6 ms·

It worries me that this study is relying on Chinese data.

• jonplackett 7y ago
  Yeah, that seems foolish at this point. Italy is doing a reasonable amount of testing and has more like 10% death rate. Could there be 15X more infected in Italy than detected? Or is it that they have mostly old people catching it? Seems like a large discrepancy either way.
  • Leary 7y ago
    Meanwhile Germany has a 1.5% cfr, how did that happen. Did Germany underreport deaths or Italy underreport cases
    • virgilp 7y ago
      Germany tests a lot more, and started testing earlier. Italy got overwhelmed, for a very long while only tested suspected people (those that have fairly severe symptoms)
    • ufo 7y ago
      From what I've read the lethaliy is higher both because they can't test enough people (meaning that they tend to only test the more severe cases) and also because the hospitals were overwhelmed (meaning they can't provide appropriate treatment for everyone).
    • greedo 7y ago
      Germany's CFR has been steadily rising.
      • endorphone 7y ago
        Indeed, today it is 1.5%. 7 days ago it was 0.75%. 14 days ago it was 0.375%. It has literally doubled each week.
    • rurban 7y ago
      It happened, because it just now hit the German seniors homes. It didn't before. In Germany seniors do live in special homes, seperated from their children. Unlike Italy or Spain. Also beware that the Italian IFR for the bi-yearly flu peaks is extremely high, 1%. (2014 being much worse than this year with the new flu). The current IFR looks also to be in that ballpark.
    • jonplackett 7y ago
      Germany also have masses of spare ICU capacity. To the point where they will take so-far-mild cases to hospital at day 5 (the point where you may deteriorate) so they’re ready if they do. Obviously that improves your chances a lot!
  • eloff 7y ago
    Yeah Italy missed a lot of cases with their testing, which makes it seem higher. Spain also. If you look at Germany, South Korea you see a much lower death rate, but they also have younger populations. In this case you want the min, not the max or the average, because the death rate of the virus should be fixed. The lower the rate just tells you how effectively the country did their testing, and thus how accurate the denominator is. What complicates that greatly is the fact that the age of the population matters a lot. And Italy has one of the oldest populations. Countries in Africa with very young populations would expect a much lower death rate - complicated again by their relatively poor population and health systems and incompetent and corrupt governments.
    • luckylion 7y ago
      Germany's median age is 47.1 compared to Italy's 45.5. It holds for South Korea at 41.8 though.
      • eloff 7y ago
        Median hides a lot of information. What you really want to know is how many people over 70. Still Germany and Italy are almost equal there at 20% over 65. South Korea is about 13%. Given it's so close between Germany and Italy, testing probably accounts for the majority of the difference.
    • raverbashing 7y ago
      The test has a high false-negative rate as well, it seems it's around 30% (also depends on how the test was done and where the sample was collected)
  • secfirstmd 7y ago
    Good god, imagine what this thing is going to do to overpopulated parts of the developing world like India, Bangladesh, Nigeria etc
    • dominotw 7y ago
      i really think herd immunity is their only hope but govts are too scared to not do a lockdown which is insane give none of them any social safety nets from the poor and a large part of population earn their food on a daily basis.
      • throwaway_pdp09 7y ago
        AIUI herd immunity can come only after the infection wave has passed. By then the damage will have been done. Another concern is covid stresses will extend to social instability, and not just in the poorer countries. . That's going to be really unpredictable.
    • disgruntledphd2 7y ago
      This is my real concern. I assume that Western countries have some hope of containing this, but poor countries with large informal sectors? I can't see it working out well, at all.
    • greedo 7y ago
      The developing world will be devastated. Over 3B people, with marginal healthcare systems, and fragile governments. It's not too far fetched to see 15m people die from this. And possible a magnitude higher. Not to mention all the knock on effects.
  • wolco 7y ago
    China only counts certain cases. For example if you had covid and retest positive later it doesn't count unless you have physical signs. Your death doesn't count unless it's in a hospital. Many barriers are in place to prevent you from being admitted.
    • est 7y ago
      That's your assumption with Chinese CDC number, which is true. But Chinese researchers and MDs also publish papter on Lancet/NEJM/medrxiv which sometimes contradicts CDC's reports, which I think is much more believable.
      • wolco 7y ago
        They can't get accurate numbers because patients aren't even allowed the test, allowed to be admitted to hospitals. While the researchers will be able to retrieve some facts they won't be able to count those that never made it into the system.
  • marcinzm 7y ago
    Italy is probably not testing anywhere near as many people as they optimally should or rather the disease has outpaced their ability to test. Add in a collapsing medical system and the end result isn't pretty. Unless you're on death's door I assume there's little point in someone taking up the system's time to get tested in Italy. As a comparison, Germany has a <2% fatality rate and has tested more people than Italy.
    • endorphone 7y ago
      "As a comparison, Germany has a <2% fatality rate" Germany's good numbers may not hold. 20 days ago Germany had 7256 cases. Italy had 27977. 10 days ago Germany had 37307 cases. Italy had 74383. 0 days ago Germany had 96076 cases. Italy had 124629. The point being that Germany saw the outbreak take hold considerably after Italy. Italy had a very low original death rate as well -- approximately 2% weeks into the outbreak. This virus takes weeks to kill most of its victims. 14 days ago Germany had a death rate of 0.375%. 7 days ago, Germany had a death to case rate of 0.75%. Today it's at 1.5%. It has increased every day between. The fact that Italy is a hyper-social society, while Germany, at least from my probably wrong foreign view, is quite the opposite, probably changed the path of the disease, accelerating its spread in Italy.
      • endorphone 7y ago
        Germany is up to 1.76% now.
        • marcinzm 7y ago
          Yes, as the infection spreads testing becomes overwhelmed and the apparent fatality rate goes up. A recent trial found that in one German town the actual fatality rate was 0.37%. They did antibody testing so they knew everyone who had been or was infected.
          • xenonite 7y ago
            I am not sure if it’s even possible to give the fatality rate before everything is over because we don’t know if an infected patient eventually dies from the disease with a long delay. This is why I totally expect a growing fatality rate now.
  • federicoponzi 7y ago
    It's definitely possible that there are more infected then reported. The issue is Italy is testing only people who are suspected to be sick in the first place. Most of the people who got covid, are asymptomatic thus they probably won't be tested and added to the count. This means that 10% is taken from a population of people who are both sick and symptomatic. Since China is testing asymptomatic people as well, they should have a more precise ratio.
  • eveningcoffee 7y ago
    Italy had CFR 2% before their intensive care capacity hit the wall and advanced triage kicked in. They have also very tangled households where old and young live together and they are extremely social but I think you may say the same about Chinese (perhaps somebody with better knowledge can extend from this). The same happened in Spain. I think the CFR we see is mix of multiple things. Testing protocol (who gets testes - every possible case, only seriously sick etc), social structure (household structure, standard social behavior), demographics, chronic illnesses, health care capacity. I have observed two patters. When there are low amount (~20%) of elderly among the infected and health care capacity is not reached then CFR can be very low <<1% (Germany 02.% in the beginning for long time, Norway 0.5%). When there the number of elderly reaches is > 50% then the CFR will be order of magnitude higher (Italy, Spain in the beginning). When health care capacity is exceeded then CFR% will rise about 5 times (Italy, Spain).
• endorphone 7y ago
  It is based upon Chinese data that we know is effectively junk, to which they add pure speculation: The methodology for determining those infected but not symptomatic is complete guesswork. It is invented rationalization atop garbage data. A few countries are starting mid-sized randomized studies to look for antibodies in the general public and that will give us a much better idea of the scope. To which it should be noted that already there is fake news spreading making broad claims that they already discovered XYZ (saw one atop Reddit). I realize there are China sympathists on HN, however it is widely known and acknowledged that China has been very deceptive about the scale of the outbreak and the number of deaths.
  • dang 7y ago
    Please make your substantive points without flamey swipes about "China sympathists". Solid factual critique is welcome regardless of whose sympathies it favors, but when people start planting little swipes and booby traps against the other side, it evokes worse from others, and down we spiral. That's called nationalistic flamebait, and if you're going to post on a controversial topic, you need to clean your comment of any of that so it can be a good contribution to discussion. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html