7 ms·

It needs to be emphasized here: This virus is much more transmissible than the viruses we usually deal with in humans. If a virus has a low fatality rate, but

by JPKab 7y ago

It needs to be emphasized here: This virus is much more transmissible than the viruses we usually deal with in humans. If a virus has a low fatality rate, but is extremely contagious and prevalent, hospitals will get overwhelmed. A small percentage of a big enough number is itself a big number. The subway and high-utilization of buses are likely factors in NYC vs. LA. LA is much more representative of the typical US city. Frankly, I'm not sure why so many on HN are surprised by this. The scientific data on asymptomatic carriers coming out of Italy, Germany, South Korea, and Iceland has been very clear on a majority asymptomatic frame for this virus. I think that maybe authorities and responsible people are concerned that this information could lead to people flouting lockdowns more.

arcticbull 7y ago
Even the Diamond Princess showed a 50+% asymptomatic rate and that group skewed way, way older than average -- you know, people who take cruises.
- acqq 7y ago
  50? Just initially, but in a week or two more of these developed symptoms, so more recent number was just 18%: https://www.cebm.net/covid-19/covid-19-what-proportion-are-asymptomatic/ https://www.cebm.net/covid-19/covid-19-what-proportion-are-a... "Setting: Diamond Princess cruise ship, Yokohama, Japan (n=-634 tested positive). Proportion: 18%" Also: "23 Residents of a Long-Term Care Nursing Facility King County, Washington 10 (43%) had symptoms, and 13 (57%) were asymptomatic." But then: "Seven days after testing, 10 of 13 asymptomatics developed symptoms" That means that just 3 of 23 remained asymptomatic there too, i.e. 13%. It is estimated that the people mostly spread this virus exactly in the phase where they still haven't developed symptoms, and the virus can be detected. But that doesn't mean they will remain without the symptoms.
  - asdf21 7y ago
    I suspect most people notice a bit of a cold or "allergies" Like you said, probably only 10% to 15% truly asymptomatic.
  - arcticbull 7y ago
    Thanks, I actually didn't realize the number drifted so much over time. Good to know! I'm curious how many of them were actually seriously afflicted vs. a stuffy nose. I'd argue almost 20% actually asymptomatic is still huge in context. Especially as we know the disease affects these demographics up to 100X more than the young. For instance consider: "Emerging evidence suggests many more people are infected than tested. In Vo Italy, at the time the first symptomatic case was diagnosed, about 3%, had already been infected – most were completely asymptomatic." [1] [1] https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/ https://www.cebm.net/covid-19/global-covid-19-case-fatality-...
    - DanBC 7y ago
      > a stuffy nose. Not a covid-19 symptom. EDIT: I'm wrong, sorry. Thank you to kgwgk for the correction.
      - kgwgk 7y ago
        https://www.who.int/news-room/q-a-detail/q-a-coronaviruses https://www.who.int/news-room/q-a-detail/q-a-coronaviruses The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, NASAL CONGESTION, runny nose, sore throat or diarrhea.
tempsy 7y ago
I mean NYC publishes the number of positive tests each day and it’s dropped from 60% to 30%. So majority of people proactively getting a test because they are symptomatic are showing up negative. Hard to believe a very high percentage of all people have had Covid, then. https://twitter.com/natesilver538/status/1252317247785271297?s=21 https://twitter.com/natesilver538/status/1252317247785271297...
- joe_the_user 7y ago
  Isn't that the virus test, not the anti-body test? Maybe a fairly low percentage have the virus but a high percentage have been exposed and have the anti-body. The optimistic take on this is: that means soon enough will be exposed that their immunity will stop the spread. The pessimistic take on this is: we also don't have strong evidence that the previously exposed are immune, ie, have a strong enough immune response to stop the virus.
- JPKab 7y ago
  You are conflating a test for active virus versus an antibody test. my suspicion is that a very large percentage of people in certain neighborhoods of New York City are going to show up having been exposed and never presented symptoms. I just don't compute how else you can explain this with a virus that is so transmissible. we should also keep in mind that the number of deaths isn't necessarily indicative by itself of number of infections since deaths can be caused by hospitals being overrun.
- DeonPenny 7y ago
  This only tells if you are sick not if you were sick
- paganel 7y ago
  Those 30% numbers are still very high, the similar rate in Italy has dropped bellow 10% for 2 weeks now (it's the line-chart on this page [1] bellow "Tamponi giornalieri e contagiati"), with the latest week's figures somewhere between 5% and 7%. [1] https://lab24.ilsole24ore.com/coronavirus/ https://lab24.ilsole24ore.com/coronavirus/
asdf21 7y ago
It's rough because it's simultaneously very mild in the vast majority of people, but a horrific, suffocating death in a tiny minority, and highly contagious. I don't know if there is a "right" policy answer on what to do with something like that. As someone else said, the lockdowns are probably illegal, you can't just throw away freedom of association over the flu. But if we didn't have them, we might have seen another 100k dead..
- hsitz 7y ago
  ". . . the lockdowns are probably illegal, you can't just throw away freedom of association over the flu." Where did you study constutional law? Rights granted in the constitution are subject to many restrictions. There is no explicit "freedom of association" in the Constitution, although it has been held to be implicit in freedom of speech. Free speech doctrine includes a "time, place, and manner" test that's applied to restrictions on speech when the government has a "significant interest" in the restriction[1] (e.g., national emergency for a viral pandemic). I don't know how the lockdowns (which are mostly not full lockdowns) would fare if Supreme Court were to apply the time, place, manner test, but I wouldn't presume to offer an offhand opinion that they're "probably illegal". [1] https://en.wikipedia.org/wiki/Freedom_of_speech_in_the_United_States#Time,_place,_and_manner_restrictions https://en.wikipedia.org/wiki/Freedom_of_speech_in_the_Unite...
  - sethammons 7y ago
    Not op. I am not a lawyer and I’ve not studied constitutional law. What I recall from high school is that anything not expressly stated as illegal is legal for citizens and any power not expressly given to a state or federal government is unavailable to them. A law has to exist that gives states and the federal government the ability to do what they are doing and that law needs to not violate special protections built into the Bill of Rights. With a state of emergency declared, some things can temporarily be enacted that under normal circumstances would not be legal. I don’t know if all the lock down rules are legal, but I wouldn’t be surprised to find out that governments have overstepped their bounds.
    - 7y ago
cylinder 7y ago
there's a really big pro-density crowd online which is working hard to undermine this argument in order to satisfy its agenda.
buzzkillington 7y ago
>Frankly, I'm not sure why so many on HN are surprised by this. The scientific data on asymptomatic carriers coming out of Italy, Germany, South Korea, and Iceland has been very clear on a majority asymptomatic frame for this virus. I think that maybe authorities and responsible people are concerned that this information could lead to people flouting lockdowns more. Because people on here panicked without thinking and don't want to admit it. No one wants to say "Oh yeah, I ignored second year calculus and never bothered plotting logistic growth curves with the full spread of expected fatalities. Because of this I supported legislation that's started the next Great Depression. But I meant well!"
- closeparen 7y ago
  We don't know that the fatality rate is off, we just suspect and hope it. Measurements of this kind are how we'll find out.
- Guest42 7y ago
  Are you claiming that everything is normal and would benefit from a complete reopen? Are you also claiming that the economy is in otherwise healthy shape regardless of the interest rate levels and global buyback programs that have been ongoing prior to the outbreak?
  - SpicyLemonZest 7y ago
    A complete reopen, no - crowded stadiums and amusement parks probably shouldn't happen. Things would never have been normal right now, and there's no silver bullet to make them normal again. I can't speak for the original commenter, but I think the evidence increasingly suggests that we would benefit from allowing people to visit small groups of friends and run non-essential businesses.
brigade 7y ago
Already 0.1% of NYC's population has died from COVID-19 - 10k deaths of 8.54 million people. That's... quite a bit higher than LA's current 576 of 10 million. So either everyone in New York City was infected, or most probably 200-400k infected in LA is an order of magnitude of wishful thinking (e.g. ~2% false positive test rate.)
- eanzenberg 7y ago
  Not from, with. Also, gov’t pays a hospital out $70k for every covid death.
  - DanBC 7y ago
    This "with, not from" stuff collapses when you look at 5 year averages. EG this from UK https://twitter.com/ONS/status/1252518098047041536 https://twitter.com/ONS/status/1252518098047041536
- woofie11 7y ago
  Another option: A bunch of people will die in a few weeks.
- nradov 7y ago
  Could some of the discrepancy in regional death rates be explained by a mutation in the virus?
  - mgleason_3 7y ago
    Honestly, it seems more likely that California's much maligned car culture has served us well in this case - ensuring many of us maintain social distance which is impossible on NYC's subway and bus system. All the positive press about governor Cuomo's leadership and handling of the crisis seems a little weird given his failure to shut-down the subways (or at least curtail a but the absolutely most urgent ridership).
    - dragonwriter 7y ago
DeonPenny 7y ago
Seems so obvious that this was the flu but far more contagious from the beginning because of the lack of herd immunity and vaccines. We are just getting verification.
- andybak 7y ago
  "so obvious". I love it when people have strong opinions about a complex, constantly changing piece of difficult science.
  - DeonPenny 7y ago
    It's not opinion is the logical conclusion from literally every random sampling study. Pretty much consistently 50x as many people have been infected that we thought. And if we made the current strategy with limited data why aren't we updating what we are doing with more data.

by JPKab 7y ago

arcticbull 7y ago

Even the Diamond Princess showed a 50+% asymptomatic rate and that group skewed way, way older than average -- you know, people who take cruises.

acqq 7y ago
50? Just initially, but in a week or two more of these developed symptoms, so more recent number was just 18%: https://www.cebm.net/covid-19/covid-19-what-proportion-are-asymptomatic/ https://www.cebm.net/covid-19/covid-19-what-proportion-are-a... "Setting: Diamond Princess cruise ship, Yokohama, Japan (n=-634 tested positive). Proportion: 18%" Also: "23 Residents of a Long-Term Care Nursing Facility King County, Washington 10 (43%) had symptoms, and 13 (57%) were asymptomatic." But then: "Seven days after testing, 10 of 13 asymptomatics developed symptoms" That means that just 3 of 23 remained asymptomatic there too, i.e. 13%. It is estimated that the people mostly spread this virus exactly in the phase where they still haven't developed symptoms, and the virus can be detected. But that doesn't mean they will remain without the symptoms.
- asdf21 7y ago
  I suspect most people notice a bit of a cold or "allergies" Like you said, probably only 10% to 15% truly asymptomatic.
- arcticbull 7y ago
  Thanks, I actually didn't realize the number drifted so much over time. Good to know! I'm curious how many of them were actually seriously afflicted vs. a stuffy nose. I'd argue almost 20% actually asymptomatic is still huge in context. Especially as we know the disease affects these demographics up to 100X more than the young. For instance consider: "Emerging evidence suggests many more people are infected than tested. In Vo Italy, at the time the first symptomatic case was diagnosed, about 3%, had already been infected – most were completely asymptomatic." [1] [1] https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/ https://www.cebm.net/covid-19/global-covid-19-case-fatality-...
  - DanBC 7y ago
    > a stuffy nose. Not a covid-19 symptom. EDIT: I'm wrong, sorry. Thank you to kgwgk for the correction.
    - kgwgk 7y ago
      https://www.who.int/news-room/q-a-detail/q-a-coronaviruses https://www.who.int/news-room/q-a-detail/q-a-coronaviruses The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, NASAL CONGESTION, runny nose, sore throat or diarrhea.

tempsy 7y ago

I mean NYC publishes the number of positive tests each day and it’s dropped from 60% to 30%. So majority of people proactively getting a test because they are symptomatic are showing up negative. Hard to believe a very high percentage of all people have had Covid, then. https://twitter.com/natesilver538/status/1252317247785271297?s=21 https://twitter.com/natesilver538/status/1252317247785271297...

joe_the_user 7y ago
Isn't that the virus test, not the anti-body test? Maybe a fairly low percentage have the virus but a high percentage have been exposed and have the anti-body. The optimistic take on this is: that means soon enough will be exposed that their immunity will stop the spread. The pessimistic take on this is: we also don't have strong evidence that the previously exposed are immune, ie, have a strong enough immune response to stop the virus.
JPKab 7y ago
You are conflating a test for active virus versus an antibody test. my suspicion is that a very large percentage of people in certain neighborhoods of New York City are going to show up having been exposed and never presented symptoms. I just don't compute how else you can explain this with a virus that is so transmissible. we should also keep in mind that the number of deaths isn't necessarily indicative by itself of number of infections since deaths can be caused by hospitals being overrun.
DeonPenny 7y ago
This only tells if you are sick not if you were sick
paganel 7y ago
Those 30% numbers are still very high, the similar rate in Italy has dropped bellow 10% for 2 weeks now (it's the line-chart on this page [1] bellow "Tamponi giornalieri e contagiati"), with the latest week's figures somewhere between 5% and 7%. [1] https://lab24.ilsole24ore.com/coronavirus/ https://lab24.ilsole24ore.com/coronavirus/

asdf21 7y ago

It's rough because it's simultaneously very mild in the vast majority of people, but a horrific, suffocating death in a tiny minority, and highly contagious. I don't know if there is a "right" policy answer on what to do with something like that. As someone else said, the lockdowns are probably illegal, you can't just throw away freedom of association over the flu. But if we didn't have them, we might have seen another 100k dead..

hsitz 7y ago
". . . the lockdowns are probably illegal, you can't just throw away freedom of association over the flu." Where did you study constutional law? Rights granted in the constitution are subject to many restrictions. There is no explicit "freedom of association" in the Constitution, although it has been held to be implicit in freedom of speech. Free speech doctrine includes a "time, place, and manner" test that's applied to restrictions on speech when the government has a "significant interest" in the restriction[1] (e.g., national emergency for a viral pandemic). I don't know how the lockdowns (which are mostly not full lockdowns) would fare if Supreme Court were to apply the time, place, manner test, but I wouldn't presume to offer an offhand opinion that they're "probably illegal". [1] https://en.wikipedia.org/wiki/Freedom_of_speech_in_the_United_States#Time,_place,_and_manner_restrictions https://en.wikipedia.org/wiki/Freedom_of_speech_in_the_Unite...
- sethammons 7y ago
  Not op. I am not a lawyer and I’ve not studied constitutional law. What I recall from high school is that anything not expressly stated as illegal is legal for citizens and any power not expressly given to a state or federal government is unavailable to them. A law has to exist that gives states and the federal government the ability to do what they are doing and that law needs to not violate special protections built into the Bill of Rights. With a state of emergency declared, some things can temporarily be enacted that under normal circumstances would not be legal. I don’t know if all the lock down rules are legal, but I wouldn’t be surprised to find out that governments have overstepped their bounds.
  - 7y ago

cylinder 7y ago

there's a really big pro-density crowd online which is working hard to undermine this argument in order to satisfy its agenda.

buzzkillington 7y ago

>Frankly, I'm not sure why so many on HN are surprised by this. The scientific data on asymptomatic carriers coming out of Italy, Germany, South Korea, and Iceland has been very clear on a majority asymptomatic frame for this virus. I think that maybe authorities and responsible people are concerned that this information could lead to people flouting lockdowns more. Because people on here panicked without thinking and don't want to admit it. No one wants to say "Oh yeah, I ignored second year calculus and never bothered plotting logistic growth curves with the full spread of expected fatalities. Because of this I supported legislation that's started the next Great Depression. But I meant well!"

closeparen 7y ago
We don't know that the fatality rate is off, we just suspect and hope it. Measurements of this kind are how we'll find out.
Guest42 7y ago
Are you claiming that everything is normal and would benefit from a complete reopen? Are you also claiming that the economy is in otherwise healthy shape regardless of the interest rate levels and global buyback programs that have been ongoing prior to the outbreak?
- SpicyLemonZest 7y ago
  A complete reopen, no - crowded stadiums and amusement parks probably shouldn't happen. Things would never have been normal right now, and there's no silver bullet to make them normal again. I can't speak for the original commenter, but I think the evidence increasingly suggests that we would benefit from allowing people to visit small groups of friends and run non-essential businesses.

brigade 7y ago

Already 0.1% of NYC's population has died from COVID-19 - 10k deaths of 8.54 million people. That's... quite a bit higher than LA's current 576 of 10 million. So either everyone in New York City was infected, or most probably 200-400k infected in LA is an order of magnitude of wishful thinking (e.g. ~2% false positive test rate.)

eanzenberg 7y ago
Not from, with. Also, gov’t pays a hospital out $70k for every covid death.
- DanBC 7y ago
  This "with, not from" stuff collapses when you look at 5 year averages. EG this from UK https://twitter.com/ONS/status/1252518098047041536 https://twitter.com/ONS/status/1252518098047041536
woofie11 7y ago
Another option: A bunch of people will die in a few weeks.
nradov 7y ago
Could some of the discrepancy in regional death rates be explained by a mutation in the virus?
- mgleason_3 7y ago
  Honestly, it seems more likely that California's much maligned car culture has served us well in this case - ensuring many of us maintain social distance which is impossible on NYC's subway and bus system. All the positive press about governor Cuomo's leadership and handling of the crisis seems a little weird given his failure to shut-down the subways (or at least curtail a but the absolutely most urgent ridership).
  - dragonwriter 7y ago

DeonPenny 7y ago

Seems so obvious that this was the flu but far more contagious from the beginning because of the lack of herd immunity and vaccines. We are just getting verification.

andybak 7y ago
"so obvious". I love it when people have strong opinions about a complex, constantly changing piece of difficult science.
- DeonPenny 7y ago
  It's not opinion is the logical conclusion from literally every random sampling study. Pretty much consistently 50x as many people have been infected that we thought. And if we made the current strategy with limited data why aren't we updating what we are doing with more data.