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99% of those who died from virus had other illness, Italy says
- oakesm9 7y agoJust because you don't and a pre-existing condition doesn't mean you should take this lightly. Stay at home and stay away from people to stop it spreading to those that do. Most of us are in the very fortunate position that we can work just as effectively from home and our jobs are not on the line during this.
- tomtompl 7y agoNot sure if that needs to be said but I am quite convinced not everyone is realising that: If you can work from home just as effectively as from the office - it doesn't matter if clients of your company can - companies who can work 100% well in the face of crisis still can and many will go bankrupt.
- mstade 7y agoDo you mean it doesn't matter if clients of your company can't? Is there a typo in your comment or am I too dumb to get it? :o)
- chris_va 7y agoIt does beg the question, though... If you can identify (maybe iffy) the subset of the population likely to required hospitalization, might it make sense to relax the quarantine to only that subgroup (and immediate contacts)? Building up herd immunity in the rest of the population once hospital supply lines are robust might be the best way to unwind the existing rules. With any exponential there is going to be a crunch no matter how things are done, so unwinding in risk order may be optimal.
- jacquesm 7y agoNo because if you relax the quarantine you turn a lot of people that don't have the virus right now into potential vectors for infection of new hosts once they do acquire it, which is pretty much inevitable once people start moving around again at the old rate. And once you have enough people spreading it those at risk will be more at risk than they are now.
- RealityVoid 7y agoYes, but once the disease passes for them, they will be immune. Herd immunity is basically the only way this will pass away now, so we might as well be clever and push it on the side of the population that can take it. EDIT: If we assume this is true and this will end when 40-50% of the population has already caught it, would it not be clever of us to make sure the 40-50% of the population that caught it is the one least affected by it? By making the measures the same for everyone you basically make sure the percentage affected will be uniformly distributed among all groups. If you make the measures distinct for each group, you tilt the odds in favour of one or another group, and might get a better outcome in the end. IMO, now the people in power should balance several factors: - People in need of medical assistance - the group of people more likely to have permanent health effects from the infection - Economic impact of measures ( this, imo, can probably cause deaths in an indirect way as well) - population compliance to lock down measures (this will erode in time, I expect) Ideally, the would find some social valve where they could play with the number of infected and they would direct this to the less at risk population and adjust the pressure over the medical system so it's just close to breaking, but not quite there, and directing the disease towards the least affected segment. Problem with this is the disease is not spreading linearly, so it's _very_ easy to loose this from under control. If they manage to make the status quo distanced enough so that the spread is more linear without disrupting too much the lives of normal people, and in the meantime playing with this valve for the less-at-risk population. If htis is feasible, I do nto know, but sounds like a reasonable idea.
- RealityVoid 7y agoI think this is a reasonable point of action. The problem, IMO, is that the rest of the population MUST be more stricter than ever regarding their distancing. And here comes the rub, because I, honestly, do not think this is about to happen. People are _still_ not taking this seriously, even those in the most at risk groups. Enforcing this separately would be a nightmare. We might end up there anyway, because I think people will get exhausted with the current situation and will sill up anyways. Once the cat is out of the bag and the disease is rampaging through the population, it will be too late.
- pengaru 7y ago> Building up herd immunity in the rest of the population once hospital supply lines are robust might be the best way to unwind the existing rules Have you been out in public in the USA since the "shelter in place" orders took effect in any of the affected states/cities? This is not a quarantine, it's not an absolute containment effort. The effect is to simply slow the spread to something hopefully less than wildfire. There will be herd immunity developing regardless of what we do. Vulnerable people are already afraid and staying home as much as possible. Plenty of people are out going about their lives despite the shutdown. I'm in CA and went for a supply run yesterday, Home Depot was crowded with folks who seemed to be taking advantage of the time off to do home improvement projects. Plenty of evidence of sick folks out there being careless as well. The contagion is spreading either way.
- marknutter 7y agoOur quarantine has thus far been socially enforced, and quite effectively I might add. Schools are closed across the entire nation, despite the fact that children are the least likely age group to even express symptoms upon contracting coronavirus, let alone die from it. If the contagion is "spreading either way", why not allow people in the lowest risk groups continue on with our lives while we help the most vulnerable groups weather the storm from the safety of their homes?
- pengaru 7y agoAre you aware that even with the measures you're arguing are unnecessary in place, our hospitals are fast approaching capacity and we're having PPE shortages? It'd only be worse.
- Mvandenbergh 7y agoThe UK considered this until late last week but reversed course over the weekend when new modelling revealed that ICU admission rates in populations they had previously assumed were less vulnerable were higher than anticipated if still very small. That would mean completely overwhelming ICU capacity (like more than 20x) for weeks at a time with otherwise healthy young people who would likely survive with ICU care and die without it.
- gridlockd 7y agoThat doesn't mean it's the wrong approach in general, just the wrong approach at this point in time. In the short term, the curve needs to be flattened at (almost) any cost, while treatment and testing capacity ramps up. In the long term, we need to gauge the risk and isolate more selectively. There is no way around herd immunity, we can't shut down almost everything for two years or more.
- Someone 7y agoLikely very iffy. Age alone isn’t enough. Possibly, the best check would be something like “can run x miles/hour for y minutes” (‘measures’ lung function relative to body demand), but even if you can find even halfway decent criteria, who’s going to do the testing? Who’s going to repeat that testing every week? Also, I would think a significant fraction of “the population likely to require hospitalization” currently already requires care (they are in hospital, care homes, or even just have family or neighbors visiting them every few days). You can’t quarantine those [1] , and you can’t afford having a large fraction of those caregivers fall ill at the same time, either. [1] technically, camps housing all those in the danger group and their caregivers in ‘camps’ would probably work, but I think that’s a step up from asking the entire population to stay home.
- gridlockd 7y agoAnother significant but hard to measure factor is virus load. A lot of otherwise healthy young healthcare workers are at elevated risk due to constant exposure and lots of stress.
- aphextron 7y agoIt's also important to note that just because it doesn't kill you, doesn't mean it's harmless. Serious fevers can cause permanent lifelong organ damage and other complications regardless of if it's acutely fatal. The fatality rates also only reflect the beginning stages of this where everyone has access to a ventilator and ICU support. Once this thing really gets going in the US it's going to get ugly.
- marknutter 7y agoWell then we're all fucked, because it's going to make its way through the population no matter what we do. Might as well continue on with our lives.
- onetimemanytime 7y agoalso, many people don't know what issues they have, until they find out the hard way.
- decebalus1 7y ago> Just because you don't and a pre-existing condition doesn't mean you should take this lightly. Stay at home and stay away from people to stop it spreading to those that do. Correction: known pre-existing condition. Not a lot of people get annual physicals and a lot of heart conditions are asymptomatic.
- bpnichol 7y agoI'd be interested in having a better sense as to what would constitute an underlying or pre-existing condition. Is limited to conditions which have already weakened the immune system?
- ulfw 7y agoHow is illness defined? I don't know anyone who doesn't have some kind of illness. Some major, most very minor.
- deleted 7y ago[deleted]
- etrk 7y agoSee Table 1 in the original study: https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_17_marzo-v2.pdf https://www.epicentro.iss.it/coronavirus/bollettino/Report-C... Ipertensione arteriosa (high blood pressure) 76.1% Diabete mellito (diabetes) 35.5% Cardiopatia ischemica (heart disease) 33% Fibrillazione atriale (atrial fibrillation) 24.5% Cancro attivo negli ultimi 5 anni (cancer in past 5 years) 20.3% Insufficienza renale cronica (renal failure) 18% BPCO (COPD) 13.2% Ictus (stroke) 9.6% Demenza (dementia) 6.8% Epatopatia cronica (chronic liver disease) 3.1% Note that the most of the people in this study were 70+ years old, and I have no idea what the typical prevalence of these diseases is among 70+ year old Italians.
- DoofusOfDeath 7y agoI haven't been able to figure out from the public statements regarding blood pressure: does the high mortality correspond to treated BP, untreated BP, or both?
- joeyh 7y agoI have not seen any studies that broke it down. The studies out of China only had patients self-report other conditions.
- laichzeit0 7y agoHigh blood pressure, or related to the medication that people with high blood pressure take (ACE inhibitors)?
- chewz 7y ago> 70% of U.S. adults aged 65 years and older have high blood pressure (BP), and the prevalence increases with age. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639920/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639920/
- samcal 7y agoI think the title should be changed to "99% of the people who have died to date from Coronavirus had other illnesses". It is irresponsible to frame this as a complete sample of deaths from this virus. In other words, it would make sense that the most vulnerable would die first.
- mhb 7y agoPrevious discussion: https://news.ycombinator.com/item?id=22616354 https://news.ycombinator.com/item?id=22616354
- rossdavidh 7y agoUsing Google Translate on the original report (so, auto-translated from Italian so keep that in mind): diseases N % ----------------------------- Ischemic heart disease 117 33.0 Atrial fibrillation 87 24.5 Stroke 34 9.6 Hypertension 270 76.1 Diabetes mellitus 126 35.5 Dementia 24 6.8 COPD 47 13.2 Active cancer in the past 5 years 72 20.3 Chronic liver disease 11 3.1 Chronic renal failure 64 18.0 Number of pathologies 0 pathologies 3 0.8 1 pathologies 89 25.1 2 pathologies 91 25.6 3 or more pathologies 172 48.5
- IkmoIkmo 7y agoRather than frame it like this, it would probably be more useful to talk about whether these people differ from a typical person. For example, about 80% of adults in the US are either overweight or obese, with some extremely obese. With that come many issues, e.g. diabetes. So, are we talking about typical people here, many of whom (us) have some form of health issue, e.g. a 40 year old who is overweight and may have high blood pressure because of it, which is very common? Or are we talking about people we consider truly sick and fragile, e.g. a 82 year old who was hospitalised for a heart attack last year, has vitamin deficiencies in the bloodwork, and smoked for 30 years and survived cancer.
- keiferski 7y agoFrom the report: Median age of patients who died: 80.5 years Median age of patients with infection: 63 years So the data would seem to suggest that the overweight 40 year old is not likely to die and is far below the median for even getting the infection (and going to the hospital.)
- jlokier 7y agoNot likely to die with ventilation and medical care. But what's the likelihood of the overweight 40 year old dying without critical care because the hospital cannot provide it?
- jacobolus 7y agoKeep in mind, in this time of limited doctors and equipment, Italian hospitals are forced to choose who gets treatment, and they are preferentially treating young people without preexisting conditions.
- etrk 7y agoWhat is a "typical person"? As the article states, most of these people are 70+ years old. It would be interesting to know the prevalence of these illnesses among the cohort of 70+ year old Italians, but that would require more searching/translating than I care to do now. But feel free have at it.
- 7y ago
- KarlKemp 7y agoOTOH, quite a few people in their 30s survived only after two weeks on a ventilator. That involves “fixating the patient, who will otherwise try to pull out the tube because he believes it is suffocating him”. No fun.
- onetimemanytime 7y ago>>OTOH, quite a few people in their 30s survived only after two weeks on a ventilator. I wonder if anyone needing one will get a ventilator when times comes? Especially since you need it for weeks
- exhilaration 7y agoThere's ongoing planning for how to distribute limited resources if hospitals are overwhelmed: Fearing a critical shortage of lifesaving resources as the coronavirus spreads, Washington State is engaged in grim discussions to determine which dying patients would get priority. https://www.nytimes.com/2020/03/20/us/coronavirus-in-seattle-washington-state.html https://www.nytimes.com/2020/03/20/us/coronavirus-in-seattle...
- jrs235 7y agoArticle is paywalled for me. Will they take a ventilator off and away from say an 80 year old and give it to a 30 year old? In other words will they take ventilators away or will they leave them until a person recovers or dies?
- exhilaration 7y agoThat's a very good question. The article doesn't mention that scenario.
- NotSammyHagar 7y agoThey won't start them on people younger than 60 in Italy. They will be making these decisions in Washington state, which they have been discussing and putting out in the public so we know ahead of time. All these people wanting to argue that most people dying are old are leading to one conclusion, I'll be okay, what's the big deal, I want to go out to a bar, it won't kill me, probably. Yeah, so, you want to kill grandma and grandpa? One day you will be that old. Most people don't want people who are "old", that indefinite thing older than you, to die. But for those that don't give a shit, think practically, that the people filling up the hospital for when you get sick, or if you break your arm or get the regular flu, they will prevent you from being able to see a doctor.
- tamaharbor 7y agoWe are destroying our economies to save people who will just die in a few years anyway.
- djdkrkfkgk 7y agoEven if so, do you feel like taking a 1% chance?
- adrusi 7y agoYou know, many people reading this have a pre-existing condition, so even if this is a reasonable way to interpret the data, it's not much encouragement for them. Also, just because 99% of deaths come from people with pre-existing conditions doesn't mean that someone with no conditions has a 1% chance of dying. That's just bad math.
- Paul-ish 7y agoThis report is 3 days old. The numbers might be the same, or different.eg Healthy people might hold on longer.
- ramblerman 7y agoHere is a report from Yesterday with the same numbers: https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo.pdf https://www.epicentro.iss.it/coronavirus/bollettino/Report-C... Occams razor applies
- microdrum 7y agoItaly also released demographics unlike most countries. Median age of dead: 80.
- gridlockd 7y agoTo be fair, it's not so common to make it to your seventies without developing any of these illnesses. Being old is a risk factor for death from any cause. We need much more specific data on younger patients with pre-existing conditions. For example, hypertension or diabetes in your forties, which is less common but not that uncommon. We need to know who to isolate if this whole social isolation situation has to to go on for several months.
- ilaksh 7y agoI think they said there were only like 17 deaths for younger people.
- NotSammyHagar 7y agoThis kind of idea is being abused to argue that people are way over-reacting to covad19. There are a large number of people with these existing conditions. I don't think this kind of information helps us. There are still lots of people under 50 getting it.
- dkarl 7y agoI feel like the Covid-19 crisis is causing people to bring out all the classic arguments for authoritarianism and present them as novel ideas generated by this context, as if there weren't centuries of history and debate attached to them.
- api 7y agoAlso note that Italy has a substantial elderly population, skewing the numbers.
- aledalgrande 7y agoThe sample is 70+ year old, but the conclusion is not that people in that age range are the most at risk, it's that if you have a pre-existing condition, you are at risk. I don't think anyone is trying to say this is an overreaction. On the contrary, if you or any of your loved ones have a condition, you should be extra careful. At the end of the report linked by other commenters (https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_17_marzo-v2.pdf https://www.epicentro.iss.it/coronavirus/bollettino/Report-C...) it also says that the few <40yo people who died also had existing preconditions.
- gridlockd 7y ago
- zwm 7y agoA dangerous headline.
- aantix 7y agoIs it inaccurate?
- NotSammyHagar 7y agoIt's probably not that inaccurate, but it's incredibly misleading. Of the people in the hospital, what % are under 60? 50% is one figure I saw. And the reason this matters is that this is used to justify "I got mine and I don't care about others" (in this case 'mine' is health and youth).
- yumraj 7y agoOne thing I've been curious about is that is the issue that these people had underlying condition, or is it that they were taking some medication(s) to treat/cure those underlying condition. I believe it's the latter, or shall I say mostly-latter, due to the whole ACE2 receptor theory, though I have no data or evidence to back it up. In other words, if there are two people with hypertension: One knows about it and is treating it with some medications, while the other doesn't even know about it and is hence not taking any medication - Do they both have the same risk profile?
- t0ughcritic 7y agoSaving face?