16 ms·

Initial Covid-19 infection rate may be 80 times greater than originally reported

102 points by burlesona 6y ago

baxtr 6y ago
> “The findings suggest an alternative way of thinking about the COVID-19 pandemic. Our results suggest that the overwhelming effects of COVID-19 may have less to do with the virus’ lethality and more to do with how quickly it was able to spread through communities initially,” Silverman explained. “A lower fatality rate coupled with a higher prevalence of disease and rapid growth of regional epidemics provides an alternative explanation to the large number of deaths and overcrowding of hospitals we have seen in certain areas of the world.” Isn't this exactly what the "flatten the curve" crowd has been saying?
- fsiefken 6y ago
  yes, but the flatten the curve crowd assumes a higher lethality
  - arrrg 6y ago
    Do they? I think we have pretty ok lethality estimates somewhere in the ballpark of 0.2 to 0.5 percent.
    - crooked-v 6y ago
      The lethality rate without care is much higher than the lethality rate with care, and said care often needs to be exhaustive and for an extended period, which can easily fill the entire capacity of hospitals if enough people get infected at once.
      - deathgrips 6y ago
        Weren't doctors beginning to question whether intubation had any effect on recovery?
    - deleted 6y ago
      [deleted]
  - ben_w 6y ago
    Not high lethality, high hospitalisation rate.
- saberdancer 6y ago
  These type of studies focus on a couple of data points, ignore all others and then come up with conclusions such as these. It's impossible that the infection rate was this much less lethal as if that was the case Lombardy could not sustain the numbers it had, it would have been over 100% infected months ago. In the article they mention that New York had 9% infection rate at the end of March. With the doubling rate they specified (3 days), New York would be fully infected by April 10th.
  - lbeltrame 6y ago
    I argue that in Lombardia (where I live) the virus found niches of vulnerable populations (nursing care homes, hospitals like Alzano Lombardo which weren't closed after infections were found) and then proceeded to cut them down.
- gizmo 6y ago
  No, because the "flatten the curve" crowd believed that the virus was in early stages; the lockdown was to prevent uncontrolled spreading. The virus looks super lethal when deaths are starting to pile up when only a tiny percentage of the country was believed to have been exposed. But in reality the virus had almost peaked by the time people started to panic, which made all those lockdown or flatten the curve measures pointless.
  - baxtr 6y ago
    Got it thanks. This assumption is of course undermined by the fact that seroprevalence of antibodies is not that high even in countries like Sweden. At the same time I know a person who had minor symptoms, was then tested positive in PCR but negative in a later AB test. Combine this with studies on SARS1 and MERS where only half of all asymptomatic patients developed ABs and the assumption you presented seems suddenly quite possible. If it’s true however, the pandemic should be over in a couple of weeks?
    - gizmo 6y ago
      Your immune system protects against millions of diseases, but does it continuously produce antibodies for all of them? Of course not. This means that testing positive for covid19 antibodies is strong evidence that person has been infected with covid19, but the inverse is not true. That's why we don't do antibody tests for the seasonal flu: there's just no point. Depends on what you mean by "over". Covid19 is trending down in the northern hemisphere and it will continue to trend down even after all countries stop with their ineffective lockdown measures, but the virus won't disappear completely. But life can go back to normal, except people should be a little more careful about washing their hands and not visit the elderly if they feel sick. But handwashing and consideration for the health of the vulnerable should be the default anyway, and we should do that regardless of covid.
gvjddbnvdrbv 6y ago
How does this reconcile with the actual data we have on total infection rate in e.g. Spain where a representative poll was done?
- osullip 6y ago
  Or Australia where about 10% of the population has been tested. https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/coronavirus-covid-19-current-situation-and-case-numbers https://www.health.gov.au/news/health-alerts/novel-coronavir...
- christkv 6y ago
  We now know a significant amount of people have no symptoms or very light symptoms and no antibody response. An anecdote. My friend and his wife got tested when giving birth. She was positive for antibodies he was not. It is quite possible that for ever person who had antibodies there is some unknown x of people who got it and never developed antibodies.
  - cm2187 6y ago
    I have seen Dr Raoult in France suggesting there was likely significant cross immunity from other coronaviruses. If it is the case, would the person develop covid19-specific antibodies after getting it?
  - cube2222 6y ago
    IANAD, but you can have similar antibodies (which test positive) from previous infections with similar coronaviruses, not this one specifically. So somebody who had no exposure to COVID-19 could test positive. Afaik that's the main drawback of the antibody test.
    - koheripbal 6y ago
      The antibody test specifically tests for a protein that only exists on covid-19. A positive test result is much more reliable than a negative result.
goatinaboat 6y ago
At this point every scientist in the world is throwing any random theory out there in the hope one sticks and they will be showered in new funding. The track record of Neil Ferguson‘s Group at Imperial is representative of this industry, however. https://github.com/mrc-ide/covid-sim/issues/176 https://github.com/mrc-ide/covid-sim/issues/176
- MattGaiser 6y ago
  Don’t models assume a lack of action? Given that an alarming model is going to alter our behaviour, it seems unrealistic to expect them to match what actually happens.
  - WildParser 6y ago
    From infection date ~29.February till May the growthrate in Germany is behaving mathematically exact - following a Gompertz-Model. It's not really clear if actions and visible behaviour changes did much - all of them came way too late - and there is no sign of a trendbreak that indicates any improvement.
- WildParser 6y ago
  And they are ignoring scientists that have already found models that actually work. https://www.youtube.com/watch?v=8aHrx68IT7o https://www.youtube.com/watch?v=8aHrx68IT7o https://www.facebook.com/photo.php?fbid=10157283645163015 https://www.facebook.com/photo.php?fbid=10157283645163015
jakeogh 6y ago
Whats the non-COVID-19 pneumonia# for 2019-2020? CDC Influenza and pneumonia deaths by influenza season and age: United States, 2008–2015: https://www.cdc.gov/nchs/data/health_policy/influenza-and-pneumonia-deaths-2008-2015.pdf https://www.cdc.gov/nchs/data/health_policy/influenza-and-pn...
- micmil 6y ago
  Irrelevant, that's what the number is.
- charwalker 6y ago
  Even early on we had reports of some states seeing 10k+ more deaths due to pneumonia or other seasonal illness compared to prior years. Maybe the figures aren't accurate given current data, but it is worrisome: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
qeternity 6y ago
History books will not be kind to our past and present handling of covid-19. Incurring incredible economic and social damage without fully understanding the threat. It’s been very clear for some time that covid is not nearly as lethal as once feared AND even more clear that we over quarantined. In the UK we have hospitals built specifically for covid that are completely unused. This isn’t flattening the curve, it’s choking it. A vaccine isn’t happening anytime soon and the only way forward is herd immunity. This means we need new infections.
- martin_bech 6y ago
  You are aware that despite the world very best efforts, almost 500.000 people have already died, and in many parts of the world, its actually not slowing down, but speeding up?
  - jakeogh 6y ago
    These numbers would be much more useful if they were in pairs; (#people, #avg_years_lost). https://abcnews.go.com/Health/swine-flu-h1n1-pandemic-deaths-15-times-higher/story?id=16646281 https://abcnews.go.com/Health/swine-flu-h1n1-pandemic-deaths... "Though the virus was deadly, the swine flu pandemic is still considered to have been a fairly mild one. The CDC calculates that up to 575,000 people may have died from H1N1 in 2009. The WHO estimates that the seasonal flu kills up to 500,000 people each year. Both pale in comparison to the flu pandemic of 1918, which killed an estimated 50 million people worldwide."
    - crooked-v 6y ago
      Sure... and then consider that, unlike swine flu or seasonal flu, COVID-19 has already killed hundreds of thousands of people even with near-total lockdowns to the point of dystopic absurdity in many countries†, has done so over the course of only a few months, and due to lackluster government response in some countries is still increasing exponentially in some places. † See China's brief use of 'only specific designated people per apartment building are allowed to leave the building for specific designated shopping trips, under the threat of military force' policies at the worst of the peak in its cities.
ManlyBread 6y ago
I became numb to news like this because it doesn't seem to have any reflection in the reality around me. The numbers are supposed to be huge yet hospitals are nearly empty and no one I asked knows anyone who was infected. The 80x number looks like science fiction to me.
- crooked-v 6y ago
  Well, that obviously depends on where 'around you' is. Compare to New York City, where there have been an estimated 17,000 deaths (and even that's probably undercounted, going by some studies of excess deaths compared to previous years), and at the peak there were hundreds of unclaimed bodies per week being buried in mass graves.
  - adamhearn 6y ago
    This is completely anecdotal, but my good friend’s brother is an ER doctor. He said the hospital required them to label the cause of death for all patients in the hospital as covid if there was as much as one symptom. I don’t want to downplay the sadness of the deaths, but I think it is a bit foolish for us to base our number of deaths of off untested patients...
    - azinman2 6y ago
      Except you can see the excess total deaths compared to previous years and how well it correlates and is otherwise unexplained [1]. A lot of the labeling occurred because people couldn’t get tested yet presented symptoms that indicated covid. In that situation, you can’t say 100% without a test, yet it’s the reasonable conclusion in a pandemic. [1] https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
      - verylittlemeat 6y ago
        Something worth keeping in mind is how many fewer people died of other causes compared to previous years [1]. Yes, the data will show an excess number of people died versus previous years but I believe the parent comment is saying we should pay close attention to what the cause of death really means in terms of age and comorbidity. [1] https://i.imgur.com/HfaMhcK.jpg https://i.imgur.com/HfaMhcK.jpg
Animats 6y ago
This is not new data, but a re-interpretation of previously available data. With lots of assumptions. Now, if they'd gone back and analyzed samples taken in February and March with the newer tests, they'd have new data. Anyway, all of this is about reconstructing the early days of the epidemic. With good tests now available, it's not that useful at this point.
GoodJokes 6y ago
I really hope there is organized and research help on the over the top unfounded neuroses that will develop due to this pandemic and the media's utter inability comment on it reliably or helpfully. The media is so used to operating off a fear based model to drive clicks that that is all they can do right now. I fear my sister won't leave her apartment for the next three years. Like, agoraphobia must be developing at an insane rate right now.

102 points by burlesona 6y ago

> “The findings suggest an alternative way of thinking about the COVID-19 pandemic. Our results suggest that the overwhelming effects of COVID-19 may have less to do with the virus’ lethality and more to do with how quickly it was able to spread through communities initially,” Silverman explained. “A lower fatality rate coupled with a higher prevalence of disease and rapid growth of regional epidemics provides an alternative explanation to the large number of deaths and overcrowding of hospitals we have seen in certain areas of the world.” Isn't this exactly what the "flatten the curve" crowd has been saying?

fsiefken 6y ago
yes, but the flatten the curve crowd assumes a higher lethality
- arrrg 6y ago
  Do they? I think we have pretty ok lethality estimates somewhere in the ballpark of 0.2 to 0.5 percent.
  - crooked-v 6y ago
    The lethality rate without care is much higher than the lethality rate with care, and said care often needs to be exhaustive and for an extended period, which can easily fill the entire capacity of hospitals if enough people get infected at once.
    - deathgrips 6y ago
      Weren't doctors beginning to question whether intubation had any effect on recovery?
  - deleted 6y ago
    [deleted]
- ben_w 6y ago
  Not high lethality, high hospitalisation rate.
saberdancer 6y ago
These type of studies focus on a couple of data points, ignore all others and then come up with conclusions such as these. It's impossible that the infection rate was this much less lethal as if that was the case Lombardy could not sustain the numbers it had, it would have been over 100% infected months ago. In the article they mention that New York had 9% infection rate at the end of March. With the doubling rate they specified (3 days), New York would be fully infected by April 10th.
- lbeltrame 6y ago
  I argue that in Lombardia (where I live) the virus found niches of vulnerable populations (nursing care homes, hospitals like Alzano Lombardo which weren't closed after infections were found) and then proceeded to cut them down.
gizmo 6y ago
No, because the "flatten the curve" crowd believed that the virus was in early stages; the lockdown was to prevent uncontrolled spreading. The virus looks super lethal when deaths are starting to pile up when only a tiny percentage of the country was believed to have been exposed. But in reality the virus had almost peaked by the time people started to panic, which made all those lockdown or flatten the curve measures pointless.
- baxtr 6y ago
  Got it thanks. This assumption is of course undermined by the fact that seroprevalence of antibodies is not that high even in countries like Sweden. At the same time I know a person who had minor symptoms, was then tested positive in PCR but negative in a later AB test. Combine this with studies on SARS1 and MERS where only half of all asymptomatic patients developed ABs and the assumption you presented seems suddenly quite possible. If it’s true however, the pandemic should be over in a couple of weeks?
  - gizmo 6y ago
    Your immune system protects against millions of diseases, but does it continuously produce antibodies for all of them? Of course not. This means that testing positive for covid19 antibodies is strong evidence that person has been infected with covid19, but the inverse is not true. That's why we don't do antibody tests for the seasonal flu: there's just no point. Depends on what you mean by "over". Covid19 is trending down in the northern hemisphere and it will continue to trend down even after all countries stop with their ineffective lockdown measures, but the virus won't disappear completely. But life can go back to normal, except people should be a little more careful about washing their hands and not visit the elderly if they feel sick. But handwashing and consideration for the health of the vulnerable should be the default anyway, and we should do that regardless of covid.

gvjddbnvdrbv 6y ago

How does this reconcile with the actual data we have on total infection rate in e.g. Spain where a representative poll was done?

osullip 6y ago
Or Australia where about 10% of the population has been tested. https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/coronavirus-covid-19-current-situation-and-case-numbers https://www.health.gov.au/news/health-alerts/novel-coronavir...
christkv 6y ago
We now know a significant amount of people have no symptoms or very light symptoms and no antibody response. An anecdote. My friend and his wife got tested when giving birth. She was positive for antibodies he was not. It is quite possible that for ever person who had antibodies there is some unknown x of people who got it and never developed antibodies.
- cm2187 6y ago
  I have seen Dr Raoult in France suggesting there was likely significant cross immunity from other coronaviruses. If it is the case, would the person develop covid19-specific antibodies after getting it?
- cube2222 6y ago
  IANAD, but you can have similar antibodies (which test positive) from previous infections with similar coronaviruses, not this one specifically. So somebody who had no exposure to COVID-19 could test positive. Afaik that's the main drawback of the antibody test.
  - koheripbal 6y ago
    The antibody test specifically tests for a protein that only exists on covid-19. A positive test result is much more reliable than a negative result.

goatinaboat 6y ago

At this point every scientist in the world is throwing any random theory out there in the hope one sticks and they will be showered in new funding. The track record of Neil Ferguson‘s Group at Imperial is representative of this industry, however. https://github.com/mrc-ide/covid-sim/issues/176 https://github.com/mrc-ide/covid-sim/issues/176

MattGaiser 6y ago
Don’t models assume a lack of action? Given that an alarming model is going to alter our behaviour, it seems unrealistic to expect them to match what actually happens.
- WildParser 6y ago
  From infection date ~29.February till May the growthrate in Germany is behaving mathematically exact - following a Gompertz-Model. It's not really clear if actions and visible behaviour changes did much - all of them came way too late - and there is no sign of a trendbreak that indicates any improvement.
WildParser 6y ago
And they are ignoring scientists that have already found models that actually work. https://www.youtube.com/watch?v=8aHrx68IT7o https://www.youtube.com/watch?v=8aHrx68IT7o https://www.facebook.com/photo.php?fbid=10157283645163015 https://www.facebook.com/photo.php?fbid=10157283645163015

jakeogh 6y ago

Whats the non-COVID-19 pneumonia# for 2019-2020? CDC Influenza and pneumonia deaths by influenza season and age: United States, 2008–2015: https://www.cdc.gov/nchs/data/health_policy/influenza-and-pneumonia-deaths-2008-2015.pdf https://www.cdc.gov/nchs/data/health_policy/influenza-and-pn...

micmil 6y ago
Irrelevant, that's what the number is.
charwalker 6y ago
Even early on we had reports of some states seeing 10k+ more deaths due to pneumonia or other seasonal illness compared to prior years. Maybe the figures aren't accurate given current data, but it is worrisome: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

qeternity 6y ago

History books will not be kind to our past and present handling of covid-19. Incurring incredible economic and social damage without fully understanding the threat. It’s been very clear for some time that covid is not nearly as lethal as once feared AND even more clear that we over quarantined. In the UK we have hospitals built specifically for covid that are completely unused. This isn’t flattening the curve, it’s choking it. A vaccine isn’t happening anytime soon and the only way forward is herd immunity. This means we need new infections.

martin_bech 6y ago
You are aware that despite the world very best efforts, almost 500.000 people have already died, and in many parts of the world, its actually not slowing down, but speeding up?
- jakeogh 6y ago
  These numbers would be much more useful if they were in pairs; (#people, #avg_years_lost). https://abcnews.go.com/Health/swine-flu-h1n1-pandemic-deaths-15-times-higher/story?id=16646281 https://abcnews.go.com/Health/swine-flu-h1n1-pandemic-deaths... "Though the virus was deadly, the swine flu pandemic is still considered to have been a fairly mild one. The CDC calculates that up to 575,000 people may have died from H1N1 in 2009. The WHO estimates that the seasonal flu kills up to 500,000 people each year. Both pale in comparison to the flu pandemic of 1918, which killed an estimated 50 million people worldwide."
  - crooked-v 6y ago
    Sure... and then consider that, unlike swine flu or seasonal flu, COVID-19 has already killed hundreds of thousands of people even with near-total lockdowns to the point of dystopic absurdity in many countries†, has done so over the course of only a few months, and due to lackluster government response in some countries is still increasing exponentially in some places. † See China's brief use of 'only specific designated people per apartment building are allowed to leave the building for specific designated shopping trips, under the threat of military force' policies at the worst of the peak in its cities.

ManlyBread 6y ago

I became numb to news like this because it doesn't seem to have any reflection in the reality around me. The numbers are supposed to be huge yet hospitals are nearly empty and no one I asked knows anyone who was infected. The 80x number looks like science fiction to me.

crooked-v 6y ago
Well, that obviously depends on where 'around you' is. Compare to New York City, where there have been an estimated 17,000 deaths (and even that's probably undercounted, going by some studies of excess deaths compared to previous years), and at the peak there were hundreds of unclaimed bodies per week being buried in mass graves.
- adamhearn 6y ago
  This is completely anecdotal, but my good friend’s brother is an ER doctor. He said the hospital required them to label the cause of death for all patients in the hospital as covid if there was as much as one symptom. I don’t want to downplay the sadness of the deaths, but I think it is a bit foolish for us to base our number of deaths of off untested patients...
  - azinman2 6y ago
    Except you can see the excess total deaths compared to previous years and how well it correlates and is otherwise unexplained [1]. A lot of the labeling occurred because people couldn’t get tested yet presented symptoms that indicated covid. In that situation, you can’t say 100% without a test, yet it’s the reasonable conclusion in a pandemic. [1] https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
    - verylittlemeat 6y ago
      Something worth keeping in mind is how many fewer people died of other causes compared to previous years [1]. Yes, the data will show an excess number of people died versus previous years but I believe the parent comment is saying we should pay close attention to what the cause of death really means in terms of age and comorbidity. [1] https://i.imgur.com/HfaMhcK.jpg https://i.imgur.com/HfaMhcK.jpg

Animats 6y ago

This is not new data, but a re-interpretation of previously available data. With lots of assumptions. Now, if they'd gone back and analyzed samples taken in February and March with the newer tests, they'd have new data. Anyway, all of this is about reconstructing the early days of the epidemic. With good tests now available, it's not that useful at this point.

GoodJokes 6y ago

I really hope there is organized and research help on the over the top unfounded neuroses that will develop due to this pandemic and the media's utter inability comment on it reliably or helpfully. The media is so used to operating off a fear based model to drive clicks that that is all they can do right now. I fear my sister won't leave her apartment for the next three years. Like, agoraphobia must be developing at an insane rate right now.