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Which would in fact be good news in a certain way, because either it's as deadly as reported and nowhere near as contagious as your last paragraph suggests, or

Which would in fact be good news in a certain way, because either it's as deadly as reported and nowhere near as contagious as your last paragraph suggests, or its far more contagious and widespread but thus nowhere near as deadly as is being seen from case fatality rates derived from known cases. I'm not stating anything new with this really, but your case is likely one of many, many others in which a person felt mysterious illness symptoms for days or weeks and never was registered as a positive case through any testing procedure. This is not to even mention all possible asymptomatic cases. I'm sure many COVID-ralted deaths are also under-reported bit I strongly doubt the level of inaccuracy is nearly the same as that of cases being under-reported.

birken 7y ago
The problem with this interpretation is that whatever the combination of deadly/contagious the virus is, we already have direct evidence that when it spreads without any containment it causes unacceptably extreme amounts of sickness and death. So exactly where the virus ends up on the grid of mortality/contagiousness doesn't seem to be all that important because it is well beyond the frontier of being problematic. Hopefully in the next few days/weeks we'll get very concrete data on exactly what percentage of people are/were asymptomatic cases, but my guess is it will not be some crazy high number because if so we'd have likely already figured that out by now.
- vanniv 7y ago
  Yes, but. If we go with the highest realistic-seeming estimates of contagiousness and (and thus lowest of deadliness), then we can say that what NY and Italy saw was something close to worst-case. One reasoned estimate had 20% of Italians -- and almost 40% of Northern Italians -- infected in a six-week period. If that estimate is correct, then even if Italy completely unlocked tomorrow, and held mass hug-ins and cough-ins at every gathering place, it still would probably only get back to as bad as it was 3 weeks ago, and probably only stay there for a month or so. That would be incredibly tragic, but not world endingly so. On the other hand, if you take the maximal estimate the other way, and say that Italy and NY at the peak were detecting 1/3-1/2 of their cases (it kinda can't be more than that), then there is the potential for outbreaks 5x as bad and 10x as long unless they stay socially distant until there is a vaccine in widepsread use -- and even so, hundreds of thousands more will inevitably die along the way. Myself, I think the evidence points to higher contagiousness than this, but the difference does actually matter, even if that still outs us beyond the "threshold of ignorability"
- ksk 7y ago
  >we already have direct evidence that when it spreads without any containment it causes unacceptably extreme amounts of sickness and death That hasn't happened in Sweden.
  - ta999999171 7y ago
    What of the UK?
  - jdkee 7y ago
    Yet.
    - ksk 7y ago
      I'm hoping they succeed in getting herd immunity.
  - joe_the_user 7y ago
    Sweden didn't take no measures. Sweden took flexible measures[1]. Social distancing, allowing anyone who felt sick to stay home, encouraging people to work from home (and 50% Swedes apparently can do that[2]). The problem is that when American employers grant to no sick leave to employees and are brutally against ever doing so, applying the flexible Swedish model to the US would be extremely hard. The model involves mutual trust and responsibility between the state, employers and employees and there's very little trust there in most other countries. [1] https://www.businessinsider.com/coronavirus-sweden-no-lockdown-asks-people-to-stay-apart-2020-4 https://www.businessinsider.com/coronavirus-sweden-no-lockdo... [2] https://www.statista.com/statistics/545241/sweden-enterprises-with-home-workers/ https://www.statista.com/statistics/545241/sweden-enterprise...
    - ksk 7y ago
      All I know is that the streets are just as crowded, people are still going out and businesses are still open. There are plenty of news reports showing that. There is no known method of stopping the spread of this disease. Even if you flatten the curve, without a vaccine, the area under the curve remains the same.
- shadowprofile77 7y ago
  There is one problem with what you say about its spread at levels that saturate healthcare systems and cause extreme amounts of sickness and death: They may not be the case so much because the virus is particularly deadly or even much deadlier than the flu -which may indeed be the case: that it's only part of an order of magnitude deadlier than H1N1, we don't know yet until we get more concrete infection rate surveys- but there are reasoned arguments supporting this idea. Instead it saturates in such ugly ways because it's so contagious (as the comment below this mentions). Thus, highly contagious + entirely virgin population of susceptible people (of all types: asymptomatic, lightly symptomatic, moderately, severely, mortally) will inevitably result in very high infection rates and thus an initial saturation that's also high even if hospital-worthy cases are a small percentage of total known and unknown cases. This saturation may or may not be capable of getting worse than what we've seen so far in NYC, Northern Italy, Spain and Iran to a lesser extent, but though we don't yet know this for sure, if it is the case, the virus being allowed to spread far and fast will likely cause these bad but possibly tolerable saturations to happen quickly only once, and then simply cease as enough people become immune or at least resistant, and healthcare systems steadily adapt.. So far, it seems that Italy and Spain might actually be close to as bad as it gets even with widespread infection of the population, since credible estimates are presupposing at least 2 million cases in total in Italy at this point, for example. Even in New York there are signs of slowdown already. Again, if that is in fact the worst case scenario in any given region, its cost, as tragic as it is, might be worth weighing against the possibly more catastrophic cost of prolonged quarantine and its resulting economic and social consequences. We could possibly be delaying an inevitable event with only briefly heavy localized consequences and moderate general clinical consequences by artificially creating a much worse long term problem that kills too, albeit more indirectly and among a wider demographic through missed clinical care appointments of other kinds, depressive suicides, economic ruin, substance abuse and other general population harm factors we can only start guessing at so far.
  - deleted 7y ago
    [deleted]
ajross 7y ago
> Which would in fact be good news in a certain way This holds for the calculus of personal risk ("I'm sick, will I die?"), but not public risk nor policymaking. Whatever the "true" severity of this disease is, it's known, experimentally, to be high enough to overwhelm regional hospital capacity. That means that it has to be controlled, because if it isn't then a lot of people will be sick without care, and thus a lot more people will die. It's true that we don't know the "pessimal peak" of case load. Maybe we'd be looking at a doomsday scenario of only 4M people dead globally, and not the 40M the measured fatality rate would indicate. But... who cares? We won't get that high, because we had to lock down even for the "good news" 4M number.
cdelsolar 7y ago
I believe there have been several random studies and very educated estimates that came from these that show that the mortality rate is about 0.5% or even lower, which might put it close to the same order of magnitude as the flu. However, crucially, it is much much more contagious than the flu. With an R0 of 2 or more (some estimate up to 6) the difference after a few days, because of exponential growth, is as much as a thousandfold more infections. My thought is that the mortality rate is rather low, especially for those that are healthy, but there's a ton of people that have it. More than 1% of New York State is now infected with Coronavirus. That's crazy.
- shadowprofile77 7y ago
  I would hazard to guess that it's well above 1% of the state that's infected so far if even conservative multiples of 5x for undiagnosed cases apply.
- rimliu 7y ago
  I have a proble with a single number mortality rate gor this virus, because mortality differs by the two or three orders of magnitude depending on the age. Not an infant and younger than 2 (or even 30)—almost zero chances to die (Italy's data). Over 70/80? It's 30-40%.

birken 7y ago

The problem with this interpretation is that whatever the combination of deadly/contagious the virus is, we already have direct evidence that when it spreads without any containment it causes unacceptably extreme amounts of sickness and death. So exactly where the virus ends up on the grid of mortality/contagiousness doesn't seem to be all that important because it is well beyond the frontier of being problematic. Hopefully in the next few days/weeks we'll get very concrete data on exactly what percentage of people are/were asymptomatic cases, but my guess is it will not be some crazy high number because if so we'd have likely already figured that out by now.

vanniv 7y ago
Yes, but. If we go with the highest realistic-seeming estimates of contagiousness and (and thus lowest of deadliness), then we can say that what NY and Italy saw was something close to worst-case. One reasoned estimate had 20% of Italians -- and almost 40% of Northern Italians -- infected in a six-week period. If that estimate is correct, then even if Italy completely unlocked tomorrow, and held mass hug-ins and cough-ins at every gathering place, it still would probably only get back to as bad as it was 3 weeks ago, and probably only stay there for a month or so. That would be incredibly tragic, but not world endingly so. On the other hand, if you take the maximal estimate the other way, and say that Italy and NY at the peak were detecting 1/3-1/2 of their cases (it kinda can't be more than that), then there is the potential for outbreaks 5x as bad and 10x as long unless they stay socially distant until there is a vaccine in widepsread use -- and even so, hundreds of thousands more will inevitably die along the way. Myself, I think the evidence points to higher contagiousness than this, but the difference does actually matter, even if that still outs us beyond the "threshold of ignorability"
ksk 7y ago
>we already have direct evidence that when it spreads without any containment it causes unacceptably extreme amounts of sickness and death That hasn't happened in Sweden.
- ta999999171 7y ago
  What of the UK?
- jdkee 7y ago
  Yet.
  - ksk 7y ago
    I'm hoping they succeed in getting herd immunity.
- joe_the_user 7y ago
  Sweden didn't take no measures. Sweden took flexible measures[1]. Social distancing, allowing anyone who felt sick to stay home, encouraging people to work from home (and 50% Swedes apparently can do that[2]). The problem is that when American employers grant to no sick leave to employees and are brutally against ever doing so, applying the flexible Swedish model to the US would be extremely hard. The model involves mutual trust and responsibility between the state, employers and employees and there's very little trust there in most other countries. [1] https://www.businessinsider.com/coronavirus-sweden-no-lockdown-asks-people-to-stay-apart-2020-4 https://www.businessinsider.com/coronavirus-sweden-no-lockdo... [2] https://www.statista.com/statistics/545241/sweden-enterprises-with-home-workers/ https://www.statista.com/statistics/545241/sweden-enterprise...
  - ksk 7y ago
    All I know is that the streets are just as crowded, people are still going out and businesses are still open. There are plenty of news reports showing that. There is no known method of stopping the spread of this disease. Even if you flatten the curve, without a vaccine, the area under the curve remains the same.
shadowprofile77 7y ago
There is one problem with what you say about its spread at levels that saturate healthcare systems and cause extreme amounts of sickness and death: They may not be the case so much because the virus is particularly deadly or even much deadlier than the flu -which may indeed be the case: that it's only part of an order of magnitude deadlier than H1N1, we don't know yet until we get more concrete infection rate surveys- but there are reasoned arguments supporting this idea. Instead it saturates in such ugly ways because it's so contagious (as the comment below this mentions). Thus, highly contagious + entirely virgin population of susceptible people (of all types: asymptomatic, lightly symptomatic, moderately, severely, mortally) will inevitably result in very high infection rates and thus an initial saturation that's also high even if hospital-worthy cases are a small percentage of total known and unknown cases. This saturation may or may not be capable of getting worse than what we've seen so far in NYC, Northern Italy, Spain and Iran to a lesser extent, but though we don't yet know this for sure, if it is the case, the virus being allowed to spread far and fast will likely cause these bad but possibly tolerable saturations to happen quickly only once, and then simply cease as enough people become immune or at least resistant, and healthcare systems steadily adapt.. So far, it seems that Italy and Spain might actually be close to as bad as it gets even with widespread infection of the population, since credible estimates are presupposing at least 2 million cases in total in Italy at this point, for example. Even in New York there are signs of slowdown already. Again, if that is in fact the worst case scenario in any given region, its cost, as tragic as it is, might be worth weighing against the possibly more catastrophic cost of prolonged quarantine and its resulting economic and social consequences. We could possibly be delaying an inevitable event with only briefly heavy localized consequences and moderate general clinical consequences by artificially creating a much worse long term problem that kills too, albeit more indirectly and among a wider demographic through missed clinical care appointments of other kinds, depressive suicides, economic ruin, substance abuse and other general population harm factors we can only start guessing at so far.
- deleted 7y ago
  [deleted]

ajross 7y ago

> Which would in fact be good news in a certain way This holds for the calculus of personal risk ("I'm sick, will I die?"), but not public risk nor policymaking. Whatever the "true" severity of this disease is, it's known, experimentally, to be high enough to overwhelm regional hospital capacity. That means that it has to be controlled, because if it isn't then a lot of people will be sick without care, and thus a lot more people will die. It's true that we don't know the "pessimal peak" of case load. Maybe we'd be looking at a doomsday scenario of only 4M people dead globally, and not the 40M the measured fatality rate would indicate. But... who cares? We won't get that high, because we had to lock down even for the "good news" 4M number.

cdelsolar 7y ago

I believe there have been several random studies and very educated estimates that came from these that show that the mortality rate is about 0.5% or even lower, which might put it close to the same order of magnitude as the flu. However, crucially, it is much much more contagious than the flu. With an R0 of 2 or more (some estimate up to 6) the difference after a few days, because of exponential growth, is as much as a thousandfold more infections. My thought is that the mortality rate is rather low, especially for those that are healthy, but there's a ton of people that have it. More than 1% of New York State is now infected with Coronavirus. That's crazy.

shadowprofile77 7y ago
I would hazard to guess that it's well above 1% of the state that's infected so far if even conservative multiples of 5x for undiagnosed cases apply.
rimliu 7y ago
I have a proble with a single number mortality rate gor this virus, because mortality differs by the two or three orders of magnitude depending on the age. Not an infant and younger than 2 (or even 30)—almost zero chances to die (Italy's data). Over 70/80? It's 30-40%.