3 ms·

The number we need to know is the death rate in the absence of hospitalization. Because if we let it ride, and the hospitals fill up, that's the number we're lo

The number we need to know is the death rate in the absence of hospitalization. Because if we let it ride, and the hospitals fill up, that's the number we're looking at. If it turns out to be only 1%, then shutting down the economy is probably a mistake. But if it's more like 10%, then without quarantine we would get an economic collapse anyway, plus a much higher death toll.

greedo 7y ago
A 1% CFR will be catastrophic if we let it ride. Over 7 billion people worldwide. Assuming a simple 1% infection rate (extremely unlikely consider the R0 of SARS-CoV-2), that would result in over 700K dying worldwide. And that ignores the hospitalization required for non-fatal cases. Currently it looks like 18% of all infections require multi-week hospitalization. So again, with 1% infection rate, that means over 12 million hospitalizations. And that's just a 1%/1%/18% assumption.
- Gys 7y ago
  A completely collapsed economy could trigger a society breakdown and will have deadly consequences as well, like violence (fighting over food, possesions) and bad healthcare
  - greedo 7y ago
    True. But imagine a more realistic scenario based on the CFR we've seen worldwide. Start with 7B people. Assume 50% get infected because we don't want to do a lockdown. 3.5B infections means 630M multi-week hospitalizations and 70M fatalities worldwide. And the follow-on effects will kill even more since these hospitalization rates will consume all our medical resources, so other illnesses will have higher CFRs as well. I don't know about you, but avoiding 70m fatalities and over 600M hospitalizations is the optimal choice. Pursuing this choice would be the greatest human calamity, surpassing the destruction of WW2 in terms of lives.
    - tunesmith 7y ago
      Is there a way to derive infection rate from the R0 value? Because we don't even get close to 50% infection with the flu, and covid's R0 isn't like measles or anything.
      - SpicyLemonZest 7y ago
        There's no way to derive infection rate at all, unfortunately. Even for pandemics in the past, where we can go back and look at all the epidemological data, estimates of infection rates tend to vary by at least 10 percentage points.
      - greedo 7y ago
        We don't really have an accurate infection rate from the flu since we don't test for it. Most of the flu data is collected via surveys...
      - DanBC 7y ago
        Don't forget we have massive campaigns to immunise against flu.
- seunosewa 7y ago
  1% of 7 billion is 70 million, so its 100 times worse than you thought.
  - greedo 7y ago
    That was the percentage of infections I was spitballing. 1% of that (a really low CFR) would be 700K fatalities.
sbuttgereit 7y ago
I think this somewhat gets to the gist of the issue really. This virus is not the black death or the start of a zombie apocalypse. To a small percentage of people, getting this will be a really bad day and that percentage is higher than it is for viruses that similarly don't cause major health issues to most, but dramatically impact others. Having said that, the aforementioned small percentage IS enough to overwhelm the existing health care system and that alone would be enough to cause many, many of the more severely effected to die when they otherwise mightn't with proper care. So, having said all that I do, very wearily, agree largely with the lock-down measures in place. But I also think we're in a grey area between taking appropriate measures and overreacting. I think the article gets to another real issue. Many of our esteemed political leaders are selling this more like the black death/zombie apocalypse. Granted, most people I meet aren't so good with "nuance"; but overselling government responses to the virus to get compliance will create another, perhaps even worse, set of issues. Is the real impact of illnesses necessarily jeopardizing our supply chains? No. But the messaging is telling everybody that we're on the brink of societal collapse. So everyone is hoarding and living in fear that if they get it, they're all but dead. We may well be shutting down important businesses that are important, if not essential, and we're causing greater threats because of these artificial disruptions. I'm also worried longer term about what gets classed as this kind of emergency latter... for any number of civil liberties reasons. But I don't think the time is now to go call for a mass-protest on the steps of city hall either; though I expect that, due to this event, that day is closer than it was before the outbreak.
- taborj 7y ago
  Very well written.
everybodyknows 7y ago
> death rate in the absence of hospitalization A reasonable proxy for that I suggest is the ICU rate from Diamond Princess -- assume all ICU-severity cases die, and all normal hospitalization cases survive, under a tent in the hospital parking lot. About 4x DP fatality rate.
DanBC 7y ago
You need to include number of infections, because 1% of a very large number will overwhelm healthcare systems.
dragonwriter 7y ago
> Because if we let it ride, and the hospitals fill up, that's the number we're looking at. Actually, we're looking at a bigger number in that case, because people without the disease but still in need of a hospital/ICU.bed are going to die who otherwise would have survived.

greedo 7y ago

A 1% CFR will be catastrophic if we let it ride. Over 7 billion people worldwide. Assuming a simple 1% infection rate (extremely unlikely consider the R0 of SARS-CoV-2), that would result in over 700K dying worldwide. And that ignores the hospitalization required for non-fatal cases. Currently it looks like 18% of all infections require multi-week hospitalization. So again, with 1% infection rate, that means over 12 million hospitalizations. And that's just a 1%/1%/18% assumption.

Gys 7y ago
A completely collapsed economy could trigger a society breakdown and will have deadly consequences as well, like violence (fighting over food, possesions) and bad healthcare
- greedo 7y ago
  True. But imagine a more realistic scenario based on the CFR we've seen worldwide. Start with 7B people. Assume 50% get infected because we don't want to do a lockdown. 3.5B infections means 630M multi-week hospitalizations and 70M fatalities worldwide. And the follow-on effects will kill even more since these hospitalization rates will consume all our medical resources, so other illnesses will have higher CFRs as well. I don't know about you, but avoiding 70m fatalities and over 600M hospitalizations is the optimal choice. Pursuing this choice would be the greatest human calamity, surpassing the destruction of WW2 in terms of lives.
  - tunesmith 7y ago
    Is there a way to derive infection rate from the R0 value? Because we don't even get close to 50% infection with the flu, and covid's R0 isn't like measles or anything.
    - SpicyLemonZest 7y ago
      There's no way to derive infection rate at all, unfortunately. Even for pandemics in the past, where we can go back and look at all the epidemological data, estimates of infection rates tend to vary by at least 10 percentage points.
    - greedo 7y ago
      We don't really have an accurate infection rate from the flu since we don't test for it. Most of the flu data is collected via surveys...
    - DanBC 7y ago
      Don't forget we have massive campaigns to immunise against flu.
seunosewa 7y ago
1% of 7 billion is 70 million, so its 100 times worse than you thought.
- greedo 7y ago
  That was the percentage of infections I was spitballing. 1% of that (a really low CFR) would be 700K fatalities.

sbuttgereit 7y ago

I think this somewhat gets to the gist of the issue really. This virus is not the black death or the start of a zombie apocalypse. To a small percentage of people, getting this will be a really bad day and that percentage is higher than it is for viruses that similarly don't cause major health issues to most, but dramatically impact others. Having said that, the aforementioned small percentage IS enough to overwhelm the existing health care system and that alone would be enough to cause many, many of the more severely effected to die when they otherwise mightn't with proper care. So, having said all that I do, very wearily, agree largely with the lock-down measures in place. But I also think we're in a grey area between taking appropriate measures and overreacting. I think the article gets to another real issue. Many of our esteemed political leaders are selling this more like the black death/zombie apocalypse. Granted, most people I meet aren't so good with "nuance"; but overselling government responses to the virus to get compliance will create another, perhaps even worse, set of issues. Is the real impact of illnesses necessarily jeopardizing our supply chains? No. But the messaging is telling everybody that we're on the brink of societal collapse. So everyone is hoarding and living in fear that if they get it, they're all but dead. We may well be shutting down important businesses that are important, if not essential, and we're causing greater threats because of these artificial disruptions. I'm also worried longer term about what gets classed as this kind of emergency latter... for any number of civil liberties reasons. But I don't think the time is now to go call for a mass-protest on the steps of city hall either; though I expect that, due to this event, that day is closer than it was before the outbreak.

taborj 7y ago
Very well written.

everybodyknows 7y ago

> death rate in the absence of hospitalization A reasonable proxy for that I suggest is the ICU rate from Diamond Princess -- assume all ICU-severity cases die, and all normal hospitalization cases survive, under a tent in the hospital parking lot. About 4x DP fatality rate.

DanBC 7y ago

You need to include number of infections, because 1% of a very large number will overwhelm healthcare systems.

dragonwriter 7y ago

> Because if we let it ride, and the hospitals fill up, that's the number we're looking at. Actually, we're looking at a bigger number in that case, because people without the disease but still in need of a hospital/ICU.bed are going to die who otherwise would have survived.