive growth, the health care systems stands a very good chance of being overwhelmed, causing substantially more deaths. For instance, those 10% to 17% of severe cases that might have otherwise survived had they gotten care in an ICU could well die because they can't get that care. In addition many other, non-infected people who need critical care may not be able to get that care either and die, raising the overall death toll even higher. [1] - https://www.marketwatch.com/story/why-this-epidemiologist-is-more-worried-about-coronavirus-than-he-was-a-month-ago-2020-03-09 https://www.marketwatch.com/story/why-this-epidemiologist-is... [2] - http://www.microbe.tv/twiv/twiv-591/ http://www.microbe.tv/twiv/twiv-591/ [3] - about 8 minutes in to the program [4] - about 38 minutes in to the program
  - grecy 7y ago
    This CDC article [1] Estimates worst case at 1.7 million deaths. Let's dig into that. They say it could be up to 214 million infected ( which is 64.8% of the population, so my number differs from theirs by 5.2%), but they say only 1.7 million deaths. That's a CDC projected death rate of 0.8% .... which is extremely optimistic. The WHO says 3.4% [2] China 3.6% - 6.1% [2] Italy 3-4% [2] So I have no idea why the CDC would make their estimates based on a 0.8% death rate. That doesn't seem realistic to me, especially when we know the US has less hospital beds per capita than for example Italy. [1] https://nymag.com/intelligencer/2020/03/cdcs-worst-case-coronavirus-model-210m-infected-1-7m-dead.html https://nymag.com/intelligencer/2020/03/cdcs-worst-case-coro... [2] https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
    - solidasparagus 7y ago
      So first off I've spent enough time with people in epidemiology/at the CDC to know that I (and probably you) don't know enough to have a more accurate armchair analysis than what their experts produce. Second, I would imagine ICU/critical care beds per capita is a better predictor of fatality rate than hospital beds and the US is very well equipped in that regard. The US medical system has numerous flaws, but in terms of technical ability to keep extremely sick people alive, the US is pretty good. We can debate the details, but since neither of us are experts it's probably a waste of time. However, there is absolutely no basis to say "best-case estimates right now have US deaths at 2 million". It is blatantly untrue - it directly contradicts every single expert analysis that I have seen.
    - tathougies 7y ago
      The us has more icu beds than italy.
      - stevekemp 7y ago
        Percapita? Obviously there are more American ICU beds in absolute numbers, but also there is a bigger population.
    - thu2111 7y ago
- pmoriarty 7y ago
  The deaths aren't going to be limited to those that get infected either. As the health care system gets overwhelmed many others in critical need of lifesaving care will be unable to get it. That's not to mention the shortages of medicines and medical equipment made in China and other vulnerable places around the world that the US relies on.
zaroth 7y ago
For example, 97.1% of fatalities in Italy are over 60 years old, and 99.9% of fatalities are over 50 years old. The 65+ crowd isn’t living paycheck to paycheck and working every day to pay for rent and groceries. There are a lot of people living paycheck to paycheck who are at basically zero risk from this virus who should be allowed to work. Since we’re talking about a few trillion dollars of economic damages, I would expect something a bit less hysterical and a bit more focused on the actual at-risk population.
- mirimir 7y ago
  I think that you're missing the point that younger people are still at risk of infection. They're far less likely to die, and so make great carriers.
  - zaroth 7y ago
    I’m not missing that fact at all. People who are at risk should self-isolate, and we should put policies in place to assist the vulnerable population in doing so. The most at risk population is also very unlikely to depend on a weekly paycheck.
    - crooked-v 7y ago
      You're conveniently avoiding engaging with the part where "let people just go to work" means that the death rate in under-60 severe cases skyrockets because hospitals can't handle that many people needing ventilators and round-the-clock care all at once.
      - zaroth 7y ago
        People with mild symptoms aren’t going to the ICU at all. And overall disease severity even in hospital cases is significantly lower in people < 50yrs .
- Terretta 7y ago
  > a lot of people ... at basically zero risk from this virus This is a super dangerous myth. Death is not the only risk. Here’s what this coronavirus does to the body: https://www.nationalgeographic.com/science/2020/02/here-is-what-coronavirus-does-to-the-body/ https://www.nationalgeographic.com/science/2020/02/here-is-w... TL;DR: It’s nasty, can leave lasting damage.
koheripbal 7y ago
Projections range from 200,000 dead to 2.x million dead in the US alone. I don't care what age or what pre-existing conditions those people have... that is a LOT of human death and suffering. ...not to mention the millions of survivors that will require being hooked up to a mechanical ventilator and walk away with permanent lung damage.
- copperx 7y ago
  I thought it was 1 million dead absolutely best case scenario, and 11 million dead worst case.

grecy 7y ago

Even the best-case estimates right now have US deaths at 2 million. i.e. 70% of people infected (230mil), 1% of those people die (2.3mil). 1% death rate is extremely low, it will more likely be 3 or 4 or 5. It's very possible 10 million people in the US are going to die (5% of infected).

solidasparagus 7y ago
This is blatantly untrue. Worst case scenario is currently believed to be 1.7 million deaths. https://thehill.com/homenews/sunday-talk-shows/487652-fauci-offers-updates-on-coronavirus-mitigation-as-administration https://thehill.com/homenews/sunday-talk-shows/487652-fauci-...
- crooked-v 7y ago
  That only holds if all of the people suffering severe cases can get enough medical care, which becomes much less likely if hospitals get overwhelmed. That's why 'flattening the curve' is extremely important.
  - solidasparagus 7y ago
    What are you basing that statement on? The worst case-scenario is based on a scenario where no effort is made to protect against the spread of Coronavirus and I'd imagine the CDC considered the impact of overwhelmed hospitals when doing their analysis.
- pmoriarty 7y ago
  From a Penn State epidemiologist (note that the quote below speaks of the "infection fatality rate", which is different from the "case fatality rate", the difference is explained in the article)[1]: "Scientists working at the London School of Hygiene and Tropical Medicine, Imperial College London and the Institute for Disease Modeling have used these approaches to estimate the infection fatality rate. Currently, these estimates range from 0.5% to 0.94% indicating that COVID-19 is about 10 to 20 times as deadly as seasonal influenza. Evidence coming in from genomics and large-scale testing of fevers is consistent with these conclusions. The only potentially good news is that the epidemic in Korea may ultimately show a lower CFR than the epidemic in China. ... "On balance, it is reasonable to guess that COVID-19 will infect as many Americans over the next year as influenza does in a typical winter -- somewhere between 25 million and 115 million. Maybe a bit more if the virus turns out to be more contagious than we thought. Maybe a bit less if we put restrictions in place that minimize our travel and our social and professional contacts. "The bad news is, of course, that these infection numbers translate to 350,000 to 660,000 people dying in the U.S., with an uncertainty range that goes from 50,000 deaths to 5 million deaths. The good news is that this is not a weather forecast. The size of the epidemic, i.e., the total number of infections, is something we can reduce if we decrease our contact patterns and improve our hygiene. If the total number of infections decreases, the total number of deaths will also decrease." This analysis is a little old, however (from March 9th, six days ago), and assumes that the rate of infection of COVID-19 is comparable to seasonal influenza. A recent This Week in Virology podcast[2] had another epidemiologist, Ralph Baric, of the University of North Carolina Chapel Hill, who had this to say: "The R0, or the number of people who become infected from an infected individual, is estimated somewhere between 2.5 and 3.2. That's actually quite high. That means that for every case there is two and a half to three additional cases. Contemporary flu is much closer to 2 or 1.8, 1.6. So this is very explosive spread and rapid transmission. It's even more explosive because you have rare individuals or maybe not so rare individuals who are superspreaders, who can infect 15, 20 people just passing through a room."[3] "In Canada there was one example of a superspreader who simply walked through an emergency room that was packed that was fairly packed with individuals and infected 19 people in the less than the 15 seconds they were in the emergency room as they walked through it."[4] With such explosive growth, the health care systems stands a very good chance of being overwhelmed, causing substantially more deaths. For instance, those 10% to 17% of severe cases that might have otherwise survived had they gotten care in an ICU could well die because they can't get that care. In addition many other, non-infected people who need critical care may not be able to get that care either and die, raising the overall death toll even higher. [1] - https://www.marketwatch.com/story/why-this-epidemiologist-is-more-worried-about-coronavirus-than-he-was-a-month-ago-2020-03-09 https://www.marketwatch.com/story/why-this-epidemiologist-is... [2] - http://www.microbe.tv/twiv/twiv-591/ http://www.microbe.tv/twiv/twiv-591/ [3] - about 8 minutes in to the program [4] - about 38 minutes in to the program
- grecy 7y ago
  This CDC article [1] Estimates worst case at 1.7 million deaths. Let's dig into that. They say it could be up to 214 million infected ( which is 64.8% of the population, so my number differs from theirs by 5.2%), but they say only 1.7 million deaths. That's a CDC projected death rate of 0.8% .... which is extremely optimistic. The WHO says 3.4% [2] China 3.6% - 6.1% [2] Italy 3-4% [2] So I have no idea why the CDC would make their estimates based on a 0.8% death rate. That doesn't seem realistic to me, especially when we know the US has less hospital beds per capita than for example Italy. [1] https://nymag.com/intelligencer/2020/03/cdcs-worst-case-coronavirus-model-210m-infected-1-7m-dead.html https://nymag.com/intelligencer/2020/03/cdcs-worst-case-coro... [2] https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
  - solidasparagus 7y ago
    So first off I've spent enough time with people in epidemiology/at the CDC to know that I (and probably you) don't know enough to have a more accurate armchair analysis than what their experts produce. Second, I would imagine ICU/critical care beds per capita is a better predictor of fatality rate than hospital beds and the US is very well equipped in that regard. The US medical system has numerous flaws, but in terms of technical ability to keep extremely sick people alive, the US is pretty good. We can debate the details, but since neither of us are experts it's probably a waste of time. However, there is absolutely no basis to say "best-case estimates right now have US deaths at 2 million". It is blatantly untrue - it directly contradicts every single expert analysis that I have seen.
  - tathougies 7y ago
    The us has more icu beds than italy.
    - stevekemp 7y ago
      Percapita? Obviously there are more American ICU beds in absolute numbers, but also there is a bigger population.
  - thu2111 7y ago
pmoriarty 7y ago
The deaths aren't going to be limited to those that get infected either. As the health care system gets overwhelmed many others in critical need of lifesaving care will be unable to get it. That's not to mention the shortages of medicines and medical equipment made in China and other vulnerable places around the world that the US relies on.

zaroth 7y ago

For example, 97.1% of fatalities in Italy are over 60 years old, and 99.9% of fatalities are over 50 years old. The 65+ crowd isn’t living paycheck to paycheck and working every day to pay for rent and groceries. There are a lot of people living paycheck to paycheck who are at basically zero risk from this virus who should be allowed to work. Since we’re talking about a few trillion dollars of economic damages, I would expect something a bit less hysterical and a bit more focused on the actual at-risk population.

mirimir 7y ago
I think that you're missing the point that younger people are still at risk of infection. They're far less likely to die, and so make great carriers.
- zaroth 7y ago
  I’m not missing that fact at all. People who are at risk should self-isolate, and we should put policies in place to assist the vulnerable population in doing so. The most at risk population is also very unlikely to depend on a weekly paycheck.
  - crooked-v 7y ago
    You're conveniently avoiding engaging with the part where "let people just go to work" means that the death rate in under-60 severe cases skyrockets because hospitals can't handle that many people needing ventilators and round-the-clock care all at once.
    - zaroth 7y ago
      People with mild symptoms aren’t going to the ICU at all. And overall disease severity even in hospital cases is significantly lower in people < 50yrs .
Terretta 7y ago
> a lot of people ... at basically zero risk from this virus This is a super dangerous myth. Death is not the only risk. Here’s what this coronavirus does to the body: https://www.nationalgeographic.com/science/2020/02/here-is-what-coronavirus-does-to-the-body/ https://www.nationalgeographic.com/science/2020/02/here-is-w... TL;DR: It’s nasty, can leave lasting damage.

koheripbal 7y ago

Projections range from 200,000 dead to 2.x million dead in the US alone. I don't care what age or what pre-existing conditions those people have... that is a LOT of human death and suffering. ...not to mention the millions of survivors that will require being hooked up to a mechanical ventilator and walk away with permanent lung damage.

copperx 7y ago
I thought it was 1 million dead absolutely best case scenario, and 11 million dead worst case.