4 ms·

COVID-19 kills anywhere between 0.7-4% of the people it infects. (Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, b

COVID-19 kills anywhere between 0.7-4% of the people it infects. (Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services). How would one even tell if any of the chloroquinine derivatives have been effective without a systematic study when 96 out of 100 people (at worst) would have recovered anyways? That's another thing that makes the 20 person French study which kicked off all this so much more ridiculous. There was a 44% chance that they would have all recovered without any intervention. But it was probably higher for this group since they did have intervention, and they clearly had a high level of medical assistance.

rootusrootus 6y ago
> COVID-19 kills anywhere between 0.7-4% of the people it infects. (Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services). That is mixing up IFR and CFR. We don't have any good way of knowing IFR yet, and it may be quite a while before we can get a good estimate. The denominator in CFR is confirmed cases, so Italy's inflated CFR could be (and probably is) entirely related to the lack of sufficient testing.
- rurban 6y ago
  Italy has a very high IFR of 1%, the same rate as their every year flu epidemic. Or better very two years. The flu comes every two years. Italy has traditionally the highest flu death rates in the world. This year, with COVID-19, it is still lower than in a bad flu year. When you read 15% this might be the CFR, the case fatality rate. But only about a tenth is getting tested. So it means nothing. You can only look the death numbers, and after it settled down at the excess death rate. From there you get the real IFR. So far we are at an IFR of 0.3 - 0.6. A little bit higher than the flu, but in absolute numbes lower than a bad flu year.
  - rootusrootus 6y ago
    IIRC, Italy had a health care professional study that put their IFR at something around .35% or so. Similar for Germany, and the CDC just did a study of HCP's here and came up with 0.26% IFR (but the sample was 75% women).
- imustbeevil 6y ago
  The CFR is 21% [0]. We're already assuming the IFR is 10x lower. [0] https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
  - shadowprofile77 6y ago
    Please check your calculations more carefully before posting a number. the 21% mortality rate represents a percentage of all closed cases in the worldmeters data, not the sum total of all cases both active and closed either through fatality or recovery. The CFR from worldmeters based on total cases counted so far and total deaths counted so far sits at about 6% (and bear in mind that the total count of cases on the site is far, far off from the probable real number of cases.
    - imustbeevil 6y ago
      21% of people who have been confirmed to have the virus and don't anymore are dead. If the semantic argument hinges on the use of the CFR term, we don't need that term (though everything I've seen indicates CFR measures resolved cases, not total). People are using your small number to justify their belief that the virus is no worse than the flu. That does not reflect reality, and that belief is harmful.
      - rootusrootus 6y ago
        I don't see anyone here arguing that. An IFR of 0.35, let's say, would be great news at the same time as it would be significantly worse than the flu. Using bad numbers to come up with a 21% CFR is not responsible, and is arguably fearmongering.
        imustbeevil 6y ago
        Bad numbers? Those are the numbers. How are you getting an IFR of 0.35? Where is the source for that? Does that source represent a projection or data coming from the results of tests being conducted? My source for the CFR represents the totality of real information the world has presented us to date. "A CFR can only be considered final when all the cases have been resolved (either died or recovered). The preliminary CFR, for example, during the course of an outbreak with a high daily increase and long resolution time would be substantially lower than the final CFR." https://en.wikipedia.org/wiki/Case_fatality_rate https://en.wikipedia.org/wiki/Case_fatality_rate
adventured 6y ago
> Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services That's one factor. France and Britain have such extreme mortality rates vs case counts because of their very poor testing rates (which has been openly admitted by both nations, this isn't my opinion). Germany's mortality rate is so relatively low in part because of their vast testing program caught a lot more cases. Britain has probably had between 5x-10x the positive cases that they've reported up to this point. They were only able to test 12,750 people per day as of a week ago. That's a minimum of 1/10th the rate they needed to be at. If the US has had 600,000 positive cases, it really has had 3+ million cases, given the poor rate of testing.
funcDropShadow 6y ago
But the major problem with the french study was that they determined the outcome by testing throat swabs with RT-PCR test. But throat swabs become negative in the second week for most patients, indepedendent on the progress of symptoms of CoVid-19. As has been show by top German virologists, including Prof. Drosten, see https://www.nature.com/articles/s41586-020-2196-x_reference.pdf https://www.nature.com/articles/s41586-020-2196-x_reference..... So they measured in the french study something that would always go down.
rfoo 6y ago
From what I read [1], the Chinese "trail" (no data, only vague description) on chloroquine phosphate was mainly focused on mild - severe cases, not critical cases. These cases were not very likely going to die even without the drug. So fatality rate would not be a good metric to follow on. Metrics used in the "trail" also does not contains fatality rate, there were only something like "lung improvement rate in X days". Another interesting point is China explicitly banned usage of macrolide antibiotics (which includes Azithromycin) together with chloroquine [2]. It was posted on Feb 26, 2020. I tried to use Wayback Machine to check whether they rewrote the history, but it seems like Wayback Machine only saved it recently. Another source (and with English translation) [3] indicate it is at least earlier than Mar 1 though. I did a Google search on key sentence "禁止同时使用喹诺酮类、大环内酯类抗生素及其他可能导致QT间期延长的药物" and found widespread reposting around March 1, so the date is likely genuine. [1] http://www.scio.gov.cn/xwfbh/xwbfbh/wqfbh/42311/42568/xgbd42575/Document/1673607/1673607.htm http://www.scio.gov.cn/xwfbh/xwbfbh/wqfbh/42311/42568/xgbd42... [2] http://www.nhc.gov.cn/yzygj/s7653p/202002/0293d017621941f6b2a4890035243730.shtml http://www.nhc.gov.cn/yzygj/s7653p/202002/0293d017621941f6b2... [3] https://www.chinalawtranslate.com/en/chloroquine-phosphate/ https://www.chinalawtranslate.com/en/chloroquine-phosphate/

rootusrootus 6y ago

> COVID-19 kills anywhere between 0.7-4% of the people it infects. (Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services). That is mixing up IFR and CFR. We don't have any good way of knowing IFR yet, and it may be quite a while before we can get a good estimate. The denominator in CFR is confirmed cases, so Italy's inflated CFR could be (and probably is) entirely related to the lack of sufficient testing.

rurban 6y ago
Italy has a very high IFR of 1%, the same rate as their every year flu epidemic. Or better very two years. The flu comes every two years. Italy has traditionally the highest flu death rates in the world. This year, with COVID-19, it is still lower than in a bad flu year. When you read 15% this might be the CFR, the case fatality rate. But only about a tenth is getting tested. So it means nothing. You can only look the death numbers, and after it settled down at the excess death rate. From there you get the real IFR. So far we are at an IFR of 0.3 - 0.6. A little bit higher than the flu, but in absolute numbes lower than a bad flu year.
- rootusrootus 6y ago
  IIRC, Italy had a health care professional study that put their IFR at something around .35% or so. Similar for Germany, and the CDC just did a study of HCP's here and came up with 0.26% IFR (but the sample was 75% women).
imustbeevil 6y ago
The CFR is 21% [0]. We're already assuming the IFR is 10x lower. [0] https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
- shadowprofile77 6y ago
  Please check your calculations more carefully before posting a number. the 21% mortality rate represents a percentage of all closed cases in the worldmeters data, not the sum total of all cases both active and closed either through fatality or recovery. The CFR from worldmeters based on total cases counted so far and total deaths counted so far sits at about 6% (and bear in mind that the total count of cases on the site is far, far off from the probable real number of cases.
  - imustbeevil 6y ago
    21% of people who have been confirmed to have the virus and don't anymore are dead. If the semantic argument hinges on the use of the CFR term, we don't need that term (though everything I've seen indicates CFR measures resolved cases, not total). People are using your small number to justify their belief that the virus is no worse than the flu. That does not reflect reality, and that belief is harmful.
    - rootusrootus 6y ago
      I don't see anyone here arguing that. An IFR of 0.35, let's say, would be great news at the same time as it would be significantly worse than the flu. Using bad numbers to come up with a 21% CFR is not responsible, and is arguably fearmongering.
      - imustbeevil 6y ago
        Bad numbers? Those are the numbers. How are you getting an IFR of 0.35? Where is the source for that? Does that source represent a projection or data coming from the results of tests being conducted? My source for the CFR represents the totality of real information the world has presented us to date. "A CFR can only be considered final when all the cases have been resolved (either died or recovered). The preliminary CFR, for example, during the course of an outbreak with a high daily increase and long resolution time would be substantially lower than the final CFR." https://en.wikipedia.org/wiki/Case_fatality_rate https://en.wikipedia.org/wiki/Case_fatality_rate

adventured 6y ago

> Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services That's one factor. France and Britain have such extreme mortality rates vs case counts because of their very poor testing rates (which has been openly admitted by both nations, this isn't my opinion). Germany's mortality rate is so relatively low in part because of their vast testing program caught a lot more cases. Britain has probably had between 5x-10x the positive cases that they've reported up to this point. They were only able to test 12,750 people per day as of a week ago. That's a minimum of 1/10th the rate they needed to be at. If the US has had 600,000 positive cases, it really has had 3+ million cases, given the poor rate of testing.

funcDropShadow 6y ago

But the major problem with the french study was that they determined the outcome by testing throat swabs with RT-PCR test. But throat swabs become negative in the second week for most patients, indepedendent on the progress of symptoms of CoVid-19. As has been show by top German virologists, including Prof. Drosten, see https://www.nature.com/articles/s41586-020-2196-x_reference.pdf https://www.nature.com/articles/s41586-020-2196-x_reference..... So they measured in the french study something that would always go down.

rfoo 6y ago

From what I read [1], the Chinese "trail" (no data, only vague description) on chloroquine phosphate was mainly focused on mild - severe cases, not critical cases. These cases were not very likely going to die even without the drug. So fatality rate would not be a good metric to follow on. Metrics used in the "trail" also does not contains fatality rate, there were only something like "lung improvement rate in X days". Another interesting point is China explicitly banned usage of macrolide antibiotics (which includes Azithromycin) together with chloroquine [2]. It was posted on Feb 26, 2020. I tried to use Wayback Machine to check whether they rewrote the history, but it seems like Wayback Machine only saved it recently. Another source (and with English translation) [3] indicate it is at least earlier than Mar 1 though. I did a Google search on key sentence "禁止同时使用喹诺酮类、大环内酯类抗生素及其他可能导致QT间期延长的药物" and found widespread reposting around March 1, so the date is likely genuine. [1] http://www.scio.gov.cn/xwfbh/xwbfbh/wqfbh/42311/42568/xgbd42575/Document/1673607/1673607.htm http://www.scio.gov.cn/xwfbh/xwbfbh/wqfbh/42311/42568/xgbd42... [2] http://www.nhc.gov.cn/yzygj/s7653p/202002/0293d017621941f6b2a4890035243730.shtml http://www.nhc.gov.cn/yzygj/s7653p/202002/0293d017621941f6b2... [3] https://www.chinalawtranslate.com/en/chloroquine-phosphate/ https://www.chinalawtranslate.com/en/chloroquine-phosphate/