4 ms·

A few thoughts: 1) Extrapolating from the infection rates of very specific groups (for example, evacuees) to the entire population without taking into account

A few thoughts: 1) Extrapolating from the infection rates of very specific groups (for example, evacuees) to the entire population without taking into account transmission dynamics and the time between infection and detection does not make very much sense. The authors naively multiply the infection rate among evacuees by the population of Wuhan to conclude that Wuhan must have had 178,000 infections at the end of January. By comparison, epidemiological models have estimated there were around ~20,000 infections at that time [1][2][3]. What conclusion should we draw here? If you use sloppy, back of the napkin math to over-inflate the infection count by 10x then you can correspondingly deflate the mortality rate? 2) Speculating about the mortality rate of Covid-19 based on several gigantic assumptions ("If our surmise of six million cases is accurate, that’s a mortality rate of 0.01%") seems borderline irresponsible. Numerous researchers have been modeling this virus and have generally arrived at numbers in the range of 0.5% to 1.6% [4][5][6][7][8][9]. The authors don't present any compelling reason why we should doubt those numbers. 3) Ultimately the mortality rate is not as important a number as the hospitalization rate. The authors would have you believe this virus is no worse than the flu, but this is not congruent with the number of reports coming out of places like Italy and New York saying they're about to run out of ICU beds, or China rushing to build temporary hospitals to house all of the patients that need critical care. What the mortality rate might be under ideal circumstances where every patient receives adequate medical care might be significantly different compared to a scenario where you've run out of ICU beds and have to start rationing ventilators. [1] https://www.mdpi.com/2077-0383/9/2/419/htm https://www.mdpi.com/2077-0383/9/2/419/htm [2] https://www.medrxiv.org/content/10.1101/2020.01.23.20018549v2.full.pdf https://www.medrxiv.org/content/10.1101/2020.01.23.20018549v... [3] https://www.mdpi.com/2077-0383/9/2/523/htm https://www.mdpi.com/2077-0383/9/2/523/htm [4] https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-severity-10-02-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s... [5] https://institutefordiseasemodeling.github.io/nCoV-public/analyses/first_adjusted_mortality_estimates_and_risk_assessment/2019-nCoV-preliminary_age_and_time_adjusted_mortality_rates_and_pandemic_risk_assessment.html https://institutefordiseasemodeling.github.io/nCoV-public/an... [6] https://cmmid.github.io/topics/covid19/severity/diamond_cruise_cfr_estimates.html https://cmmid.github.io/topics/covid19/severity/diamond_crui... [7] https://www.medrxiv.org/content/10.1101/2020.03.04.20031104v1.full.pdf https://www.medrxiv.org/content/10.1101/2020.03.04.20031104v... [8] https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v1.full.pdf https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v... [9] https://www.nature.com/articles/s41591-020-0822-7 https://www.nature.com/articles/s41591-020-0822-7

whatever1 7y ago
thank you so much for the insights
glofish 7y ago
one important element is a behavioral pattern A person with flu and fever would probably stay home and just rough it out, a person with fever fearing the coronavirus will probably rush to the hospital. If everyone having a fever in a flu season would go to the hospital and would demand medical attention we would be running out of hospital beds in normal scenarios as well.
- DiogenesKynikos 7y ago
  You wouldn't run out of ventilators, though, as has happened in different countries with COVID-19.
- hiq 7y ago
  Can't you efficiently filter for this by only counting the ICU beds (rather than just hospital beds)?
- thdrdt 7y ago
  Well at least in the Netherlands your claim is false. They don't want you at the hospital unless it is absolutely necessary. Got a fever and still able te breath: stay at home.
  - withinboredom 7y ago
    Too true
  - viklove 7y ago
    It's the same in the US. They won't even test you here unless you're having trouble breathing.
    - earonesty 7y ago
      That's not even true. I've had pain breathing for weeks, they still won't test. They prescibed corticosteroids, antibiotics and bed rest. They won't test until you're nearly dead. the CFR here is wildly overestimated.

whatever1 7y ago

thank you so much for the insights

glofish 7y ago

one important element is a behavioral pattern A person with flu and fever would probably stay home and just rough it out, a person with fever fearing the coronavirus will probably rush to the hospital. If everyone having a fever in a flu season would go to the hospital and would demand medical attention we would be running out of hospital beds in normal scenarios as well.

DiogenesKynikos 7y ago
You wouldn't run out of ventilators, though, as has happened in different countries with COVID-19.
hiq 7y ago
Can't you efficiently filter for this by only counting the ICU beds (rather than just hospital beds)?
thdrdt 7y ago
Well at least in the Netherlands your claim is false. They don't want you at the hospital unless it is absolutely necessary. Got a fever and still able te breath: stay at home.
- withinboredom 7y ago
  Too true
- viklove 7y ago
  It's the same in the US. They won't even test you here unless you're having trouble breathing.
  - earonesty 7y ago
    That's not even true. I've had pain breathing for weeks, they still won't test. They prescibed corticosteroids, antibiotics and bed rest. They won't test until you're nearly dead. the CFR here is wildly overestimated.