5 ms·

I think NYC almost certainly has much large prevalence than LA given hospitalization data alone. One factor could be the nature of transmission. Regions where

I think NYC almost certainly has much large prevalence than LA given hospitalization data alone. One factor could be the nature of transmission. Regions where transmission occurs with high viral loads entering at the point of infection (for example, hospital-acquired infections) could see more severe disease progression. You would therefore expect a high hospitalization rate relative to prevalence. It's possible in other regions, including CA, hospitalization rate as a function of prevalence is lower because acquisition is largely at lower viral loads resulting in less rapid and severe disease progression. This is, of course, a hypothesis and very likely not correct. Time will tell. Other important factors include age distribution of infection, as well as weather conditions and prevalence of pre-existing conditions.

tempsy 6y ago
Yes agree NYC will have much higher prevalence but it has 17x the deaths - if fatality rate is similar then it would be like 50%+ of New Yorkers have contracted Covid. Just a little hard to believe.
- hilbertseries 6y ago
  5.6m people ride the New York subway everyday.
  - tempsy 6y ago
    There’s a decreasing number of positive test cases each day in NYC too though. At highest point was 50% and now under 30% or so. I’m not sure if those tested get the antibody test as well but it implies a larger percentage of symptomatic people are testing negative in nyc.
    - asdf21 6y ago
      Almost no one gets an antibody test yet, unless it's some special controlled study.
  - catlas3r 6y ago
    Actually, no they don't. There are 5.6m rides per day. The average trip contains at least two rides: there, and back again. Many trips contain substantially more than two legs, and many people take more than one trip per day. I can't tell you how many people ride the subway every day, but it's certainly less than half of the number of rides per day.
    - throwaway3563 6y ago
      Number of rides is actually more relevant in this context than number of distinct riders. Each trip involves a new set of people next to you in the train car and a new chance of getting infected.
      - catlas3r 6y ago
        The number of rides is useless in estimating the percentage of the population with high risk for exposure if you don't also have the proportion of the population exposed to that risk.
  - trexmix 6y ago
    Closer to 2 million: https://nyc.streetsblog.org/2020/03/23/the-subway-ridership-collapse-in-three-charts/ https://nyc.streetsblog.org/2020/03/23/the-subway-ridership-...
- timr 6y ago
  What makes it hard to believe, exactly? One way to explain the hospital surge in NYC is that a small percentage of people have had a highly fatal disease. Another plausible explanation is that a much larger number of people have had a less-fatal disease. To date, we've had very poor estimates for fatality rates and prevalence. It wouldn't be shocking at all to find out that we're off by a factor of 10-, 20-, or even 50-fold.
  - eloff 6y ago
    Typically a sufficiently infectious disease tops out around 50-80% (don't have a source, just what people, like Angela Merkel have been saying). So this implies NYC is already off the high end of that. Hard to believe.
    - timr 6y ago
      NYC has had ~141,000 infections confirmed. If the high end of this study held for NYC (50x), then the true infection count would be around 7M. That isn't impossible at all, given that the population of NYC is around 8.8M people. It would mean that the city is approaching herd immunity. (I don't personally think the ratio will be as high in NYC as in LA, but that's just a hunch based on the higher testing rate.)
      - eloff 6y ago
        That's basically the top end of the estimate of what is theoretically possible without a lockdown and infinite time. I just don't buy that it is already maxed out like that.
        timr 6y ago
        It's the top end estimate from the study. Even if you take the low-end estimate (~30x), there would be 4.2M cases, which is still ~50% of the New York population. Basically, you're just saying that you don't want to believe what they're saying, therefore it's hard to believe. But there's nothing illogical or impossible about it in the slightest.
Scipio_Afri 6y ago
I also suspect and absolutely think a large portion of the reason there is a decrease in hospitalizations is due to mitigation efforts decreasing the initial viral load. That is absolutely borne out of all evidence we know thus far for this virus and is also in line for what we know to be true about other viruses.
- strangeloops85 6y ago
  Excellent point!

tempsy 6y ago

Yes agree NYC will have much higher prevalence but it has 17x the deaths - if fatality rate is similar then it would be like 50%+ of New Yorkers have contracted Covid. Just a little hard to believe.

hilbertseries 6y ago
5.6m people ride the New York subway everyday.
- tempsy 6y ago
  There’s a decreasing number of positive test cases each day in NYC too though. At highest point was 50% and now under 30% or so. I’m not sure if those tested get the antibody test as well but it implies a larger percentage of symptomatic people are testing negative in nyc.
  - asdf21 6y ago
    Almost no one gets an antibody test yet, unless it's some special controlled study.
- catlas3r 6y ago
  Actually, no they don't. There are 5.6m rides per day. The average trip contains at least two rides: there, and back again. Many trips contain substantially more than two legs, and many people take more than one trip per day. I can't tell you how many people ride the subway every day, but it's certainly less than half of the number of rides per day.
  - throwaway3563 6y ago
    Number of rides is actually more relevant in this context than number of distinct riders. Each trip involves a new set of people next to you in the train car and a new chance of getting infected.
    - catlas3r 6y ago
      The number of rides is useless in estimating the percentage of the population with high risk for exposure if you don't also have the proportion of the population exposed to that risk.
- trexmix 6y ago
  Closer to 2 million: https://nyc.streetsblog.org/2020/03/23/the-subway-ridership-collapse-in-three-charts/ https://nyc.streetsblog.org/2020/03/23/the-subway-ridership-...
timr 6y ago
What makes it hard to believe, exactly? One way to explain the hospital surge in NYC is that a small percentage of people have had a highly fatal disease. Another plausible explanation is that a much larger number of people have had a less-fatal disease. To date, we've had very poor estimates for fatality rates and prevalence. It wouldn't be shocking at all to find out that we're off by a factor of 10-, 20-, or even 50-fold.
- eloff 6y ago
  Typically a sufficiently infectious disease tops out around 50-80% (don't have a source, just what people, like Angela Merkel have been saying). So this implies NYC is already off the high end of that. Hard to believe.
  - timr 6y ago
    NYC has had ~141,000 infections confirmed. If the high end of this study held for NYC (50x), then the true infection count would be around 7M. That isn't impossible at all, given that the population of NYC is around 8.8M people. It would mean that the city is approaching herd immunity. (I don't personally think the ratio will be as high in NYC as in LA, but that's just a hunch based on the higher testing rate.)
    - eloff 6y ago
      That's basically the top end of the estimate of what is theoretically possible without a lockdown and infinite time. I just don't buy that it is already maxed out like that.
      - timr 6y ago
        It's the top end estimate from the study. Even if you take the low-end estimate (~30x), there would be 4.2M cases, which is still ~50% of the New York population. Basically, you're just saying that you don't want to believe what they're saying, therefore it's hard to believe. But there's nothing illogical or impossible about it in the slightest.

Scipio_Afri 6y ago

I also suspect and absolutely think a large portion of the reason there is a decrease in hospitalizations is due to mitigation efforts decreasing the initial viral load. That is absolutely borne out of all evidence we know thus far for this virus and is also in line for what we know to be true about other viruses.

strangeloops85 6y ago
Excellent point!