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Antibody Tests Point to Lower Death Rate for the Coronavirus Than First Thought
- Finnucane 6y agoThat seems roughly consistent with what surveys have shown in other countries. But it still suggests that if the virus had been allowed to spread uncontained, death tolls would be several times what they are now.
- downerending 6y agoIf no changes had been made, it does seem that the ultimate deaths directly caused by the virus would have been a lot higher, yes. Once one starts thinking about indirect deaths, especially those caused by attempts to contain the virus, the picture becomes much murkier. And of course, all of this is being done under circumstances of grave uncertainty. We'll likely never really know. My guess, though, is that the "lockdown" is probably working against us, at least at this date. And clearly some containment measures, like moving infected people into care homes for the old and disabled, appear in retrospect to have been disastrous.
- redis_mlc 6y ago> But it still suggests that if the virus had been allowed to spread uncontained In the US, it is spreading uncontained, because we don't test and trace in any meaningful way. The question is when do we confront that reality and stop pretending otherwise? It appears people's acceptance of "flattening the curve" for ventilators has morphed into waiting for a vaccine, which normally takes 18 months. As I've said before, the US needs to test and trace just nursing homes/hospitals and stop the lockdown otherwise, since the mortality rate for younger people is near zero. The US economy is not setup for tens of millions of long-term unemployed people. In the case od Newsom's reopening slides, I'd like to see dates attached to each slide instead of non-specific "when adequate testing is available", which may never be true in the US. (By omitting dates, Newsom preserves his White House run at the expense of California residents.)
- nopzor 6y agodepends where in the US. for example, testing levels in NY state are extremely meaningful, they've really scaled up to the point that their testing (on a per capita basis) is among the best in the world.
- redis_mlc 6y agoCan you provide some numbers? (I follow SF news, not NY.) Several Asian countries csn do 100% of the tests they need because corona was not "uncontained." The US would need to be able to do 10-50 million tests per day to get there, plus tracing. Hope is not a strategy.
- mdemare 6y agoThere we go again. In NYC, 19 out of 100,000 people aged 18-45 died. (1) There are roughly 110M people in that age group in the U.S. so that would mean 21000 deaths if the virus would spread as widely throughout the U.S. as it has in NYC (which is estimated to be around 25% of the population). 21000 deaths is not "near zero", nor is the population aged over 45 primarily found in nursing homes. 1) https://www1.nyc.gov/site/doh/covid/covid-19-data.page https://www1.nyc.gov/site/doh/covid/covid-19-data.page
- redis_mlc 6y ago> 21000 deaths is not "near zero" I'm not sure what your contrived narrative is, but actually it is near zero, far less than several other causes of death. (The annual mortality rate is over 1,000 per 100,000, so 19 per 100,000 is a round-off error.) "He noted that between January and April in 2018, more than 234,000 people in the United States died of heart disease and nearly 199,000 died of cancer. So far during the coronavirus pandemic, there have been about 16,700 Covid-19 deaths in the United States, according to the latest data from Johns Hopkins University." https://www.cnn.com/2020/04/10/health/coronavirus-not-leading-cause-of-death-us-trnd/index.html https://www.cnn.com/2020/04/10/health/coronavirus-not-leadin... Even auto deaths are higher at 37,461 in 2016: "For 2016 specifically, National Highway Traffic Safety Administration (NHTSA) data shows 37,461 people were killed in 34,436 motor vehicle crashes, an average of 102 per day." https://en.wikipedia.org/wiki/Motor_vehicle_fatality_rate_in_U.S._by_year https://en.wikipedia.org/wiki/Motor_vehicle_fatality_rate_in... There is nothing the US can do to get to zero deaths from corona, so a more pragmatic public health policy is needed than "lock 300 million people down for years."
- dnautics 6y ago> But it still suggests that if the virus had been allowed to spread uncontained, death tolls would be several times what they are now. There's a presumption there that everyone is equally susceptible to the virus at any given viral load. There are likely people whose bodies are inhospitable enough to the virus that it never reaches a titer enough to trigger any sort of test. What percentage of the population is this? 1%? 20%? 60%? If it were allowed to spread uncontained, death tolls would certainly be higher. But can we really say "several times"? I'm not sure. Maybe, 1x more, on account of if california were as bad as new york. But still, we don't really know.
- beezle 6y agoOf course, this assumes that the testing data is accurate and indications are it may not be. Politico ran something today suggesting quite a few states had inflated the number of tests done. Also not clear is whether they are unique tests (ie, multiple tests of the same person only count once)
- MR4D 6y agoI went to look up the accuracy for antibody tests specifically (as opposed to the other test which we've all heard bad things about generally), and I found this [0]. Apparently the antibody tests suck wrt accuracy. [0] - https://www.cbsnews.com/news/cdc-warns-that-half-of-coronavirus-antibody-test-results-are-wrong-2020-05-27/ https://www.cbsnews.com/news/cdc-warns-that-half-of-coronavi...
- acqq 6y ago> Apparently the antibody tests suck wrt accuracy. Here's what I have posted here exactly a month ago, referring to the article from Guardian from April 4th: -- The "false positives" are "especially significant with these antibody tests, so with the low numbers of positives it's extremely important to evaluate if the claimed values are more than noise artifacts of the tests themselves. It is also important to be aware of the scenarios for which the use of the apparent test results is not reasonable. Moreover, here's what happened in the UK a few weeks ago: https://www.theguardian.com/world/2020/apr/09/uk-government-urged-to-abandon-poor-finger-prick-antibody-tests-coronavirus https://www.theguardian.com/world/2020/apr/09/uk-government-... "None of 3.5m home tests ordered have so far been accurate enough to detect coronavirus immunity" UK got 3.5 million(!) unusable antibody tests. https://www.bmj.com/content/369/bmj.m1449 https://www.bmj.com/content/369/bmj.m1449 "John Newton, Public Health England’s director of health improvement, said: "A number of companies were offering us these quick antibody tests, and we were hoping that they’d be fit for purpose, but when they got to test, they all worked but were just not good enough to rely on. “The judgment was made [that] it’s worth taking the time to develop a better antibody test before rolling it out, and that is what the current plan is.” "Newton told the committee that the tests trialled so far had lacked sufficient sensitivity to identify people who had been infected. “We set a clear target for tests to achieve, and none of them frankly were close.”" -- Since then, Roche actually made an antibody test which according to them, in laboratory conditions, doesn't have false positives. I haven't seen the independently done confirmation, but personally, I wouldn't use anything else. There are still a lot of bad antibody tests in circulation. Also, the estimate that the death rate is close to 1% was known since... seems like forever in this times: on Diamond Princess ship there were a lot of old people and the death rate was under 2% so adjusting to the population structure (where there are more younger people than on the ship) it was obvious even then: https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_on_Diamond_Princess https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_on_D... But it was also obvious that it's something like 10 times more deadly than flu. What was also known is that once the health system is overwhelmed the death rate would be much more than 1%, and that is also what was observed in Italy. And that is the reason for having the goal of "flattening the curve": not allowing to have more cases than the whole system could handle.
- javagram 6y agoThis headline doesn’t seem to match the body of the article: > "The current best estimates for the infection fatality risk are between 0.5% and 1%," says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. > That's in contrast with death rates of 5% or more based on calculations that included only people who got sick enough to be diagnosed with tests that detect the presence of virus in a person's body. > And the revised estimates support an early prediction by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a leading member of the White House coronavirus task force. In an editorial published in late March in The New England Journal of Medicine, Fauci and colleagues wrote that the case fatality rate for COVID-19 "may be considerably less than 1%." Unless “First Thought” simply refers to people who are unfamiliar with how figures such as CFR are calculated. I’ve been seeing the 1% number repeated by scientific figures for months. Here is a Medium article from a month ago saying the same https://medium.com/@gidmk/what-is-the-infection-fatality-rate-of-covid-19-7f58f7c90410 https://medium.com/@gidmk/what-is-the-infection-fatality-rat... > From the 13 studies — including 4 models, 4 observational studies, and 5 pre-prints of one kind or another — there was an overall estimate of 0.75% infection-fatality rate, with the 95% confidence interval ranging from 0.49% to 1.01%.
- nodamage 6y agoHere is a WHO report from February saying the same thing: > Modeling is a helpful tool to try to account for missed cases, such as those that are mild cases potentially missed in current surveillance activities, and the time lag between onset and death. Using an estimated number of total infections, the Infection Fatality Ratio can be calculated. This represents the fraction of all infections (both diagnosed and undiagnosed) that result in death. Based on these available analyses, current IFR estimates range from 0.3% to 1%. Without population-based serologic studies, it is not yet possible to know what proportion of the population has been infected with COVID-19. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200219-sitrep-30-covid-19.pdf https://www.who.int/docs/default-source/coronaviruse/situati...
- acqq 6y agoIt is a report dated 19th February! Also note that this estimate is based exclusively on the Chinese data(!) and that it practically confirms that the Chinese data were usable for the estimates even as there were doubts spread by the media and politicians. Specifically in the same report it is written (1): "Using an estimated number of total infections, the Infection Fatality Ratio can be calculated. This represents the fraction of all infections (both diagnosed and undiagnosed) that result in death. Based on these available analyses, current IFR estimates range from 0.3% to 1%." And then: "Without population-based serologic studies, it is not yet possible to know what proportion of the population has been infected with COVID-19." So even without the population-based antibody (that is what "serologic" means) data, and only using the Chinese data "as of 11 February" available to the WHO the estimate was quite good. The range depends of course also on the age structure of the population -- the countries with much more young people would have closer to the lower number, the others closer to the higher. 1) Edit: the parent post quoted the same segment later too
- pdovy 6y agoI've seen a lot of people on social media tout a 0.5-1% death rate as if that's inconsequentially low, which is baffling to me. 0.5% of the US population is 1.6 million people. Even if you make a lot of optimistic assumptions - a slow enough transmission rate to continue providing a normal standard of medical care, herd immunity at ~60% infected, etc, the number of deaths is still extremely high. Unless this is revised substantially downward as we get more data, there is no clear return to normalcy without a vaccine.
- SpicyLemonZest 6y agoIt's not inconsequentially low. However, n the individual level, it's about the same risk of death as you face over a normal year. It's worth quite a bit of effort and sacrifice to avoid multiplying that individual risk by the entire population, but a lot of people talk like it's a megaplague they need to avoid catching at all costs. By all means, everyone should try and find ways to thrive inside, and wear a mask when they go out. I see people propose that in-person social activity should just be forbidden or strongly discouraged until a vaccine comes - that would be a severe and harmful overreaction.
- acqq 6y ago> But on the individual level, it's about the same risk of death as you face over a normal year. It's surely not. Even the "normal" averages include people who have big problems. If you are an individual who is not in the group of people with big problems, and if the virus can make you sick, your risk gets up significantly, as soon as you risk being infected. Because, for example, you can know that you personally aren't in the risk group of people tending to commit suicide. The currently known estimate of "people who get the virus and have no recognizable symptoms during all phases of infection" is just around 20% across all the age groups. Knowing that younger than 45 aren't being only 20% of population, it doesn't sound so trivial. The same (that one can know that catching virus increases risk) is for some of the people with big problems, even if they are young: it is known that some of those (who have some big problems) are hit much stronger by the virus, e.g. those with diabetes: without the virus they can safely expect to live for decades more, with the virus, they can immediately expect much less. And no, not only overweight people have diabetes. And the above analysis is only for young people. But being old enough (and that is even for those being above 45) and catching the virus increases the risks of permanent health damage or death many times, according to all statistics we have. Finally, no age group can expect to have "no problems" as soon as the health system collapses, and that is why the strict measures were introduced in most of the world -- it is a reasonable goal to avoid that much.
- goalieca 6y agoHere’s the cdc estimates used for modelling. https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena... Their best guess scenario is 35% asymptomatic. Of the symptomatic the rate is 0.05% for those under 50. All ages is 0.4%.
- nradov 6y agoIt's important to note that the 0.4% number is the CDC's best estimate of symptomatic case fatality rate. The actual infection fatality rate appears to be somewhat lower.
- tamaharbor 6y agoFor some reason, people get mad when you say, “It’s the flu”.
- hedora 6y agoThe estimate of the death rate has been 0.5% since Feb. By quoting 5%, the author of the story is conflating case fatality rates (percentage of diagnosed people) with death rates (percentage of infected people). The only story here is that a surprising fraction of the media and policy makers are completely incapable understanding basic statistics.
- dragonwriter 6y ago“CDC warns antibody testing still too inaccurate to use for coronavirus-related policy decisions” https://www.cbsnews.com/news/cdc-warns-that-half-of-coronavirus-antibody-test-results-are-wrong-2020-05-27/ https://www.cbsnews.com/news/cdc-warns-that-half-of-coronavi...