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I agree, this is an over-reaction, but good luck saying that on HN without inciting an angry mob. People are at peak panic mode right now, and it shows. I jus

I agree, this is an over-reaction, but good luck saying that on HN without inciting an angry mob. People are at peak panic mode right now, and it shows. I just want to remind everyone that H1N1 in 2009 killed between 150-600k people worldwide. Between 10 and 20% of the world population caught it at some point. The fatality rate was greater than Covid-19. And yet, we got through it without panicking. People don't even give it a second thought today, and it was just 10 years ago.

fock 7y ago
CFR of around 0.6‰. Spot the difference.
- deleted 7y ago
  [deleted]
- nostromo 7y ago
  H1N1: 0.4% CFR in the US COVID-19: 0.6% CFR in South Korea (likely similar in other locations when we stop undercounting infections) These aren't so dramatically different, are they? But they are: H1N1 had a median death in the US of 37 years old, rather than 80+. https://www.who.int/immunization/sage/1.Briand_epi_7th_July_2009_(rev_6July_09).pdf https://www.who.int/immunization/sage/1.Briand_epi_7th_July_...
  - chinathrow 7y ago
    You picked SK and left Italy on the left.
    - nostromo 7y ago
      Because Italy has no idea how many cases they have. The best data sets so far are South Korea and the Princess Cruise ship, because they did widespread testing. Both show a CFR of about 0.6%.
  - ncallaway 7y ago
    > H1N1: 0.4% CFR in the US This seems categorically false. CDC estimates that ~61M Americans were infected with ~12,469 deaths. That would be a CFR in the US of 0.02%. https://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm https://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm
  - qayxc 7y ago
    According to current numbers,the CFR in SK is closer to 9‰ [1] [1] https://nssac.bii.virginia.edu/covid-19/dashboard/ https://nssac.bii.virginia.edu/covid-19/dashboard/
altoidaltoid 7y ago
So this is "just a flu bro"?
rosstex 7y ago
H1N1 was contagious 1 day before symptoms appeared. COVID-19 is contagious mean 5-6 days before symptoms appear. And it's not about the CFR, it's about healthcare system capacity.
DanBC 7y ago
SARS-Cov-2 is more infectious than H1N1. This larger pool of patients means a greater number of people will die. A small percentage of a very large number is still a lot of people. > The fatality rate was greater than Covid-19. No, it wasn't. The fatality rate for H1N1 was about 0.2%. The fatality rate for covid-19 is tricky to work out at the moment, but 2% is a reasonable low estimate.
- nostromo 7y ago
  WHO doesn't agree with your numbers: https://www.who.int/immunization/sage/1.Briand_epi_7th_July_2009_(rev_6July_09).pdf https://www.who.int/immunization/sage/1.Briand_epi_7th_July_...
  - DanBC 7y ago
    You've linked a document created during the 2009 pandemic, when CFR rates are likely to be too high. https://www.bmj.com/content/339/bmj.b2840 https://www.bmj.com/content/339/bmj.b2840 > At first sight, the data seem to imply that this new virus is relatively mild, with case fatality ratios around 0.5%, similar to the upper range of that seen for seasonal influenza2 and relatively low hospitalisation ratios. However, the case fatality ratio seems to vary substantially between countries, and deaths have occurred in much younger people than is the case for seasonal influenza.3 4 > There are many reasons why simple interpretations of these crude figures at the beginning of a pandemic may be misleading both in terms of assessing severity and in making comparisons between countries. Here, we discuss some of the important mechanisms resulting in biases, propose study designs and associated statistical methods to estimate the case fatality ratio given these limitations, and show their strengths using simulated data. The two main sources of bias in estimates of the case fatality ratio we consider stem from shifts in case ascertainment (over time, efforts may become more focused on the most severe cases, leading to an overestimation of the case fatality ratio) and from the inevitable delay between symptom onset and death, which in the early phase of the epidemic can lead to underestimation of the case fatality ratio if it is not adjusted for. > A natural definition for the case fatality ratio is the ratio of the total number of deaths from a disease divided by the total number of cases. In a fully ascertained (and complete) epidemic, this simple method works perfectly. However, in most infectious diseases there is underascertainment of cases as people who are asymptomatic or have mild infection will be less likely to present to health care, and if they do present they will be less likely to be tested and confirmed. It is therefore likely that there will be a bias towards diagnosis of more severe cases (fig 1⇓), with the result that the case fatality ratio and other measures of severity are overestimated. Furthermore, this underascertainment will change as an epidemic matures. Initially increased awareness by patients and doctors may lead to high ascertainment, but as cases increase and systems are overwhelmed, only a proportion will be tested (potentially those with links to other confirmed cases), making it difficult to understand the scale of under-reporting.
ncallaway 7y ago
> I just want to remind everyone that H1N1 in 2009 killed between 150-600k people worldwide. Between 10 and 20% of the world population caught it at some point. The fatality rate was greater than Covid-19. This is categorically false. According to estimates from the CDC, in the United States, H1N1 infected ~61M people and killed ~12,649 for a CFR of around 0.02%. https://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm https://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm Stats for the global H1N1 pandemic estimates estimate ~1B people infected with 500,000 deaths. That's a CFR of 0.05% worldwide. https://en.wikipedia.org/wiki/2009_flu_pandemic https://en.wikipedia.org/wiki/2009_flu_pandemic You should stop claiming that the CFR of H1N1 is larger than COVID-19, when all current data and epidemiological estimates show that it absolutely is not.
- dorkwood 7y ago
  What is "CFR"? Something fatality rate?
  - ncallaway 7y ago
    Yes. Case Fatality Rate. It's the number of known cases divided by the number of cases that resulted in a death.

fock 7y ago

CFR of around 0.6‰. Spot the difference.

deleted 7y ago
[deleted]
nostromo 7y ago
H1N1: 0.4% CFR in the US COVID-19: 0.6% CFR in South Korea (likely similar in other locations when we stop undercounting infections) These aren't so dramatically different, are they? But they are: H1N1 had a median death in the US of 37 years old, rather than 80+. https://www.who.int/immunization/sage/1.Briand_epi_7th_July_2009_(rev_6July_09).pdf https://www.who.int/immunization/sage/1.Briand_epi_7th_July_...
- chinathrow 7y ago
  You picked SK and left Italy on the left.
  - nostromo 7y ago
    Because Italy has no idea how many cases they have. The best data sets so far are South Korea and the Princess Cruise ship, because they did widespread testing. Both show a CFR of about 0.6%.
- ncallaway 7y ago
  > H1N1: 0.4% CFR in the US This seems categorically false. CDC estimates that ~61M Americans were infected with ~12,469 deaths. That would be a CFR in the US of 0.02%. https://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm https://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm
- qayxc 7y ago
  According to current numbers,the CFR in SK is closer to 9‰ [1] [1] https://nssac.bii.virginia.edu/covid-19/dashboard/ https://nssac.bii.virginia.edu/covid-19/dashboard/

altoidaltoid 7y ago

So this is "just a flu bro"?

rosstex 7y ago

H1N1 was contagious 1 day before symptoms appeared. COVID-19 is contagious mean 5-6 days before symptoms appear. And it's not about the CFR, it's about healthcare system capacity.

DanBC 7y ago

SARS-Cov-2 is more infectious than H1N1. This larger pool of patients means a greater number of people will die. A small percentage of a very large number is still a lot of people. > The fatality rate was greater than Covid-19. No, it wasn't. The fatality rate for H1N1 was about 0.2%. The fatality rate for covid-19 is tricky to work out at the moment, but 2% is a reasonable low estimate.

nostromo 7y ago
WHO doesn't agree with your numbers: https://www.who.int/immunization/sage/1.Briand_epi_7th_July_2009_(rev_6July_09).pdf https://www.who.int/immunization/sage/1.Briand_epi_7th_July_...
- DanBC 7y ago
  You've linked a document created during the 2009 pandemic, when CFR rates are likely to be too high. https://www.bmj.com/content/339/bmj.b2840 https://www.bmj.com/content/339/bmj.b2840 > At first sight, the data seem to imply that this new virus is relatively mild, with case fatality ratios around 0.5%, similar to the upper range of that seen for seasonal influenza2 and relatively low hospitalisation ratios. However, the case fatality ratio seems to vary substantially between countries, and deaths have occurred in much younger people than is the case for seasonal influenza.3 4 > There are many reasons why simple interpretations of these crude figures at the beginning of a pandemic may be misleading both in terms of assessing severity and in making comparisons between countries. Here, we discuss some of the important mechanisms resulting in biases, propose study designs and associated statistical methods to estimate the case fatality ratio given these limitations, and show their strengths using simulated data. The two main sources of bias in estimates of the case fatality ratio we consider stem from shifts in case ascertainment (over time, efforts may become more focused on the most severe cases, leading to an overestimation of the case fatality ratio) and from the inevitable delay between symptom onset and death, which in the early phase of the epidemic can lead to underestimation of the case fatality ratio if it is not adjusted for. > A natural definition for the case fatality ratio is the ratio of the total number of deaths from a disease divided by the total number of cases. In a fully ascertained (and complete) epidemic, this simple method works perfectly. However, in most infectious diseases there is underascertainment of cases as people who are asymptomatic or have mild infection will be less likely to present to health care, and if they do present they will be less likely to be tested and confirmed. It is therefore likely that there will be a bias towards diagnosis of more severe cases (fig 1⇓), with the result that the case fatality ratio and other measures of severity are overestimated. Furthermore, this underascertainment will change as an epidemic matures. Initially increased awareness by patients and doctors may lead to high ascertainment, but as cases increase and systems are overwhelmed, only a proportion will be tested (potentially those with links to other confirmed cases), making it difficult to understand the scale of under-reporting.

ncallaway 7y ago

> I just want to remind everyone that H1N1 in 2009 killed between 150-600k people worldwide. Between 10 and 20% of the world population caught it at some point. The fatality rate was greater than Covid-19. This is categorically false. According to estimates from the CDC, in the United States, H1N1 infected ~61M people and killed ~12,649 for a CFR of around 0.02%. https://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm https://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm Stats for the global H1N1 pandemic estimates estimate ~1B people infected with 500,000 deaths. That's a CFR of 0.05% worldwide. https://en.wikipedia.org/wiki/2009_flu_pandemic https://en.wikipedia.org/wiki/2009_flu_pandemic You should stop claiming that the CFR of H1N1 is larger than COVID-19, when all current data and epidemiological estimates show that it absolutely is not.

dorkwood 7y ago
What is "CFR"? Something fatality rate?
- ncallaway 7y ago
  Yes. Case Fatality Rate. It's the number of known cases divided by the number of cases that resulted in a death.