7 ms·

Another datapoint suggesting the death rate of this virus is within 0.5%.

by cm2187 7y ago

Exmoor 7y ago
Also another data point suggesting that the virus is much more contagious than the early estimates said. I personally don't see how the test, track and trace efforts that have been touted as the only way to open things up can work with a virus with these characteristics. You would need to test a huge percentage of the population each day with quick results tests and something like that is many months away from being possible assuming it ever would be possible.
- daxfohl 7y ago
  I agree. But it seems to have worked in Korea. The math doesn't seem to reconcile somehow. Actually probably the prevalence of masks explains the difference.
  - taeric 7y ago
    The math seems to point more to there being another factor to what makes it severe, in my eye. Going by the news we have seen, elementary schools could have 80%+ infection rates and fewer deaths that NY has seen. Similarly, are there other factors besides age? (Age feels way more like a proxy.)
- istorical 7y ago
  More contagious OR began community spread and became endemic much earlier. r0 is part of the formula for total infected at X/Y/Z date but so is date of initial infection and size of initial infected population.
- GVIrish 7y ago
  The key is testing, contract tracing, and quarantining when the number of cases is small. That's what South Korea, New Zealand, and a few other countries did and they've all suffered relatively few fatalities. You still need a massive amount of tests to contain an outbreak, but the upside is that if you contain it early you don't need toe enact clumsy and broad measures like lockdowns.
Spooks 7y ago
I wonder if we did these preliminary tests with the flu if we would see a large death rate drop for influenza as well
- nullc 7y ago
  The US's influenza mortality figures are a combined influenza and pneumonia figure because they usually don't even bother actually screening for influenza. Research attempting to determine how much of that figure is infected with influenza have found figures like 1/3rd (though with large differences year to year).
cozzyd 7y ago
I had the opposite conclusion. There are between 10k-15k COVID-19 associated deaths in NYC, depending on how you count (the higher rate is consistent with the excess-mortality data, I believe). That by itself produces a range of ~0.56%-0.86% if you assume 21.2 % of NYC has been infected (larger range if you allow for some error on the infection rate, obviously). Moreover, we don't know what fraction of the currently-infected who will die have already died. A reasonable guess might be 50%, which would mean that the fatality rate for NYC is somewhere between 1.1 and 1.7%. Either way, based on NYC, 0.5% might be a hard lower bound on the all-population fatality rate (of course, maybe NYC is not a representative sample for some reason)
- rubidium 7y ago
  “ Moreover, we don't know what fraction of the currently-infected who will die have already died. A reasonable guess might be 50%” I lost you at reasonable guess. Why not ~1%?
  - vkou 7y ago
    If the mean time between infection and death is 2 weeks (Mostly true), and the virus has doubled every two weeks (True in NYC), then assuming that not a single new infection takes place starting today (Obviously not true, but this is a hypothetical), then in two weeks, you would expect to have twice the deaths that you do right now.
  - cozzyd 7y ago
    1% would imply an unrealistically high-fatality rate, so that can't be right.
  - zucker42 7y ago
    The virus takes time (2-3 weeks) to kill people, and the prevalence was presumably measured within the last week. Therefore, we have to take out the cases that occurred in the last week or two. I would suspect that 50% is on the upper end of how much the death lag could skew the results, but 20-50% doesn't seem unreasonable.
- 7y ago
Avamander 7y ago
Mortality rate, case fatality rate and infection fatality rates are all different things and have different values. Infection fatality rate of the virus could be within 0.5% (because its the one that tries to take into account everyone who has been infected), mortality rate is very likely still the one WHO has published and the third, case fatality rate is ~38% in the US.
- rimliu 7y ago
  What? 38 out of 100 infected in US die?
  - saalweachter 7y ago
    Infection fatality rate, the big number everyone is trying to figure out, best guess is somewhere around 1% right now, with a confidence interval of something like 0.3%-2.5% Case fatality rate, calculated as "number of deaths" / "number of known cases", usually something like 10% in most countries, although occasionally much lower or higher for the odd country that has really good or really bad testing. Resolved case fatality rate, calculated as "number of deaths" / "number of recoveries + number of deaths", which has been around 40% in the countries that have been hit hardest for the duration of their outbreaks. Tends to go down after the curve is bent, because it takes people longer to recover than die in most of these cases.
vkou 7y ago
15,000 deaths (So far) in NYC. 8.4 million people. If 20% of the population has had it, the death rate is 1%... Assuming that none of the currently infected die. Which is an unreasonable assumption (As the mean time to death from the point of infection seems to be ~2 weeks, and infections have doubled over the past 2 weeks.)
- kgwgk 7y ago
  But those currently infected are not included in the 20% of the population that has had it. Or maybe some are, but most of those infected now who may still die, do not have antibodies yet.
lukasm 7y ago
Yes, but the age is a 10x factor, os CFR would be much different in Nigeria (average age is about 19) and Italy (average age 45). We have two good petri dishes: USS Theodore Roosevelt - 600 cases out of 4800. 5 sick, one dead (41 years old). which means hospitalisation is at 0.83% and CFR is 0.016% (1% dead or in hospital). Not idea what is the average age, probably around 30-35. Diamond Princess: 700 of 3711. CFR 1.1%, average age around 50. What worries me the most though is potential mutations and death rates when you are infected with Covid-19 and flu at the same time (or other pathogens). https://www.reuters.com/article/us-health-coronavirus-usa-military-sympt-idUSKCN21Y2GB?utm_source=Nature+Briefing&utm_campaign=ff928b9a9f-briefing-dy-20200417&utm_medium=email&utm_term=0_c9dfd39373-ff928b9a9f-44762053 https://www.reuters.com/article/us-health-coronavirus-usa-mi... https://www.nature.com/articles/d41586-020-00885-w?utm_source=Nature+Briefing&utm_campaign=ff928b9a9f-briefing-dy-20200417&utm_medium=email&utm_term=0_c9dfd39373-ff928b9a9f-44762053 https://www.nature.com/articles/d41586-020-00885-w?utm_sourc...
- rckoepke 7y ago
  Average age on an aircraft carrier appears to be 19 [0], 20 [1], and/or 24 [2] years old. 0: https://www.nytimes.com/2008/04/20/arts/television/20jens.html https://www.nytimes.com/2008/04/20/arts/television/20jens.ht... 1: https://archive.defense.gov/news/newsarticle.aspx?id=15334 https://archive.defense.gov/news/newsarticle.aspx?id=15334 2: https://mashable.com/2016/06/23/what-its-really-like-to-live-and-work-on-an-aircraft-carrier/ https://mashable.com/2016/06/23/what-its-really-like-to-live...
- rallison 7y ago
  > which means hospitalisation is at 0.83% and CFR is 0.016% (1% dead or in hospital). 0.16%, not 0.016%.
- greedo 7y ago
  You can't measure CFR or IFR this quickly in an isolated environment like the Roosevelt due to mortality lag. Also, the CFR for Diamond Princess is now up to 1.83%.
grumple 7y ago
The death rate would go up if more people had the virus at once, which is the entire reasoning behind isolating.
- gridlockd 7y ago
  I am wondering that number, if the limiting factor is ventilators, but the CFR of people on a ventilator is close to 90% either way. Other cases may just need oxygen supplementation, which is more manageable. It is pretty clear now that Germany is not that far from from Italy in terms of CFR when controlled for age.
gok 7y ago
…when people are able to get treatment.

Another datapoint suggesting the death rate of this virus is within 0.5%.

by cm2187 7y ago

Another datapoint suggesting the death rate of this virus is within 0.5%.

Also another data point suggesting that the virus is much more contagious than the early estimates said. I personally don't see how the test, track and trace efforts that have been touted as the only way to open things up can work with a virus with these characteristics. You would need to test a huge percentage of the population each day with quick results tests and something like that is many months away from being possible assuming it ever would be possible.

daxfohl 7y ago
I agree. But it seems to have worked in Korea. The math doesn't seem to reconcile somehow. Actually probably the prevalence of masks explains the difference.
- taeric 7y ago
  The math seems to point more to there being another factor to what makes it severe, in my eye. Going by the news we have seen, elementary schools could have 80%+ infection rates and fewer deaths that NY has seen. Similarly, are there other factors besides age? (Age feels way more like a proxy.)
istorical 7y ago
More contagious OR began community spread and became endemic much earlier. r0 is part of the formula for total infected at X/Y/Z date but so is date of initial infection and size of initial infected population.
GVIrish 7y ago
The key is testing, contract tracing, and quarantining when the number of cases is small. That's what South Korea, New Zealand, and a few other countries did and they've all suffered relatively few fatalities. You still need a massive amount of tests to contain an outbreak, but the upside is that if you contain it early you don't need toe enact clumsy and broad measures like lockdowns.

Spooks 7y ago

I wonder if we did these preliminary tests with the flu if we would see a large death rate drop for influenza as well

nullc 7y ago
The US's influenza mortality figures are a combined influenza and pneumonia figure because they usually don't even bother actually screening for influenza. Research attempting to determine how much of that figure is infected with influenza have found figures like 1/3rd (though with large differences year to year).

cozzyd 7y ago

I had the opposite conclusion. There are between 10k-15k COVID-19 associated deaths in NYC, depending on how you count (the higher rate is consistent with the excess-mortality data, I believe). That by itself produces a range of ~0.56%-0.86% if you assume 21.2 % of NYC has been infected (larger range if you allow for some error on the infection rate, obviously). Moreover, we don't know what fraction of the currently-infected who will die have already died. A reasonable guess might be 50%, which would mean that the fatality rate for NYC is somewhere between 1.1 and 1.7%. Either way, based on NYC, 0.5% might be a hard lower bound on the all-population fatality rate (of course, maybe NYC is not a representative sample for some reason)

rubidium 7y ago
“ Moreover, we don't know what fraction of the currently-infected who will die have already died. A reasonable guess might be 50%” I lost you at reasonable guess. Why not ~1%?
- vkou 7y ago
  If the mean time between infection and death is 2 weeks (Mostly true), and the virus has doubled every two weeks (True in NYC), then assuming that not a single new infection takes place starting today (Obviously not true, but this is a hypothetical), then in two weeks, you would expect to have twice the deaths that you do right now.
- cozzyd 7y ago
  1% would imply an unrealistically high-fatality rate, so that can't be right.
- zucker42 7y ago
  The virus takes time (2-3 weeks) to kill people, and the prevalence was presumably measured within the last week. Therefore, we have to take out the cases that occurred in the last week or two. I would suspect that 50% is on the upper end of how much the death lag could skew the results, but 20-50% doesn't seem unreasonable.
7y ago

Avamander 7y ago

Mortality rate, case fatality rate and infection fatality rates are all different things and have different values. Infection fatality rate of the virus could be within 0.5% (because its the one that tries to take into account everyone who has been infected), mortality rate is very likely still the one WHO has published and the third, case fatality rate is ~38% in the US.

rimliu 7y ago
What? 38 out of 100 infected in US die?
- saalweachter 7y ago
  Infection fatality rate, the big number everyone is trying to figure out, best guess is somewhere around 1% right now, with a confidence interval of something like 0.3%-2.5% Case fatality rate, calculated as "number of deaths" / "number of known cases", usually something like 10% in most countries, although occasionally much lower or higher for the odd country that has really good or really bad testing. Resolved case fatality rate, calculated as "number of deaths" / "number of recoveries + number of deaths", which has been around 40% in the countries that have been hit hardest for the duration of their outbreaks. Tends to go down after the curve is bent, because it takes people longer to recover than die in most of these cases.

vkou 7y ago

15,000 deaths (So far) in NYC. 8.4 million people. If 20% of the population has had it, the death rate is 1%... Assuming that none of the currently infected die. Which is an unreasonable assumption (As the mean time to death from the point of infection seems to be ~2 weeks, and infections have doubled over the past 2 weeks.)

kgwgk 7y ago
But those currently infected are not included in the 20% of the population that has had it. Or maybe some are, but most of those infected now who may still die, do not have antibodies yet.

lukasm 7y ago

Yes, but the age is a 10x factor, os CFR would be much different in Nigeria (average age is about 19) and Italy (average age 45). We have two good petri dishes: USS Theodore Roosevelt - 600 cases out of 4800. 5 sick, one dead (41 years old). which means hospitalisation is at 0.83% and CFR is 0.016% (1% dead or in hospital). Not idea what is the average age, probably around 30-35. Diamond Princess: 700 of 3711. CFR 1.1%, average age around 50. What worries me the most though is potential mutations and death rates when you are infected with Covid-19 and flu at the same time (or other pathogens). https://www.reuters.com/article/us-health-coronavirus-usa-military-sympt-idUSKCN21Y2GB?utm_source=Nature+Briefing&utm_campaign=ff928b9a9f-briefing-dy-20200417&utm_medium=email&utm_term=0_c9dfd39373-ff928b9a9f-44762053 https://www.reuters.com/article/us-health-coronavirus-usa-mi... https://www.nature.com/articles/d41586-020-00885-w?utm_source=Nature+Briefing&utm_campaign=ff928b9a9f-briefing-dy-20200417&utm_medium=email&utm_term=0_c9dfd39373-ff928b9a9f-44762053 https://www.nature.com/articles/d41586-020-00885-w?utm_sourc...

rckoepke 7y ago
Average age on an aircraft carrier appears to be 19 [0], 20 [1], and/or 24 [2] years old. 0: https://www.nytimes.com/2008/04/20/arts/television/20jens.html https://www.nytimes.com/2008/04/20/arts/television/20jens.ht... 1: https://archive.defense.gov/news/newsarticle.aspx?id=15334 https://archive.defense.gov/news/newsarticle.aspx?id=15334 2: https://mashable.com/2016/06/23/what-its-really-like-to-live-and-work-on-an-aircraft-carrier/ https://mashable.com/2016/06/23/what-its-really-like-to-live...
rallison 7y ago
> which means hospitalisation is at 0.83% and CFR is 0.016% (1% dead or in hospital). 0.16%, not 0.016%.
greedo 7y ago
You can't measure CFR or IFR this quickly in an isolated environment like the Roosevelt due to mortality lag. Also, the CFR for Diamond Princess is now up to 1.83%.

grumple 7y ago

The death rate would go up if more people had the virus at once, which is the entire reasoning behind isolating.

gridlockd 7y ago
I am wondering that number, if the limiting factor is ventilators, but the CFR of people on a ventilator is close to 90% either way. Other cases may just need oxygen supplementation, which is more manageable. It is pretty clear now that Germany is not that far from from Italy in terms of CFR when controlled for age.

gok 7y ago

…when people are able to get treatment.