4 ms·

The initial reports were that Covid-19 had a case fatality rate of 15%. Since than we have massively expanded testing to unprecedented levels, so the mortality

The initial reports were that Covid-19 had a case fatality rate of 15%. Since than we have massively expanded testing to unprecedented levels, so the mortality estimates are now dramatically lower, both for cases and infections. The two are not really comparable.

sudosysgen 4y ago
This is actually not at all what's happening here. Monkeypox has two variants. One has a 10% fatality rate, which is not initial - it's been measured over decades. The other is less than 1%. What's spreading right now is derived from the less fatal variant. So you're right that its not going to be 10% fatal, but it could have been, and it's not a new disease where we don't have good mortality rates, it's been here for decades.
- oldgradstudent 4y ago
  From what I gathered, the fatality rate came from papers like [1]. These are case fatality rates (CFR) derived from the number of people presenting at clinics with symptoms severe enough. It cannot be compare to fatality rates of Covid where everyone who gets a positive antigen test, regardless of the severity of symptoms, or even existence of symptoms is part of the denominator. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870502/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870502/
  - sudosysgen 4y ago
    Not quite. Clusters of monkeypox have been studied, where the number of exposed people was known and they were traced, therefore clinical presentation was not a significant confounding factor: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120683/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120683/ Of course the sample size is limited, but they seemed consistent with other mortality data. Also, unlike in COVID, asymptomatic infection has never been demonstrated.
    - oldgradstudent 4y ago
      Recent Israeli Ministry of Health presentation claims that many infections are asymptomatic as demonstrated by serological studies. https://youtu.be/U7LgEHujoTU?t=710 https://youtu.be/U7LgEHujoTU?t=710 (sorry for the Hebrew link) If this is true, the 3% of 10% mortality rates are massively inflated.
    - oldgradstudent 4y ago
      I am not sure we can deduce that from the paper. They are only testing clearly symptomatic patients. This cannot demonstrate asymptomatic infection if it exists. Tracing also cannot demonstrate asymptomatic infection. It may be able to demonstrate asymptomatic transmission, though. Today we define a Covid-19 case extremely liberally, which results in very low fatality rates. This is not comparable to the methods used for monkeypox in the early 2000s.
nikolay 4y ago
That's absolutely false! SARS has a 10% mortality rate, and the rate of COVID-19 was argued to be in the range of 0.25% to 3% - it's never been suspected to be higher than SARS'!
- oldgradstudent 4y ago
  The very early reports from China put the case fatality rate at 15%. The pattern is for the (reported) CFR to go down very quickly. > The trend in mortality reporting for COVID-19 has been typical for emerging infectious diseases. The case fatality rate (CFR) was reported to be 15% (six of 41 patients) in the initial period,1 but this estimate was calculated from a small cohort of hospitalised patients. Subsequently, with more data emerging, the CFR decreased to between 4·3% and 11·0%,2, 3 and later to 3·4%.4 The rate reported outside China in February was even lower (0·4%; two of 464).5 [1] https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30244-9/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

sudosysgen 4y ago

This is actually not at all what's happening here. Monkeypox has two variants. One has a 10% fatality rate, which is not initial - it's been measured over decades. The other is less than 1%. What's spreading right now is derived from the less fatal variant. So you're right that its not going to be 10% fatal, but it could have been, and it's not a new disease where we don't have good mortality rates, it's been here for decades.

oldgradstudent 4y ago
From what I gathered, the fatality rate came from papers like [1]. These are case fatality rates (CFR) derived from the number of people presenting at clinics with symptoms severe enough. It cannot be compare to fatality rates of Covid where everyone who gets a positive antigen test, regardless of the severity of symptoms, or even existence of symptoms is part of the denominator. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870502/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870502/
- sudosysgen 4y ago
  Not quite. Clusters of monkeypox have been studied, where the number of exposed people was known and they were traced, therefore clinical presentation was not a significant confounding factor: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120683/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120683/ Of course the sample size is limited, but they seemed consistent with other mortality data. Also, unlike in COVID, asymptomatic infection has never been demonstrated.
  - oldgradstudent 4y ago
    Recent Israeli Ministry of Health presentation claims that many infections are asymptomatic as demonstrated by serological studies. https://youtu.be/U7LgEHujoTU?t=710 https://youtu.be/U7LgEHujoTU?t=710 (sorry for the Hebrew link) If this is true, the 3% of 10% mortality rates are massively inflated.
  - oldgradstudent 4y ago
    I am not sure we can deduce that from the paper. They are only testing clearly symptomatic patients. This cannot demonstrate asymptomatic infection if it exists. Tracing also cannot demonstrate asymptomatic infection. It may be able to demonstrate asymptomatic transmission, though. Today we define a Covid-19 case extremely liberally, which results in very low fatality rates. This is not comparable to the methods used for monkeypox in the early 2000s.

nikolay 4y ago

That's absolutely false! SARS has a 10% mortality rate, and the rate of COVID-19 was argued to be in the range of 0.25% to 3% - it's never been suspected to be higher than SARS'!

oldgradstudent 4y ago
The very early reports from China put the case fatality rate at 15%. The pattern is for the (reported) CFR to go down very quickly. > The trend in mortality reporting for COVID-19 has been typical for emerging infectious diseases. The case fatality rate (CFR) was reported to be 15% (six of 41 patients) in the initial period,1 but this estimate was calculated from a small cohort of hospitalised patients. Subsequently, with more data emerging, the CFR decreased to between 4·3% and 11·0%,2, 3 and later to 3·4%.4 The rate reported outside China in February was even lower (0·4%; two of 464).5 [1] https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30244-9/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3...