14 ms·

Fauci: US can expect more than 100k Covid-19 deaths, millions of cases

45 points by ajaviaad 7y ago

BenoitEssiambre 7y ago
Isn't that just like 2x seasonal flu death numbers? This seems like a very conservative estimate.
- jude- 7y ago
  If hospitals get overrun, the total number of deaths that result from this pandemic is bound to be higher.
- Kye 7y ago
  It's not like the flu tagged covid-19 in. Both are going to cause a lot of deaths at the same time.
- analog31 7y ago
  True, but flu is spread out over the whole year, and 100k deaths is only 10 million cases, possibly a severe underestimate. We'll be at a million reported cases in a week, or 10 million not long after that. Edit: Corrected as per below. Thanks!
  - herman_toothrot 7y ago
    I'm not sure I understand you statement re: "100,000 deaths is only 1,000,000 cases". That seems an awfully high percentage compared to the recorded numbers so far.
    - deleted 7y ago
      [deleted]
- bb88 7y ago
  CDC estimates that 24k - 62k die every year from the flu. Fauci estimated 100k - 200k will die from covid-19. So that would be 2-8x on the extremes. But 2x would be the low end estimate assuming a bad flu season and a low end number for the death rate on covid-19. Hospitals are optimized for typical illness, not for pandemics. And the death rate has been calculated based upon cases that get adequate health care -- an assumption that goes away when the hospitals have to choose who lives and who dies.
  - rumanator 7y ago
    > an assumption that goes away when the hospitals have to choose who lives and who dies. I feel this sort of statement misrepresents the true problem and portrays deaths from lack of medical care as just a capricious choice made by cruel doctors and nurses. This portrsial is neither fair or truthful. If you have 10 patients requiring a respirator and only a single respirator to spare, figuring out who is a priority or has a better chance of making it alive is not the same as deciding someone should die.
    - sykick 7y ago
      I think no sufficiently intelligent person thinks that hospitals deciding who lives/dies will be done capriciously or by cruel doctors. But on the other hand there were large numbers of fools in the U.S. who thought the ACA would create death panels. So maybe for the U.S. your point is valid.
      - rumanator 7y ago
        > think no sufficiently intelligent person thinks that hospitals deciding who lives/dies will be done capriciously or by cruel doctors. The death panel political talking point suggests otherwise.
    - Kye 7y ago
      It's reasonable to assume bb88 understands the nature of triage and was referring to that in a non-judgmental way.
    - lolc 7y ago
      To me the statement "have to choose who lives and who dies" doesn't carry the meaning that the decision will be taken in a capricious way. In the end it's a horrible responsibility to decide somebody doesn't get a chance to live so that somebody else gets that chance. But that's the situation. How would you write that, then?
    - bb88 7y ago
      Someone had mentioned recently that one of HN's biggest problems was overly pedantic responses get better upvotes rather than actual content. This has a caused HN to devolve into a fact correctness engine rather than a content engine. To be fair, this is something I've done in that past too. Yes, I did use a rhetorical phrase to make a point, but one that's pretty prevalent in modern culture and especially when it comes to triage. Perhaps google phrases like "Doctors forced to play God", etc. Ironically, the first hit that comes up is this: https://www.dailymail.co.uk/news/article-8163641/NHS-doctor-reveals-shes-forced-play-God-coronavirus-patients-overwhelm-wards.html https://www.dailymail.co.uk/news/article-8163641/NHS-doctor-... I really recommend that you go watch episodes of MASH from the 1980's. Particularly the episodes where the doctors have to triage cases that might be savable if they weren't in a field hospital. If the US president says we're in a war, we should all refresh ourselves up on what meatball surgery is during an actual war.
- dannykwells 7y ago
  This is conservative, but also, this is happening in a very short time frame, AND is taking into account all of the social distancing AND is happening at the same time as flu. Without the distancing measures we have in place we would be looking at millions of deaths. Once this is over, it will be very tempting to say, "Look it was only as bad as flu, we shouldn't have trashed the economy just for that..." but that of course is not fair reasoning. We only will have 200k deaths because of the distancing.
  - mirekrusin 7y ago
    But social distancing can make at most order of magnitude difference (generous, semi-arbitrary) - which is still way too small change, it just spreads a lot of deaths in time, doesn't stop all of them, right?
    - manicdee 7y ago
      Spreading out cases over time means what might have been a death in a crowded, overworked hospital is a recovery in a moderately challenged hospital where the concerns are fresh face masks rather than available hands.
      - mirekrusin 7y ago
        I know and I don't argue that. I gave 10x less deaths for that, which is generous - but that still means deaths counted in millions.
  - edoo 7y ago
    Wrong. Flattening the curve merely delays infections and does not prevent them. It doesn't seem to work well either. It has been good for a 0.5 R-0 drop which points to other primary vectors instead of aerosols. Also it turns out if you need a ventilator you have a 95% death rate, so if the hospitals get overwhelmed the overall death toll won't be too different. If the death toll is anywhere near 100k total we trashed the economy over a bad flu. It would take 6+ months of isolation to beat the virus with quarantine measures, more than long enough to cause a wave of economic related deaths way higher than the virus. People have to get back to work.
- melling 7y ago
  Half of America is hiding inside taking extra precautions. He’s probably giving us one of the better outcomes. He also said 100,000 to 200,000 If we took more precautions with the flu, the number would be less too. And if people got the flu shot
deleted 7y ago
[deleted]
OzzyB 7y ago
I haven't seen anyone post this [1] which surprises me based on the audience here, so I'll do it. So tell me, is this relevant/wrong? Are we extrapolating that I'll have 2,000 wives by Thursday cause I got married on Sunday? [1] https://xkcd.com/605/ https://xkcd.com/605/
- dannykwells 7y ago
  Ummm, it's more like, saying, I had one wife 8 weeks ago, and 4 7 weeks ago, and 16 6 weeks ago, and 64 5 weeks ago, and 256 4 weeks ago, and 1024 4 weeks ago and 4096 3 weeks ago, and 16384 2 weeks ago, and 65536 1 week ago, and I have 262144 today, so in 4 weeks I will have 16777216 wives. That is, there is more than a single data point supporting the claims of exponential growth. There are lots of them. Nice try though.
  - H8crilA 7y ago
    You're being generous with "nice try". It's not a "nice try", it's just being a troll.
- __s 7y ago
  US has three months of data from Europe & Asia. Not to mention any other models of contagion. You're comparing it to a comic about extrapolating based on one data point. So no, the comic isn't relevant & yes, people have talked about inflection points
- analog31 7y ago
  The exponential growth curves have a couple dozen data points by now. We know they can't be extrapolated forever, but we also have no reason to expect the curve to top out before it hits nearly the entire population.
- celticninja 7y ago
  as already explained, xkcd is extrapolating from a single data point. covid infections are being extrapolated from many data points.
brohoolio 7y ago
This is so sad. We need a country wide lockdown for 8 to 10 weeks to get ahead of the virus. Give the scientists and doctors sometime to figure out potential mitigations. I’m almost certain that his estimates are too low unless we can get ahead of it.
vondur 7y ago
How about they start treating these people with Hydroxychloroquine and azithromycin? It seems to work. Has to be better than letting people die or suffer permanent lung damage.
- marvy 7y ago
  Good question. Do we have a plentiful supply? Any one know?
- mrfusion 7y ago
  the problem is that trump mentioned these medications so half the country thinks they don’t work now.
- adsfqwop 7y ago
  Interesting interview with doctor in NY using it on over 600 patients so far. 100% success rate. https://youtu.be/1TJdjhd_XG8?t=117 https://youtu.be/1TJdjhd_XG8?t=117
- kennywinker 7y ago
  From what I've read, results are mixed so far. I believe it's being tested out in MANY places right now to gather more data, but it seems clear at this point that it's definitely not a miracle cure.
- anonymous45235 7y ago
  > https://twitter.com/amyklobuchar/status/1243269061733220353 https://twitter.com/amyklobuchar/status/1243269061733220353 > All "VIP"s are immediately put on Hydroxychloroquine when they show the first symptom. Even before a test. (waiting for the test results takes way too long and gives the virus time to ruin your lungs!).
ohazi 7y ago
I haven't been shouting from the rooftops because I'm not an epidemiologist and don't really want to get into an argument, but none of the low/medium/high death estimates that I've seen have seemed plausible to me. The back-of-the-envelope math that I've been doing would put most of them about half an order of magnitude too low. From what I can tell, the best-case death estimate in the US should be around 1-2 million, and the worst case should be around 5-10 million. Does this seem wildly off? This is based on the varying death rates in other countries that have had controlled/mild/manageable outbreaks (e.g. South Korea, Singapore) vs. severe outbreaks (e.g. Italy, Iran). The overall death numbers also seem to change depending on how overrun the hospitals are (going from, e.g. 0.9% to ~3%+), national demographics, etc. I'm also assuming an eventual population infection rate of 40% - 70%. I'd obviously be thrilled to be proven wrong, but I honestly don't understand how people are coming up with numbers that are so much more optimistic.
- save_ferris 7y ago
  Agreed, I so wish one of the networks or YouTube would give someone like Fauci an hour or two to walk through their methodology in detail instead of just answering topical questions on projections from pundits. We’re not getting a whole lot of context right now that would be useful and engaging.
  - bluena 7y ago
    There's a 15 min interview on YouTube with Fauci being interviewed by Trevor Noah today. Strongly recommended: https://youtu.be/8A3jiM2FNR8 https://youtu.be/8A3jiM2FNR8
    - kennywinker 7y ago
      frustratingly not available in my region
    - fortytwo79 7y ago
      That's what our media has to offer? An interview by a comedian? I agree we need Fauci to walk us through it. I'd like a panel interview conducted by a reputable interviewer.
mirekrusin 7y ago
I'm not professional and my napkin/google calculation shows something closer to 327.2 million * 0.7 * 0.01 = two million two hundred ninety thousand four hundred deaths - is it stupid?
- throwaway8291 7y ago
  No, not stupid. It's one scenario, but the time span is absent: do we reach 0.7 in three years or three months? At the current rate probably the latter, which might increase the 0.01 as well, because of a certain overwhelming of the health care system in the US (e.g. a young boy in California has not been treated because he could not pay, so he died).
  - kennywinker 7y ago
    "can't pay" is not overwhelming the system, that's overwhelming greed.
  - bagacrap 7y ago
    If you're talking about the case I think you're talking about, """ However, Los Angeles’ County Department of Public Health later said the teen’s death was taken off a list of deaths associated with Covid-19 in the area. The department said the CDC would complete an investigation into the teen’s death. It remained unclear what symptoms he may have been experiencing prior to his death. """ The 17yo fatality that Gavin Newsom mentioned in a news report was also later reclassified as not CV related. The late 21yo patient in the UK was never tested for CV. The media do not have a great track record here.
- bagacrap 7y ago
  Fauci is not sharing the data he used but 0.01 is probably not the fatality rate he plugged in. That number ignores the many undiagnosed cases. Here are some estimates using alternative methods that don't rely on widespread testing: https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as-they-say-11585088464 https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as...
- sharken 7y ago
Fnoord 7y ago
https://archive.is/ZA6zW https://archive.is/ZA6zW
martythemaniak 7y ago
This was posted here a while back: https://neherlab.org/covid19/ https://neherlab.org/covid19/ They have number of deaths displayed, so if you try to match the observed rate and keep total deaths below 200k... well, it's doable, but with pretty strong assumptions.

45 points by ajaviaad 7y ago

BenoitEssiambre 7y ago

Isn't that just like 2x seasonal flu death numbers? This seems like a very conservative estimate.

jude- 7y ago
If hospitals get overrun, the total number of deaths that result from this pandemic is bound to be higher.
Kye 7y ago
It's not like the flu tagged covid-19 in. Both are going to cause a lot of deaths at the same time.
analog31 7y ago
True, but flu is spread out over the whole year, and 100k deaths is only 10 million cases, possibly a severe underestimate. We'll be at a million reported cases in a week, or 10 million not long after that. Edit: Corrected as per below. Thanks!
- herman_toothrot 7y ago
  I'm not sure I understand you statement re: "100,000 deaths is only 1,000,000 cases". That seems an awfully high percentage compared to the recorded numbers so far.
  - deleted 7y ago
    [deleted]
bb88 7y ago
CDC estimates that 24k - 62k die every year from the flu. Fauci estimated 100k - 200k will die from covid-19. So that would be 2-8x on the extremes. But 2x would be the low end estimate assuming a bad flu season and a low end number for the death rate on covid-19. Hospitals are optimized for typical illness, not for pandemics. And the death rate has been calculated based upon cases that get adequate health care -- an assumption that goes away when the hospitals have to choose who lives and who dies.
- rumanator 7y ago
  > an assumption that goes away when the hospitals have to choose who lives and who dies. I feel this sort of statement misrepresents the true problem and portrays deaths from lack of medical care as just a capricious choice made by cruel doctors and nurses. This portrsial is neither fair or truthful. If you have 10 patients requiring a respirator and only a single respirator to spare, figuring out who is a priority or has a better chance of making it alive is not the same as deciding someone should die.
  - sykick 7y ago
    I think no sufficiently intelligent person thinks that hospitals deciding who lives/dies will be done capriciously or by cruel doctors. But on the other hand there were large numbers of fools in the U.S. who thought the ACA would create death panels. So maybe for the U.S. your point is valid.
    - rumanator 7y ago
      > think no sufficiently intelligent person thinks that hospitals deciding who lives/dies will be done capriciously or by cruel doctors. The death panel political talking point suggests otherwise.
  - Kye 7y ago
    It's reasonable to assume bb88 understands the nature of triage and was referring to that in a non-judgmental way.
  - lolc 7y ago
    To me the statement "have to choose who lives and who dies" doesn't carry the meaning that the decision will be taken in a capricious way. In the end it's a horrible responsibility to decide somebody doesn't get a chance to live so that somebody else gets that chance. But that's the situation. How would you write that, then?
  - bb88 7y ago
    Someone had mentioned recently that one of HN's biggest problems was overly pedantic responses get better upvotes rather than actual content. This has a caused HN to devolve into a fact correctness engine rather than a content engine. To be fair, this is something I've done in that past too. Yes, I did use a rhetorical phrase to make a point, but one that's pretty prevalent in modern culture and especially when it comes to triage. Perhaps google phrases like "Doctors forced to play God", etc. Ironically, the first hit that comes up is this: https://www.dailymail.co.uk/news/article-8163641/NHS-doctor-reveals-shes-forced-play-God-coronavirus-patients-overwhelm-wards.html https://www.dailymail.co.uk/news/article-8163641/NHS-doctor-... I really recommend that you go watch episodes of MASH from the 1980's. Particularly the episodes where the doctors have to triage cases that might be savable if they weren't in a field hospital. If the US president says we're in a war, we should all refresh ourselves up on what meatball surgery is during an actual war.
dannykwells 7y ago
This is conservative, but also, this is happening in a very short time frame, AND is taking into account all of the social distancing AND is happening at the same time as flu. Without the distancing measures we have in place we would be looking at millions of deaths. Once this is over, it will be very tempting to say, "Look it was only as bad as flu, we shouldn't have trashed the economy just for that..." but that of course is not fair reasoning. We only will have 200k deaths because of the distancing.
- mirekrusin 7y ago
  But social distancing can make at most order of magnitude difference (generous, semi-arbitrary) - which is still way too small change, it just spreads a lot of deaths in time, doesn't stop all of them, right?
  - manicdee 7y ago
    Spreading out cases over time means what might have been a death in a crowded, overworked hospital is a recovery in a moderately challenged hospital where the concerns are fresh face masks rather than available hands.
    - mirekrusin 7y ago
      I know and I don't argue that. I gave 10x less deaths for that, which is generous - but that still means deaths counted in millions.
- edoo 7y ago
  Wrong. Flattening the curve merely delays infections and does not prevent them. It doesn't seem to work well either. It has been good for a 0.5 R-0 drop which points to other primary vectors instead of aerosols. Also it turns out if you need a ventilator you have a 95% death rate, so if the hospitals get overwhelmed the overall death toll won't be too different. If the death toll is anywhere near 100k total we trashed the economy over a bad flu. It would take 6+ months of isolation to beat the virus with quarantine measures, more than long enough to cause a wave of economic related deaths way higher than the virus. People have to get back to work.
melling 7y ago
Half of America is hiding inside taking extra precautions. He’s probably giving us one of the better outcomes. He also said 100,000 to 200,000 If we took more precautions with the flu, the number would be less too. And if people got the flu shot

deleted 7y ago

[deleted]

OzzyB 7y ago

I haven't seen anyone post this [1] which surprises me based on the audience here, so I'll do it. So tell me, is this relevant/wrong? Are we extrapolating that I'll have 2,000 wives by Thursday cause I got married on Sunday? [1] https://xkcd.com/605/ https://xkcd.com/605/

dannykwells 7y ago
Ummm, it's more like, saying, I had one wife 8 weeks ago, and 4 7 weeks ago, and 16 6 weeks ago, and 64 5 weeks ago, and 256 4 weeks ago, and 1024 4 weeks ago and 4096 3 weeks ago, and 16384 2 weeks ago, and 65536 1 week ago, and I have 262144 today, so in 4 weeks I will have 16777216 wives. That is, there is more than a single data point supporting the claims of exponential growth. There are lots of them. Nice try though.
- H8crilA 7y ago
  You're being generous with "nice try". It's not a "nice try", it's just being a troll.
__s 7y ago
US has three months of data from Europe & Asia. Not to mention any other models of contagion. You're comparing it to a comic about extrapolating based on one data point. So no, the comic isn't relevant & yes, people have talked about inflection points
analog31 7y ago
The exponential growth curves have a couple dozen data points by now. We know they can't be extrapolated forever, but we also have no reason to expect the curve to top out before it hits nearly the entire population.
celticninja 7y ago
as already explained, xkcd is extrapolating from a single data point. covid infections are being extrapolated from many data points.

brohoolio 7y ago

This is so sad. We need a country wide lockdown for 8 to 10 weeks to get ahead of the virus. Give the scientists and doctors sometime to figure out potential mitigations. I’m almost certain that his estimates are too low unless we can get ahead of it.

vondur 7y ago

How about they start treating these people with Hydroxychloroquine and azithromycin? It seems to work. Has to be better than letting people die or suffer permanent lung damage.

marvy 7y ago
Good question. Do we have a plentiful supply? Any one know?
mrfusion 7y ago
the problem is that trump mentioned these medications so half the country thinks they don’t work now.
adsfqwop 7y ago
Interesting interview with doctor in NY using it on over 600 patients so far. 100% success rate. https://youtu.be/1TJdjhd_XG8?t=117 https://youtu.be/1TJdjhd_XG8?t=117
kennywinker 7y ago
From what I've read, results are mixed so far. I believe it's being tested out in MANY places right now to gather more data, but it seems clear at this point that it's definitely not a miracle cure.
anonymous45235 7y ago
> https://twitter.com/amyklobuchar/status/1243269061733220353 https://twitter.com/amyklobuchar/status/1243269061733220353 > All "VIP"s are immediately put on Hydroxychloroquine when they show the first symptom. Even before a test. (waiting for the test results takes way too long and gives the virus time to ruin your lungs!).

ohazi 7y ago

I haven't been shouting from the rooftops because I'm not an epidemiologist and don't really want to get into an argument, but none of the low/medium/high death estimates that I've seen have seemed plausible to me. The back-of-the-envelope math that I've been doing would put most of them about half an order of magnitude too low. From what I can tell, the best-case death estimate in the US should be around 1-2 million, and the worst case should be around 5-10 million. Does this seem wildly off? This is based on the varying death rates in other countries that have had controlled/mild/manageable outbreaks (e.g. South Korea, Singapore) vs. severe outbreaks (e.g. Italy, Iran). The overall death numbers also seem to change depending on how overrun the hospitals are (going from, e.g. 0.9% to ~3%+), national demographics, etc. I'm also assuming an eventual population infection rate of 40% - 70%. I'd obviously be thrilled to be proven wrong, but I honestly don't understand how people are coming up with numbers that are so much more optimistic.

save_ferris 7y ago
Agreed, I so wish one of the networks or YouTube would give someone like Fauci an hour or two to walk through their methodology in detail instead of just answering topical questions on projections from pundits. We’re not getting a whole lot of context right now that would be useful and engaging.
- bluena 7y ago
  There's a 15 min interview on YouTube with Fauci being interviewed by Trevor Noah today. Strongly recommended: https://youtu.be/8A3jiM2FNR8 https://youtu.be/8A3jiM2FNR8
  - kennywinker 7y ago
    frustratingly not available in my region
  - fortytwo79 7y ago
    That's what our media has to offer? An interview by a comedian? I agree we need Fauci to walk us through it. I'd like a panel interview conducted by a reputable interviewer.

mirekrusin 7y ago

I'm not professional and my napkin/google calculation shows something closer to 327.2 million * 0.7 * 0.01 = two million two hundred ninety thousand four hundred deaths - is it stupid?

throwaway8291 7y ago
No, not stupid. It's one scenario, but the time span is absent: do we reach 0.7 in three years or three months? At the current rate probably the latter, which might increase the 0.01 as well, because of a certain overwhelming of the health care system in the US (e.g. a young boy in California has not been treated because he could not pay, so he died).
- kennywinker 7y ago
  "can't pay" is not overwhelming the system, that's overwhelming greed.
- bagacrap 7y ago
  If you're talking about the case I think you're talking about, """ However, Los Angeles’ County Department of Public Health later said the teen’s death was taken off a list of deaths associated with Covid-19 in the area. The department said the CDC would complete an investigation into the teen’s death. It remained unclear what symptoms he may have been experiencing prior to his death. """ The 17yo fatality that Gavin Newsom mentioned in a news report was also later reclassified as not CV related. The late 21yo patient in the UK was never tested for CV. The media do not have a great track record here.
bagacrap 7y ago
Fauci is not sharing the data he used but 0.01 is probably not the fatality rate he plugged in. That number ignores the many undiagnosed cases. Here are some estimates using alternative methods that don't rely on widespread testing: https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as-they-say-11585088464 https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as...
sharken 7y ago

Fnoord 7y ago

https://archive.is/ZA6zW https://archive.is/ZA6zW

martythemaniak 7y ago

This was posted here a while back: https://neherlab.org/covid19/ https://neherlab.org/covid19/ They have number of deaths displayed, so if you try to match the observed rate and keep total deaths below 200k... well, it's doable, but with pretty strong assumptions.