16 ms·

I would really like to know if covid19 is worse than malaria, globally. Up until now it seems that it is worse only because it affects us. I was shocked to find

by GoToRO 6y ago

I would really like to know if covid19 is worse than malaria, globally. Up until now it seems that it is worse only because it affects us. I was shocked to find out there is no treatment for malaria when I traveled in affected areas. I felt the same way as I am today, except I was the only one feeling like that.

darkerside 6y ago
I thought hydroxychloroquine was a much vaunted treatment for malaria? COVID certainly has a lower mortality right now, but it's only because of the extreme precautions we've all taken. In a world where we didn't bother, I presume that would completely change.
- vidarh 6y ago
  Malaria has kept getting resistant against more and more medication. This map [1] is pretty terrifying - very few areas that have malaria does not have some extent of (hydro-)chloroquine resistant malaria. [1] https://en.wikipedia.org/wiki/Malaria#/media/File:Paludisme.png https://en.wikipedia.org/wiki/Malaria#/media/File:Paludisme....
- elliekelly 6y ago
  I think it depends on the strain (species?) of malaria and even the geography of where a person has been infected. Some infections are more resistant to treatment than others.
- screye 6y ago
  > COVID certainly has a lower mortality right now Yep. A vast majority of those who've contracted COVID are asymptomatic. The mortality rate might be significantly lower than previously reported.
  - krzyk 6y ago
    > A vast majority of those who've contracted COVID are asymptomatic. Any sources on that? From the https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180 https://www.eurosurveillance.org/content/10.2807/1560-7917.E... it looks like at most 17% could be asymptomatic, but I'm not sure if it wouldn't be lower if they waited longer.
    - klmadfejno 6y ago
      Age affects everything. The diamond princess cohort is much older than the population average. Older people are more likely to die from the disease, suffer symptoms from the disease, and catch the disease, all things being held equal. The concept of death rates, symptomatic rates, and even transmission rates as a generic term is meaningless because it depends entirely on the age demographics of the population (and behavior, and other things, etc.). The idea the most people who catch it are asymptomatic is true if our antibody tests aren't throwing out massive false positive rates. For something closer to the general population, the USS Theodore Roosevelt is probably a better guess. https://en.wikipedia.org/wiki/COVID-19_pandemic_on_USS_Theodore_Roosevelt https://en.wikipedia.org/wiki/COVID-19_pandemic_on_USS_Theod... Looks like 90% of them had the disease on April 11. By April 20, 60% were asymptomatic. The last update seems to have been on April 22, with about 50% asymptomatic. That's probably a good bet for an actual figure in my opinion.
      - yojo 6y ago
        I would assume the crew of a military ship are substantially younger and healthier than the general population. Since both health and age seem to play a key role, 50% is almost certainly an upper bound, with the true number lying between 17% and 50%
        toomanybeersies 6y ago
        There are indications that severity of infection is proportional to the initial viral load. I'd imagine that being locked in close quarters on a warship would subject the sailors to a higher viral load than you'd expect in the general population, and subsequently they'd have on average more severe infections, so it could be lower than 50%.
        klmadfejno 6y ago
        Most will be in the range of 20-40. Some will be older, but none will be kids. So take it as you will. The true number doesn't have any intuitive meaning anyway, since the likelihood of being infected is correlated with the likelihood of being symptomatic. E.g. if hypothetically people under 20 never exhibit symptoms but also never get the disease, they won't bring the asymptomatic rate down because they won't be infected in the first place. Averages suck in this context.
  - athenot 6y ago
    One way to find out is to look at the overall death rates (of all causes) in an area and see how it evolved. NY started doing that and found there's a discrepancy. One explanation among others is that some people who've caught it and died from it never got a positive test (either no test, or false negative). That seems to point to the opposite happening: a higher mortality that is still not fully understood for lack of accurate data.
    - TsiCClawOfLight 6y ago
      Don't forget the secondary effects of shutting down entire countries: depression, supply chain failures, sudden poverty, degradation of infrastructure, and increasingly lack of exercise and unhealthy eating as this drags on. I suspect that will account for most of the differential, and possibly even be the more important number. (because many countries diagnose deaths with covid as deaths by covid)
      - stOneskull 6y ago
        The secondary effects are much worse. The virus is being used as an excuse to get more control of the people and planet by the psychopaths. They don't really care about us.
        seppin 6y ago
        I don't know why something so easily disproved is being repeated so often. The worst-case of an economic shutdown is not worse than 2 million dead people. Added bonus: the economic outcome of 2 million dead people is bad too, perhaps worse than a shutdown of (largely) healthy people. It's not an either/or, economic hardship right now is unavoidable. The choice is between getting a handle on the virus or not, and thousands dead instead of millions.
      - cma 6y ago
        Later on it may be a major factor, but right now it is probably outweighed in the counts by less car accident deaths, lower transmission of other communicable respiratory diseases, and less work and leisure accidents.
  - wolco 6y ago
    More likely much higher when you start parsing how China determines COVID cases/deaths. Or those people not allowed in hospitals. There deaths do not count.. so there is a big difference but going the other way.
  - cycomanic 6y ago
    The antibody tests in New York showed 12. 3% for the state and 19% infection rate for the city https://www.axios.com/coronavirus-new-york-antibody-test-f4fbed78-646f-4b46-90b8-5e8ca75380e4.html https://www.axios.com/coronavirus-new-york-antibody-test-f4f... Confirmed and probable deaths are 16700 for a population of 8.4 million we come to about 1% IFR. However the excess deaths (for example how we count deaths during flu seasons) are 21000, so we are likely undercounting covid 19 deaths. Based on that number the IFR is 1.2% both these numbers are significantly higher than the flu. The other thing is that the numbers there are taken at similar times. However there is an incubation time of about 4 days (IIRC) and a time to death from first symptoms of about 10 days. So we really should compare the infection rate now with the death toll in 2 weeks. Which likely will increase IFR https://www.nationalreview.com/corner/coronavirus-crisis-21000-more-deaths-than-normal-in-new-york-city-since-march/ https://www.nationalreview.com/corner/coronavirus-crisis-210...
    - cc81 6y ago
      19.9% for the city. You are still in the end of the flu season though so some of those excess death numbers might be that.
- burnishing 6y ago
  What precautions would reduce the mortality? Social distancing, masks, etc. can decrease the chances of spreading the disease but I don't see how they reduce mortality once you catch it.
IAmEveryone 6y ago
Total confirmed Covid deaths currently stand at 230,000. But total mortality data, where available, points at excess mortality of around 50% to 100% more than that. That puts current mortality somewhere between 300,000 and 500,000. Malaria deaths are also around 400,000 says Wikipedia. But, crucially, that's annual death. Even in the optimistic case of Covid deaths currently being at their peak and going down as fast as they grew on the way up, total deaths are double Malaria's. And looking at the graphs, it doesn't seem like it's receding symmetrical to its growth. As to regional differences, see here for some recent excess-mortality data that includes Ecuador and Brazil, two countries that don't have Malaria but share some characteristics with countries that do, such as climate and relative poverty: https://www.ft.com/__origami/service/image/v2/images/raw/http%3A%2F%2Fcom.ft.imagepublish.upp-prod-eu.s3.amazonaws.com%2F4cc12db0-8be2-11ea-9dcb-fe6871f4145a?fit=scale-down&quality=highest&source=next&width=1260 https://www.ft.com/__origami/service/image/v2/images/raw/htt... This isn't going to spare the countries affected by Malaria, except that some of them have a demographic advantage. The only redeeming factor in Covid's favour is that mortality isn't the only, and possibly not even the most important, harm of Malaria: Just like Covid, it kills only a minority of those infected. But survivors sometimes suffer chronic relapses, enduring symptoms such as fatigue, and, in children, cognitive deficits.
- azernik 6y ago
  There's some evidence that COVID-19 infections are going to cause long-lasting damage: https://www.healthline.com/health-news/what-we-know-about-the-long-term-effects-of-covid-19 https://www.healthline.com/health-news/what-we-know-about-th...
jml7c5 6y ago
Around 500,000 people died of malaria in 2018. COVID-19 deaths are currently at 250,000 (according to worldometers.info), but deaths are only just starting to slow down, and it's unclear how many deaths are going unreported. (There has been suggestion that in some places, actual deaths may be twice as high; apparently even after one adds reported COVID-19 deaths to an area's expected "regular" deaths, there is a shortfall vs actual deaths.) It's worth noting that in terms of person-years lost, an average malaria death is significantly worse as it predominantly kills children under the age of 5.
- SamBam 6y ago
  > in terms of person-years lost "Potential" person years lost, I guess. If you used "person years" the same way you use "Our firm has a combined 125 years of experience" then it's the other way round. (Grim discussion, I guess, but I'm just not certain I agree with the unspoken assumption that seems to be in that statement, that the younger the death, the more tragic/more effect on society.)
  - xiphias2 6y ago
    It's a horrible assumption. I know that my parents probably have only 5-15 years of their life left, so I make sure to have contact with them as much as possible, and keep up longevity research, though I know that they don't like to experiment as much as I would in their place.
    - SamBam 6y ago
      > I know that they don't like to experiment as much as I would in their place. Hard to know. Do you think there's zero chance that, when you're their age, you might be the one telling your adult kid that you've had a happy, long life, and don't feel the need to experiment with longevity?
  - jml7c5 6y ago
    Yes, "potential person years" or a similar phrasing would have been clearer. >(Grim discussion, I guess, but I'm just not certain I agree with the unspoken assumption that seems to be in that statement, that the younger the death, the more tragic/more effect on society.) It is a matter of morality and personal ethics. I chose to mention it only because the discrepancy in this case is so large, and it felt almost misleading to not relate the information. That said, I regret framing it in such a coldly utilitarian way.
aaron695 6y ago
The flu kills around 600,000 each year - https://www.who.int/news-room/detail/14-12-2017-up-to-650-000-people-die-of-respiratory-diseases-linked-to-seasonal-flu-each-year https://www.who.int/news-room/detail/14-12-2017-up-to-650-00... Covid-19 should kill 30 million. .5% * 80% * 7.8 billion. That will be over many years however. Maybe 2-3 years. Some estimates put Covid-19 at 10 years lost per person average. If you can get it multiple times, which is likely after a few years, it'll keep killing forever but it'll slow down, and we might even slow it even more in the richer countries, like we sort of bother with the Flu for, if a vaccine is ever possible. Currently China has an unsustainable model going (School is not back properly) for 1.4 billion. If however they can move to a sustainable model, maybe they might not get it..... Good luck everyone else.
- cc81 6y ago
  I think 80% for heard immunity is a pretty high count. IFR is a guess and yours could be right. It is lower than NYC but the developing world is much younger than the west so they might have a much lower IFR unless their lack of available health care hurts them too much. Hopefully IFR will drop as well as we learn to protect the elderly better.
ngold 6y ago
The aversion to testing by the American government is how we know that we live in dark times. I look forward to see what Silicon Valley finds in their testing of people that died in november.
- gmanley 6y ago
  What makes you think it's an aversion to testing? It seems to me more just general incompetence and slow response that caused the testing crisis in the US.
7952 6y ago
The response to covid is due to its newness. That means that our response can have much greater effect and is more urgent.
danenania 6y ago
The main difference is that malaria, as bad as it is, is not contagious between people. So while the numbers are bad, there’s effectively a lid on them—they aren’t suddenly going to start growing exponentially. With covid, the worst case scenario with no mitigation is quite literally that everyone in the world gets it in fairly short order, which could cause tens of millions of deaths even with low IFR estimates, plus all the social and economic destabilization that implies.
thaumasiotes 6y ago
> I was shocked to find out there is no treatment for malaria when I traveled in affected areas. I'd be shocked too; there IS a treatment for malaria.

by GoToRO 6y ago

darkerside 6y ago

I thought hydroxychloroquine was a much vaunted treatment for malaria? COVID certainly has a lower mortality right now, but it's only because of the extreme precautions we've all taken. In a world where we didn't bother, I presume that would completely change.

vidarh 6y ago
Malaria has kept getting resistant against more and more medication. This map [1] is pretty terrifying - very few areas that have malaria does not have some extent of (hydro-)chloroquine resistant malaria. [1] https://en.wikipedia.org/wiki/Malaria#/media/File:Paludisme.png https://en.wikipedia.org/wiki/Malaria#/media/File:Paludisme....
elliekelly 6y ago
I think it depends on the strain (species?) of malaria and even the geography of where a person has been infected. Some infections are more resistant to treatment than others.
screye 6y ago
> COVID certainly has a lower mortality right now Yep. A vast majority of those who've contracted COVID are asymptomatic. The mortality rate might be significantly lower than previously reported.
- krzyk 6y ago
  > A vast majority of those who've contracted COVID are asymptomatic. Any sources on that? From the https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180 https://www.eurosurveillance.org/content/10.2807/1560-7917.E... it looks like at most 17% could be asymptomatic, but I'm not sure if it wouldn't be lower if they waited longer.
  - klmadfejno 6y ago
    Age affects everything. The diamond princess cohort is much older than the population average. Older people are more likely to die from the disease, suffer symptoms from the disease, and catch the disease, all things being held equal. The concept of death rates, symptomatic rates, and even transmission rates as a generic term is meaningless because it depends entirely on the age demographics of the population (and behavior, and other things, etc.). The idea the most people who catch it are asymptomatic is true if our antibody tests aren't throwing out massive false positive rates. For something closer to the general population, the USS Theodore Roosevelt is probably a better guess. https://en.wikipedia.org/wiki/COVID-19_pandemic_on_USS_Theodore_Roosevelt https://en.wikipedia.org/wiki/COVID-19_pandemic_on_USS_Theod... Looks like 90% of them had the disease on April 11. By April 20, 60% were asymptomatic. The last update seems to have been on April 22, with about 50% asymptomatic. That's probably a good bet for an actual figure in my opinion.
    - yojo 6y ago
      I would assume the crew of a military ship are substantially younger and healthier than the general population. Since both health and age seem to play a key role, 50% is almost certainly an upper bound, with the true number lying between 17% and 50%
      - toomanybeersies 6y ago
        There are indications that severity of infection is proportional to the initial viral load. I'd imagine that being locked in close quarters on a warship would subject the sailors to a higher viral load than you'd expect in the general population, and subsequently they'd have on average more severe infections, so it could be lower than 50%.
      - klmadfejno 6y ago
        Most will be in the range of 20-40. Some will be older, but none will be kids. So take it as you will. The true number doesn't have any intuitive meaning anyway, since the likelihood of being infected is correlated with the likelihood of being symptomatic. E.g. if hypothetically people under 20 never exhibit symptoms but also never get the disease, they won't bring the asymptomatic rate down because they won't be infected in the first place. Averages suck in this context.
- athenot 6y ago
  One way to find out is to look at the overall death rates (of all causes) in an area and see how it evolved. NY started doing that and found there's a discrepancy. One explanation among others is that some people who've caught it and died from it never got a positive test (either no test, or false negative). That seems to point to the opposite happening: a higher mortality that is still not fully understood for lack of accurate data.
  - TsiCClawOfLight 6y ago
    Don't forget the secondary effects of shutting down entire countries: depression, supply chain failures, sudden poverty, degradation of infrastructure, and increasingly lack of exercise and unhealthy eating as this drags on. I suspect that will account for most of the differential, and possibly even be the more important number. (because many countries diagnose deaths with covid as deaths by covid)
    - stOneskull 6y ago
      The secondary effects are much worse. The virus is being used as an excuse to get more control of the people and planet by the psychopaths. They don't really care about us.
      - seppin 6y ago
        I don't know why something so easily disproved is being repeated so often. The worst-case of an economic shutdown is not worse than 2 million dead people. Added bonus: the economic outcome of 2 million dead people is bad too, perhaps worse than a shutdown of (largely) healthy people. It's not an either/or, economic hardship right now is unavoidable. The choice is between getting a handle on the virus or not, and thousands dead instead of millions.
    - cma 6y ago
      Later on it may be a major factor, but right now it is probably outweighed in the counts by less car accident deaths, lower transmission of other communicable respiratory diseases, and less work and leisure accidents.
- wolco 6y ago
  More likely much higher when you start parsing how China determines COVID cases/deaths. Or those people not allowed in hospitals. There deaths do not count.. so there is a big difference but going the other way.
- cycomanic 6y ago
  The antibody tests in New York showed 12. 3% for the state and 19% infection rate for the city https://www.axios.com/coronavirus-new-york-antibody-test-f4fbed78-646f-4b46-90b8-5e8ca75380e4.html https://www.axios.com/coronavirus-new-york-antibody-test-f4f... Confirmed and probable deaths are 16700 for a population of 8.4 million we come to about 1% IFR. However the excess deaths (for example how we count deaths during flu seasons) are 21000, so we are likely undercounting covid 19 deaths. Based on that number the IFR is 1.2% both these numbers are significantly higher than the flu. The other thing is that the numbers there are taken at similar times. However there is an incubation time of about 4 days (IIRC) and a time to death from first symptoms of about 10 days. So we really should compare the infection rate now with the death toll in 2 weeks. Which likely will increase IFR https://www.nationalreview.com/corner/coronavirus-crisis-21000-more-deaths-than-normal-in-new-york-city-since-march/ https://www.nationalreview.com/corner/coronavirus-crisis-210...
  - cc81 6y ago
    19.9% for the city. You are still in the end of the flu season though so some of those excess death numbers might be that.
burnishing 6y ago
What precautions would reduce the mortality? Social distancing, masks, etc. can decrease the chances of spreading the disease but I don't see how they reduce mortality once you catch it.

IAmEveryone 6y ago

Total confirmed Covid deaths currently stand at 230,000. But total mortality data, where available, points at excess mortality of around 50% to 100% more than that. That puts current mortality somewhere between 300,000 and 500,000. Malaria deaths are also around 400,000 says Wikipedia. But, crucially, that's annual death. Even in the optimistic case of Covid deaths currently being at their peak and going down as fast as they grew on the way up, total deaths are double Malaria's. And looking at the graphs, it doesn't seem like it's receding symmetrical to its growth. As to regional differences, see here for some recent excess-mortality data that includes Ecuador and Brazil, two countries that don't have Malaria but share some characteristics with countries that do, such as climate and relative poverty: https://www.ft.com/__origami/service/image/v2/images/raw/http%3A%2F%2Fcom.ft.imagepublish.upp-prod-eu.s3.amazonaws.com%2F4cc12db0-8be2-11ea-9dcb-fe6871f4145a?fit=scale-down&quality=highest&source=next&width=1260 https://www.ft.com/__origami/service/image/v2/images/raw/htt... This isn't going to spare the countries affected by Malaria, except that some of them have a demographic advantage. The only redeeming factor in Covid's favour is that mortality isn't the only, and possibly not even the most important, harm of Malaria: Just like Covid, it kills only a minority of those infected. But survivors sometimes suffer chronic relapses, enduring symptoms such as fatigue, and, in children, cognitive deficits.

azernik 6y ago
There's some evidence that COVID-19 infections are going to cause long-lasting damage: https://www.healthline.com/health-news/what-we-know-about-the-long-term-effects-of-covid-19 https://www.healthline.com/health-news/what-we-know-about-th...

jml7c5 6y ago

Around 500,000 people died of malaria in 2018. COVID-19 deaths are currently at 250,000 (according to worldometers.info), but deaths are only just starting to slow down, and it's unclear how many deaths are going unreported. (There has been suggestion that in some places, actual deaths may be twice as high; apparently even after one adds reported COVID-19 deaths to an area's expected "regular" deaths, there is a shortfall vs actual deaths.) It's worth noting that in terms of person-years lost, an average malaria death is significantly worse as it predominantly kills children under the age of 5.

SamBam 6y ago
> in terms of person-years lost "Potential" person years lost, I guess. If you used "person years" the same way you use "Our firm has a combined 125 years of experience" then it's the other way round. (Grim discussion, I guess, but I'm just not certain I agree with the unspoken assumption that seems to be in that statement, that the younger the death, the more tragic/more effect on society.)
- xiphias2 6y ago
  It's a horrible assumption. I know that my parents probably have only 5-15 years of their life left, so I make sure to have contact with them as much as possible, and keep up longevity research, though I know that they don't like to experiment as much as I would in their place.
  - SamBam 6y ago
    > I know that they don't like to experiment as much as I would in their place. Hard to know. Do you think there's zero chance that, when you're their age, you might be the one telling your adult kid that you've had a happy, long life, and don't feel the need to experiment with longevity?
- jml7c5 6y ago
  Yes, "potential person years" or a similar phrasing would have been clearer. >(Grim discussion, I guess, but I'm just not certain I agree with the unspoken assumption that seems to be in that statement, that the younger the death, the more tragic/more effect on society.) It is a matter of morality and personal ethics. I chose to mention it only because the discrepancy in this case is so large, and it felt almost misleading to not relate the information. That said, I regret framing it in such a coldly utilitarian way.

aaron695 6y ago

The flu kills around 600,000 each year - https://www.who.int/news-room/detail/14-12-2017-up-to-650-000-people-die-of-respiratory-diseases-linked-to-seasonal-flu-each-year https://www.who.int/news-room/detail/14-12-2017-up-to-650-00... Covid-19 should kill 30 million. .5% * 80% * 7.8 billion. That will be over many years however. Maybe 2-3 years. Some estimates put Covid-19 at 10 years lost per person average. If you can get it multiple times, which is likely after a few years, it'll keep killing forever but it'll slow down, and we might even slow it even more in the richer countries, like we sort of bother with the Flu for, if a vaccine is ever possible. Currently China has an unsustainable model going (School is not back properly) for 1.4 billion. If however they can move to a sustainable model, maybe they might not get it..... Good luck everyone else.

cc81 6y ago
I think 80% for heard immunity is a pretty high count. IFR is a guess and yours could be right. It is lower than NYC but the developing world is much younger than the west so they might have a much lower IFR unless their lack of available health care hurts them too much. Hopefully IFR will drop as well as we learn to protect the elderly better.

ngold 6y ago

The aversion to testing by the American government is how we know that we live in dark times. I look forward to see what Silicon Valley finds in their testing of people that died in november.

gmanley 6y ago
What makes you think it's an aversion to testing? It seems to me more just general incompetence and slow response that caused the testing crisis in the US.

7952 6y ago

The response to covid is due to its newness. That means that our response can have much greater effect and is more urgent.

danenania 6y ago

The main difference is that malaria, as bad as it is, is not contagious between people. So while the numbers are bad, there’s effectively a lid on them—they aren’t suddenly going to start growing exponentially. With covid, the worst case scenario with no mitigation is quite literally that everyone in the world gets it in fairly short order, which could cause tens of millions of deaths even with low IFR estimates, plus all the social and economic destabilization that implies.

thaumasiotes 6y ago

> I was shocked to find out there is no treatment for malaria when I traveled in affected areas. I'd be shocked too; there IS a treatment for malaria.