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"Letting the virus infect everyone" at a 1% death rate means 3 million deaths in the US, right up there with the worst catastrophes of the 20th century. You can

"Letting the virus infect everyone" at a 1% death rate means 3 million deaths in the US, right up there with the worst catastrophes of the 20th century. You can change the death rate and projections of number infected needed to get herd immunity and move that number around, of course, but not enough to change the overall moral calculus.

edgefield0 7y ago
1% death rate assumes reasonable medical care. If you let everyone get infected, you'll have people dying on the streets. I bet this % jumps to 5% or more. We'd easily see 15m+ deaths.
- twblalock 7y ago
  That seems far worse than any statistics reported so far. What is the basis for that number?
  - kingbirdy 7y ago
    Italy's current mortality rate is 8% (3,405 deaths, 41,035 confirmed cases). Of course their lack of testing is probably influencing the numbers somewhat, but still. Source: https://www.wsj.com/articles/italys-virus-death-toll-on-the-cusp-of-overtaking-chinas-11584626731 https://www.wsj.com/articles/italys-virus-death-toll-on-the-...
    - sershe 7y ago
      According to a recent study from Columbia University up to 86% cases are undetected based on pre-lockdown Chinese data. That would bring this number down to ~1.1%. That is in the oldest-skewing population out there, barely any containment (assuming 14 days infection to death), and with overwhelmed healthcare capacity. Frankly I didn't even expect it to be this low, I thought it was supposed to be closer to 2.5-3% after healthcare collapse and 0.5% before.
      - littlestymaar 7y ago
        Please be careful with every study you read or be talked about in the news: there's over one thousand studies on Covid19 so far, with a big discrepancy in results. Cherry-picking the one we want to hear is pretty dangerous if it gives us a false sense of security. For the record, on the Diamond Princess (with everybody tested) the number of asymptomatic case was 60% with more than 1% death rate with Japanese healthcare (not overloaded). You can't generalize on these figures either for many reasons but thats's still a strong warning.
- MiroF 7y ago
  There is no scenario in which we see 15 million deaths. I would like to see a single real academic you can find saying anything like that.
  - tempestn 7y ago
    Agreed, because that's unthinkable, so lockdowns would be enacted instead. Without any measures taken to limit spread though, that would be the expected result.
    - MiroF 7y ago
      Again, based on what? I have seen nowhere near that level of estimate assuming peak hospital overload and unmitigated spread. Stats from Italy are going to be heavily skewed towards fatalities for a number of reasons that have been documented by epidemiologists.
      - tempestn 7y ago
        Based on the death rates in Wuhan and in Italy where this actually happened.
        olalonde 7y ago
        Careful with those death rates, my guess is that they likely exclude a ton of mildly or asymptomatic patients who never got tested (skewing the death rate upwards).
        tempestn 7y ago
        Sure. And yes, Italy's population is more elderly as well. So I agree it's possible the death rate will be less than 5%. (Although I believe they're currently at ~8%, so we don't know that.) But those are the closest parallels we've seen so far as to what happens when a modern heathcare system gets overwhelmed by this, so they're the best estimates we have to work from. And regardless, it would be very, very bad. If it's only 5M people instead of 15M, that's still catastrophic. Also while the hospitals are completely overwhelmed with COVID-19, people will die of other things that would normally be survivable. And finally, we have an alternative: keep employing distancing and, where necessary, lockdown measures while scaling up testing. These lockdowns will get the cases under control, but they would flare back up as soon as they're ended. However, with the expanded testing, we can instead perform sufficient testing across the entire population to catch outbreaks before they start. With sufficient testing, things can go back to normal while remaining confident that we're not spreading the virus undetected and seeding a new outbreak. It needs to be orders of magnitude more than we have now, but it's entirely possible.
- tempestn 7y ago
  Exactly. Death rate in Italy is over 5% I believe. Allowing it to spread unchecked would be an unmitigated catastrophe, and the deaths certainly wouldn't be limited to the elderly. What we need to do is massively expand testing so that the lockdowns and distancing measures can be ended without allowing the virus to go back to spreading through the community.
  - jacobolus 7y ago
    Keep in mind, the number you are talking about is known deaths / known cases. Neither of these is a final or accurate number: many of the current cases will progress to death, and many who have been (or are) infected have not been tested (e.g. because they were asymptomatic or had only minor symptoms). Here’s a more careful attempt to determine the numbers for Wuhan (published today) which results in numbers substantially lower (though still scary) than those suggested by the WHO previously https://www.nature.com/articles/s41591-020-0822-7 https://www.nature.com/articles/s41591-020-0822-7
    - tempestn 7y ago
      For sure, to have an accurate number you need to wait until all cases resolved AND you need to have thorough testing to know what the total number of cases were. Good to see that it may not have been quite as bad as thought in Wuhan. That said, they did enact pretty strict quarantine measures there and massively surged hospital capacity, so it's not like that number represents total healthcare collapse either. Regardless, to me it seems to great to just say it's outweighed by the costs of control measures, especially since there is another path to take.
      - averros 7y ago
        Note that the estimate of mortality in the article (which is about 3x of the normal flu) is relative to symptomatic cases. The actual mortality is lower by a factor of 6 or so, considering the percentage of cases which are asymptomatic.
- swat535 7y ago
  Well, tbh, to beat the WW2 death count, you'd have to infect 8.5B people
pmoleri 7y ago
If you let it go wild is not gonna be a 1% death rate, health care collapses and it suddenly jumps to 5% or higher. With the health system collapsed deaths are not only about COVID-19, but everything else that depends on health care.
- surewhynat 7y ago
  We're also betting on it not having any mutations .. the more people it sees, the more paths it can take as it replicates..
whb07 7y ago
Except it’s significantly less than 1%. You should find the actuarial tables and life expectancies for an 80 year old. It ain’t sunshine and rainbows.
onlyrealcuzzo 7y ago
I think people are oblivious to some obvious ways our system operates. Wealthy people have power. It takes time to accrue wealth, most wealthy people are old. Coronavirus kills 10% of 80+, and 5% of all 65+. Old people vote. If the hospital systems are overwhelmed because we don't flatten the curve, those percentages likely double or triple. Look at how much we've learned about treating this virus in the 3-ish months we've been paying it the attention it deserves. If we slow it for another month, maybe these percentages could be cut in half.
Supermancho 7y ago
Permanent respiratory damage in ~2% of survivors is catastrophic as well.
- standardUser 7y ago
  Is there data to back this up? It would be very early to make specific declarations of the after effects of an illness that sprang in to existence 3 months ago.
  - maigret 7y ago
    I would expect doctors are able to make kinda accurate diagnostics on damaged lungs and have already lots of data on recovery prospects. Might not be 1% exact, but they are probably not on the wrong side either.
dntbnmpls 7y ago
> "Letting the virus infect everyone" at a 1% death rate means 3 million deaths in the US, right up there with the worst catastrophes of the 20th century Every year nearly 3 million people die in the US already. https://www.cdc.gov/nchs/fastats/deaths.htm https://www.cdc.gov/nchs/fastats/deaths.htm Are you saying we experience the worst catastrophe year in and year out? The hyperbole and exaggerated fearmongering over coronavirus is something to keep an eye out for. Also, if everyone gets infected, it likely means that the virus is far less deadly than you assume and the death rate is far lower than 1%. Think about it rather than cherrypicking data to push an agenda.
- syspec 7y ago
  This is in addition to that, not either or
  - standardUser 7y ago
    There would be significant overlap.
chourobin 7y ago
The death rate is probably a lot lower given all the under tested asymptomatic infections.

edgefield0 7y ago

1% death rate assumes reasonable medical care. If you let everyone get infected, you'll have people dying on the streets. I bet this % jumps to 5% or more. We'd easily see 15m+ deaths.

twblalock 7y ago
That seems far worse than any statistics reported so far. What is the basis for that number?
- kingbirdy 7y ago
  Italy's current mortality rate is 8% (3,405 deaths, 41,035 confirmed cases). Of course their lack of testing is probably influencing the numbers somewhat, but still. Source: https://www.wsj.com/articles/italys-virus-death-toll-on-the-cusp-of-overtaking-chinas-11584626731 https://www.wsj.com/articles/italys-virus-death-toll-on-the-...
  - sershe 7y ago
    According to a recent study from Columbia University up to 86% cases are undetected based on pre-lockdown Chinese data. That would bring this number down to ~1.1%. That is in the oldest-skewing population out there, barely any containment (assuming 14 days infection to death), and with overwhelmed healthcare capacity. Frankly I didn't even expect it to be this low, I thought it was supposed to be closer to 2.5-3% after healthcare collapse and 0.5% before.
    - littlestymaar 7y ago
      Please be careful with every study you read or be talked about in the news: there's over one thousand studies on Covid19 so far, with a big discrepancy in results. Cherry-picking the one we want to hear is pretty dangerous if it gives us a false sense of security. For the record, on the Diamond Princess (with everybody tested) the number of asymptomatic case was 60% with more than 1% death rate with Japanese healthcare (not overloaded). You can't generalize on these figures either for many reasons but thats's still a strong warning.
MiroF 7y ago
There is no scenario in which we see 15 million deaths. I would like to see a single real academic you can find saying anything like that.
- tempestn 7y ago
  Agreed, because that's unthinkable, so lockdowns would be enacted instead. Without any measures taken to limit spread though, that would be the expected result.
  - MiroF 7y ago
    Again, based on what? I have seen nowhere near that level of estimate assuming peak hospital overload and unmitigated spread. Stats from Italy are going to be heavily skewed towards fatalities for a number of reasons that have been documented by epidemiologists.
    - tempestn 7y ago
      Based on the death rates in Wuhan and in Italy where this actually happened.
      - olalonde 7y ago
        Careful with those death rates, my guess is that they likely exclude a ton of mildly or asymptomatic patients who never got tested (skewing the death rate upwards).
        tempestn 7y ago
        Sure. And yes, Italy's population is more elderly as well. So I agree it's possible the death rate will be less than 5%. (Although I believe they're currently at ~8%, so we don't know that.) But those are the closest parallels we've seen so far as to what happens when a modern heathcare system gets overwhelmed by this, so they're the best estimates we have to work from. And regardless, it would be very, very bad. If it's only 5M people instead of 15M, that's still catastrophic. Also while the hospitals are completely overwhelmed with COVID-19, people will die of other things that would normally be survivable. And finally, we have an alternative: keep employing distancing and, where necessary, lockdown measures while scaling up testing. These lockdowns will get the cases under control, but they would flare back up as soon as they're ended. However, with the expanded testing, we can instead perform sufficient testing across the entire population to catch outbreaks before they start. With sufficient testing, things can go back to normal while remaining confident that we're not spreading the virus undetected and seeding a new outbreak. It needs to be orders of magnitude more than we have now, but it's entirely possible.
tempestn 7y ago
Exactly. Death rate in Italy is over 5% I believe. Allowing it to spread unchecked would be an unmitigated catastrophe, and the deaths certainly wouldn't be limited to the elderly. What we need to do is massively expand testing so that the lockdowns and distancing measures can be ended without allowing the virus to go back to spreading through the community.
- jacobolus 7y ago
  Keep in mind, the number you are talking about is known deaths / known cases. Neither of these is a final or accurate number: many of the current cases will progress to death, and many who have been (or are) infected have not been tested (e.g. because they were asymptomatic or had only minor symptoms). Here’s a more careful attempt to determine the numbers for Wuhan (published today) which results in numbers substantially lower (though still scary) than those suggested by the WHO previously https://www.nature.com/articles/s41591-020-0822-7 https://www.nature.com/articles/s41591-020-0822-7
  - tempestn 7y ago
    For sure, to have an accurate number you need to wait until all cases resolved AND you need to have thorough testing to know what the total number of cases were. Good to see that it may not have been quite as bad as thought in Wuhan. That said, they did enact pretty strict quarantine measures there and massively surged hospital capacity, so it's not like that number represents total healthcare collapse either. Regardless, to me it seems to great to just say it's outweighed by the costs of control measures, especially since there is another path to take.
    - averros 7y ago
      Note that the estimate of mortality in the article (which is about 3x of the normal flu) is relative to symptomatic cases. The actual mortality is lower by a factor of 6 or so, considering the percentage of cases which are asymptomatic.
swat535 7y ago
Well, tbh, to beat the WW2 death count, you'd have to infect 8.5B people

pmoleri 7y ago

If you let it go wild is not gonna be a 1% death rate, health care collapses and it suddenly jumps to 5% or higher. With the health system collapsed deaths are not only about COVID-19, but everything else that depends on health care.

surewhynat 7y ago
We're also betting on it not having any mutations .. the more people it sees, the more paths it can take as it replicates..

whb07 7y ago

Except it’s significantly less than 1%. You should find the actuarial tables and life expectancies for an 80 year old. It ain’t sunshine and rainbows.

onlyrealcuzzo 7y ago

I think people are oblivious to some obvious ways our system operates. Wealthy people have power. It takes time to accrue wealth, most wealthy people are old. Coronavirus kills 10% of 80+, and 5% of all 65+. Old people vote. If the hospital systems are overwhelmed because we don't flatten the curve, those percentages likely double or triple. Look at how much we've learned about treating this virus in the 3-ish months we've been paying it the attention it deserves. If we slow it for another month, maybe these percentages could be cut in half.

Supermancho 7y ago

Permanent respiratory damage in ~2% of survivors is catastrophic as well.

standardUser 7y ago
Is there data to back this up? It would be very early to make specific declarations of the after effects of an illness that sprang in to existence 3 months ago.
- maigret 7y ago
  I would expect doctors are able to make kinda accurate diagnostics on damaged lungs and have already lots of data on recovery prospects. Might not be 1% exact, but they are probably not on the wrong side either.

dntbnmpls 7y ago

> "Letting the virus infect everyone" at a 1% death rate means 3 million deaths in the US, right up there with the worst catastrophes of the 20th century Every year nearly 3 million people die in the US already. https://www.cdc.gov/nchs/fastats/deaths.htm https://www.cdc.gov/nchs/fastats/deaths.htm Are you saying we experience the worst catastrophe year in and year out? The hyperbole and exaggerated fearmongering over coronavirus is something to keep an eye out for. Also, if everyone gets infected, it likely means that the virus is far less deadly than you assume and the death rate is far lower than 1%. Think about it rather than cherrypicking data to push an agenda.

syspec 7y ago
This is in addition to that, not either or
- standardUser 7y ago
  There would be significant overlap.

chourobin 7y ago

The death rate is probably a lot lower given all the under tested asymptomatic infections.