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The CDC's worst case estimate was 214 Million Infected, 1.7 Million Dead https://nymag.com/intelligencer/2020/03/cdcs-worst-case-coronavirus-model-210m-infecte

The CDC's worst case estimate was 214 Million Infected, 1.7 Million Dead 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...

marklacey 7y ago
To be clear, this is the worst-case estimate for the current coronavirus outbreak in the US, not the worst-case estimate for the 2009 H1N1 flu outbreak.
Taek 7y ago
I'm not sure how they got 1.7 million dead as the worst case scenario. That implies a mortality rate of 0.7%. Mortality rates for Covid19/SARS2 are estimated to be closer to 3.5% by the WHO, a 35x jump. At 214 million infected, the worst case scenario should be at least 7.5 million. But I believe the 3.5% estimate also assumes that hospitals are able to provide intensive care for all critical patients. The US only has 100k ICU beds, and SARS2 has an ICU rate about 10%. SARS2 patients typically need 2-4 weeks, meaning that the entire US healthcare system can only handle about 2 million SARS2 infections per month. In order to keep a mortality rate of 3.5%, the US would need to spread out those 214 million infections over 9 years. Conclusion: The CDC's worst case estimate of 1.7 million deaths is completely incongruent with their worst case estimate of 214 million infections.
- _-___________-_ 7y ago
  3.5% just doesn't make sense based on any of the case-fatality-rate data we've seen so far combined with the estimates of what proportion of infections are being detected as cases. The UK government's chief medical adviser expects the real fatality rate to be around 0.6%, which is a lot easier to explain with the data than 3.5%.
  - Taek 7y ago
    https://wwwnc.cdc.gov/eid/article/26/6/20-0320_article https://wwwnc.cdc.gov/eid/article/26/6/20-0320_article "The case-fatality risks, when adjusted for a 13-day lag time from reporting to death, were 3.5% in China; 0.8% in China, excluding Hubei Province; 4.2% in the group of 82 countries, territories, and areas; and 0.6% for the cruise ship (Table). Our result for China, excluding Hubei Province, is similar to a previous estimate of 0.9% (95% CI 0.6% - 1.3%) by using a time-delay adjusted case-fatality risk for the same area" This is the only research data I could find. Do have other data? I have multiple sources citing the WHO estimating 3.5%, but I was unable to find any first hand material from the WHO that said 3.5%. The information above - from the CDC, which I consider to be biased and underplaying the situation - has 0.6% as the lowest number, and 4.2% as the highest number. But honestly none of the data I just went digging through felt comfortable. Another thing to remember is that the case-fatality-rates we are seeing in most areas are because the hospital infrastructure can keep up with the number of infections. If the US gets over 1 million infections, the hospitals will not be able to keep up and mortality rates will spike significantly.
    - _-___________-_ 7y ago
      Wait, you're talking about case fatality rates. I thought the above discussion was about the real fatality rate. Obviously CFR is going to be higher because you're excluding all the infections that didn't become cases - which are also the infections least likely to lead to death.
  - sauwan 7y ago
    The morbidity rate is around 5%. In locations where they can keep the ICU beds from being overwhelmed, the mortality rate is low. In locations where the ICU beds are overwhelmed, the mortality rate goes up considerably. It all comes down to how well the system can respond to the load of people needing substantial medical care.
    - _-___________-_ 7y ago
      It doesn't "all come down" to that, the testing regime and thus the proportion of infections that are actually detected is an enormous factor.

marklacey 7y ago

To be clear, this is the worst-case estimate for the current coronavirus outbreak in the US, not the worst-case estimate for the 2009 H1N1 flu outbreak.

Taek 7y ago

I'm not sure how they got 1.7 million dead as the worst case scenario. That implies a mortality rate of 0.7%. Mortality rates for Covid19/SARS2 are estimated to be closer to 3.5% by the WHO, a 35x jump. At 214 million infected, the worst case scenario should be at least 7.5 million. But I believe the 3.5% estimate also assumes that hospitals are able to provide intensive care for all critical patients. The US only has 100k ICU beds, and SARS2 has an ICU rate about 10%. SARS2 patients typically need 2-4 weeks, meaning that the entire US healthcare system can only handle about 2 million SARS2 infections per month. In order to keep a mortality rate of 3.5%, the US would need to spread out those 214 million infections over 9 years. Conclusion: The CDC's worst case estimate of 1.7 million deaths is completely incongruent with their worst case estimate of 214 million infections.

_-___________-_ 7y ago
3.5% just doesn't make sense based on any of the case-fatality-rate data we've seen so far combined with the estimates of what proportion of infections are being detected as cases. The UK government's chief medical adviser expects the real fatality rate to be around 0.6%, which is a lot easier to explain with the data than 3.5%.
- Taek 7y ago
  https://wwwnc.cdc.gov/eid/article/26/6/20-0320_article https://wwwnc.cdc.gov/eid/article/26/6/20-0320_article "The case-fatality risks, when adjusted for a 13-day lag time from reporting to death, were 3.5% in China; 0.8% in China, excluding Hubei Province; 4.2% in the group of 82 countries, territories, and areas; and 0.6% for the cruise ship (Table). Our result for China, excluding Hubei Province, is similar to a previous estimate of 0.9% (95% CI 0.6% - 1.3%) by using a time-delay adjusted case-fatality risk for the same area" This is the only research data I could find. Do have other data? I have multiple sources citing the WHO estimating 3.5%, but I was unable to find any first hand material from the WHO that said 3.5%. The information above - from the CDC, which I consider to be biased and underplaying the situation - has 0.6% as the lowest number, and 4.2% as the highest number. But honestly none of the data I just went digging through felt comfortable. Another thing to remember is that the case-fatality-rates we are seeing in most areas are because the hospital infrastructure can keep up with the number of infections. If the US gets over 1 million infections, the hospitals will not be able to keep up and mortality rates will spike significantly.
  - _-___________-_ 7y ago
    Wait, you're talking about case fatality rates. I thought the above discussion was about the real fatality rate. Obviously CFR is going to be higher because you're excluding all the infections that didn't become cases - which are also the infections least likely to lead to death.
- sauwan 7y ago
  The morbidity rate is around 5%. In locations where they can keep the ICU beds from being overwhelmed, the mortality rate is low. In locations where the ICU beds are overwhelmed, the mortality rate goes up considerably. It all comes down to how well the system can respond to the load of people needing substantial medical care.
  - _-___________-_ 7y ago
    It doesn't "all come down" to that, the testing regime and thus the proportion of infections that are actually detected is an enormous factor.