4 ms·

Scary thing is. Milder disease is a constant factor improvement in hospitalization. But faster spreading (higher R value) is an exponential worsening in hospita

by rocqua 5y ago

Scary thing is. Milder disease is a constant factor improvement in hospitalization. But faster spreading (higher R value) is an exponential worsening in hospitalization. It's probably better to have a 50% hospitalization rate and an R value of 0.8 than a 5% hospitalization rate and an R value of 2. After 3 'generations' of spreading the second situation already has more hospitalizations.

tomp 5y ago
Maybe but “exponential growth” is a conspiracy theory promoted by epidemiologists. In reality, growth follows the S-curve, so a milder, faster spreading disease will also saturate the population (flatten the S-curve) much sooner, so overall the impact will be much less.
- _Microft 5y ago
  You want to keep the number of cases in a range that the health care system still can deal with. Reaching the the flat part of an S-curve (i.e. infecting everyone as fast as possible) is NOT desirable because that leads to many cases in very short term.
  - ngcc_hk 5y ago
    That what I hope for. It looks like uk is like this. But is USA like this?
- KSteffensen 5y ago
  I've seen this argument elsewhere and I don't get it. From my understanding the limitation on exponential growth, the flattening of the top part of the S-curve, comes from total population. There is no one left to infect, basically. If the rising part of the S-curve is steep, that means people get infected within a shorter timespan and a corresponding higher load on hospital beds and healthcare personnel, which is what we are trying to avoid with the lockdowns. What am I missing? Also, calling exponential growth a 'conspiracy theory' seems unnecessary
  - deleted 5y ago
    [deleted]
- cinntaile 5y ago
  A conspiracy theory lol. When they talk about exponential growth, they are talking about an R0 > 1. Yes, after some point it drops under 1 and flattens out because there are fewer and fewer people to infect.
parkingrift 5y ago
> It's probably better to have a 50% hospitalization rate and an R value of 0.8 than a 5% hospitalization rate and an R value of 2. After 3 'generations' of spreading the second situation already has more hospitalizations. Sure, but those aren’t the only choices. Over the last 30 days the daily case average has increased by 500%. During that same time the daily average hospitalized has risen 100%. And the test positivity rate has increased to almost 30%, which implies an almost comical undercount in actual cases. The contagiousness and severity are diverging in an extraordinary way. We’re likely undercounting cases by 1/5 or 1/10th.
- ianhawes 5y ago
  The testing positivity rate is relatively useless at this point. For example, in my State, there is no way to report a positive test from a rapid result. Only PCR tests administered by a medical professional are considered valid for statistical purposes, even though the government is giving out free rapid tests.
  - parkingrift 5y ago
    I don't think it's useless. I think it's a pretty good indication that there are many multiples of actual cases for every confirmed case. If covid cases have risen 5,000% in 30 days, but hospitalizations have only risen 100%, that's an extraordinarily positive outcome.
  - thomaslord 5y ago
    This is for good reason. Rapid tests are substantially less sensitive and often give false negatives, especially for asymptomatic cases. There are also a lot of rapid "at home" tests out there that have high false positive rates, so even if non-PCR tests were added to the data the only reasonable approach would be to still require them to be administered by a medical professional to make sure the test is correctly administered and that the test itself is relatively high quality.
    - ianhawes 5y ago
      The idea that rapid tests are less sensitive and therefore not valuable is summer-2020 thinking and outdated. Rapid tests are perfectly fine and should be counted by health departments. Case in point. My family of 4 all tested positive on rapid tests. 3/4 of us had symptoms. None of us received PCR tests because the next available appointments (other than a 6 hour wait at a state run testing center) were a week away. Thats 4 people not counted. And we were part of an outbreak that included 3 other families that all tested positive via rapid tests.
nradov 5y ago
The CDC has estimated the overall hospitalization rate since the start of the pandemic at about 5%. Now with vaccines and other improved outpatient therapies the hospitalization rate is dropping. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burden.html https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd... The Omicron variant R0 value appears to be somewhere in the 7 - 10 range. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00559-2/fulltext https://www.thelancet.com/journals/lanres/article/PIIS2213-2...
rhino369 5y ago
An R value of .8 would quickly go extinct.
- rocqua 5y ago
  Exactly!

by rocqua 5y ago

tomp 5y ago

Maybe but “exponential growth” is a conspiracy theory promoted by epidemiologists. In reality, growth follows the S-curve, so a milder, faster spreading disease will also saturate the population (flatten the S-curve) much sooner, so overall the impact will be much less.

_Microft 5y ago
You want to keep the number of cases in a range that the health care system still can deal with. Reaching the the flat part of an S-curve (i.e. infecting everyone as fast as possible) is NOT desirable because that leads to many cases in very short term.
- ngcc_hk 5y ago
  That what I hope for. It looks like uk is like this. But is USA like this?
KSteffensen 5y ago
I've seen this argument elsewhere and I don't get it. From my understanding the limitation on exponential growth, the flattening of the top part of the S-curve, comes from total population. There is no one left to infect, basically. If the rising part of the S-curve is steep, that means people get infected within a shorter timespan and a corresponding higher load on hospital beds and healthcare personnel, which is what we are trying to avoid with the lockdowns. What am I missing? Also, calling exponential growth a 'conspiracy theory' seems unnecessary
- deleted 5y ago
  [deleted]
cinntaile 5y ago
A conspiracy theory lol. When they talk about exponential growth, they are talking about an R0 > 1. Yes, after some point it drops under 1 and flattens out because there are fewer and fewer people to infect.

parkingrift 5y ago

> It's probably better to have a 50% hospitalization rate and an R value of 0.8 than a 5% hospitalization rate and an R value of 2. After 3 'generations' of spreading the second situation already has more hospitalizations. Sure, but those aren’t the only choices. Over the last 30 days the daily case average has increased by 500%. During that same time the daily average hospitalized has risen 100%. And the test positivity rate has increased to almost 30%, which implies an almost comical undercount in actual cases. The contagiousness and severity are diverging in an extraordinary way. We’re likely undercounting cases by 1/5 or 1/10th.

ianhawes 5y ago
The testing positivity rate is relatively useless at this point. For example, in my State, there is no way to report a positive test from a rapid result. Only PCR tests administered by a medical professional are considered valid for statistical purposes, even though the government is giving out free rapid tests.
- parkingrift 5y ago
  I don't think it's useless. I think it's a pretty good indication that there are many multiples of actual cases for every confirmed case. If covid cases have risen 5,000% in 30 days, but hospitalizations have only risen 100%, that's an extraordinarily positive outcome.
- thomaslord 5y ago
  This is for good reason. Rapid tests are substantially less sensitive and often give false negatives, especially for asymptomatic cases. There are also a lot of rapid "at home" tests out there that have high false positive rates, so even if non-PCR tests were added to the data the only reasonable approach would be to still require them to be administered by a medical professional to make sure the test is correctly administered and that the test itself is relatively high quality.
  - ianhawes 5y ago
    The idea that rapid tests are less sensitive and therefore not valuable is summer-2020 thinking and outdated. Rapid tests are perfectly fine and should be counted by health departments. Case in point. My family of 4 all tested positive on rapid tests. 3/4 of us had symptoms. None of us received PCR tests because the next available appointments (other than a 6 hour wait at a state run testing center) were a week away. Thats 4 people not counted. And we were part of an outbreak that included 3 other families that all tested positive via rapid tests.

nradov 5y ago

The CDC has estimated the overall hospitalization rate since the start of the pandemic at about 5%. Now with vaccines and other improved outpatient therapies the hospitalization rate is dropping. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burden.html https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd... The Omicron variant R0 value appears to be somewhere in the 7 - 10 range. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00559-2/fulltext https://www.thelancet.com/journals/lanres/article/PIIS2213-2...

rhino369 5y ago

An R value of .8 would quickly go extinct.

rocqua 5y ago
Exactly!