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How can a disease with 1% mortality shut down the United States?
- throwaway122378 6y agoFlawed response. Every single human in the country or the world for that matter will not get infected by the virus
- deleted 6y ago[deleted]
- crooked-v 6y agoThe tl;dr: > So now all of a sudden, that “but it’s only 1% fatal!” becomes: > 3,282,000 people dead. > 62,358,000 hospitalized. > 59,076,000 people with permanent heart damage. > 32,820,000 people with permanent lung damage. > 9,846,000 people with strokes. > 6,564,000 people with muscle weakness. > 6,564,000 people with loss of cognitive function.
- ceejayoz 6y agoIt becomes far worse than that, as our medical system can't handle 62M hospitalizations. (Nor 60-70% of that, which is more realistic, as it's unlikely to hit 100% of the population.) NYC's hospitals came close to the breaking point; Italy's exceeded it in spots.
- jlg23 6y agoThe author addresses that: > This model assumes that the question’s hypothetical is correct and the fatality rate is 1%. It also assumes for the sake of argument 100% infection. (In reality, of course, neither of these is a perfect match to reality. The infection rate will never hit 100%, but the fatality rate in a widespread infection is likely to be greater than 1%, because health care services will be overwhelmed.)
- ceejayoz 6y agoYes; I felt it important enough to warrant inclusion in the TL;DR version.
- pwdisswordfish2 6y agoEven those things wouldn’t shut down the country if it were, for example, sexually transmitted. The problem that you can contract it just by breathing in the wrong place at the wrong time is the real desaster. You wouldn’t want to take those odds even if it were 1% drop dead/99% completely fine.
- TheGrim-888 6y agoWhere are these rates coming from? They seem absolutely absurd. Are you suggesting that 17% of the US population is going to have permanent heart damage, and that 3% of the population is going to have a stroke, from contracting covid? That seems completely disconnected from reality. 3.5MM people in the US (at least) have already tested positive. Are you trying to imply that over 100,000 of these people have had a stroke? More related to the article - isn't the latest IFR estimate from the CDC even less than 1%?
- 6nf 6y agoThe author got his math wrong.
- senectus1 6y agoNot that I agree with the article, but a most of those numbers are the same people... but yeah. US population, approx 330M, 59M of which are likely to be permanently fucked up by this virus and 3M permanently dead. not to mention the amount of people that died or got permanently damaged due to the fact that the hospitals were overloaded. They may not have been Covid patients but bleeding out from a undiscovered brain hemorrhage because the hospital was packed and the dr's overworked is still just as dead as 1% of covid sufferers...
- Eric_WVGG 6y agoI find it useful and illuminating to just come up with some common large spaces and make a few estimates… - remember the last time you were at the movies? Three people dropped dead during your screening of Avengers. - two people dying per subway car on your morning rush hour commute into the city - seven of the kids in your child’s high school graduating class die. he probably knew at least a couple by name. … but the points this author makes about problems the survivors face even more striking, so, yeah.
- FabHK 6y agoAnother comparison I like to make - it's in the same ballpark as going on a Space Shuttle mission (2/135 = 1.5% crashed). Would you want to send your loved ones on a Space Shuttle ride (minus the yay, going to space thing)? And that's not accounting for the massive side effects, or the fact that the fatality risk is much higher for vulnerable populations.
- saurik 6y agoFWIW, massive side effects and increased fatality risks for vulnerable populations are also true of going on a Space Shuttle mission :(.
- Consultant32452 6y agoOnly about 1% of the people dying from covid are under 35. That's the big monkey wrench. If it was kids dying, I think the perception would be very different. There's other factors even more difficult to discuss than age. The state is powerless to shape policy in a way that adequately fits the risk due to Western culture's focus on individual rights. It's up to us to shape our behavior. Are we adult enough to have that kind of conversation? I am doubtful.
- 6nf 6y agoWhat is the mortality rate of one of the more severe stains of the common cold or the flu? I'm sure we've had one of those that got to 0.5% or more in recent history? Does that mean 0.5% is too low to shut everything down?
- mayneack 6y agoThis puts the IFR of the worst flu in recent history (2009 H1N1) at 0.03% https://en.wikipedia.org/wiki/2009_swine_flu_pandemic#Comparisons_to_other_pandemics_and_epidemics https://en.wikipedia.org/wiki/2009_swine_flu_pandemic#Compar...
- FabHK 6y agoFirst, the flu doesn't have the other severe consequences outlined in the article. Second, basically everyone except small children has had the flu, and has some immunity to it, while we're all "immunologically naive" vis-a-vis SARS-CoV-2.
- 6nf 6y agoYoung people are basically at 0% mortality from covid
- ceejayoz 6y agoThat's the precise logical fallacy the article highlights - that mortality is not the only significant component here.
- deleted 6y ago[deleted]
- FabHK 6y agoThat has no bearing whatsoever on what I said. For small kids, the flu and COVID-19 are the same - they're encountering it for the first time, and are basically ok with it. With adults, flu and COVID-19 are different: they have encountered the flu before, so it doesn't rampage through a population. COVID-19 does. In other words: for flu, we basically have achieved some level of herd immunity already.
- justinzollars 6y agohttps://www.frbatlanta.org/cqer/research/gdpnow https://www.frbatlanta.org/cqer/research/gdpnow Fed GDP Now Latest estimate: -35.5 percent — July 9, 2020
- Apocryphon 6y agoIt's shut down most countries in the world, not just the U.S.
- ceejayoz 6y agoYes, but the US is somewhat unique in having a widespread "so what if 1% of people die?" attitude.
- 6nf 6y agoSweden didn't shut down much at all either.
- Apocryphon 6y agoSweden and Japan were the major exceptions of the rule, I'm not sure who else didn't.
- umanwizard 6y agoBelarus
- logicchains 6y agoHong Kong, Korea, Taiwan.
- goldfeld 6y agoAnd how can 1% of the U.S. population shut down its wealth in their safes?
- 6nf 6y ago> For every one person who dies: > 19 more require hospitalization. > 18 of those will have permanent heart damage for the rest of their lives. ... > One study published in March found that out of 416 _hospitalized_ Covid-19 patients, 19% showed signs of heart damage. How many other mistakes can you spot?
- deleted 6y ago[deleted]
- stoksc 6y agoI just spent 5 minutes typing this up only to see your post.. thank you for also noticing. The other point made from this source (about permanent lung damage) is also wrong. I don’t see sources for the other numbers. I agree never closing the economy would’ve been a total disaster. But the math here is bad.
- me_me_me 6y agoWriting from Ireland, >20 cases a day (as of writing). The lockdown here was a huge success. But looking at the US numbers it seems that you got the worse outcome of lockdown/no-lockdown. Economical hit, plus number of cases are back on the rise due to people not isolating properly. One could argue that for US lockdown was a mistake. Or at least very costly move to delay/prepare for peak infections.
- akira2501 6y ago> Three million people dead would monkey wrench the economy no matter what. Wouldn't that largely depend on the age of the victims? If the majority of victims are over retirement age, then this isn't likely to be true. We've had nearly 1% of our population killed or wounded in a short period of time before, it's impact on the economy doesn't seem that obvious. > 18 of those will have permanent heart damage for the rest of their lives. > 10 will have permanent lung damage. The extent of these doesn't seem clear either, looking back to the previous SARS epidemic, there was significant ARDS recovery after diagnoses over a period of several years; however, with other certain pre-existing conditions the organ damage was permanent. Even in those cases, the rates are significantly lower than this suggests. It seems like a lot of small sample size studies were used to generate these numbers. I don't doubt COVID is horrific and requires special care to address, but I don't see any benefit in exaggeration.. particularly if your goal is to address an already skeptical audience.
- dragonwriter 6y ago> If the majority of victims are over retirement age No, it's not an election where the majority is the only thing that counts. And if younger people that are seriously ill are spending months debilitated (much of that hospitalized) where older people would die because they couldn't withstand the combination of the disease and the necessary supportive measures, taking more resources while losing more productivity for each young person that gets seriously ill, the fact that more old people are dying is even less relevant to the economic impact
- umanwizard 6y ago> We've had nearly 1% of our population killed or wounded in a short period of time before In fact, more than 1% of the population dies every single year.
- toomuchtodo 6y agoIt’s actually a little less than 1% a year (~2.8 million out of ~329 million people). https://www.cdc.gov/nchs/fastats/deaths.htm https://www.cdc.gov/nchs/fastats/deaths.htm
- stoksc 6y ago> (out of a sample of 100 people) For every one person who dies: * 19 more require hospitalization. * 18 of those will have permanent heart damage for the rest of their lives. > One study published in March found that out of 416 hospitalized Covid-19 patients, 19% showed signs of heart damage. Assuming 19 in 100 require hospitalization, according to the study: 19% of 19 will have heart damage or 3.61. Similar breakdown for other points. Disclaimer: shutdown was the right call and the point is still valid with smaller numbers (they’re still huge). Just pointing it out.
- noxer 6y agoCan't believe people still question the shutdowns as if there would be a scenario without. The people in power could choose between enforced but somewhat controlled shutdowns or the chaos shutdown. No shutdown was never an option. Most people would have long done their own "shutdown" completely voluntary. It would just be more chaotic and less effective and it would have needed way more people to die first.
- 6nf 6y agoSeveral countries like Sweden and Japan and Korea proved that there are other options.
- ceejayoz 6y agoSweden appears to bear out the parent comment's point, that the end result is still lockdown, just voluntary and less well organized: https://www.nytimes.com/2020/07/07/business/sweden-economy-coronavirus.html https://www.nytimes.com/2020/07/07/business/sweden-economy-c... > This is what has happened: Not only have thousands more people died than in neighboring countries that imposed lockdowns, but Sweden’s economy has fared little better. “They literally gained nothing,” said Jacob F. Kirkegaard, a senior fellow at the Peterson Institute for International Economics in Washington. “It’s a self-inflicted wound, and they have no economic gains.”
- deleted 6y ago[deleted]
- noxer 6y agoDid you even read my post? Do you think people in Sweden still went to the the cinema watching 2h long movies with 200 other people in the same room when everyone around them closed everything? Do you think it needed a ban/regulation for that to stop? People in Sweden knew exactly what everyone around them did. Also Sweden death per million is one of the highest despite the fact they got it rather late and hospitals where officially never overwhelmed.
- detaro 6y agopreviously: https://news.ycombinator.com/item?id=23816640 https://news.ycombinator.com/item?id=23816640
- oliwarner 6y agoHow can people consider anything else? 1% excess mortality isn't acceptable. Hospitalising 5-10% is crippling hospitals. The ongoing health issues in 20% will haunt us for years after we have a vaccine and before we do, we face the prospect that post-exposure immunity might be measured in months. Only idiots think this is worth ignoring. Coincidentally, they're the same idiots that came in a day late and a dollar short when it was time to close borders and quarantine travelers. We could have stopped this.
- skeppy 6y agoHelp me. I’m confused. Is the author saying that 1% of the people who are diagnosed with it will die? (That’s how I read it at first). Or is he saying that 1% of everyone will die? Maybe that sounds like a dumb question, but I honestly don’t know if everyone is using the term “mortality rate” the way I think of it (which for me, until recently, was the first option above). I guess I don’t even know if it makes a difference. Won’t we all be exposed to it anyway, if we haven’t already? Some of us may never know if we were, and others (sadly) will know straightaway. If we can assume that nearly all of the USA (for instance) will be exposed and “catch” it, whether tested positive or not, then is the second version of “mortality rate”, in effect, the same as the first? I’m only asking because I honestly don’t know and there is so much speculation and confusion out there. Hoping that someone on HN who is much experienced (and maybe in the world of medical stats) can clarify this for me.
- D13Fd 6y agoThere are two categories of ways this can resolve: (1) We beat the coronavirus. People no longer regularly get infected. (2) Coronavirus is here to stay. We'll all get it eventually just like we all eventually get colds and the flu. I think it's pretty clear at this point that (1) isn't happening, at least absent a vaccine. If we do get a vaccine, it may be a polio/measles type situation where we can eliminate the disease, or it may be a flu-type situation where we all just get vaccinated every year. So focusing on (2), where we all get the virus. We don't know the exact mortality rate for those infected. We don't know how the rate varies for re-infections. We do know that the mortality rate is lower if the hospitals aren't full. So the shut downs may be logical in terms of keeping the infection rate low enough that the hospitals don't fill up, if we think it's worth it. Whether the mortality rate benefits are worth the economic harms is another question, though.
- lazyloop 6y agoShutdowns also give the virus more time and incentive to evolve into more contagious variants with much milder symptoms. If we delay it long enough it can actually end up just being like the seasonal flu.
- habanany 6y ago"But evil men and seducers shall wax worse and worse, deceiving, and being deceived."