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Ask HN: What's Missing from Covid19 Reporting?
What questions do you have about covid19 that seem important but aren't being asked/answered in public forums?
(I'll post my own below)
- DoofusOfDeath 7y agoI've heard that high blood pressure is a risk factor for the severity of a covid19 infection. But does that mean... (a) People who have actual, uncontrolled high BP? (b) People who would have high BP, but don't because it's controlled by medication? (c) People who are taking specific BP-controlling meds? (d) Some combo of (a), (b), (c)?
- dchyrdvh 7y agoIirc, it's about ACE2 inhibitors used in many BP drugs: they mess up with ACE receptors and the virus has an easy way in.
- DoofusOfDeath 7y agoI know ACE inhibitors are sometimes prescribed to people with Type 1 diabetes. I wonder to what extent ACE inhibitors are responsible for both high-BP and diabetes being risk factors for covid19 severity.
- mrfusion 7y agoSo should we treat corona with the opposite of an ace inhibitor?
- dchyrdvh 7y agoYou're asking a mechanic what technique we should use in this brain surgery. As a mechanic, I'd say that a good wrench is a safe proven choice.
- vidro3 7y agoMedCram on youtube has a good video on this. cant get the link on my corporate vpn though.
- DoofusOfDeath 7y agoWe hear stories about production ramps for personal protective equipment, for healthcare providers and regular citizens. But what are the actual projections for the need-curve vs. the availability-curve of those commodities in various places?
- DoofusOfDeath 7y agoSome anecdotes of covid19 infection talk about people being in severe pain. What's the relationship between that symptom and final disease outcome?
- DoofusOfDeath 7y agoIn early public reporting on covid19 in the U.S., when the patient died it was common to hear that he/she had "underlying health issues". Why be so vague? It seems like more detail would help people identify their personal risk level. (Edited for tone.)
- tomstoms 7y agoPrivacy?
- DoofusOfDeath 7y agoI've heard that idea floated before, sometimes in conjunction with references to the U.S.'s HIPAA law. But I've only heard speculation about this - never an explanation from someone closer to the source.
- tomstoms 7y agoI don’t know about the US but at least in Norway it’s stated as a reason. Age, geography and diagnosis is sometimes enough to identify a person, and there are regulations governing that here.
- DoofusOfDeath 7y agoWhat are the current projections of test-kit availability vs. need for different regions? E.g., when do we expect that doctors can test everyone that suspect of having covid19?
- pmiller2 7y agoWe actually need more testing than that. Yes, we should be testing every suspected case, but we should also be mass testing everybody, or, at least random samples of everybody. We need to know where this virus is and is not and what the extent of asymptomatic carriers is. Information is the only weapon we currently have against this virus, and we have shockingly little.
- tiredwired 7y agoWhich medical centers are overwhelmed and which ones are operating normally.
- burntoutfire 7y agoThe origin of the virus. The mainstream media assumes the virus was created in a natural process of mutation and jumping species, while there's this little paper [1] in Nature Medicine from 2015 where authors (virologists) confirm that they created a novel, human-transmisible coronavirus, based on a new virus they discovered among bats. Some of the authors of the paper are from Key Laboratory of Special Pathogens and Biosafety at the Wuhan Institute of Virology... [1] https://www.nature.com/articles/nm.3985 https://www.nature.com/articles/nm.3985
- mancerayder 7y ago"This was created in a lab" has been the whisper of conspiracy-theorists. How likely is it? And a vial broke and it got released like in a Marvel comic?
- burntoutfire 7y agoCoronaviruses are actually created in labs as part of virology research (see my original link). It just seems that, in light of links that people posted, it did not escape/was released from the Wuhan lab - the strain that created the pandemic originated via natural processes.
- tropo 7y agoNah, see my comment above. Those links only tell us that we did not find evidence of the use modern gene-editing technology in the virus. It's misdirection with a straw man. The lab was breeding viruses the old-fashioned way long before modern gene-editing technology was invented. Bat coronaviruses would be mixed with other viruses and repeatedly passed through human cells. That leaves no evidence in the genome. It looks just like natural selection. The virus labs in China have had several other dangerous accidents that let viruses get out. Those previous accidents were gotten under control. With this one, we weren't so lucky. I think the lesson is clear: don't screw around making deadly viruses when your biohazard containment is substandard. Maybe just don't attempt it under any conditions.
- whb07 7y agoA detailed break down by age. Then bonus points would be a column showing the mortality rate of a person in that country. For instance an 80 yo in the US has a 6% mortality.
- kuczmama 7y agoHere you go. This shows a breakdown of fatality rate by age. https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ https://www.worldometers.info/coronavirus/coronavirus-age-se...
- fool_wolf 7y agoNumbers related to the outbreak that are meaningful without denominators (since we don't have any and won't until long after things get back to some semblance of normalcy). Seems like this would be hospitalizations (due to covid) and deaths (due to covid). Those are numbers where the volume (as opposed to the rate) are the signal.
- zomglings 7y ago1. How do frequency and density of exposure correspond to infection rate? I'm assuming there are some basic principles that apply to any virus, but I don't know what they are and have found it difficult to get find meaningful information. 2. If lowering frequency and density of exposure reduces infection rate - as the papers that Google surfaces when querying this kind of thing suggest - does this mean that social distancing could be more than a knee-jerk means of reducing the stress of the healthcare system? Could it form the basis of a long-term containment strategy? 3. Would it be possible to randomly test high-traffic areas (grocery stores and gas stations in the US) to get a better sense for how this disease is spreading? Why are we not doing this?
- kleer001 7y agoWhy did/does China lie so early and so often about the progression of the epidemic?
- throwaway963577 7y agoBecause like the current US administration, local officials punish and silence the bearers of bad or ideologically-inconsistent news.
- rosspackard 7y agoFully anonymized medical history/demographics data across countries and open to the public. This would allow crowd sourcing and statistics to be applied by the best minds in the world. I know regulations can make this difficult but many difficult boundaries are being pressed now.
- GoMonad 7y ago1. What happens in the middle, between a lock-down bringing down the infected numbers and vaccine. I've read a few things from epidemiologists, but there seems to be little discussion in the wider media. https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56 https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-th... 2. What's going on with the PCR reagent shortage? Where are they produced? Why is it hard to make it quickly? etc.
- orsenthil 7y agoAs per: https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594... In China: Total Confirmed = 81,782 Total Recovered = 74,181 Total Dead = 3,291 -------------------------- Remaining = 4,370 * I am assuming the number 4,370 will fall either into Recovered or Dead. Can someone confirm this theory? Is this going to the same for US? Total Confirmed Cases = 69,684 Total Recovered = 619 Total Dead = 1,049 -------------------------------- Remaining = 68,016 Does this mean the fate of 68,016 not known yet in US? A similar concerning number exists for Italy too.
- Leary 7y ago80%-85% of the 68k are probably mild cases that will recover without medical help. 15-20% will need hospitalization. ~5% will need ICUs. 0.5%-5% will die depending on whether the medical system is overwhelmed.
- amanaplanacanal 7y agoMaybe. If most are mild, how did they ever become confirmed cases? I would assume that mild cases would never get tested.
- throwaway963577 7y agoWhat should governments be doing for maximum practical containment?
- throwaway963577 7y agoWhat does successful containment look like 3 months, 6 months, and a year from now?
- he11ow 7y agoReliable data on asymptomatic cases. The models we have at the moment are trying to fit parameters based on the known data, but of the known data, the only reliable one is the death rate. So there are a lot of degrees of freedom here with regards to the spread of the virus. (Because carriers are only identified on a limited basis, mostly in hospitals, it presents a skewed picture, so this data is not hugely useful) Once antibodies tests are available, you can get a sense of how many people in a sample population have had the disease with mild-to-no symptoms, and that can say a lot about how it's spread.
- Terretta 7y ago> of the known data, the only reliable one is the death rate Back of the napkin numbers to get someone's attention: deaths today / CFR of 0.009 = cases three weeks ago cases three weeks ago * 7 three day doublings = cases today In much more detail: http://hyperdrive.ca/coronavirus/index.php http://hyperdrive.ca/coronavirus/index.php And in the "4 out of 5 dentists agree" category: https://fivethirtyeight.com/features/experts-say-the-coronavirus-outlook-has-worsened-but-the-trajectory-is-still-unclear/ https://fivethirtyeight.com/features/experts-say-the-coronav...
- abstractbarista 7y agoWhat is the true mortality rate? All the numbers are based on positive test counts, but testing isn't being done for most people with nominal (casual) symptoms. This has led to a situation where we think (for example) 2% of positive cases die, when in reality, there may be millions of positive untested cases resolving without issue.
- throwaway963577 7y agoTo what extent will lies, half-truths, spin, and disinformation increase preventable fatalities? What can be done within existing legal frameworks to stop this disinformation?
- unlinked_dll 7y agomore granular or qualified statistics. e.g. yesterday, Gov. Newsom went on the radio and said something along the lines of "half of people hospitalized were 18-60" (paraphrasing, don't remember the numbers exactly, etc). But something like 2/3rds of our population is that age! Another thing would be statistics on triage as the outbreak overwhelmed Italy. I'd like to know who was going to the hospitals, who was admitted, who needed to be in the ICU, etc, and how the profile of patients changed as beds got filled. Nutrition. I've already noticed food purchasing has changed at my local stores. I would like to know if we're exasperating our public health crisis by ruining our diets and if we should be concerned about that moving forward. And finally, alcohol and drug consumption - particularly by millenials. Anecdotally, many of my peers are drinking a lot more regularly than they normally would during the day and week. There are plenty of memes about it, but I'd like to know if we're looking for hope at the bottom of a bottle for the next few months.
- mrfusion 7y agoI think we should be following all of these vaccines and clinical trials really closely. We all watch what the stock market does every day. Let’s start watching what these trials are doing every day. Really put the spotlight on these folks. I feel like as a population we’re acting too much like victims. Let’s take charge of this.
- mrfusion 7y agoI’d like to see the rumor that people can’t develop an immunity to this put to bed. Surely we have enough data at this point.
- pmiller2 7y agoIs that the rumor? Last I had heard, the best science is essentially a guess, but the thinking is that people will develop some kind of immunity. We know this happens with other coronaviruses, and we have found antibodies in people who have recovered from the disease. I don't really know how we can definitively and ethically say "yes, people do develop some immunity to the virus" without deliberately attempting to reinfect people. Maybe an in vitro study would add to the evidence, but in vitro studies frequently don't scale up to whole humans.
- mrfusion 7y agoWhy do medical personnel seem to get hit harder with this?
- mrfusion 7y agoWhy does almost everyone I talk to report having a flu like illness in January that tested negative for flu?
- clircle 7y agoWhat is the sensitivity and specificity of the Coronavirus tests?
- mrfusion 7y agoWhy don’t we get any information on if the shutdowns are working? Why is nyc still so bad?
- skat20phys 7y agoA discussion of how regulatory structures contributed to problems in the US (lack of tests, number and variety of providers and services, and so forth).