5 ms·

> somewhat more lethal than influenza My understanding is that most evidence points to order of magnitude more lethal even when the hospitals aren't overflown.

by acqq 7y ago

> somewhat more lethal than influenza My understanding is that most evidence points to order of magnitude more lethal even when the hospitals aren't overflown. Regarding "testing negative then positive" the experts already expected that there were no real reinfections.

throwaway894345 7y ago
> My understanding is that most evidence points to order of magnitude more lethal even when the hospitals aren't overflown. If those mortality estimates were based on the number of positive test cases, then they're very likely overblown. Recent seralogical studies indicate that the number of positive test results are likely a small fraction of the total number of cases, and likely the most severe subset at that. None of this is to say that it's less lethal than influenza, only that the situation is developing rapidly and any given mortality estimate may well be outdated.
- JoeAltmaier 7y ago
  In any case, we can all agree that regardless of the value of the number, its "way too many fatalities". My family has lost several colleagues/classmates already. This did not happen in other years. This year is very different, and concerning.
  - throwaway894345 7y ago
    I'm terribly sorry for your losses. It's an awful disease, and loss of life is terrible. It is indeed concerning, but if we can understand whether these fatalities are due to high morbidity or "simply" because it is highly contagious, we can make better decisions about treating the disease, setting policy, etc which can all drive down the amount of suffering and death. That's perhaps a small consolation to those who have lost friends and family already. :'(
- rocha 7y ago
  My understanding is that the current estimated IFR from those studies (NY specially) is between 0.6% and 1.2%. I think flu is around 0.1% (however I am not sure if that is the CFR or the IFR). The second factor to consider is the attack rate, how many people are likely to get infected. For flu is around between 10% to 15% of the total population, while for Covid it is, potentially, larger than 80% (no natural immunity and no vaccines). It is however unlikely that it will reach that level given the current containment and mitigation measures. But if it reaches something like 40% (double of the latest NY estimate), it will mean covid is between 16 to 48 times deadlier than the flu.
  - throwaway894345 7y ago
    Yes, sorry, I thought we were comparing IFR and not CFR.
    - rocha 7y ago
      No worries, I had made the same mistake. I just wanted to point out that the attack rate is also part of the fatality equation, and it is commonly not taken into account.
  - Lewton 7y ago
    I believe 0.1% is the CFR for the flu, and the IFR is close to 0.04%?
    - rocha 7y ago
      Thanks. I have seen serious estimates of 0.1% CFR for the 1957 and 1964 flu pandemics, but only notes saying that the seasonal flu CFR is <0.1%. Do you have a source for the 0.04% IFR?
      - Lewton 7y ago
        No (hence the question mark), I'm seeing 0.04% pop up everywhere but I haven't found the source for the number. But it seems plausible if the CFR is <0.1% as there are both asymptomatic cases of the flu and people don't always go to the doctor even if they have symptoms. It seems like caring about IFR was rare before this pandemic and the lockdown
- acqq 7y ago
  > Recent seralogical studies indicate that the number of positive test results are likely a small fraction of the total number of cases No: the antibody tests were done with the expectation that the total number of the infected would be much higher. The tests have such false positive rates that with the results actually observed the tests in most of the cases say nothing -- in most of the locations the numbers would be similar even if nobody would be a real positive. And there where the results are above these "noise" thresholds we also have a big numbers of deaths which do confirm my claim of order of magnitude deadlier than flu. Even observing the pure death statistics we can see that, even in spite of all the measures actively taken throughout the world. Without them it's obvious it would have been again the difference of some orders of magnitude: https://www.euromomo.eu/graphs-and-maps/ https://www.euromomo.eu/graphs-and-maps/ See also here: https://www.ft.com/coronavirus-latest https://www.ft.com/coronavirus-latest the "Death rates have climbed far above historical averages" graph.
  - throwaway374810 7y ago
    Going by the death rates, it's definitely deadlier than any flu of the past five years, but not by a magnitude. Not even close. Saying that it would've been a magnitude higher without any of the measures is pure speculation.
- pbhjpbhj 7y ago
  Well UK deaths from flu are about were 500 deaths per 66M for the most recent year of published cause of death statistics, which I understand (from a couple of papers on annual infection rates) represents about 500/13M infections. Covid19 figures in the UK are 26,000 [hospital] deaths for 165,000 confirmed infections. Even if we assume the entire population is infected ... that makes it a minimum of 10x as deadly as flu. We're at a slowly falling ~5000 deaths per day; when care-home and other Covid deaths get added ... I think perhaps you're down-playing it a little too much.
  - throwaway894345 7y ago
    To reiterate the third/last sentence of my post, I'm explicitly not down-playing anything--I'm not asserting anything about covid WRT the flu, only cautioning against drawing conclusions based on potentially outdated information.
- talaketu 7y ago
  So? I haven't read any of this studies either, but I'd expect seralogical studies to likewise indicate that positive flu test results are a small fraction of the total number of cases, and likely the most severe subset.
  - throwaway894345 7y ago
    We have decades of data about the flu--we pretty much understand its morbidity. We don't need to make guesses based on positive test results like we were doing with covid.
    - talaketu 7y ago
      Your argument is invalid.
manfredo 7y ago
This is due to testing methods that undercount the denominator. Countries conducting random testing have yielded an IFR of about 0.4%. 4x deadlier than the flu.
- Lewton 7y ago
  You're comparing the IFR of the corona virus with the CFR of the flu
  - manfredo 7y ago
    No it's not. The IFR of the flu is 0.1%. The CFR is higher. The Case Fatality Rate will always be higher than the Infection Fatality Rate. The people who present cases will be a strict subset of the people who are infected. Early studies treated the Case Fatality Rate as the Infection Fatality Rate, by virtue of the fact that the only people getting tested were people with symptoms. Random testing in Germany has indicated that ~20% of the population was infected or has been infected, and the corresponding death rate yielded an IFR of 0.37%.
    - Lewton 7y ago
      What's your source for the 0.1% flu number? People are linking to the CDC website which explicitly only looks at symptomatic flu cases. Which means it's NOT the IFR. The flu also has asymptomatic cases!
      - manfredo 7y ago
        If you're talking about this CDC website, it does track CFR [1]. And as I said, the CFR rate is higher than the IFR rate. Several years the seasonal flu has a CFR above 0.13%. Measuring IFR is inherently speculative, unless 100% of the population is administered a test with no risk of false negative or positives. In order to compare the IFR of COVID-19 to the seasonal flu, we'd need to use the same estimation techniques. I've only found a few experts that have done comparisons of IFR rates of the flu and of COVID-19. The most reputable source on this reported an estimated IFR for the flu of 0.04%, but also an estimated IFR for COVID-19 of 0.2-0.3% [2]. This is "many times deadlier" if by "many" you mean 5 to 8 times deadlier. This is nowhere near the multiple orders of magnitude deadlier that was reported initially (IFR rates of 2-3% and above). 1. https://www.cdc.gov/flu/about/burden/index.html https://www.cdc.gov/flu/about/burden/index.html 2. https://www.bloomberg.com/opinion/articles/2020-04-24/is-coronavirus-worse-than-the-flu-blood-studies-say-yes-by-far https://www.bloomberg.com/opinion/articles/2020-04-24/is-cor...
f38zf5vdt 7y ago
You found my favorite part of that whole comment. I hereby announce my support for redefining "somewhat" to mean "an order of magnitude" for all subsequent HN discussions.

by acqq 7y ago

throwaway894345 7y ago

> My understanding is that most evidence points to order of magnitude more lethal even when the hospitals aren't overflown. If those mortality estimates were based on the number of positive test cases, then they're very likely overblown. Recent seralogical studies indicate that the number of positive test results are likely a small fraction of the total number of cases, and likely the most severe subset at that. None of this is to say that it's less lethal than influenza, only that the situation is developing rapidly and any given mortality estimate may well be outdated.

JoeAltmaier 7y ago
In any case, we can all agree that regardless of the value of the number, its "way too many fatalities". My family has lost several colleagues/classmates already. This did not happen in other years. This year is very different, and concerning.
- throwaway894345 7y ago
  I'm terribly sorry for your losses. It's an awful disease, and loss of life is terrible. It is indeed concerning, but if we can understand whether these fatalities are due to high morbidity or "simply" because it is highly contagious, we can make better decisions about treating the disease, setting policy, etc which can all drive down the amount of suffering and death. That's perhaps a small consolation to those who have lost friends and family already. :'(
rocha 7y ago
My understanding is that the current estimated IFR from those studies (NY specially) is between 0.6% and 1.2%. I think flu is around 0.1% (however I am not sure if that is the CFR or the IFR). The second factor to consider is the attack rate, how many people are likely to get infected. For flu is around between 10% to 15% of the total population, while for Covid it is, potentially, larger than 80% (no natural immunity and no vaccines). It is however unlikely that it will reach that level given the current containment and mitigation measures. But if it reaches something like 40% (double of the latest NY estimate), it will mean covid is between 16 to 48 times deadlier than the flu.
- throwaway894345 7y ago
  Yes, sorry, I thought we were comparing IFR and not CFR.
  - rocha 7y ago
    No worries, I had made the same mistake. I just wanted to point out that the attack rate is also part of the fatality equation, and it is commonly not taken into account.
- Lewton 7y ago
  I believe 0.1% is the CFR for the flu, and the IFR is close to 0.04%?
  - rocha 7y ago
    Thanks. I have seen serious estimates of 0.1% CFR for the 1957 and 1964 flu pandemics, but only notes saying that the seasonal flu CFR is <0.1%. Do you have a source for the 0.04% IFR?
    - Lewton 7y ago
      No (hence the question mark), I'm seeing 0.04% pop up everywhere but I haven't found the source for the number. But it seems plausible if the CFR is <0.1% as there are both asymptomatic cases of the flu and people don't always go to the doctor even if they have symptoms. It seems like caring about IFR was rare before this pandemic and the lockdown
acqq 7y ago
> Recent seralogical studies indicate that the number of positive test results are likely a small fraction of the total number of cases No: the antibody tests were done with the expectation that the total number of the infected would be much higher. The tests have such false positive rates that with the results actually observed the tests in most of the cases say nothing -- in most of the locations the numbers would be similar even if nobody would be a real positive. And there where the results are above these "noise" thresholds we also have a big numbers of deaths which do confirm my claim of order of magnitude deadlier than flu. Even observing the pure death statistics we can see that, even in spite of all the measures actively taken throughout the world. Without them it's obvious it would have been again the difference of some orders of magnitude: https://www.euromomo.eu/graphs-and-maps/ https://www.euromomo.eu/graphs-and-maps/ See also here: https://www.ft.com/coronavirus-latest https://www.ft.com/coronavirus-latest the "Death rates have climbed far above historical averages" graph.
- throwaway374810 7y ago
  Going by the death rates, it's definitely deadlier than any flu of the past five years, but not by a magnitude. Not even close. Saying that it would've been a magnitude higher without any of the measures is pure speculation.
pbhjpbhj 7y ago
Well UK deaths from flu are about were 500 deaths per 66M for the most recent year of published cause of death statistics, which I understand (from a couple of papers on annual infection rates) represents about 500/13M infections. Covid19 figures in the UK are 26,000 [hospital] deaths for 165,000 confirmed infections. Even if we assume the entire population is infected ... that makes it a minimum of 10x as deadly as flu. We're at a slowly falling ~5000 deaths per day; when care-home and other Covid deaths get added ... I think perhaps you're down-playing it a little too much.
- throwaway894345 7y ago
  To reiterate the third/last sentence of my post, I'm explicitly not down-playing anything--I'm not asserting anything about covid WRT the flu, only cautioning against drawing conclusions based on potentially outdated information.
talaketu 7y ago
So? I haven't read any of this studies either, but I'd expect seralogical studies to likewise indicate that positive flu test results are a small fraction of the total number of cases, and likely the most severe subset.
- throwaway894345 7y ago
  We have decades of data about the flu--we pretty much understand its morbidity. We don't need to make guesses based on positive test results like we were doing with covid.
  - talaketu 7y ago
    Your argument is invalid.

manfredo 7y ago

This is due to testing methods that undercount the denominator. Countries conducting random testing have yielded an IFR of about 0.4%. 4x deadlier than the flu.

Lewton 7y ago
You're comparing the IFR of the corona virus with the CFR of the flu
- manfredo 7y ago
  No it's not. The IFR of the flu is 0.1%. The CFR is higher. The Case Fatality Rate will always be higher than the Infection Fatality Rate. The people who present cases will be a strict subset of the people who are infected. Early studies treated the Case Fatality Rate as the Infection Fatality Rate, by virtue of the fact that the only people getting tested were people with symptoms. Random testing in Germany has indicated that ~20% of the population was infected or has been infected, and the corresponding death rate yielded an IFR of 0.37%.
  - Lewton 7y ago
    What's your source for the 0.1% flu number? People are linking to the CDC website which explicitly only looks at symptomatic flu cases. Which means it's NOT the IFR. The flu also has asymptomatic cases!
    - manfredo 7y ago
      If you're talking about this CDC website, it does track CFR [1]. And as I said, the CFR rate is higher than the IFR rate. Several years the seasonal flu has a CFR above 0.13%. Measuring IFR is inherently speculative, unless 100% of the population is administered a test with no risk of false negative or positives. In order to compare the IFR of COVID-19 to the seasonal flu, we'd need to use the same estimation techniques. I've only found a few experts that have done comparisons of IFR rates of the flu and of COVID-19. The most reputable source on this reported an estimated IFR for the flu of 0.04%, but also an estimated IFR for COVID-19 of 0.2-0.3% [2]. This is "many times deadlier" if by "many" you mean 5 to 8 times deadlier. This is nowhere near the multiple orders of magnitude deadlier that was reported initially (IFR rates of 2-3% and above). 1. https://www.cdc.gov/flu/about/burden/index.html https://www.cdc.gov/flu/about/burden/index.html 2. https://www.bloomberg.com/opinion/articles/2020-04-24/is-coronavirus-worse-than-the-flu-blood-studies-say-yes-by-far https://www.bloomberg.com/opinion/articles/2020-04-24/is-cor...

f38zf5vdt 7y ago

You found my favorite part of that whole comment. I hereby announce my support for redefining "somewhat" to mean "an order of magnitude" for all subsequent HN discussions.