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> we are missing the VAST majority of all cases (due to them being mild) and only seeing the severe ones / deaths This is entirely possible, and is the conclus

by jMyles 7y ago

> we are missing the VAST majority of all cases (due to them being mild) and only seeing the severe ones / deaths This is entirely possible, and is the conclusion of a different, unrelated paper published today. [0] > But there's a simple check to this - how many deaths does Italy have per day in a bad flu season vs how many Covid-19 deaths per day are they having now? This is a good idea, and a reasonable metric, but it's not a good way to compare the CFR, because there are too many confounding factors. For example, it's possible that the early lockdown in Northern Italy actually increased the number of deaths by expanding the window of exposure to elderly populations (whose younger relatives normally would have been out of the house all day). It's possible that, for some reason, Italians are particularly susceptible to SARS-CoV-2. It's possible that the weather pattern or air quality had some strange impact. I'm not saying any of these things are true; I'm saying that it's not a great way to compare CFRs or speculate about the number of mild or asymptomatic cases. 0: https://www.reddit.com/r/PrepareInsteadOfPanic/comments/fljzvy/a_study_shows_the_fatality_rate_for_covid19_may/ https://www.reddit.com/r/PrepareInsteadOfPanic/comments/fljz...

bugzz 7y ago
> it's possible that the early lockdown in Northern Italy actually increased the number of deaths So in China the lockdowns stopped the Virus from spreading, but in Italy it increased the spread? If the young are all at home giving it to their grandparents, you think it already spread to almost all young people, at pretty much the same point in time, and then lockdowns started and they gave to elderly who somehow mostly didn't get it before that? > It's possible that, for some reason, Italians are particularly susceptible to SARS-CoV-2. It's possible that the weather pattern or air quality had some strange impact. If we are considering these as possibilities than we'd better prepare for the U.S. (or any other country) have genetic predispositions or weather patterns that make it even more deadly here than Italy! I just think my method shows that barring highly unlikely scenarios, this thing is at least 5x as bad as flu, not a lower bound of 0.5 as bad. So we should act accordingly.
- jMyles 7y ago
  > I just think my method shows that barring highly unlikely scenarios, this thing is at least 5x as bad as flu, not a lower bound of 0.5 as bad. So we should act accordingly. I don't think your method allows any conclusion of the comparison between SARS-CoV-2 and A(H1N1) or whichever flu is in Italy this year. And it depends what "act accordingly" means. I think it's unwise to take extreme measures like school closings or shelter-in-place, which we know will have their own adverse impacts, without first retracting the flawed science that arrived at the 3.4% CFR and then seeking to replicate the study which I linked above. I mean, do you think that study is equally flawed? Do you think that the researchers who submitted it for review today simply didn't think to compare the number of deaths yesterday with the mean deaths from flu?
  - shalmanese 7y ago
    All the people I've ever seen calling the 3.4% figure "flawed science" only seem to ever attack it for being too high. There's very rarely ever voices from the other direction of calling it too low. People underestimate how many cases Hubei actually managed to treat. They built two purpose built hospitals where every bed was an ICU and converted stadiums and hotels to centralized quarantine facilities so the less acute cases could be near but not in hospitals but could be rapidly shuttled there if the symptoms got worse. They flew in over 40K+ medical workers from all over China to treat less than 80K cases, 80% of which were "mild" which means 2.5 medical workers per non-mild case. What we really need is the cohort from China who had hospitalizatable symptoms and were denied any sort of treatment, what the range of outcomes in those cases? Even then, it's not a natural experiment because China is practicing triage, same as Italy, and so we need to compare like to like as much as possible. If the models are correct at assuming that our hospitals are going to get more than 10X overwhelmed, then this is the real number that matters. What's the rate of death for people who have 0 medical intervention. The reason why is, if the healthcare system isn't overwhelmed, then the CFR is not an important number because the total number of deaths is small enough that variances in that range are trivia. If the healthcare system is overwhelmed, then any data we get from non-overwhelmed systems, which is all people appear to be using, is utterly bollocks. If people are suggesting that 70% of people in their country could be infected in a year, then we should be using a CFR closer to 10 - 15% as the true number and that means we could be imagining a world where 7 - 10% of all people are dead by this time next year.

by jMyles 7y ago

bugzz 7y ago

> it's possible that the early lockdown in Northern Italy actually increased the number of deaths So in China the lockdowns stopped the Virus from spreading, but in Italy it increased the spread? If the young are all at home giving it to their grandparents, you think it already spread to almost all young people, at pretty much the same point in time, and then lockdowns started and they gave to elderly who somehow mostly didn't get it before that? > It's possible that, for some reason, Italians are particularly susceptible to SARS-CoV-2. It's possible that the weather pattern or air quality had some strange impact. If we are considering these as possibilities than we'd better prepare for the U.S. (or any other country) have genetic predispositions or weather patterns that make it even more deadly here than Italy! I just think my method shows that barring highly unlikely scenarios, this thing is at least 5x as bad as flu, not a lower bound of 0.5 as bad. So we should act accordingly.

jMyles 7y ago
> I just think my method shows that barring highly unlikely scenarios, this thing is at least 5x as bad as flu, not a lower bound of 0.5 as bad. So we should act accordingly. I don't think your method allows any conclusion of the comparison between SARS-CoV-2 and A(H1N1) or whichever flu is in Italy this year. And it depends what "act accordingly" means. I think it's unwise to take extreme measures like school closings or shelter-in-place, which we know will have their own adverse impacts, without first retracting the flawed science that arrived at the 3.4% CFR and then seeking to replicate the study which I linked above. I mean, do you think that study is equally flawed? Do you think that the researchers who submitted it for review today simply didn't think to compare the number of deaths yesterday with the mean deaths from flu?
- shalmanese 7y ago
  All the people I've ever seen calling the 3.4% figure "flawed science" only seem to ever attack it for being too high. There's very rarely ever voices from the other direction of calling it too low. People underestimate how many cases Hubei actually managed to treat. They built two purpose built hospitals where every bed was an ICU and converted stadiums and hotels to centralized quarantine facilities so the less acute cases could be near but not in hospitals but could be rapidly shuttled there if the symptoms got worse. They flew in over 40K+ medical workers from all over China to treat less than 80K cases, 80% of which were "mild" which means 2.5 medical workers per non-mild case. What we really need is the cohort from China who had hospitalizatable symptoms and were denied any sort of treatment, what the range of outcomes in those cases? Even then, it's not a natural experiment because China is practicing triage, same as Italy, and so we need to compare like to like as much as possible. If the models are correct at assuming that our hospitals are going to get more than 10X overwhelmed, then this is the real number that matters. What's the rate of death for people who have 0 medical intervention. The reason why is, if the healthcare system isn't overwhelmed, then the CFR is not an important number because the total number of deaths is small enough that variances in that range are trivia. If the healthcare system is overwhelmed, then any data we get from non-overwhelmed systems, which is all people appear to be using, is utterly bollocks. If people are suggesting that 70% of people in their country could be infected in a year, then we should be using a CFR closer to 10 - 15% as the true number and that means we could be imagining a world where 7 - 10% of all people are dead by this time next year.