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One thing I've had trouble reconciling is the fact that the CDC estimates 24k-63k deaths from the flu this flu season[0] We just passed 10k from covid-19. Onl

One thing I've had trouble reconciling is the fact that the CDC estimates 24k-63k deaths from the flu this flu season[0] We just passed 10k from covid-19. Only last week a "low" estimation of covid deaths this year was 200k. So it seems the expectation is there will be many, many more, and we're just at the start of all this. On the other hand, it also seems this week like the infamous curve is beginning to flatten, and the epidemic is slowing down. Does this contradict the "low" 200k number? Or does the 200k number factor this in, and indicates that the "long tail" of the disease will be very long and damaging indeed? Some of the clips show in the video referenced in the article actually seem pretty "sane" to me - the one guy saying "I'm not worried about getting this illness", another saying for most people it will seem just like the flu. Those two statements, as far as we know, are not that outlandish, right? I'm certainly not worried about myself, and for many people it does seem to be mild or asymptomatic? I don't want to have an "opinion" on this matter, I want to interpret the data and understand the truth, Fauci-style. [0] https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm https://www.cdc.gov/flu/about/burden/preliminary-in-season-e...

itronitron 6y ago
The low 200k fatality estimate probably factors in the that the curve is flattening. The current estimate is that 300k people are infected in the US. If the number of people infected by Covid-19 doubles every week, then in 10 weeks there will be 300 million infected in the US. Assuming 1% mortality puts you at 3 million dead.
- cortesoft 6y ago
  Doubling each week is not how it happens... as a higher percentage of people have or have had the virus, the growth rate decreases because there are less people available to infect. That is why infection percentage is an s shaped curve.
  - itronitron 6y ago
    I already baked that in by starting with a low infection rate (2x per week instead of 2x every 3 days).
    - cortesoft 6y ago
      Yes, but 90% is an unrealistic infection number no matter what you start with. I think most experts had it at around 60-70% if we do nothing. That is not acceptable, either, given the fatality rate and the strain it would put on hospitals... but I think it is important we try to be accurate.
  - analog31 6y ago
    It's an s shaped curve, but we don't know the upper magnitude of that curve. A large percentage of the population would have to get infected in order to run the COVID out of new recruits. If it tops out at 50% of the population, that's a disaster. Forcing the doubling rate to decrease short of hitting that point requires something else to happen. South Korea clearly did something other than running itself out of cannon fodder.
  - aledalgrande 6y ago
    > as a higher percentage of people have or have had the virus, the growth rate decreases because there are less people available to infect That is what you would call "herd immunity" and no, current numbers of recovered patients are not even close to have it. It doesn't happen like magic like some politician wants to make people believe, and current estimations for COVID _herd immunity threshold_ are 29%-74% of the community [1]. Make a count of that on the US population. [1] https://en.wikipedia.org/wiki/Herd_immunity#Mechanics https://en.wikipedia.org/wiki/Herd_immunity#Mechanics
    - cortesoft 6y ago
      Sure, but the comment I was replying to was suggesting that in 10 weeks, 300 million Americans would be infected... that is 91% of the population of the United States. We aren't going to hit that number.
      - aledalgrande 6y ago
        The growth is not going to be that much, sure, but because we slow it down with isolation, not because the immune people stop it from spreading.
        cortesoft 6y ago
        Yes... but even if we did nothing, we are unlikely to hit 90% infected... 60 to 70% yes, but not 90%. I am not saying that is ok, or that we should just let it run its course... just that saying we will hit 90% infection is unrealistic.
adjkant 6y ago
The thing missing here is that you're looking at deaths without looking at number of cases of each. The flu causes the number of deaths it does because it infects tens of millions of people a year[0]. The death rate is an order of magnitude lower than with COVID-19 across every single age bracket. [2] So when people say things like: > "I'm not worried about getting this illness" They are likely not considering that even the younger are taking as much as a 1% risk of their life, which is incredibly high. Depending on factors like the load on the medical community at the time and others, it can get as high as 5% or more quite easily as we have seen around the world. Currently using only napkin math from the numbers here[1], the death rate is currently at just under 4% over all age groups in the US. Additionally, it is not considering the danger they are putting others in by getting it. With the flu at a death rate of 0.2% or lower, causing deaths by infecting people is a very small risk. Passing it to one person here significantly ups the chances of you causing someone else to die. Finally, flu deaths almost exclusively happen in the immunocompromised and elderly, while COVID-19 affects younger people a LOT more.[2] [0] https://www.cdc.gov/flu/about/keyfacts.htm https://www.cdc.gov/flu/about/keyfacts.htm [1] https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html https://www.nytimes.com/interactive/2020/us/coronavirus-us-c... [2] https://i.insider.com/5e81f6460c2a6261b1771b05?width=600&format=jpeg&auto=webp https://i.insider.com/5e81f6460c2a6261b1771b05?width=600&for...
- 2bitencryption 6y ago
  > They are likely not considering that even the younger are taking as much as a 1% risk of their life I know the numbers are still super fuzzy and it depends on who you ask, but at least according to Wikipedia, the US fatality rate for ages 20-44 is 0.1-0.2%, not near 1% (though certainly at-risk individuals would be higher than the average...) https://en.wikipedia.org/wiki/Coronavirus_disease_2019#Prognosis https://en.wikipedia.org/wiki/Coronavirus_disease_2019#Progn...
  - adjkant 6y ago
    That "as much as" was attempting to account for overloaded medical conditions which will raise the rate, though for 20-44 it'd be unclear by how much. If we go by that table using a 2.3% death rate, that'd already be .3% using a naive literal scaling to the death rate for that age group for the US currently. But yeah, fuzzy numbers and napkin math warning is certainly warranted, I'm nowhere near an expert on this. As mentioned, the flu death rate of 0.1% is overall as well - for younger people it is also significantly lower, so the increased risk still holds for younger folks. Source [2] shows that well.
maps 6y ago
>Some of the clips show in the video referenced in the article actually seem pretty "sane" to me - the one guy saying "I'm not worried about getting this illness", another saying for most people it will seem just like the flu. Those two statements, as far as we know, are not that outlandish, right? I'm certainly not worried about myself, and for many people it does seem to be mild or asymptomatic? The flu season is 6 months for ~ 40k deaths. We are at 10k deaths of covid in the USA. Depending on how you measure the 'season' it could be as little as a month in. If we keep with these numbers it will surely pass the flu death toll for the same time period. Now also consider that unlike flu, we have no vaccine and the virus kills people in the prime of their life just as much as the elderly. We also have no idea on the way this virus works. We are making assumptions that it will work like a normal flu virus. There is anecdotal evidence it resides in people even after they have 'recovered', which isn't the same as a normal flu or cold. It is certainly something to be concerned with.
- lbeltrame 6y ago
  > Now also consider that unlike flu, we have no vaccine and the virus kills people in the prime of their life just as much as the elderly. Not with the same rates. This should be kept into account, because when lockdowns will be lifted (you will have to at some point, even if it's just to prevent people from becoming insane), you won't have a risk of 0, so letting the lowest-risk population out first is a goood bet. > Now also consider that unlike flu, we have no vaccine But there are drugs in development and in trial. None will work miracles, some will not work at all, some will have marginal impact, some will have a little more impact. Those are the best bets at this point in time. Waiting out for a vaccine, like many governments are hoping for, is irrational IMO, because there's no guarantee that a working one will be found - and you can't lock up your population for 18 months, even if you don't factor the economy in, because people will be destroyed psychologically.
analog31 6y ago
One issue to consider is that the COVID wipes out our ability to treat serious flu cases by swamping the hospitals.
defen 6y ago
The "official" 200k estimate (https://www.medrxiv.org/content/10.1101/2020.03.27.20043752v1.full.pdf https://www.medrxiv.org/content/10.1101/2020.03.27.20043752v...) assumes that China isn't lying about their numbers, that Italy's official numbers are correct (Even though the death rate in some places there is 5-10x higher than normal), that the US will be able to implement "lockdowns" as effectively as China did, and that the rate of decline of new cases of COVID-19 will match the rate of increase before the peak. I'm not sure any of those assumptions are warranted.

itronitron 6y ago

The low 200k fatality estimate probably factors in the that the curve is flattening. The current estimate is that 300k people are infected in the US. If the number of people infected by Covid-19 doubles every week, then in 10 weeks there will be 300 million infected in the US. Assuming 1% mortality puts you at 3 million dead.

cortesoft 6y ago
Doubling each week is not how it happens... as a higher percentage of people have or have had the virus, the growth rate decreases because there are less people available to infect. That is why infection percentage is an s shaped curve.
- itronitron 6y ago
  I already baked that in by starting with a low infection rate (2x per week instead of 2x every 3 days).
  - cortesoft 6y ago
    Yes, but 90% is an unrealistic infection number no matter what you start with. I think most experts had it at around 60-70% if we do nothing. That is not acceptable, either, given the fatality rate and the strain it would put on hospitals... but I think it is important we try to be accurate.
- analog31 6y ago
  It's an s shaped curve, but we don't know the upper magnitude of that curve. A large percentage of the population would have to get infected in order to run the COVID out of new recruits. If it tops out at 50% of the population, that's a disaster. Forcing the doubling rate to decrease short of hitting that point requires something else to happen. South Korea clearly did something other than running itself out of cannon fodder.
- aledalgrande 6y ago
  > as a higher percentage of people have or have had the virus, the growth rate decreases because there are less people available to infect That is what you would call "herd immunity" and no, current numbers of recovered patients are not even close to have it. It doesn't happen like magic like some politician wants to make people believe, and current estimations for COVID _herd immunity threshold_ are 29%-74% of the community [1]. Make a count of that on the US population. [1] https://en.wikipedia.org/wiki/Herd_immunity#Mechanics https://en.wikipedia.org/wiki/Herd_immunity#Mechanics
  - cortesoft 6y ago
    Sure, but the comment I was replying to was suggesting that in 10 weeks, 300 million Americans would be infected... that is 91% of the population of the United States. We aren't going to hit that number.
    - aledalgrande 6y ago
      The growth is not going to be that much, sure, but because we slow it down with isolation, not because the immune people stop it from spreading.
      - cortesoft 6y ago
        Yes... but even if we did nothing, we are unlikely to hit 90% infected... 60 to 70% yes, but not 90%. I am not saying that is ok, or that we should just let it run its course... just that saying we will hit 90% infection is unrealistic.

adjkant 6y ago

The thing missing here is that you're looking at deaths without looking at number of cases of each. The flu causes the number of deaths it does because it infects tens of millions of people a year[0]. The death rate is an order of magnitude lower than with COVID-19 across every single age bracket. [2] So when people say things like: > "I'm not worried about getting this illness" They are likely not considering that even the younger are taking as much as a 1% risk of their life, which is incredibly high. Depending on factors like the load on the medical community at the time and others, it can get as high as 5% or more quite easily as we have seen around the world. Currently using only napkin math from the numbers here[1], the death rate is currently at just under 4% over all age groups in the US. Additionally, it is not considering the danger they are putting others in by getting it. With the flu at a death rate of 0.2% or lower, causing deaths by infecting people is a very small risk. Passing it to one person here significantly ups the chances of you causing someone else to die. Finally, flu deaths almost exclusively happen in the immunocompromised and elderly, while COVID-19 affects younger people a LOT more.[2] [0] https://www.cdc.gov/flu/about/keyfacts.htm https://www.cdc.gov/flu/about/keyfacts.htm [1] https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html https://www.nytimes.com/interactive/2020/us/coronavirus-us-c... [2] https://i.insider.com/5e81f6460c2a6261b1771b05?width=600&format=jpeg&auto=webp https://i.insider.com/5e81f6460c2a6261b1771b05?width=600&for...

2bitencryption 6y ago
> They are likely not considering that even the younger are taking as much as a 1% risk of their life I know the numbers are still super fuzzy and it depends on who you ask, but at least according to Wikipedia, the US fatality rate for ages 20-44 is 0.1-0.2%, not near 1% (though certainly at-risk individuals would be higher than the average...) https://en.wikipedia.org/wiki/Coronavirus_disease_2019#Prognosis https://en.wikipedia.org/wiki/Coronavirus_disease_2019#Progn...
- adjkant 6y ago
  That "as much as" was attempting to account for overloaded medical conditions which will raise the rate, though for 20-44 it'd be unclear by how much. If we go by that table using a 2.3% death rate, that'd already be .3% using a naive literal scaling to the death rate for that age group for the US currently. But yeah, fuzzy numbers and napkin math warning is certainly warranted, I'm nowhere near an expert on this. As mentioned, the flu death rate of 0.1% is overall as well - for younger people it is also significantly lower, so the increased risk still holds for younger folks. Source [2] shows that well.

maps 6y ago

>Some of the clips show in the video referenced in the article actually seem pretty "sane" to me - the one guy saying "I'm not worried about getting this illness", another saying for most people it will seem just like the flu. Those two statements, as far as we know, are not that outlandish, right? I'm certainly not worried about myself, and for many people it does seem to be mild or asymptomatic? The flu season is 6 months for ~ 40k deaths. We are at 10k deaths of covid in the USA. Depending on how you measure the 'season' it could be as little as a month in. If we keep with these numbers it will surely pass the flu death toll for the same time period. Now also consider that unlike flu, we have no vaccine and the virus kills people in the prime of their life just as much as the elderly. We also have no idea on the way this virus works. We are making assumptions that it will work like a normal flu virus. There is anecdotal evidence it resides in people even after they have 'recovered', which isn't the same as a normal flu or cold. It is certainly something to be concerned with.

lbeltrame 6y ago
> Now also consider that unlike flu, we have no vaccine and the virus kills people in the prime of their life just as much as the elderly. Not with the same rates. This should be kept into account, because when lockdowns will be lifted (you will have to at some point, even if it's just to prevent people from becoming insane), you won't have a risk of 0, so letting the lowest-risk population out first is a goood bet. > Now also consider that unlike flu, we have no vaccine But there are drugs in development and in trial. None will work miracles, some will not work at all, some will have marginal impact, some will have a little more impact. Those are the best bets at this point in time. Waiting out for a vaccine, like many governments are hoping for, is irrational IMO, because there's no guarantee that a working one will be found - and you can't lock up your population for 18 months, even if you don't factor the economy in, because people will be destroyed psychologically.

analog31 6y ago

One issue to consider is that the COVID wipes out our ability to treat serious flu cases by swamping the hospitals.

defen 6y ago

The "official" 200k estimate (https://www.medrxiv.org/content/10.1101/2020.03.27.20043752v1.full.pdf https://www.medrxiv.org/content/10.1101/2020.03.27.20043752v...) assumes that China isn't lying about their numbers, that Italy's official numbers are correct (Even though the death rate in some places there is 5-10x higher than normal), that the US will be able to implement "lockdowns" as effectively as China did, and that the rate of decline of new cases of COVID-19 will match the rate of increase before the peak. I'm not sure any of those assumptions are warranted.