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Risk management is the correct way to go when uncertainty is high. Containment was the correct approach at the time. When evidence starts coming in, then you c

Risk management is the correct way to go when uncertainty is high. Containment was the correct approach at the time. When evidence starts coming in, then you can start applying evidence based approaches. > Mortality rate: Mortality and morbidity rates are also downward biased, due to the lag between identified cases, deaths and reporting of those deaths [1] > Among 3,711 Diamond Princess passengers and crew, 712 (19.2%) had positive test results for SARS-CoV-2 (Figure 1). Of these, 331 (46.5%) were asymptomatic at the time of testing. Among 381 symptomatic patients, 37 (9.7%) required intensive care, and nine (1.3%) died (8) . . . As of March 13, among 428 U.S. passengers and crew, 107 (25.0%) had positive test results for COVID-19; 11 U.S. passengers remain hospitalized in Japan (median age = 75 years), including seven in serious condition (median age = 76 years) [2]. Based on the second source, who can still seriously believe that the naive death rate is too conservative, because all the people in intensive care just have not died yet? Look at the deaths/recoveries in Singapore and Hong Kong for more evidence [3][4]. Whereas, if you compare fatality rates reported by Germany, SK, HK, Singapore and other high testers vs China, Italy and Spain, it's pretty clear the latter are under-diagnosing mild/asymptomatic cases, which increase their fatality rate by a factor of 10 or more. [1] https://necsi.edu/systemic-risk-of-pandemic-via-novel-pathogens-coronavirus-a-note https://necsi.edu/systemic-risk-of-pandemic-via-novel-pathog... [2] https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e3.htm?s_cid=mm6912e3_w https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e3.htm?s_cid=mm... [3] https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Hong_Kong https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_H... [4] https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Singapore https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_S...

joe_the_user 7y ago
Whereas, if you compare fatality rates reported by Germany, SK, HK, Singapore and other high testers vs China, Italy and Spain, it's pretty clear the latter are under-diagnosing mild/asymptomatic cases, which increase their fatality rate by a factor of 10 or more. South Korea has 1% fatality rate at the end of their epidemic, they showed .5% in the middle of this. Germany has .2% rate but it has crept up to .4% and I suspect it will continue to creep to 1%, and if they get overwhelmed it could go higher. China has a less than 1% rate outside of Wuhan, since outside that area, the health care system wasn't overwhelmed [1]. The extra deaths in Wuhan could be attributed to the health care system getting overwhelmed rather than under counting - 20 or 10% of those infected require intensive care. You quote 10% of the infected on the Diamond Princess as requiring hospitalization. With an overwhelmed health care system, that might be the death rate. Which is to say that we have more evidence but that evidence seems to point to a desperate need for containment. [1] You can compare all the statistics at: https://covid19info.live https://covid19info.live
- guscost 7y ago
  > You quote 10% of the infected on the Diamond Princess as requiring hospitalization. 10% of symptomatic cases, not all cases, and definitely not all infected.
cameldrv 7y ago
Right, so do the math. 5% of positives required intensive care. If 197 million Americans get this, That means 10 million people go to intensive care. There are 60,000 ICU beds in the U.S. If 10 million people need the ICU, effectively none get a ventilator and they all die. Now it's true that the cruise ship passengers skewed significantly older, but on the other hand, they were all ambulatory and healthy enough to be taking a cruise. There are populations that are at significantly higher risk than the cruise ship passengers. Also, Chinese experience was that about half of the people admitted to the ICU eventually died.
- dvsfish 7y ago
  >Now it's true that the cruise ship passengers skewed significantly older, but on the other hand, they were all ambulatory and healthy enough to be taking a cruise. While yes this is true technically, I'm not sure the bar for "healthy enough" is as high as you're making out it is. In my experience (apologies for the anecdote), significantly obese people are quite capable of going on a cruise almost always.
  - cameldrv 7y ago
    I'm talking about people in nursing homes, people in hospitals, people on immunosuppressants, for example, after a transplant (who wouldn't go on a cruise because of norovirus etc), people with other immune diseases, etc. There are a lot of these people out there, and these people would be very hard hit if we just let COVID run through the population.
- guscost 7y ago
  But on the other other hand, they were all traveling, eating cruise ship food, and probably drinking, all of which could weaken their immune systems. We can add speculative adjustments all day long, but there's no way we're going to get a randomized double-blind study out of it. Also you can't conclude much of anything based on a linear extrapolation, even if you have good data.
  - cameldrv 7y ago

joe_the_user 7y ago

Whereas, if you compare fatality rates reported by Germany, SK, HK, Singapore and other high testers vs China, Italy and Spain, it's pretty clear the latter are under-diagnosing mild/asymptomatic cases, which increase their fatality rate by a factor of 10 or more. South Korea has 1% fatality rate at the end of their epidemic, they showed .5% in the middle of this. Germany has .2% rate but it has crept up to .4% and I suspect it will continue to creep to 1%, and if they get overwhelmed it could go higher. China has a less than 1% rate outside of Wuhan, since outside that area, the health care system wasn't overwhelmed [1]. The extra deaths in Wuhan could be attributed to the health care system getting overwhelmed rather than under counting - 20 or 10% of those infected require intensive care. You quote 10% of the infected on the Diamond Princess as requiring hospitalization. With an overwhelmed health care system, that might be the death rate. Which is to say that we have more evidence but that evidence seems to point to a desperate need for containment. [1] You can compare all the statistics at: https://covid19info.live https://covid19info.live

guscost 7y ago
> You quote 10% of the infected on the Diamond Princess as requiring hospitalization. 10% of symptomatic cases, not all cases, and definitely not all infected.

cameldrv 7y ago

Right, so do the math. 5% of positives required intensive care. If 197 million Americans get this, That means 10 million people go to intensive care. There are 60,000 ICU beds in the U.S. If 10 million people need the ICU, effectively none get a ventilator and they all die. Now it's true that the cruise ship passengers skewed significantly older, but on the other hand, they were all ambulatory and healthy enough to be taking a cruise. There are populations that are at significantly higher risk than the cruise ship passengers. Also, Chinese experience was that about half of the people admitted to the ICU eventually died.

dvsfish 7y ago
>Now it's true that the cruise ship passengers skewed significantly older, but on the other hand, they were all ambulatory and healthy enough to be taking a cruise. While yes this is true technically, I'm not sure the bar for "healthy enough" is as high as you're making out it is. In my experience (apologies for the anecdote), significantly obese people are quite capable of going on a cruise almost always.
- cameldrv 7y ago
  I'm talking about people in nursing homes, people in hospitals, people on immunosuppressants, for example, after a transplant (who wouldn't go on a cruise because of norovirus etc), people with other immune diseases, etc. There are a lot of these people out there, and these people would be very hard hit if we just let COVID run through the population.
guscost 7y ago
But on the other other hand, they were all traveling, eating cruise ship food, and probably drinking, all of which could weaken their immune systems. We can add speculative adjustments all day long, but there's no way we're going to get a randomized double-blind study out of it. Also you can't conclude much of anything based on a linear extrapolation, even if you have good data.
- cameldrv 7y ago