Age, Sex, Existing Conditions of Covid-19 Cases and Deaths | Hacker News Reader

Age, Sex, Existing Conditions of Covid-19 Cases and Deaths

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498 pointsdavedx419 comments

The general issue with this measure of mortality (dead/(infected + dead)) is that you're assuming that the infected won't die. In a disease that is exponentially growing, a better approximation of evaluating your survival chances is to look at the death to recovery rate (dead / (recovered + dead)). Based on the available data [1], we are closer to 7.8% than 2% mortality, which is closer to the final mortality rate of SARS of 9.6% [2].

Nevertheless, I think all these statistics need to be taken with a grain of salt - I doubt that the numbers we are seeing are of very high quality, given the political and cultural pressures in China to underreport, the lack of test kits, corona virus deaths being attributed to other diseases, ... On the flip side, it's very likely that mild cases will never be reported, which in turn would decrease the mortality rate.

[1] https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...

[2] https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...

[edit: corrected the formula - thank you @anhner and @11thEarlOfMar for spotting the mistake]

[edit: indicated that there's also a chance of under-reporting mild cases - my edit coincided with @Tenoke's post - sorry for noticing this late @Tenoke]

I don't understand your first argument. Surely increasing the denominator would lower the mortality percent?

Also does the total number of infected not include the dead?

Indeed, you are right - I corrected the formulas.

But the infected who isn’t dead may or may not die at the end. So using infected as the denominator is not accurate. But using just the recovered as denim Arie is also incorrect unless you have enough samples. Using China’s figures are wildly inaccurate because of lack of tests and transparency. So maybe a better complex model can be derived from current datas

I think you mean (dead/(recovered+dead)).

Indeed - thank you, I adapted the formula in the original post.

It's difficult/impossible to put a specific probability (which would be an oxymoron) on any one particular person dying. The somewhat vague risk factors take time to accumulate from statically-larger samples if there were more deaths. We know it's a couple of orders of magnitude worse than the seasonal flu but less than the 1918 flu and the plague, hence the extreme quarantine measures to reduce its infectivity to essentially 0. Once quarantine goes into effect, it doesn't matter how infectious is a pathogen because it's dead because of math.

> specific probability (which would be an oxymoron)

Not at all. For example, if I flip a fair coin, I can assign a very specific probability to the event that I get heads.

> We know it's a couple of orders of magnitude worse than the seasonal flu

Maybe one order of magnitude. Seasonal flu is about 0.1-0.2% mortality in the US. The evidence suggests that covid-19 is less than 1% mortality.

> hence the extreme quarantine measures to reduce its infectivity to essentially 0

It doesn't need a high mortality rate to justify extreme quarantine measures. The fear is that it will become a perpetual thing, another seasonal illness like the flu. Even if the mortality rate were the same as the flu it would be worth taking extreme measures to avoid that.

>The general issue with this measure of mortality (dead/infected) is that you're assuming that the infected won't die.

On the other hand, there are also a lot of infected who only have a mild version and are never checked and recorded, which swings it in the other direction.

Edit: Seems like the parent post later edited their post to mention the above.

In the hardest hit areas like Wuhan, almost everyone has been tested.

Reference for that, please?

In the who presentation, Dr Bruce Aylward mentioned this. I'll try to dig up the exact spot in the clip for you. At 1:07:44 this is discussed in depth: https://youtu.be/-o0q1XMRKYM

Thanks for the link! He says that there have been door to door testing of temperatures, and I'd nitpick by saying that's not quite the same thing as testing everyone for the virus, but it is better coverage than I had realised.

Surprised! I worry about unintended consequences. During an epidemic, officials visit every home! Potentially spreading the virus unintentionally thru healthcare personnel. Don't know if I'd open the door to somebody who admits having visited thousands of people before getting to me...

I suspect this played out on the diamond princess.

Yeah he's rolling with what he's got. The antibody studies that come at the tail of these things would be definitive.

Here's a response I wrote earlier to that.

After he said that someone else from the WHO contradicted him.

"The claim was quickly challenged by an infectious diseases expert who serves on a committee that advises the WHO’s health emergencies program.

Gary Kobinger, director of the Infectious Disease Research Center at Laval University in Quebec, said it would be highly unusual for there not to be mild or symptom-free cases that are being missed. He pointed to the fact that outbreaks have popped up in countries far from China — including Iran and Italy — because people with mild infections were not detected and traveled to other places.

'There are mild cases that are undetected. This is why it’s spreading. Otherwise it would not be spreading because we would know where those cases are and they would be contained and that would be the end of it,' said Kobinger, who insisted that mild, undetected infections cannot be ruled out until people who haven’t been diagnosed with the illness can be tested for antibodies to the virus.

'As long as we do not have good serology data, I think that it is completely speculative to say that there are no undetected cases,' Kobinger said."

What Dr. Aylward says makes no sense and reads more like a PR fluff piece designed to praise China to keep them happy, and as Kobinger points out he's probably wrong. From the same press conference he says this "If I had COVID-19, I’d want to be treated in China."

Which is obviously bullshit.

He gives more detailed numbers about Guandong: at the height of the epidemic, they performed 320000 tests, of which less than 0.5% were positive, which means that they missed less than 200 cases. In other words, Aylward thinks the Chinese numbers are basically correct. Even though of course not all cases are detected, we are not looking at magnitudes more undetected cases driving up the infections in the background.

>320000 tests, of which less than 0.5% were positive, which means that they missed less than 200 cases

That doesn't follow from your premise and it doesn't match what he said.

"Of 320,000 tests performed, just under 0.5% were positive for the virus at the peak of transmission there, he said — which suggests that only 1 case out of 200 was being missed."

And even based on what he said the conclusion he's drawing doesn't follow either. From other sources the 320,000 was from a community sample. Guangdong has a population of 113 million, a 0.5% infection rate is over half a million people.

Even assuming it's not a random community sample, and it's from people who self selected, so the infection rate is much higher than the general population, there is still room for an order of magnitude more mild cases than are showing up in official numbers.

> "Wuhan, almost everyone has been tested"

Very doubtful. This is a city of 11 million people. I doubt they would have the kits or lab capacity to test even 1% of the population so far.

In the case of the Diamond Princess, all infections, mild to severe, have been identified. Out of ~800 infected, 4 have died, which suggests that with the best case scenario the mortality rate is 0.5%.

This also should be read with the context that cruise ship passengers tend to be older.

Also, that number will climb a bit.

The biggest risk isn't the bare mortality rate when properly treated, but the actual mortality rate when the healthcare system is loaded to capacity and there are additional patients to handle. And since the worst patients end up in respirators for a week or more... Well, it makes the problem of load balancing keepalives very literal.

I think it’s also safe to assume that all ~3,700 people onboard were exposed to the virus, so it gives an idea of the exposure vs infection rate as well.

Agreed. Hypothetically, there was a quarantine going on, but it was pretty half assed.

As you said cruise ships skew much older than the general population, so this tells us very little about the actual mortality rate. All 4 people who died were in their 80s.

IMO it’s one of the best data points we have. As I understand it, everyone on the ship was exposed, everyone was tested, we know exactly how many people became infected, and under close to ideal treatment conditions, there have been (so far) 4 fatalities of elderly patients.

Yes, this doesn’t tell you what happens with less than ideal care (higher fatality rates), or under different populations (lower fatality rates) but it’s a world of difference from the 10% fatality rates being tossed around elsewhere in this thread.

4/800 = 0.5%. And if you accept the very reasonable likelihood that actually everyone on the ship was exposed, 4/3700 = 0.1%.

>but it’s a world of difference from the 10% fatality rates being tossed around elsewhere in this thread.

I agree.

I misspoke when I said very little. I was taking issue with the OPs assertion that 0.5% was a best case mortality rate. I should have said it's closer to an upper bound assuming ideal treatment, since it looks like this is much worse for the elderly.

Best case was ambiguous phrasing, but I intended it to mean "in the case of the best possible treatment."

Which makes it more or less identical to flu.

There are around 400,000 deaths from flu globally, every year. (The numbers vary by quite a bit.) And that's after vaccination efforts.

So far I'm seeing no evidence to persuade me this is significantly deadlier. Everything that has been said about COVID-19 - the stress on healthcare, and so on - has already been happening during flu waves. For decades.

The real difference is the scale of the response. Flu's effect on the economy is a little more than a rounding error, but not by much.

Because of the measures taken, this is likely to have very significant negative economic and social effects which will last far longer than the danger of infection.

Which makes it more or less identical to flu.

No, it makes it about 5x worse than a typical flu season (10x worse than what America is seeing this year).

5x worse than a typical flu season. We have atypical flu seasons all the time.

Could you elaborate?

That seems to be the numbers (0.5%) coming out of S. Korea, which I believe has the best publicly available numbers. See https://corona-live.com so far it seems accurate and the linked supporting articles are from "internet reliable" sources ...not fringe.

I came to say that the diamond princess is kind of an ideal case for getting a handle on things because it's a largish finite closedish population, kind of like why ecologists often love islands.

One thing that's puzzling to me though is even though the infected rate from the diamond princess is reported at 700+, the recovery rate is still reported at 10+. So what's going on with the other 690+ people? Are they still sick in a way they could still deteriorate? It's confusing because the cfr based on dead and recovered is still pretty high.

Again, though, the diamond princess is helping to clarify things, because nonreporting and nonpresenting aren't issues for the most part.

However, we're also talking about older people who were healthy enough to travel on a cruise, a large number of people over 80 wouldn't do this.

.5% is far lower then the commonly reported mortality rate. That it occured in an older (and therefore more at risk) strengthens the evidence that other estimates are overstating the mortality.

Of course, within the population of old people, I would expect cruise goers to be relativly healthy; so I would expect this population to be more vulnerable then the general public, but less vulnerable then their age based demographics.

It will be very useful data but how many have recovered? We need to wait at least two more weeks.

Thank you - I came to the same conclusion while still editing my post - I think my edit and your post coincided. I clarified this edit in my original post.

But that could be said about any disease. As is, it is mortality given that you have symptoms which is a pretty good measure to have. For everything else, you need some many more parameters, better tests etc. Even a test for antibodies in blood which would be the gold standard can fail. Also, we do not know how many people are naturally immune to the disease. May be 10 world wide, maybe 10%, who knows?

> mortality given that you have symptoms which is a pretty good measure to have

It's a very bad metric to estimate the impact of an epidemics. It's way worse than useless for that, it can only lead to baseless panic.

It's a pretty good metric for many uses, just not for this one.

>But that could be said about any disease.

With diseases that have been better studied, we have large population studies to determine how many people have been infected for every 1 person reported.

>As is, it is mortality given that you have symptoms which is a pretty good measure to have

We don't know that because we have no idea how many people have mild to moderate symptoms and haven't been tested.

At best it's mortality given that you are severe enough to seek treatment.

According to Johns Hopkins data Feb 27, 2020 [0], Iran would come to:

Deaths: 26

Recovered: 49

(26 / (26 + 49)) = 34.7%

[0] https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...

We can conclude that Iran is severely underreporting cases.

Or severely overreporting deaths.

We also have that Iran does not have the health care system to even provide proper equipment for their health staff. This is a case of massive under reporting, but unfortunately that means they are not containing it and do not even know the extent of their problem. That is the teal worry with Iran, not some super deadly variant

The diamond princess saw almost 100% exposure and only 0.5% of people died who got infected. Depending if you choose that stat, or the 2% WHO star, that suggests 15-100x more cases are in Iran than their lousy health system realizes.

A few days ago I looked up the numbers for the 1918 flu - https://en.wikipedia.org/wiki/Spanish_flu

- world population: 1800 million

- infected: 500 million

- dead: 50 million

I did not know it had been that bad.

There's this weird social media thirst for this to become the next spanish flu. My family (midwest conservatives) fall into one of two camps:

1. This was sent by Jesus and is a prelude to the rapture, literally.

2. The spanish flu happened 100 years ago, and 100 is a big round number, so this is going to do the same things.

It's very strange and surreal around the home town right now. Many elderly are openly embracing what they see as their future deaths because it's God's will.

I'm very, very confused by all of this.

My own personal opinion is that the Great Recession and it's repercussions (inequality, deaths of despair, the hallowing out of middle American economies, the opioid crises, Flint water crises, etc) over last 10+ years have really ramped up a zeitgeist of inevitable doom. I don't really blame anyone in the Midwest for being full of doom and gloom, because for the most part that's all they have known for the last decade.

My other opinion is that more so than racism and actually believing Trump would make America great again, that most of the support that pushed Trump over the edge came from wanting to burn the whole thing down.

I would agree with that. During the last election cycle (and already this one), the one thing the polls consistently got wrong was just how pissed "Joe-Midwest Average Voter" is that his life is much worse than his parents' were at the same age.

When people online and in the news express how they just don't understand why people still support Trump, it's because they're not trying to understand. If all you care about is disrupting as much of the system as possible and pissing people off as much as possible, you're getting exactly what you wanted.

I'd say 99% of my post-millennial friends (zoomers?) live with not just the assumption that their lives are shittier than previous generations, but more importantly with the assumption that the dire climate change predictions are true.

While some of them might still have kids, or act 'irrationally' in relation to that belief, it's there, and I can't help but feel it's going to have huge effects over time as these people become politically active and vote.

To be clear, that's putting aside my beliefs on these issues. Just describing what I'm seeing.

> 1. This was sent by Jesus and is a prelude to the rapture, literally.

This one has me concerned. There's a lot of overlap between that group and the preppers with itchy trigger fingers.

I've seen remarks from some about believing the virus is the case ("pestilence, floods") with others responding "Yes, praise God. It's time to make your peace".

It is kind of interesting. Well, the fundamentalist Christian part is expected; there is a very creepy number of people who expect and welcome the Rapture (knowing full well many of their friends aren't along for the ride).

As for the rest of the world, I think catastrophe is a spectacle and people like to "live in interesting times". Take a NASCAR crash and multiply it by 10,000,000, you know.

I think religion near the end of life, like the phrase "there are no atheists in foxholes" can be a powerful coping method to give the end of their lives perceived meaning. My Grandma is around that age and has grown more religous - looking at the end from a more pessimistic perspective for her likely seems rather bleak. Hopefully it's more that and less enjoying the idea of the end of the world.

These numbers have been revised substantially upwards in the last few decades. I think the estimates were closer to 10-15 million in early 2000s.

Your formula has the opposite problem, by looking at cases that have a known outcome you are biasing results towards cases that end quickly (in particular cases that end in death).

For a proper estimate we should look at cases where the infection is known to have begun e.g. a month ago. Then the mortality rate should be somewhere between dead/infected and dead/(dead + recovered).

There's also the possibility of reinfection and false negatives. The best data we have is not even close to perfect.

> Your formula has the opposite problem, by looking at cases that have a known outcome you are biasing results towards cases that end quickly (in particular case that end in death).

Unless I'm mistaken, that would only be true if cases that end in death are much faster than the cases that end in recovery. I have found it difficult to find detailed statistics on the topic, so I cannot tell you that it's definitely true or not, but I agree that it's an important variable that should be taken into the equation.

With many viral respiratory bugs, symptoms appear a few days after infection, peak a few days after that, and then there's a long tail of sniffling and coughing. Deaths happening in the peak and recovery being declared nearer the end of the tail leads to the intuition that maybe deaths could cluster earlier than recoveries. Of course, I don't know how/when recoveries are being tallied right now and don't want to guess.

Bigger picture: lots of factors go into a good estimate, and epidemiologists are not new to mathematical modeling. When back-of-the-envelope math doesn't get the same prediction as the consensus models of what's going on, we shouldn't assume the epidemiologists are wrong.

I do have one question and I'm asking this seriously, not to start an argument or to attack someone. I also saw this here in a lot of the posts about covid-19. We have numbers, but every time people tend to ignore them or say we should not trust the numbers, take them with a grain of salt, "I think this is way worse, it's going to get way worse" and so on. It's like there is this thirst for disaster or some global drama everywhere, and this is not something that I would expect from Hackernews. If the numbers don't align with our hopes or fears, we should take them with a grain of salt and trust the gut feeling of whoever comments. It's quite weird to see that when it comes to this, people seem to think that it's some sort of conspiracy, China is hiding numbers, now EU is not doing things properly, as I see it everywhere "my country can't have 0 cases, I know that our airport is a big hub and it can't be, we will be doomed as we probably have hundred of cases instead of none and our government is not doing anything".

I'm not saying that this virus is not a threat and I worry for my parents as this could be a big issue for their condition, but we've gone down the rabbit hole with the hysteria in the press and online and it's scary to see this need for a global pandemic and the urge to constantly feed the panic monster.

ever since the beginning of this crisis, countries have been either hiding or underreporting the numbers. lack of adequate testing means that clusters are discovered late, after the virus has had a chance to spread. it's not so much a thirst for disaster as it is a thirst for knowledge so that we can better prepare ourselves. even in the US, the CDC seems at odds with the president as to the severity of the virus and its spread. if anything, it's governments that are "aligning the numbers" so as to avoid mass panic, downturns in markets, etc.

What evidence can you point to of this "hiding"?

Lack of adequate testing is a factor, I Grant you, and a big one -- but clusters are discovered late because it now appears that people can shed virus when they're not symptomatic.

Perhaps the most notorious happened at the very beginning, search for Li Wenliang

Agreed. I think we all know at this point that the numbers are not perfect, and that's OK. Also we all need to recognize the hysteria that seems to be ratcheting way up this week.

I don't think that calling the numbers unreliable implies incompetence or even worse, malice, on the part of the reporting country. It's simply difficult as shit to come up with reliable stats on something very new in the middle of an outbreak. Think of how many people aren't even noticing that they have the virus, and thus will never be counted as infected. This is just as true in Milan or California as it is in Wuhan. All numbers are noisy and subject to substantial revision. It is, however, quite clear that this virus is not as serious as SARS or especially MERS. It can still kill millions if it infects hundreds of millions though, so that's just a comment on whether you, individually, should worry about getting it.

> It is, however, quite clear that this virus is not as serious as SARS or especially MERS.

I know that the 'severity' of the virus often refers to how severe it is once you have it, but in the context of new viruses and pandemics, IMO 'severity' should refer to overall potential impact. Covid-19 blows SARS/MERS out of the water on that front given its different transmission profile and already-established footholds.

If my original post gave off the impression of being conspiracy-theory-driven, I want to apologize, because that wasn't the intent.

My original post aimed at clarifying that death rates in exponentially spreading diseases that have a lag between infection and possible recovery and death is a tricky topic, and that the numbers generally reported seem to not take this nuance into account.

I think collecting accurate data in the middle of a crisis is incredibly difficult for a host of reasons, none of which need to originate from ill intent. Test kits may be missing, data may be collected differently, methodologies for evaluating "who is infected" and "who has recovered" may differ between countries, patients' records might just not be a top priority for hospital staff, ...

Yet your post seemed to hint at willful manipulation of data, which isn't something for which there is reliable concrete evidence for, and which in my view is adding to the paranoia. The line of thinking for eg:, Chinese numbers are untrustworthy, WHO numbers are untrustworthy etc, is very frequently echoed by the western press, and even here in HN.

I think you're referring specifically to the "political and cultural pressure in China" part of my original post. I was basing this on reporting from the New York Times [1] of the original outbreak. It very well might be that the reporting has improved since then, but I do think that there is evidence to say that there was manipulation of data, or at least a very strong incentive to under-report cases initially.

[1] https://www.nytimes.com/2020/01/30/podcasts/the-daily/corona...

People’s mistrust of China data stems from the known manipulation of economic indicators by Chinese authorities. The running assumption is that this behavior would apply to virus outbreak data, but this is unproven.

They lied about their numbers during the SARS outbreak.

Didn't want to make it sound like you are promoting a conspiracy, sorry, it's just that everyone treats the numbers as somehow manipulated. My point is that the current numbers are all that we have - we are mostly technical people here - looking at them, there is no obvious statistical anomaly to say that yes, China is hiding something from us. Maybe the numbers are not fully accurate, and it's too early to tell, but these are the stats that we have, there is no reason for jumping on the bandwagon and questioning everything now. You can't really hide things at this global scale, no government wants to bomb its economy and cause an epidemic by hiding the infections, I just think that people/countries handling this are overwhelmed and not prepared, there is no malice. It would be good for people to be rational about this and help others be properly informed, and right now it looks more like a desire in a lot of places for something big or bad to happen, I don't see some worried, more like hungry for bad news.

"looking at them, there is no obvious statistical anomaly to say that yes, China is hiding something from us"

Sure, but we wouldn't be able to find any statistical anomaly if China was hiding something because we simply don't have enough data ourselves to determine that.

I feel like your stance may be the opposite extreme of fear-mongering, which is downplaying the potential unreliability of data that many people have good reason to speculate about (as you might've already seen in this thread SARS cases were underreported).

I think being skeptical of numbers from China is reasonable.

Historically speaking even inside China it is a pretty well known quantity (even openly spoken of in China) that local governments are hesitant to give bad news to the central government until it is too late and so on. The result usually is the central government is behind the ball dealing in broad (sometimes less than useful) strokes until things are resolved.

As far as any conclusions you can draw such as "well it must be much worse". I think that is pure speculation.

Specific speculation that isn't founded in much and IMO not helpful. The scale and wonkyness of China's efforts could be because this is a very dangerous / misunderstood disease ... or the massive efforts simply a byproduct if poor internal information / a product of the political nature of China.. panic by their leadership (historically they're very wary of any unrest of their own population), or both.

Skepticism of some information from countries with proven track records of not being forthcoming / have had issues with accurate information is reasonable. Conclusions based in nothing, not so much.

I think China has reached a tipping point in this one though and local governments are giving the information they have to the central government. When this started hiding things was a reasonable policy for the local governments, but now that this has so much international attention I think it is clear to everybody in local governments that being caught hiding anything is worse than whatever good could come out of the best case of hiding something.

Do not mistake the above for local governments having good information to give. I'm also not sure if China is giving everything out either publicly or internationally.

Of course I'm just an outside observer with no inside knowledge making what I think are reasonable guesses.

I agree, there is a doomer mentality that applies to everything (climate change, geopolitical tensions, etc) and which the media are more than happy to fuel to sell paper and commercials.

While I agree with the overall sentiment, in the context of a novel pandemic, downplaying the risks is far worse than overplaying them IMO.

> While I agree with the overall sentiment, in the context of a novel pandemic, downplaying the risks is far worse than overplaying them IMO.

Probably true, as long as you're not one of the ones rounded up and sent to prison, er, I mean, quarantine.

Or the people who will lose their job because of the economic impact of an unnecessary panic.

Unfortunately, sickness and death also have an economic impact. I have no idea how to balance those two forces.

The problem with that reasonning is that it applies to pretty much every "risk", without consideration of quality. What you're saying is "better safe than sorry".

I'm sure you wouldn't suggest putting everybody systematically in quarantine for a flu epidemic, every year, makes a lot of sense. Yet the death rates for influenza is much higher than coronavirus atm..

edit: much lower -> much higher

True, but the same claims are made about the other things you mention also.

Boy who cried wolf story comes to mind.

Overplaying increases the baseline of perceived risk, so you'll have to overplay it even more next time to provoke the same reaction. That's difficult, because once you're at "we're all going to die with 99.9% certainty", will people really care tomorrow when it's 99.99% or 99.999% the day after that?

It feels a bit like throwing antibiotics at everything. Sure, it's effective in the moment, but you're lowering the future effectiveness.

My reasoning for thinking this is worthy of panic:

I recently moved to China. The PRC has good numbers (internally) and knows more about COVID-19's severity and risk profile than anyone else. And, on the ground, the PRC is putting the entire country on what amounts to wartime footing (in a way that's unimaginable to most HN readers), to the point that it's willing to sacrifice a quarter or more worth of economic production because the alternative is potentially worse.

It's managed to be successfully contained here (it's been some time since I saw any corpses ferried out of my apartment complex), but Western countries, let alone developing countries, simply lack the state capacity to respond as decisively and effectively as China has.

I'm hoping Spring ends up curtailing the pandemic; letting warmer temperatures do their work requires slowing down the virus' spread as much as possible, and that requires significant disruptions to people's everyday lives.

EDIT:

--- As the replies to my comment indicate I have totally misunderstood the paper. And there IS in fact evidence that the temperature changes the transmission. Sorry my bad. leaving the rest as is ---

> I'm hoping Spring ends up curtailing the pandemic; letting warmer temperatures do their work requires slowing down the virus' spread as much as possible, and that requires significant disruptions to people's everyday lives.

from this paper "Temperature significant change COVID-19 Transmission in 429 cities": https://www.medrxiv.org/content/10.1101/2020.02.22.20025791v...

> There is no evidence supporting that temperature changes COVID-19 transmission. Methods: We collected the cumulative number of confirmed cases of all cities and regions affected by COVID-19 in the world from January 20 to February 4, 2020, and calculated the daily means of the average, minimum and maximum temperatures in January. ....

EDIT: I'm also very worried about this point you mention:

> the PRC is putting the entire country on what amounts to wartime footing (in a way that's unimaginable to most HN readers),

the effect of isolation/quarantine can have massive psychological damage and after-effects (especially on kids), such as PTSD, depression, ... years after the virus is gone:

"The psychological impact of quarantine and how to reduce it: rapid review of the evidence" https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Very much underrated. There isn't enough dialogue right now with the public about what they are likely to expect.

To be clear, the "There is no evidence supporting that temperature changes COVID-19 transmission" is part of the background statement of the paper. The paper establishes evidence that temperatures do significantly effect transmission rates.

correct, I have messed up here. edited the orig. post to make it clear. thanks for pointing it out everyone.

Note that the quote above is the background of the paper, not the conclusion, which states:

"The study found that, to certain extent, temperature could significant change COVID-19 transmission, and there might be a best temperature for the viral transmission, which may partly explain why it first broke out in Wuhan. It is suggested that countries and regions with a lower temperature in the world adopt the strictest control measures to prevent future reversal"

That paper correlating temperature with transmission is comically bad. As stated above, the likelihood warmer temperatures by themselves will have any affect on COVID-19 transmission or deaths is close to zero.

I've been seeing comments all over that the temperature will reduce transmission, and even heard it cited in the news today. I'm very skeptic about this since citing SARS research is useless here.

fwiw trying to find evidence of this claim in studies relating to covid19 (peer reviewed or not) has so far yielded no results.

"citing SARS research is useless here"

Huh? SARS is the closest studied virus there is to COVID-19. It is certainly not useless. Of course there are no/few results for COVID-19, it didn't exist until a few months ago and even then was relatively unknown until about a end of January.

My read on the Chinese reaction is the same in that they seem to be taking it very seriously indeed. But it might not be because the PRC are so worried about the disease per se. They may just be worried about the unrest and panic an insufficient response could cause. I.e. the PRC may be trying to prevent the infodemic more than the epidemic, to use current parlance.

Both probably play a role in the equation of how China and the PRC has acted thus far in the wake of the disease. I certainly don't think China is acting with some far greater knowledge of the virus than other affected states/countries. The virus genome has been mapped and the world is working on developing a vaccine (I believe I read a recent story that Hong Kong claims they developed one). Unfortunately (or perhaps fortunately), any kind of vaccine will need to go through phases of testing and validation to ensure its efficacy and this process will inevitably take time. That time will regrettably see more people fall victim to Covid-19.

Of course, China was also probably worried about the economic and political repercussions of appearing to the world as not being strong or proactive enough in its response. So much of the global supply chain relies on China that even having the resemblance of not being in control of the situation would have produced a far greater economic bloodbath than we've seen thus far.

One interesting frame to view this through is as a stress test of Chinese state capacity. I.e. is the state able to rapidly deploy resources vastly and effectively, at the cost of very dear priorities, to achieve some key national security objective?

If I were a CPC member, I'd be pretty happy with how this has gone. It was able to turn an initial misstep into a triumph: the people I talk to tend to take the view that China got a pop quiz and scored a B+, while all the other countries around are getting the same exam take home and flunking it.

China is taking it seriously which is different from addressing it competently ... welding occupied apartment buildings shut, throwing undiagnosed into Hotel California[1] quarantine centers, randomly spraying things with who knows what, etc does not inspire a sense of efficient effectiveness in onlookers.

[1] - "Welcome to Hotel California / ... / You can never leave!"

I agree with this sentiment, to a point. Economic growth is, at least to Western eyes, the main point of derived legitimacy for PRC. If the calculation is that blowing containment of the virus was a worse threat to that than 2 quarters of negative growth then, yeah, this is a big deal. I think I disagree a little with Western countries' governments not being able to enact policies for containment. What I'm more concerned about is people who live in Western countries actually following them, and the government failing to force compliance.

I have the polar opposite view, China is not transparent with their numbers, and their response is hamfisted because they aren't competent and a lot of it is theater (typical of communist regimes.) It is possible that in many years more people will die from cancer from their irresponsible spraying than the actual virus. Western countries are also traditionally cleaner, and things like "gutter grease" aren't common. I have much more faith in the west than hamfisted policies from China.

They may not be transparent with their numbers, and certainly weren’t in the early days, but what about their response has been not competent? And what does gutter grease have to do with this virus or containment?

Does this look like a competent response to you? Or do you think is was thought of by a bureaucrat within the CCP? This is one of many examples. https://www.youtube.com/watch?v=Yw7M-fUaIb0

Also fecal matter might be part of the transmission. Gutter grease is produced from sewage waste (in many case.) https://www.bloomberg.com/news/articles/2020-02-20/fecal-tra...

If making a stupid PSA video is the criteria for incompetence, I'm not sure I've ever interacted with a single competent organization that was large enough to film one.

I don't care about their filmographic teams. I care about whether or not the control measures are working.

I said that was one of -many- examples. Try reading around. China even went so far as to blame the outbreak on the US. Sounds a lot like the Soviet era. https://foreignpolicy.com/2020/02/15/coronavirus-xi-jinping-...

Outside of just lying about case numbers...

"But by Feb. 5, the funeral parlors and crematoriums were reported to be having problems keeping up with the disposal of the dead in Wuhan. Though no data was provided to address the matter, Wuhan’s lockdown was endangering not only the lives of coronavirus-infected individuals but also those of thousands of people who required medications and occasional treatment for such things as HIV infection, kidney disease, diabetes, and hypertension. Hospitals no longer welcomed them, medicines were running out, yet there is no count of their numbers or deaths."

"As the makeshift quarantine facilities filled, questions arose about their safety, as people were stacked side by side and shared toilet facilities. There was clear evidence that the coronavirus disease could be spread via feces or the off-gassing from overused toilets and taxed plumbing."

Sounds like they've been everything but competent.

Trust and theatre perhaps; and there is certainly a lot of precedence for it from China. And I don't think anyone is taking the news and numbers from China at face value.

Flip it around a bit. China has taken the actions they have to contain the virus, there are some indications of success. You think it's not enough or not done correctly. What would you have done instead?

Mind you, the US currently has a President that blames the milk going sour on Mexicans, thermometers showing higher temperatures on China, and the colour of his hair on LED light bulbs. Half the country does not believe that this makes him incompetent...

> Sounds like they've been everything but competent.

If you think that our cities are any more prepared for an epidemic of this magnitude... I don't know what to say.

I will point out, however, that the US has fewer ICU beds across the entire country (Most of which are currently occupied), than there are documented COVID-19 cases in one city in China.

If an outbreak occurs here, do you really think that we will have enough medical resources to provide quality care for everyone? If yes - what are you, and your legislators doing, to put us in that situation? Because with our current medical infrastructure, we are not in that situation.

When talking about competence in containment we need to look at aggregate data. Clearly there will be pockets of mishandling things, everything from medical facilities to airports etc.

Aside from the initial mishandling due to downplaying the situation and hiding information, the subsequent actions seems to have been pretty effective. Outside of Hubei the virus seems to be pretty well contained and relatively quickly at that.

They actively tried to cover it up and waited until it was too late to take action, and they're engaging in a lot of sterility theater.

Never heard of that vile substance before: https://en.m.wikipedia.org/wiki/Gutter_oil

Did you move to Hubei? I have been in Shanghai through this entire thing and have an extremely hard time believing you saw any corpses ferried out of your apartment complex. 94% of the reported deaths are in Hubei - what city are you in exactly?

My mining through his comments shows he is from Beijing [0].

[0] - https://news.ycombinator.com/item?id=22149446

Broadly speaking, I was trapped in a lower tier city for a couple weeks after LNY, which is where I saw two corpses removed from my apartment complex. Not in Hubei. Recently allowed to travel back to Beijing.

It is interesting how in times of crisis, people start looking for a heavy handed, authoritative response to the situation. Moderates will be brushed aside as weak and impotent.

I do not disagree with you on the point that China's response has been herculean, but we must not forget that this also comes at a hefty price, one that I am personally not willing to pay.

> I do not disagree with you on the point that China's response has been herculean, but we must not forget that this also comes at a hefty price, one that I am personally not willing to pay.

One that you're not ever willing to pay, regardless of what you'd get for it? Even if it saved a million lives?

Given N=1, we obviously don't currently know how effective these quarantine measures have been so far, compared to whatever platonic ideal that does not come at a 'hefty price'. [1]

I think it's more likely then not that we will have a better grasp on it in a few months, when other countries start having outbreaks, especially if they don't react seriously to them. It's becoming quite clear that travel restrictions on their own are not going to keep the virus isolated.

[1] I have no idea what exactly you mean by that, so I'm going to assume you are not a fan of the quarantine, as implemented in China.

Edit: Thank you for clarifying your point, by pointing out that your concern is for the overall context - the other repressive systems of the CPC. I am very deliberately not addressing them in this sub-thread.

By hefty price, did not mean any potentially mishandled quarantine measures. Quarantine is a compromise, a hard one, and I am certainly in no position to form an informed position on this matter.

I meant the human rights violations perpetrated by the regime. This is always the price we seem to have to pay for a "competent crisis handling". I would indeed rather choose a free, but impotent country.

It is ironic that personal freedoms and public health are not often compatible. Doubly important to be aware of what we are being sold.

"letting warmer temperatures do their work"

The likelihood that warmer temperatures per se will have any affect on COVID-19 transmission, morbidity, or mortality is close to zero.

I guess this comment has garnered some negative reactions from people. I have yet to read/hear/come across a plausible explanation regarding how the warmer temperature will actually curtail transmission or improve health outcomes. Is there an actual theory here or are people just paraphrasing our genius President's semi-coherent remarks regarding same.

For the same reason(s) the common flu is more prevalent in the winter. Wikipedia has some proposed explanations: https://en.wikipedia.org/wiki/Flu_season#Cause.

What level of expected infections and deaths would justify their panic, and how much do your estimates differ from those numbers?

There does seem to be a section of punditry and commentators, internet and traditional media, who are absolutely salivating for a big dramatic disaster. A lot of people seem to enjoy the thought of doom. It's as if everyone's joined a doomsday cult, like the Millenium.

As well as the opposite, the "it's just a flu" person, which honestly I've not given much thought before and am morbidly fascinated by.

COVID-19 is uniquely terrifying because it is so hard to quarantine. The fatality rate also doesn't factor in the debilitation rate: survivors aren't walking away from this thing unscathed - you have to worry for yourself also. A reasonable amount of panic is healthy, panic is an emotion that we experience for very good evolutionary reasons. Fight or flight often overidentifies threats, but it can underidentify them (e.g. America's official response).

Conspiracy theories aside.

> It's like there is this thirst for disaster or some global drama everywhere

Yes, I see the same effect skewing media and popular perception. It's an artifact of natural selection biasing human responses to perceived potential danger. It slightly enhanced survival rates to incorrectly fear every rustling bush hid a hungry tiger than correctly calculate it was almost certainly a squirrel. Hence, every historical era is overrun with politicians, pundits, journalists and activists incentivized to leverage this innate bias in service of their cause.

After a few decades of observing this in action, my best model is to assume everyone has some bias driven by their background, perspective and incentives - even if it's entirely unconscious. Then it's just a matter of determining direction and degree to apply a debiasing adjustment.

Journalists tend to sensationalize, whether overtly or merely through curation ("the bad thing isn't so bad" doesn't get clicks). Politicians either over or underplay threats depending on the context. Exaggerating the Huawei threat to support tariff policy or minimizing COVID-19 to reduce negative economic perceptions in an election year.

In my estimation, some sources, such as the CDC, are less biased not necessarily because they lack biasing incentives but often due to those incentives having opposite signs and offsetting each other. For example, the senior CDC administrators who control public statements (as opposed to the medical and science staff doing the work). Those administrators are most likely good people trying to do a very tough job as well as they can. However, they also live in a world of budget battles, congressional hearings, and the media blame-game. In the underplay direction, a public panic makes things worse and leads to post hoc blame game ("why wasn't the CDC ready?"). In the overplay direction, people not taking the threat seriously means they don't cancel large events or reduce airplane travel and it spreads faster.

The problem is in the healthcare capacities.

I live in a country with ~2mio people. If you're patient zero here, you get a comfy private room, your own bed, 5 doctors, 10 nurses, whole research teams, respirators, priority with all the tests, examinations, etc. Same for patient 1, 2, 3.

If 200k people get infected (10% of population), and only 10% of those need extra medical care, that's 20.000 people. We don't have that many hospital beds, doctors, respirators.. probably not even enough medicine (some test have shown that malaria medicine and aids medicine works on some people). You get thrown into an army tent or a school gym with many more ill people, and you get almost zero resources. Need a respirator? Sorry, only 5 available at that location, and are used on other people.. or kids.. or pregnant women... and you can just slowly suffocate.

China built a hospital in a couple of days. I don't think there's a country in EU that can do anything remotely fast as that.. we probably need 10 days just to discuss where to put the emergency tents, and even then we'd get protesters not wanting them there. Same probably in the USA.

We also don't have companies making respirators and other medical equipment. Large countries who do, are making them for their own hospitals (if they're not stuck in paperpushing hell with the government).

Basically, if there's a wide-spread epidemic, a lot of people will get really really fscked.

Spot on. Medical facilities are not up to support in times of widespread epidemics. Which means most people would not get any treatment and you should expect mortality rate to increase over time as it becomes more widespread.

You can see this in provincial level mortality rates: at low infection concentrations, it's a more deadly than flu but nothing insane. But once resources are swamped (e.g. in Hubei), the mortality jumps an order of magnitude.

Thank you. I have this constant argument with those that want to shut borders and blow up our economy as a result: that if you break the stats down on Hubei vs everywhere else, it’s a very different picture of the virulence and mortality rates.

Hubei’s mortality rate for literally everything at the moment would expected to be higher than anywhere else given how stretched their resources are.

I don't understand. How is the mortality rate being worse when resources are stretched thin a point in favour of not shutting borders?

> If you're patient zero here, you get a comfy private room, your own bed, 5 doctors, 10 nurses, whole research teams, respirators, priority with all the tests, examinations, etc. Same for patient 1, 2, 3.

I read a similar comment from someone on another forum. If you're certain this will end up a pandemic, with almost everyone eventually catching it, your best move is to catch the virus as soon as possible, ensuring you'll get the best care.

Though this assumes you can't get it a second time, after the antibodies are generated. This appears not to be the case with this virus, possibly.

How fast or slow does the virus evolve towards lower mortality? If you get infected months later, is it still essentially the same virus, or a less aggressive strain?

Given the 2-3 week transmissible incubation period where the infected show no symptoms, it doesn't seem like there's short enough feedback loop for the lethality to be tempered through natural selection within the initial period of the outbreak (which we're just beginning).

>Given the 2-3 week transmissible incubation period

No one knows if it's transmissible during the entire incubation period. It's almost certainly not given how other viruses behave. Also the possibility of transmission during asymptomatic periods doesn't mean that it's likely, or that most transmissions happen during that time.

Good points!

Or, hole up and wait for a vaccine.

"As of 2020, there is no cure or protective vaccine for SARS that has been shown to be both safe and effective in humans." https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...

There are reports that you can get it a second time, and it is worse on the second time:

https://www.theburningplatform.com/2020/02/15/hubei-doctors-...

And you forgot the last thing: Europeans would never put the money in.

The Coronavirus isn't new. Since mid-January we knew this will be serious. Nothing has been done since to prepare.

Maybe Europeans can't build a field hospital in ten days, but we haven't even tried to start building anything in 40 days.

We wait until it hits our shores, as is now the case and then throw our hands up in the air.

it already has hit your shore.

From the parent:

"as is now the case"

that was edited in.

Yes I felt I needed to edit it in because you thought I didn't know about the COVID-19 cases.

The numbers probably get worse with scale rather than better because larger countries can get away with having lower medical capacity than smaller countries (i.e., larger countries will be more efficient).

The U.S. could probably build a hospital very quickly, but neither China nor the U.S. can build enough hospitals quickly enough, let alone equip them, let alone train nurses and doctors quickly enough.

If the brown stuff really hits the moving fan blades, then military tent cities it will be, and it will be more like bad hospice care than like bad hospital care.

One thing this crisis will do is highlight the need for more emergency pandemic handling capacity. That means: a) faster testing of vaccines (e.g., do double-blind testing on medical staff, since they need it most), b) faster emergency mass production of vaccines, c) faster emergency distribution of vaccines.

Creation of new treatments (new anti-virals, ...) on an emergency basis is necessarily going to lag because it's much more costly and time consuming than development of new prevention (vaccines). Manufacturing new equipment (respirators) and so on also takes time (retooling, etc.). Building hospitals takes even longer (even if you can pull together to build one very quickly, equipping it will take time). And training staff takes eons. Throw in supply chain disruptions and, really, I think only emergency development and testing of new vaccines is plausible on a timescale similar to that of a pandemic.

It's not like you can have a ton of spare capacity around: that's very costly too, and there's depreciation issues. Reaction time needs to be faster instead.

One thing I'd like to see come out of this is a treaty or agreement on cross-certification and inspection of bio labs around the world, and an agreement to not develop bioweapons, or at the very very least to not develop bioweapons that are trivially transmissible from human to human. I think it's becoming clear that SARS-covid19 was leaked accidentally from the BSL-4 lab in Wuhan, or at least that it's very plausible that it came from there, and that is rather upsetting -- this must not happen again!

I thought you had a good take till I got to the end and saw a conspiracy theory that to my knowledge has very little basis in fact. Simple explanations (species jump, evidence of similar viruses in adjacent species) are way more likely than some arcane BSL 4 leak. We shouldn’t compound hysteria with wild conspiracies.

I don't disagree with your position - if there's a wide-spread epidemic, things will go bad, especially as the healthcare system gets overwhelmed. But that's not a novel or interesting point of view, and I doubt many would disagree. So why go around inciting panic?

Lets try some other numbers. If 1% of the population gets infected, and 1% needs extra medical care, that's 200 people. If 0.1% of the population is infected and 0.1% of the population need extra medical care, that's... two people. That's not so scary, and I'm not going to slowly suffocate. (There's no need to threaten me with asphyxiation, thanks.) We don't have any reliable information, so any numbers used for "back of the envelope" math might as well be relating my birth date to star signs and be used to find my future lover, for all the basis in reality they ultimately have.

I mean, you're scared. I get it, I'm scared too. I feel powerless in the face of this epidemic and being told to wash my hands a bit more, and touch my face less only serves to reiterate my impotence. Is that where the thirst for disaster potential comes from? An addiction to the panic endorphins?

(I am genuinely curious, and am hopeful that mns' comment will stimulate commentary about the meta-topic.) (And apologies for singling you out personally, ajsnigrutin, the other sibling replies are of the same nature and yours was the comment I chose to reply to.)

That is where speed of spreading the disease comes in. If you can limit it so that 1% of population in local area is sick simultaneously, then it is fine.

If you cant limit the speed of spreading the disease, then the hospitals will miss those needed respirators and more people will die. Cause respirator is necessary if you are one of the unlucky ones.

Which is where "hysteria" around locking areas, washing hands and testing people on airports comes in. That is why locking cities, working from home and having some reasonable amount of food so that you are comfortable. The whole point is to slow down spreading, so that resources are available for sick people.

> I feel powerless in the face of this epidemic and being told to wash my hands a bit more, and touch my face less only serves to reiterate my impotence. Is that where the thirst for disaster potential comes from? An addiction to the panic endorphins?

It is not impotent to wash hands and touch face less and avoid unnecessary crowd. That done in masses is to slow down the spread. It is all actually useful.

According to the Chinese papers, something like 15% of cases are serious and need hospitalization. If it does become widespread, it would be a major calamity (though most people would survive and the world would move on once it is over).

As to whether it will become widespread, the jury is still out. China appears to have gotten it under control, but it took drastic measures to do so. The rest of the world has yet to demonstrate an ability and willingness to do the same. There is a decent chance this will spread as widely as the swine flu did, but with more than 20x the case fatality rate, we would be looking at tens of millions of deaths worldwide.

But if you get a bunch of "it's just a flu" people, who sneeze everywhere and don't wash their hands, that "1%" number gets higher. I'm not saying we should close up the whole country, but basic measures (you're ill, even if it is just a flu, you stay home... people must wash hands. Hand desinfectants at stores, schools, etc. No large gatherings if it's not neccessary. If you can, work from home, if someone near you got sick. etc)

Yes, you are right, if 10% of people in your country get infected it would be an absolute calamity... because it is already such an extreme scenario. Does it even have a precedent in modern times?

The 1918 flu pandemic.

And that's still ignoring the factor that many of those care workers will get ill themselves compounding the problem significantly.

That "10 day hospital" is the field hospital equivalent of a school gym.

>It's like there is this thirst for disaster or some global drama everywhere, and this is not something that I would expect from Hackernews.

Being somewhat of a cynic, it doesn't surprise me to see it here. HackerNews posters apparently love thinking about global catastophes and societal discontinuities. Read the breathless posts warning of dire consequences arising from the tariffs on in China 24 months or so ago. The flurry of horrific predictions arising as a result of Brexit. The neverending hysteria about CO2, ocean warming, ocean acidification, the mass-extinction insects, etc....

Most posts to hackernews come from workers who are bored... they turn to HackerNews to read interesting articles. And, there is nothing more interesting than fantasizing about some event that would give them a reason not to go work the next day. It's a normal thing to do... back in my day, it was nuclear strikes and Soviet invasions ( "wolverines!!"). Nowadays it's viruses and CO2... (a poor substitute, in my opinion, for the much cooler angst about nuclear winter and the like... but, to each their own.)

And, whatever the cause celebre may be at the time, you can always count on posters getting really ticked off at skeptics and responding along the lines of, "You just don't get it! The science is clear! This time it's different!"

Complex society is more fragile than you think: https://en.wikipedia.org/wiki/Late_Bronze_Age_collapse

Conversely, there's a group of people who like to show off how sensible and level-headed they are by being able to rise above the concerns of other people. They do this by handwaving away problems rather than engaging with the evidence.

The threat of nuclear war was (and is) real.

The mass reduction of insects is well-documented.

The threat of rising CO2 levels is one of the most-studied phenomena in science.

> "You just don't get it! The science is clear! This time it's different!"

Actually, it's not necessarily different. There are historical precedents for viral pandemics. The flu pandemic of 1918 killed 50–100 million people.

That doesn't mean this outbreak will be on the same scale, but it's not unreasonable to be concerned.

>Conversely, there's a group of people who like to show off how sensible and level-headed they are by being able to rise above the concerns of other people.

Quite right. Let us at HackerNews strive to be part of that group. ;)

There are plenty of other sites for the chicken-littles.

In any case, I don't expect to persuade you...

But a couple months from now, when Covid-19 is but a memory and we're off with the next impending catastrophe (Caribbean volcano? Tremors along the San Andres? Killer Bees? Whatever it may be...) perhaps you'll be so kind as to revisit this thread and give me an upvote. Likewise, if a couple months from now I'n in a crowded hospital, feverish, and on a ventilator, before I pass, I will request the nurse log me on to HackerNews so I can return here and do the same for you.

> But a couple months from now, when Covid-19 is but a memory ...

Still backing this claim, 11 days later?

It would give me no satisfaction for it to be retracted :(

And I hope lurquer will not find themselves in the situation they suggested above.

Yep.

Check back in 37 days.

Will do. I admire your optimism!

You have got to be shitting me.

There's a difference between "my honest prediction is that this is legitimately going to get way worse, because of X, Y, and Z", and "I feel a psychological need to pretend that this small problem is much bigger than the information makes it seem, because I like drama".

I've been watching Canada's medical system's near-total non-reaction to this situation. Basically the measures they have taken are to caution people not to worry to much or discriminate against Chinese people. Based on that, our throughput of travellers, and the fact that asking people if they've been in Wuhan in the last two weeks is no longer good enough to rule out cases, it's obvious that it's just a matter of time before Canada has a serious outbreak.

When I crossed the US border recently, all they asked me was whether or not I've been to China.

I think it's just realistic to acknowledge that at some point we lose the containment game, and that's very likely happened already. Maybe the long term consequence is a flu season that is twice as lethal. Or maybe there will be a very effective vaccine that eraducates the virus next year. Who knows.

To me I simply have never seen this before. I remember SARS, and H1N1. There was a big media blitz about both, but that was it.

With this I am seeing cities / countries on lockdown. I have friends that can't go home in Italy because of the lockdown. My own government (Canada) has asked us to prepare for pandemic, and we only have a handful of cases ?!?

The most bizarre thing to me is that people are taking the numbers with a grain of salt and assuming this means the real numbers are worse.

Deaths are terrible, but they are also really easy to count. Hospitalizations are terrible, but they are only marginally harder to count correctly. Most of the difficulty is that there is some evidence of undercounting at this stage, but it isn't very strong.

Non-hospitalizations of untested citizens with matching symptoms are practically impossible to count accurately.

Each step leads to more error, but these errors may actually imply reduced severity rather than greater severity. Its bad, to be sure, but seriously, there is too much public panic in the air right now.

> We have numbers, but every time people tend to ignore them or say we should not trust the numbers, take them with a grain of salt

Well, the numbers are very wrong. That's known. There are plenty of large factors with unknown impacts pushing the numbers both ways.

But there are about as many people saying "it's not that large a problem" as there are saying "this is way worse"... What is just natural when we don't have reliable numbers.

> It's like there is this thirst for disaster or some global drama everywhere

People like to pretend like the world is causing their internal state, that their mood is an inevitable product of the environment they're in. I feel catastrophic, disastrous, and look at all the evidence that the world is headed for a cliff! True, we're embedded in our world, but a peaceful person doesn't spend as much time focusing on Eschatology.

Life is confirmation bias. Numbers can help, I suppose.

Exactly this. It feels like this day and age people are trying to blame everything around them for their troubles. They can't bare to look at themselves and think "maybe I need to change?"

It's because modern life is exceptionally easy. Anyway, it's good for the markets anyway.

> We have numbers, but every time people tend to ignore them or say we should not trust the numbers, take them with a grain of salt, "I think this is way worse, it's going to get way worse" and so on.

I think everyone notices it now because they all say the same thing and in the same manner. It's always, the numbers can't be trusted ( China/WHO/CDC/EU/UN/US/etc ) followed by an "anecdote" and/or their own made up numbers and without fail an intentionally misleading and false mortality/fatality rate. Every covid and even non-covid thread has the exact same fearmongering. Whatever the case, it's definitely intentional and feels a tad bit organized.

I think that it's possible, but unlikely, that this will 'blow over' and turn out to be a tempest in a teacup.

But I also think that it is extremely worrying that this 'HN/internet hysteria' has so rapidly become part of the national conversation. Just yesterday we (NL) had a prime-time broadcast about this.

The way I see it, it doesn't matter whether the facts align with the response. Clearly this is treated as more than just another virus, this will have effects on our global economy and compounded by a general sense of unease about there not being some big recession, it's going to have effects and they will suck.

Practically speaking, it means that I stock up on shit so at the very best I don't need to wait in line for things.

More hypothetically speaking, I'm thinking of our economy collapsing to some extent, because either it was due to anyways, or because it will because of a pandemic, or because it will because of everyone thinking there's a pandemic even when it's not that bad and <insert definition of pandemic> is not a cause for panic.

We're in panic mode, and I'm surprised and worried that this is not just an 'internet thing'.

Currently, it's better to overestimate the gravity of the situation, than to underestimate. Better to err on the right side. Panic is bad, but at least you get prepared.

> a better approximation of evaluating your survival chances is to look at the death to recovery rate (dead / (recovered + dead))

This formula is still fundamentally wrong because it assumes that the time between infection and death is the same as the time between infection and recovery. I don't see why that would be true.

The argument is it’s a closer approximation. Abstractly if the average death took place X days after infection and recovery took more than 2X days after infection then deaths:infection is a better metric. On the other hand if the average recovery takes less than 2X then deaths:recoveries is a better metric. And if it’s close to 2X then averaging them is a better idea.

Of course detection also lags infection so that’s another consideration. I suspect that’s the real difference as outside of China a lot of cases where discovered before symptoms developed due to blood tests.

PS: South Korea has 1,766 confirmed cases, 13 dead, and 26 recovered. Iran has 245 confirmed cases, 26 dead, and 21 recovered. Those numbers are far enough apart to suggest underlying differences in reporting, which is I a larger issue. https://en.wikipedia.org/wiki/2019–20_coronavirus_outbreak

I don't think a sensible mortality rate can be computed at this point, because we have no idea, not even good estimates, how many people contracted the pathogen. 10 dead out of 1000? Or 10000? Or 20000? In Wuhan they apparently checked ~almost everyone for symptoms - temperature - but showing symptoms != infected. So far it seems that there is an exceptionally large proportion of infected people showing no or barely any symptoms.

doesn't that mean that we can only compute an upper bound on the mortality rate?

We will never know for certain how many cases there are, but _of the cases we know about_ we can compute a reasonable upper bound on mortality. Were more likely not to learn of cases than were not fatal than we are of cases which are fatal as severe cases are more likely to seek treatment.

With the measurement people are using, yes, you can only know an upper bound.

It's possible to discover an actual estimate, but it takes time and resources. Researchers may care about doing that after the crisis passes, but it's very unlikely anybody will care about this right now.

Which is fine, people keep pointing to all these unknown as "we can't possibly compute the morality rate!" Which leaves the door open for assuming its way higher than estimated, when in reality current estimates are likely an upper bound.

Although I think the official estimates are severely overestimating the lethality (by an order of magnitude), I also think there isn't enough information for establishing an upper bound yet.

Current estimates are bad.

> On the flip side, it's very likely that mild cases will never be reported, which in turn would decrease the mortality rate.

Indeed. This calculation ignores severe underreporting of mild cases--for example, Johns Hopkins researchers (the same ones who made that map you linked to for data) estimated that only ~10% of cases in mainland China (mostly Wuhan at the time) were being reported [1]. That would put the mortality rate at under 1%, which is close to the evidence we have from elsewhere (e.g. the Diamond Princess).

dead / (recovered + dead) is only a reasonable estimate if you actually have good numbers for the recovered count. We don't, so it's irresponsible to use it.

[1] https://systems.jhu.edu/research/public-health/ncov-model-2/

> That would put the mortality rate at under 1%, which is close to the evidence we have from elsewhere (e.g. the Diamond Princess).

Since it takes 3+ weeks to die from this illness, we're not going to know the fatality rate from the diamond princess for another month. And that's still going to be a lower bound since they'll all be getting medical care from often before they're even diagnosed.

>And that's still going to be a lower bound since they'll all be getting medical care from often before they're even diagnosed.

It's not a lower bound because cruise ships skew much older than the general population. All 4 who have died so far have been in their 80s.

Good point. That you can at least try to correct for to match various populations though.

We know the percentage of people who are in critical condition and it's very low.

Well the death rates seem to be lower outside of China so that doesn’t seem to support that China is understating the lethality of the virus, nor that it is particularly more lethal than the chinese numbers.

Re the higher death rates in the chinese province, I thought it was due to people not showing up to hospital when having milder symptoms, but I watched an interview of a french doctor who suggested it is rather because of the lack of medical infrastructures in that region, to which the chinese remediated by building these spectacular field hospitals.

I agree with your general point that rate=deaths/infections is making a big assumption about unresolved cases and almost surely gives a too low number -- but rate=deaths/recovered I think does the same thing in the opposite direction. Unfortunately we just don't know right now. It would be nice to see deaths vs recovered vs mild cases vs critical cases for people who have been infected >N days, but that's much more nuanced information to consume than some "death rate".

Btw, you made a point about exponential growth, but is that happening? The logarithmic graph on https://www.worldometers.info/coronavirus/ appears flatlined to me. Maybe (probably?) that's just about containment in China, but when we're discussing death rates that's where most of the data is.

I have heard this argument that the real mortality rate may be under-reported for this reason since the outbreak began around the start of January and it makes sense to me.

On the other hand, what do you say to the claims that the real mortality rate is much lower due to people infected but with symptoms so mild they don't seek treatment?

Right. It takes 3+ weeks to die from CoVID-19, so if they're looking at people who were diagnosed as late as Feb. 11th then this is going to be a substantial underestimate of fatality. Especially since as awareness of the disease has increased, the time to diagnosis after first symptoms has fallen from 5 - 6 days to 1 - 2 days.

5 people have died that were on the princess cruise out of 705 infected. At just over 1/2 a percent, it is more deadly than the flu, but not 2% and certainly not 7.8%

The princess cruise gives us a crucial piece of information which is a fully tested population.

2 things to consider:

1) population is like older due to being a princess cruise which would increase death rate.

2) not everyone is cleared yet, so more deaths could come

And how healthy are their immune systems? I imagine they are eating a lot of sugary foods, drinking more than usual and staying up later in a time zone they are not acclimated for.

Only 4 have died, and all 4 were in their 80s.

You are correct: https://bnonews.com/index.php/2020/02/the-latest-coronavirus...

I must have remembered the wrong number.

4/705 = 0.5% (1/2 a percent), which is still pretty high vs the flu, but not 2% or 7.8% or whatever crazy numbers people are quoting.

Wouldn't the quick discovery and level of care also factor in?

The infected might be terribly maimed for the rest of their life as well. Can you imagine if they develop COPD or some similar chronic inflammatory lung disease because of this?

You are exactly correct. With the formulas you described:

naïve CFR = deaths / cases

resolved CFR = deaths / (deaths + recoveries)

It can be shown pretty dramatically in outbreak simulations how more accurate the resolved CFR is than the naïve CFR. See for example the chart https://blog.zorinaq.com/assets/outbreak2.svg In that specific example, the naïve CFR underestimates by 5x, while the resolved CFR is only off by ~1.3x. I ran this simulation as part of my blog post on how to estimate the Case Fatality Ratio of the coronavirus: https://blog.zorinaq.com/case-fatality-ratio-ncov/

The survival rate is also probably thrown off though because some countries have better trained health professionals. No one in the US (that made it to US care) has died as of yet. In other countries without advanced facilities available, the rates are much higher. If the disease hits Africa and more of the ME, the rate will go up. While in the US, and richer countries like Germany, etc the rate will probably be low.

There's some validity to that, but a lot depends on how widespread the disease becomes. There are about 100,000 ICU beds in the US, and they can't all be allocated to coronavirus patients. Not having access to a ventilator would be pretty much equivalent to a death sentence for some patients. There are <100,000 ventilators in the US, and they're not evenly distributed (some areas and hospitals have very few). It wouldn't take much of a pandemic to exhaust our supply of ICU beds and other critical-care resources.

The dead / (recovered + dead) is the worst-case assessment, since most of the people who have not technically recovered yet (but may not even have any symptoms anymore), won't die either.

The dead / (infected + dead) is the best-case assessment, since some of the people who have not recovered yet, will die.

A somewhat better metric would be dead / (infected X days ago) where X is the median time for the illness to fully develop.

To me this article seems to be missing the most important stat from the original article, which is that the case fatality rate as measured is 2.9% inside Hubei (possibly under-reported) and 0.4% outside.

I think this strongly suggests that, as one would expect, the situation is much worse if patients lack the medical resources for care. And it also shows how important quarantine and preventative measures are.

Dead / (dead+recovered) is overestimating (even assuming 100% detection of mild cases) because it takes longer for people to recover than to die from it.

You have to take into account that 80% of cases are not severe, so you could have it and just think it was the flu. Most people wouldn’t go to the hospital in that case, so that 7.8% figure is not realistic. The WHO numbers (2%) do at least try to take this into account

I’m legitimately confused why we’re seeing these responses make top response on hn. It’s WEIRD

You assume recovered data is correct? Maybe it takes longer to be counted as recovered than it takes on average to die. This could change the rate

How would you know the number of infected people? You know the number of infected people with symptoms that were severe enough to get tested.

For the same reason: How would you know the number of people who have recovered? You know the number of people who were observed and then recovered.

On another page [1] Worldometer correctly explains the better estimate of mortality deaths / (recoveries + deaths) for ongoing outbreaks. Not sure why they got it wrong here.

[1]: https://www.worldometers.info/coronavirus/coronavirus-death-... "Coronavirus Mortality Rate"

How on earth is this the top rated comment? You can't make up your own statistical measure for mortality rates for a novel virus unless you're an epidemiologist. Of course there is under-reporting of mild cases...there's a shortage of test kits!

Built a simple `PyMC3` model based on your comment: https://github.com/zachwill/covid-19

There seems to be many cases of young patients dying in Iran. Either because there are way more cases than being officially reported or (hopefully not) the virus has mutated to affect the young more, or both.

The first hypothesis is likely based on the number of infections found in international travellers who went to Iran. We still cannot rule out the second hypothesis though.

A 23-year-old woman soccer player: https://www.reddit.com/r/Coronavirus/comments/faadg4/a_23_ye...

A male nurse talking of 8 deaths in one night during his shift. 23-year-old female (same case?), 29- and 30-year-old males, 50-year-old female among them. (1-minute clip)

EDIT: It's just n=8, but 37.5% dying at age 30 or below is most likely drawn from a different distribution from 0.6% among the 70,000+ cases in the largest Chinese study (where the worldometers data comes from).

EDIT 2: Based on a link in a sibling comment, only 7 deaths among 20-29 yo and 18 deaths among 30-39 yo in the n=44,672 Chinese report.

https://twitter.com/AlinejadMasih/status/1232779487647031302

http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9...

Dr. Li Wenliang, who warned of Covid early on, was also only 34 years old.

Doctors and nurses are exposed to a much higher viral load than most people. In Wuhan, they may also overwork and have insufficient sleep.

Good thing no younger adults in the western world are overworked and under rested ;)

> higher viral load

What is "higher viral load"? Isn't it binary - you are either infected or not?

Agree but they may also be constantly reinfected.

If you’re infected by a couple of individual viruses, it’ll take a while before it starts spreading throughout your body, which will have more time to prove an immune response. Compared to essentially bathing yourself in it for days at a time.

afaik viral infections increase at an exponential rate. If the initial load is higher, the peak infection before your immune system can get things under control will be much higher/dangerous.

Ex: 3^10 v.s. 30^10

Exposure to a virus doesn't ensure infection - there is some probability involved, depending at least partially on the number of virus particles that you are exposed to, over what period of time.

Viral load is literally a numerical expression of the quantity of virus in a given volume. It is often expressed as viral particles, or infectious particles per mL depending on the type of assay. And a higher viral load often correlates with the severity of an active viral infection.

No, your symptoms are affected by the number of viruses in your system. The virus is constantly replicating and your immune system is constantly destroying them. If the rate of increase is greater than the rate of decrease, you will not recover.

Same goes for their high death rate. Either they're lying about infections (which seems to be the current shared assumption of everyone else) or their version of the virus grew some really nasty teeth.

> There seems to be many cases of young patients dying in Iran. Either because there are way more cases than being officially reported or (hopefully not) the virus has mutated to affect the young more, or both.

They could easily have had an undiagnosed underlying condition that made them more susceptible to complications. This is to be expected in places like Iran with severe limitations in their healthcare system. It might be a more useful data point if it was from the US, UK, Spain, etc.

Yes, or a specific HLA type that is more prevalent in the population.

Is it just me or is your comment really insensitive? I would think that about half of world has no better healthcare system than Iran.

It's you. That half the world has no better healthcare system than Iran is a sad reflection on the state of healthcare in world, not an implication that Iran's dilapidated and overstretched healthcare system\* is a good one. Combine that with their authoritarian government with zero communications skills and no credibility due to being habitual liars, and we should place no stock in their reassurances/projections, and very little stock even in their hard-to-fuck-up stats like # of deaths.

\* I should say this is anecdata, based on comments by several Iranian friends and acquaintances.

I'm not defending Iran's healthcare system. The info I was able to dig up places it as above average, which means that more than 50% of world population will be affected just as bad or worse. Dismissing Iran's data point as not useful takes a specific viewpoint that I consider not empathic enough for my tastes, but everyone is free to disagree.

I don't see the insensitivity. This subject is not something that's very sensitive, I just see the comment as objective.

> half of world

Like he said, severe limitations.

Iran's healthcare is a lot worse than would be expected for a country of its wealth and development level because of the US embargo.

Why would you think a country under severe sanctions can have a very good health care system?

There’s something off about Iran. According to Wikipedia [0], Spanish Flu killed a much higher percentage in Iran too, in comparison with the rest of the world:

“The World Health Organization estimates that 2–3% of those who were infected died (case-fatality ratio).

[...]

In Iran, the mortality was very high: according to an estimate, between 902,400 and 2,431,000, or 8% to 22% of the total population died.” — source, Wikipedia, see [0].

I wonder if it’s genetics (immune system reacts differently?), or cultural (habits - kissing on cheeks, handshaking, large religious or non-religious gatherings) or climate, or a mix.

References: [0]: https://en.wikipedia.org/wiki/Spanish_flu

Edit: admittedly, it’s too early to draw conclusions. It’ll take a few weeks to have more realistic numbers.

It's hard to find up to date records filtered by country, but they might have higher count of the ACE2 enzyme which is thought to be an entry point for coronaviruses. Asian populations have much higher count than other populations.

https://en.wikipedia.org/wiki/Angiotensin-converting_enzyme_...

Once the beds are all occupied it doesn't matter how many a country has.

Source for Asians having more? This disagrees: https://www.google.com/url?sa=t&source=web&rct=j&url=https:/...

Would that mean Covid-19 would progress faster once inside the body? I assume that could mean an infected person’s immune system could be overwhelmed, hence resulting in a more severe case and even death.

> There’s something off about Iran.

Iran is a theocratic authoritarian regime under extreme international sanctions. Might have something to do with that. Iran also only has 0.2 hospital beds per 1k people.

It's in fact 1.5 beds per 1000 capita according to World Bank data.

https://data.worldbank.org/indicator/SH.MED.BEDS.ZS

The CIA begs to differ.

https://www.cia.gov/library/publications/the-world-factbook/...

A bit off topic but Iran is mostly only under American and Israeli sanctions at this point after Trump unilaterally pulled out of the Iran nuclear deal. The rest of the world can trade with Iran though many companies are still unwilling due to the American pressure.

Due to how interconnected European and American finance and business is this effectively means that Europe cannot trade to Iran.

The Europeans cannot enforce the JCPOA without either some kind of American cooperation or a major decoupling their financial systems from the US. I believe Macron has made public musing about the latter as an option, but then again Macron says a lot of things that lack pan-european support.

Specifically, the US imposes/threatens to impose secondary sanctions ie anyone who does business with Iran is also supposed to be subject to sanctions by the US, even if they are not US companies/US parent companies. So those companies can't then themselves do business with US companies or in the US.

Last I checked that still is international as it involves 2+ nations.. Not sure why you had drag Orange Man bad into this. You come off as a bit deranged.

The Spanish Flu was a hundred years ago, I highly doubt that what happened then in Iran has much relations to what's happening now.

What's happening now has more to do with their theocratic regime that didn't take the threat seriously and doesn't care much about their people.

Wouldn't that require two unrelated explanations for higher viral-outbreak mortality rates? Isn't the explanation that doesn't require a coincidence more plausible?

> Wouldn't that require two unrelated explanations for higher viral-outbreak mortality rates?

That doesn't sound unreasonable at all when the two outbreaks are separated by a century. A lot has changed between 1920 and 2020.

I have a suspicion, and it sounds obvious when you state it, that there's a correlation between smoking and severity and both China and Iran are relatively heavy smokers.

For the first time since the revolution Friday prayers have been cancelled in Tehran. They are still on in Qom.

https://twitter.com/alihashem_tv/status/1233017138119659520

Iran said it had no cases up until the moment it announced 4 people had died. Its safe to assume that the scope of the infection in Iran is either far greater than they have been able to track, or far greater than they are willing to admit. I think its less likely that the virus is killing more young people in Iran, and more likely that there are thousands if not tens of thousands of cases in Iran that simply haven't been counted/reported.

We saw the Iranian response to the airliner being shot down recently. It’ll be just as you say.

Citing individual deaths is sort of meaningless without an idea of how many people are sick. I suspect it’s in the many thousands in Iran already.

Preprint paper of Iran infection estimates the number of infected around 18k. (https://www.medrxiv.org/content/10.1101/2020.02.24.20027375v...)

Could be many reasons: 1. Iran has more young people. 2. Iran does not have any monitoring program of significance 3. Young people in Iran are probably more mobile and more likely to contract it.

> 1. Iran has more young people.

Just wondering if that's true. It does look like that's the case:

https://www.gapminder.org/tools/#$state$entities$show$geo$/$...

Iran is an outlier because it has an extremely poor healthcare system for a country of its size or GDP.

This page only has death rates, not number of cases for each group, so it only tells half of the story. See Table 1 of the actual paper for complete stats (source of the stats on the linked page).

http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9...

And screencapped image:

https://imgur.com/a/Ve5gT3O (posted by me)

Seems like the larger correlation in deaths is related to societal status - farmers, laborers, and retirees have much higher death rates.

Farmers — likely crappy rural healthcare.

Retirees — obviously age-skewed.

Quite possibly also: arriving sicker.

Hypothesis: If you're a rural / non-urban farmer, under quarantine and travel restrictions, you don't go to a hospital unless you're already very sick.

One of the real challenges here is in separating data artefacts from ground truth. Testing, surveillance, self-presentation, doctor-lobbying (by the patient or family) can all influence that.

This makes all data already somewhat suspect, before any overt manipulations are considered (and makes those manipulations all the more toxic to a full understanding).

And of course, there are numerous other factors. Farmers may well have poorer overall health (nutrition, behavioural risk factors (smoking, drink), preexisting conditions, latent or opportunistic infection, etc., etc.). All of which I'm very openly speculating on -- these are hypotheses which would have to be demonstrated through clinical assessment or systematic observation.

Note that "systematic" and "complete" aren't the same -- if you are following a defensible sampling method, then 100% coverage isn't necessary. But you'd want to capture samples from other populations.

The overall prevalence of COVID-19 within even Wuhan City and Hubei Province is still low, based on assessed cases (clinical symptoms or the more accurate PCR genetic screen for the SARS-nCoV-2 virus), still under 1%. Which means that population sampling would be unlikely to detect many cases without something on the order of many hundreds, possibly thousands, of samples. You're looking for an accurate central-tendency descriptor of a ~1:100 event.

Knowing what the actual exposure rate has been would be useful. Whether it's sufficiently useful to come up with a comprehensive large-scale sampling methodology is another question. Note that it's not merely the sampling size, but the selection and successful measurement from each of the selected individuals for sampling which is necessary.

(I've some statistics background, and some healthcare background. Enough to know basics of sampling, error, and bias. Epidemiological public health monitoring is beyond my pay grade however.)

What would explain kids being so immune? ~1000 confined cases under 19 year old while you have 10 000 50-59 year olds?

This is the aspect of the disease that is so interesting to me. With many diseases, like the flu, the most at risk are the elderly and the very young. But barely 1% of infections in China are children younger than 10, and 0 deaths.

Can it be that smoking plays big part in this? As this also explains gender statistics.

An early preprint from the team of China’s leading expert Zhong Nanshan tagged smokers and non-smokers among the 1099 cases they analyzed. 85.4% supposedly never smoked, with 14.5% of those cases severe. So it’s not like non-smokers are very much immune.

https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v...

I would say that it really dismisses smoking as a big factor then.

The percentage of severe cases among smokers is definitely higher, although the sample size is small.

I wouldn't: https://news.ycombinator.com/item?id=22435408

Looking at the numbers from Wei-jie Guan et al (https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v...):

nonsmokers = 927 cases, 793 non-severe, 134 severe

exsmokers = 21 cases, 12 non-severe, 9 severe

smokers = 137 cases, 108 non-severe, 29 severe

That gives:

nonsmokers: 14% severe cases of presented

ex-smokers: 43% severe cases of presented

smokers: 21% severe cases of presented

The low number of ex-smokers as well as other factors (did they quit because of advanced smoking-related diseases, etc.?) makes that number hard to interpret.

But smoking carries a normalised average 40% increased risk of severe cases.

    100 * (21-14)/((21 + 14)/2) = 40

Isn't smoking much more common among the Chinese than this sample suggests? I would expect a random sample to include more smokers than not. It may imply that the act of smoking or the associated health states reduce the likelihood of infection, even if they increase the likelihood of a bad infection if it does land.

Or length of time exposed to air pollution, where smoking habit increases the likelihood of mortality?

According to today's interview with a NY Times reporter on The Daily podcast, the immunity is explained by the close relationship to the common cold. Children tend to get lots of common colds. Around 1/3rd of common colds are a form of coronavirus, because of this, their immune systems are more prepared for this new coronavirus. Over time, this immunity fades, but it takes many years.

https://www.nytimes.com/2020/02/27/podcasts/the-daily/corona...

The death rate seems to not consider subclinical cases which did not escalate to the point of getting tested, which is probably the majority of cases

Isn't the preexisting conditions table incredibly uninformative and heavily confounded by the fact that a lot of these conditions are far more prevalent in elderly people?

Possibly. Or possibly the reason the disease is more fatal for elderly — they are more likely to have these preexisting conditions.

I think it helps point out that there is probably an underreporting and selection bias in the cases of coronavirus that get reported, precisely because healthy patients with coronavirus probably won't go to the hospital, and if they do they just treat for a pneumonia without doing coronavirus testing (what's the indication to make the cost worthwhile?).

> what's the indication to make the cost worthwhile?

That sentence doesn’t quite parse, but in China COVID-19 is treated for free whereas for regular pneumonia you have to pay whatever out of pocket cost after insurance coverage.

I meant that in a healthy patient with good access to health care, who presumably would not suffer tremendously from COVID-19, and be treated the same regardless of whether they had that or influenza, why get testing? It's a bit more complicated than that, but that's the gist. In the US, at least, I doubt that the cost of care would change whether or not it is COVID-19 vs influenza pneumonia versus bacterial pneumonia.

i know it's passe to rail on the media, but i think the hyperconnectedness of everyone is causing the amount of panic i'm sensing out there to significantly outweigh the risks wrt covid-19.

I agree. The Chinese went hysterical when the outbreak was first noticed, and I heard a lot about it spontaneously when wishing people happy new year. Hysteria continued right up to the point where... everyone went back to work.

I think the government got unlucky that the outbreak coincided with a major holiday. And while shutting things down was a good idea in many ways, it also meant that people were stuck at home with nothing to do but freak out. So that's what everybody did.

There is another possibility that the situation is much, much worse and Chinese are just telling part of the truth. Look how spreading is much worse in Korea than what Chinese says happens in China.

They may not be simply compared like that, because of the different measures taken. China did shutdown the entire country basically, cities with millions of people won't allow anyone to come in / out, and almost all shops / stores shut down.

What gives you the impression that the risk is small?

If you look at it from the point of view of "am I going to die from corona virus?" then yes, the panic is overblown (for most people anyway). The real fear is that enough people are going to get sick and have to stay home (to eventually recover) that it will severely disrupt the world, ranging from economic markets to supply of food/drugs at grocery stores. I'm not necessarily saying I buy into that doomsday/prepper hype, but seeing news like Japan recommending school closures definitely makes me worry.

“I am an old man and have known a great many troubles, but most of them never happened.” Attributed to Mark Twain in Reader's Digest, Apr. 1934

On the other hand, I'm fairly happy that many people wash their hands more, stay out of current hotspots like Lombardy, and do other things that make this less deadly. You wouldn't get this effect without significant coverage.

I really would like to know if smoking is implicated. Are there any smoker/nonsmoker stats anywhere?

Yes, though that's mostly rolled up in the gender statistics. Men are far more likely smokers than women in China.

Mentioned in TFA.

Is the F in 'TFA' what I think it is?

Fine is fine.

Sometimes some of the letters are different.

Yes, you're right. It's "featured".

https://en.wikipedia.org/wiki/RTFM

> RTFM is an initialism for the expression "read the fucking manual".

> RTFA ("read the fucking/featured article"—common on news forums such as Fark.com[6] and Slashdot, where using "TFA" instead of "the article" has become a meme)

I don't know of any studies looking specifically at smoking vs non-smoking, but its been highly speculated to be a strong risk factor. Apparently, there is a big gap in prevalence of smoking between men and women in China (close 50% for men, closer to 5% for women), which is thought to be at least partially an explanation for the differences in deaths (2/3rds of deaths were male, 1/3 were female).

There's this paper: https://onlinelibrary.wiley.com/doi/pdf/10.1111/all.14238

"Low prevalence of smokers, and no allergic diseases despite of drug hypersensitivity and urticaria was self-reported by any patients, indicating that allergic diseases and smoking history may not be the susceptible factors for COVID-19."

And this one: https://www.medrxiv.org/content/10.1101/2020.02.05.20020107v...

"Together, this study indicates that smokers especially former smokers may be more susceptible to 2019-nCov and have infection paths different with non-smokers."

They reach opposite conclusions.

Does anyone have a system for keeping on top of the latest studies and preprints? I get study links second-hand on social media sites, but I'd like to watch them closer.

I find this subreddit more scientific based than even many epidemiologists I follow: https://www.reddit.com/r/COVID19/

Most new biology papers (in general, not just for coronavirus) are posted to bioarXiv.

Bear in mind that these are unreviewed and, given the importance (and trendiness) many of them have been rushed out. There are also strong career incentives to make sensational claims that go viral.

Definitely worth reading if you've got some relevant background, but keep your skeptical hat on too.

"that go viral" :)

This is the email I sent my team last night.

We should consider working from home.

You may all have seen the news by now. A patient was just diagnosed with COVID-19 at UC Davis after having no known contact with anyone travelling. Importantly, they were diagnosed after being intubated already for 7 days. It is suspected that this is the first known case of public transmission of the virus in the US. From what we know about the incubation times and progression of the illness, that means they contracted it sometime between 14-21 days ago. This is the letter UC Davis sent to their staff.

If the virus has already been in the wild in California for 3 weeks, it seems likely to me that it has or will reach the bay area, and given the limited testing capability that has been reported, we may not know until the first cases end up in the ICU, weeks after exposure.

The death rate for young healthy people is relatively low, around 0.2%. It is much higher for older people, who it kills in double digit percentages. Still, 20% of the people it infects need intensive hospital care. Many epidemiologists now suspect that it is likely to become endemic, and that 40-70% of the world's population will contract it. https://www.theatlantic.com/health/archive/2020/02/covid-vac...

So what can we do?

The most important thing to keep the death rate low is to reduce the burden on the hospital system so that they don't end up with more cases needing critical care than they can handle. And the most important thing for reducing the burden on hospitals is to slow the spread of the virus, so that even if it ends up infecting all of us, it doesn't infect all of us at once.

We're fortunate enough that aside from impromptu collaboration and whiteboarding, all of our concrete tasks can be done at home. Most workers will not be in this situation, and will have to come to work to keep the economy running. For those of you familiar with random graph theory, the average number of edges in a graph has an exponential effect on its diameter, and so the best thing we can do is to avoid as much contact as we can. https://www.ndsu.edu/pubweb/~novozhil/Teaching/767%20Data/ch...

For people coming to the office, the WHO has a document on getting your workplace ready for COVID-19 that I'd encourage you to read and internalize. https://www.who.int/docs/default-source/coronaviruse/getting...

I'm already conveniently WFH with a cold, which I hope is just a cold, but I think we should consider making this the norm, at least until we have more clarity on what the situation is.

> I'm already conveniently WFH with a cold, which I hope is just a cold.

I would be really interested in getting some take-home test packages that could be done for situations like these.

It would be irresponsible to go to a doctors office where elderly people could become infected.

Does anyone know if they exist ?!

Short answer, no.

The government currently doesn't even have enough test kits for hospitals. We're very very far from getting take home kits.

I read that South Korea is developing them and it's close to ready. They probably need them for their own people first though.

It's a huge opportunity for a startup/company to create a home test kit for COVID-19. Massive global market for the product and growing exponentially.

Doing well & doing good at the same time.

> It's a huge opportunity for a startup/company to create a home test kit for COVID-19. Massive global market for the product and growing exponentially.

If someone has a list of materials thatwould be required to pull these affordable tests something could be put together for sure.

the worrying thing is to keep the costs down, one would think a lot of those materials and components would need to come from Chine to be cost effective.. The tangled web.

Edit: the problem wil step from China's supply chain being slowed down.

They are far from existing. Right now the only workable test for the virus is a genetic fingerprint via PCR. This takes time and needs both a lab and some very specific reagents which the CDC is presently having trouble producing.

If you develop severe symptoms, wear a mask (either sterilize it or use disposables), call the hospital and talk with them about it. If they tell you to come in, they will take the necessary precautions to make sure you don't infect anyone else.

"It would be irresponsible to go to a doctors office where elderly people could become infected."

Yes it is. But it is usually required. Required madness.

The concept of herding sick people in a waiting room in close distance is the best way, to get all the slightly sick people really sick with various other diseases.

I probably would have to be half dying, to get me into an doctors waiting room in the flu season. And then I would just go straight to the hospital.

You and every government in existence.

Why is this comment being downvoted?

Compared to many other countries, the United States has unpredictably overpriced medical costs that specifically burden the patient.

my concern is that it's trained many people (especial those living paycheck to paycheck) to simply not seek medical services unless their condition demands the emergency room.

I feel this economic reality will create conditions advantagous to the spread of Covid 19 in the United States.

I think you're pretty far off the mark here.

>90% of people have healthcare coverage in the U.S.[1]. Those that don't are likely illegal or homeless or in some way don't qualify for medical coverage (I also don't know how prisoners are counted in the data).

Many people I know visit the doctor way more often than they need to or should (I know those who receive it free to purchase it to use employer insurance - like myself).

People will seek medical treatment and in this case will overwhelm the system if they get nervous they have this disease.

[1] https://www.census.gov/library/publications/2019/demo/p60-26...

I have heard multiple times that one of the problems with American healthcare is that we are over treated. Part of the reason our healthcare costs are so much higher is because we tend to get large amounts of doctor visits, presciptions, and procedures compared to other nations. I wonder how this squares with the notion I keep seeing about how Americans will avoid the doctor as much as possible?

Anecdotally, I know way more people who avoid the doctor due to unknown treatment costs than go too often. My relatives that work in healthcare seem to agree.

Yes, Americans will go to the doctor and demand antibiotics, even if that's not the optimal treatment.

But that's when they go to the doctor. A lot avoid going at all. When I suspected I had strep throat a couple months ago, I went to an in-network doctor and was charged ~$70. Additionally, that charge was unpredictable--when I went there, I had no idea if it would be free or $200, and when I left, they told me it was $0. They sent the bill a few weeks after dealing with my insurance.

To a lot of Americans, "this will cost somewhere between $0 and $200" is not something they can just shrug their shoulders at. It can actually affects their short-term finances in a significant way.

(Also, before anyone chimes in with "this is because they're irresponsible with budgeting", that's irrelevant to the point being raised here: A lot of Americans will avoid the doctor to avoid these bills. It doesn't matter whether we blame them or not--the effect is the same.)

And some extra bad news: It's not chiefly software engineers in this situation. I live with a teacher, a teaching assistant, and several food service workers. They're the ones who fall in the "doctor visits are too expensive" category.

People with excellent health care insurance are often over treated. People with no insurance or high deductible insurance are under treated. There's also an ethic of pushing through colds and flus and not going to the doctor for them.

I hope you're right, but 10% or 5% of 300 million people are quite enough to get an epidemic around.

Seems like a pretty strong overreaction. The flu leads to about half a million hospitalizations in the US each year, while COVID-19 has lead to dozens. So your team is thousands of times more likely to transmit the flu then COVID-19 - even if COVID-19 is 50x more dangerous, it is far more likely that your team will cause hospitalizations due to the flu. I don't see why anyone should be taking precautions for COVID-19 that they weren't already taking for the flu if they are in the US.

The R naught and the percent requiring advanced hospital care are the reason to be so aggressive with this. Days matter and can save hundreds, thousands, perhaps millions of lives. Watch this at about the 23:00 minute mark. https://youtu.be/-o0q1XMRKYM

The reason for the reaction is described in my post. We now have community transmission 50 miles away from my office that was undetected for at least 2 weeks. At the moment, nobody knows how many cases there are.

The flu is less virulent, less deadly, and most people get flu shots which creates herd immunity.

Why do people who bring up the flu not seem to understand that if your company is big and your office is white collar that everybody there pretty much already has the flu shot if they're not a dumbass?

There are a few reasons why this may not be a strong overreaction. The first is that since flu is always with us, we normalize the risk. This doesn't mean that our chosen countermeasures and decisions for flu is actually correct or optimal, just that we're for the moment comfortable with them. Just like how lots of young people don't get the flu vaccine until after they actually get the flu.

So just because their current flu countermeasures don't include the measures proposed doesn't mean that it's not rational to consider them. Their prior actions could actually be irrational, and the context shift is just allowing them to adjust their perception and actions.

The second is that since WFH is an preventative measure designed to minimize the probability of COVID-19 reaching flu transmission rates, you can't simply say that "the current risk is low", you have to try to consider the likelyhood of risk significantly increasing without action.

Let's be real here, even if COVID-19 was literally exactly a different flu, it would be still be a problem and we should be planning for it carefully. North American hospitals are cost conscious and therefore typically only have enough resources to just about cover a normal flu season spike. Doubling (say nothing about 10x) the amount the hospitalizations required would be an incredible stress to the system.

I wish there was statistics available on mortality for people taking immunosuppressants (secondary immunosuppression).

Very interesting point, although this population should be very small (people with transplants or treating rheumatic deseases with biologicals).

I am also interested in this. If you find information on this, please post it here.

A related item that's been languishing in HN's submissions queue: "Mapping Coronavirus, Responsibly"

https://www.esri.com/arcgis-blog/products/product/mapping/ma...

https://news.ycombinator.com/item?id=22427334

This looks at the geographic distribution of COVID-19, and ways of accurately (and non-emotionally) conveying that information. Existing infographics have tended to hide information as much as they reveal it.

This is a really great format. I particularly appreciate the proactive interpretative pitfall warning. Would that all publications be so upfront.

> The percentage shown below does NOT represent in any way the

Zero infants or children between 0-9 have died. The article mentions:

> In general, relatively few cases are seen among children.

How come? My expectation would be something akin to an elderly range.

I'm curious about the dramatically increased mortality rate with diabetes. Given America's situation, especially with insulin prices at a perverse high, that could be catastrophic.

People, if you haven’t yet go get the seasonal flu vaccine. Reduces burden on strained ops and your risk of getting double tapped

Isn't this something you can only get if you are in at risk group? I can't go to my doctor and just get a flu shot, I don't think?

Everyone except very young children are encouraged to get the vaccine. You can get them at clinics, hospitals or chain pharmacies.

Yes, you can

You can in normal countries

That tends to only be the case when there's some limit on flu shot production. The normal case is that you can walk into most CVS or other pharmacy, ask for a flu shot, and walk out having been immunized within 15 minutes.

Even if you're not a high risk, getting a flu shot is an important preventative measure for any high risk individuals you may come in contact with.

In NL, I literally did just that: I walked in, asked if it was still worthwhile and the doc said “sure, we haven’t peaked on the flu yet. Want one?” I said “yeah” and we were done in 5 min max.

I guess it’s somehow got to do with living in a country with some leftovers of the Socialist hellhole it used to be... /s

Ahh, I love seeing these kinds of snarky comments go grey.

Let’s see how long it takes for yours to join :P

In the US, you don't even have to go to your doctor. Pretty much any in-pharmacy clinic will give you a shot as a walk-in and it's covered 100% by most insurance.

(There's a special version you get if you're in a risk group but most people over a certain age can get the standard one.)

Possibly more than 100% covered. My local CVS gives a nominal discount ($5) when you get a flu vaccine.

In the US you can stroll into Walmart and get a flu shot. Covered in full by most insurance and Medicare and so on.

Sometimes if the vaccine supply is impacted by something they will try to give it to at risk people first. I don't think there is any such restriction right now.

In Brazil they usually restrict the flu vaccine to just risk groups at the start of the vaccination campaign, but after that they open it up for everyone if there is still leftover stock.

you can also pay out of pocket to get the vaccine.

some private health insurances also cover it.

In the US, authorities recommend that everyone older than 6 months get the flu shot, and you can get it nearly anywhere with a pharmacy. I got mine at the grocery store.

In America, everyone should get it unless your doctor tells you not to.

In the US, you can get the flu shot at Wall-Greens. No doctor visit necessary. Insurance usually covers the entire cost, but I think it’s pretty cheap otherwise.

Depending on where you live you can get a flu shot at your local pharmacy. You just have to pay, unless you're over a certain age, then it's free... Again depending one where you live.

One issue may be the availability of flu shots at this point. Also there is a small risk of getting sick from the shot, which would put you at increased risk if contracting Covid-19.

Cannot upvote this enough. Swine flu, in addition to covid-19, raises risk of complications from 20% to 70%.

But please inform yourself before.

In my area in germany for example, the flu is already peaking, so it would be actually harmful to get the vaccine now, as the protection time is around 2 weeks later(I think) and the vaccine temporarily lowers your immune system. Which means, getting the vaccine now means actually a higher risk of getting the real flu (or something else).

Vaccines should be taken ahead of the season.

> the vaccine temporarily lowers your immune system

Medical science seems to disagree with you.

Edit: And HN disagrees with me. Have we become Reddit? On second thought, don't answer that. Bro science has a long tradition on HN just like anywhere else.

Yep, it actually takes decades to lower the immune system: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870374/ .

Hm. And where?

Because the known side effects can be: dizziness, fever, headache, fainting. I associate those with general low energy, meaning lower immune system. Now the last conclusion might be incorrect, true, I don't know if I drew this conclusion by myself or have this from a medical person. In either case, medical doctors here definitely advised against taking the vaccine now.

No, it’s the immune reaction to the inoculation. It means there actually was something to look at in the shot

Yes. Usual mostly those things to look at are mercury etc. which are in the shot to make the immune system react.

Now, this immune reaction means stress, right? The question is just, does this mean the immune system is general in a more active state so it can fight other diseases also more effectivly, or is it fully occupied with the fake illness, so real diseases can enter? I don't know, but would like a medical person to answer me that.

> mercury etc. which are in the shot to make the immune system react

By mercury do you mean Thimerosal? It is a preservative, it is not an active ingredient of the vaccine.

Are you saying the flu vaccine can help prevent covid-19? Just trying to clarify. I'm traveling to Asia in 3 weeks from US and haven't gotten the flu shot the past year. I got it in 2017 and got sick, 2018 and got sick, but last year I decided not to and didn't get sick at all. Maybe just a coincidence though.

No, it can't. But it can prevent getting both at the same time.

No, but you really don't want to get both the flu and coronavirus at the same time. And on a community level - if you're not going into the ER because you have swine flu, that's one more bed/ventilator that can be used for a coronavirus patient.

It's also just a good idea. Spanish/Swine Flu (H1N1) is circulating again this year, and if we didn't have coronavirus occupying all the headlines people would be talking about the swine flu epidemic. (In fact, they were, back in November - there were a bunch of articles about how this year would be an unusually bad flu season.)

Thanks for the info. Maybe should head to the pharmacy for a free shot then.

I expected something disaggregate. This would make a great alternative to titanic.csv to teach an intro class.

How much can we trust the data coming out of China?

We can't but it doesn't matter anymore, the data from South Korea, Italy and Japan will be the most interesting for the next week or so.

Then I would imagine each country will be gathering a lot more data as it spreads further in another generation.

I wouldn't put too much faith in the data coming out of Japan at the moment. People are being told to only report to doctors if they are showing serious symptoms associated with the illness. Japan has a "gaman" (perseverance) culture, so I'm worried a lot of cases are gonna be people sitting at home trying to power through what they think is just the run of the mill flu.

Indonesia on the other hand seems to have decided not to tell the world or their people how many cases there have been - when clearly they must have some by now.

They might be 'massaging' the numbers, or maybe they aren't, but considering the importance of the issue for China and the world, and how many eyes are watching, their interest is still to report factual trends and overall situation. At this point they cannot afford to claim that everything is fine if it isn't.

I'm more worried about Iran than China.

> their interest is still to report factual trends and overall situation

Unfortunately it isn't. They are trying to put people back to work and reopen trade because of the damage it is doing to their economy, and massaging the numbers is one crucial element of making that happen.

This is FUD.

They are not in a vacuum. Business and travel will resume only if the situation is demonstrably resolved, or close to.

They cannot afford to fake it and re-open factories and lift quarantines just for mass contamination to occur, which would be very public and screw them internationally for good.

Edit: Everyone, from all impacted countries say that they are still open for business because they don't want everything to stop and people to be spooked. The country is not all under quarantine. That has nothing to do with faking numbers.

Dude, they are literally releasing videos from officials telling some businesspeople that they're still open for business. Don't shoot the messenger, I know it's a dumb idea, but how surprised can you be that the CCP is trying to do something dumb after all the dumb things they've done?

Maybe instead of declaring something "FUD", which to me sounds like you're saying I'm here in bad faith, consider that I meant what I said.

You can’t get this upset when you haven’t posted any sources for your claims. I believe what you’re saying, but not everyone will give you the benefit of the doubt.

The most cooked are the numbers for rest of the world obviously. Look how well they stick to the exponential here

https://en.m.wikipedia.org/wiki/File:NCoV20200209_Hubei_Chin...

> their interest is still to report factual trends and overall situation

Maybe, but it's important to never underestimate the value regimes like China put on image. Parallels can be drawn to how the USSR downplayed the Chernobyl incident and how many more lives were affected by their nationalistic pride.

Not a direct answer to your question but related: https://www.vox.com/2020/1/27/21082354/coronavirus-outbreak-...

TL;DR: The beginning was not great, but it seems better now.

Let's look at China's flu death stats to get an idea of how honest the government tends to be. From a 2018 article in a CCP-owned newspaper[1]:

> The total number of flu deaths last year was 144, compared with 56 in 2016 and 41 in 2017.

A recent article in The Global Times (a tabloid owned by the CCP's official newspaper) gives similar figures.[2]

So China lies about flu deaths by 2-3 orders of magnitude. Who knows how much they're juking the stats on covid-19 deaths.

1. https://www.chinadaily.com.cn/a/201902/22/WS5c6f11daa3106c65...

2. https://www.globaltimes.cn/content/1177725.shtml

Can’t you see the word “reported” next to the stats? Most flu hospitalizations and deaths aren’t reported.

I encourage you to read U.S. CDC’s explanations on how they estimate flu hospitalizations and deaths. Only a small percentage is ever reported even in the U.S.

https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm

In the same article about 144 reported flu deaths, they cite the comparable Hong Kong flu stats (226 dead) despite Hong Kong having 0.5% of the population of China. Nowhere in that article do they mention differences in methodologies of reported vs estimated.

My point is that if the China CDC is counting covid-19 cases the way they count flu cases, that means the actual numbers are much worse. They underreport the number of flu cases by a factor of 50. eg: They claim 700,000 cases in 2018, which is less than 0.1% of the population. (In developed countries, around 5% of the population gets the flu each year.) Then they juke the stats to claim fewer flu deaths than there actually are (144 deaths instead of 150,000).

I don't think the numbers for covid-19 are off by two orders of magnitude, but my point is that the China CDC loves to publish numbers that amount to outright lies.

> Yes, my point is blah blah

Yes, and that’s a ridiculous “point” however you interpret it.

Please don't use quote tags if it's not a quote.

Also it's clear by your mockery that you don't want to discuss this in good faith.

You should really read more materials on international reporting standards before making uninformed claims like “if the China CDC is counting covid-19 cases the way they count flu cases...” These are completely different things and your “contribution” to the discussion unfortunately only adds noise to already widespread misinformation and obscures real concerns.

Edit: And to be absolutely clear, being suspicious of the accuracy of the data is one thing and I have no objection to that; saying the stats are off because “they are counting covid-19 cases the way they count flu cases” only shows you’re uninformed about the topic.

The line within China is that they made a big mistake with the figures initially, but those responsible (e.g. Wuhan officials) have been dealt with and everything is now more truthful.

what css artifact is causing the last "e" in "Rate" to be consistently out of the bold formatting?

Asking the real questions right here.

Not CSS's fault, it's just how the document is marked-up:

    <p>*<strong>Death Rat</strong>e = (number of deaths / number of cases) ...

The fact that it happens consistently is probably a result of copy-and-paste (or equivalently, it's wrong in a report-generating template of some kind that produced each section).

Looks like a WYSIWYG wreck.

So, it seems as if smoking actually prevents infection, or something along the lines of it?

Such a shame we can't trust anything the Chinese gov't says. These stats are likely all bogus.

Given 0.2% chance to die I see no reason to care, I probably have higher chances to die in a car accident on any given day. Even if I were 80 years old I still would see no reason to worry about the 14.8% chance to die as I would probably have comparable chances to get a hear attack and die on any given day anyway.

We need real data, not theories. Hopefully we'll get it soon.

This article literally is data.

It's incomplete data, that is being combined in ways to give certain impressions, that aren't necessarily backed by actual medical science.

Gah, the data in this article is literally medical science. It's reporting on a paper from the Chinese Journal of Epidemiology, which it even links you to directly.

Now, maybe this science is wrong. If you want to make that argument, though, you need to make it with evidence. You don't get to dismiss it like that without doing your own science.

The way the data is sliced and diced is not necessarily meaningful. Looks at the mortality rates based on those simple categories can paint a misleading picture.

Imagine if people would get as excited about actual problems like global warming and the unfolding mass extinction as they do about a new mild flu.

Exponential vs logistic growth. This is far more of a threat.

This virus is not a threat to long term survival of the human species by any stretch of imagination. Meanwhile the collapse of our biosphere is an existential threat. What's more, we know that we have a very short window to make any meaningful changes to prevent the worst outcomes including our extinction. Yet, we're still completely reliant on fossil fuels, and the industry is actually being subsidized right now.

Thinking that this is more of a threat because it's happening now as opposed to a few decades in the future is sheer idiocy.

Timescale, and immediacy of the threat. Humans are not good at long timescale thinking.

BTW I don't think these things need to be mutually exclusive. We should take action against all kinds of threats

Obviously we should take action against all kinds of threats. My point is that the reaction to this virus is completely disproportional to the level of the threat. Meanwhile, lack of reaction to an actual existential threat we're facing in the near future is utterly terrifying.

It's symptoms are pneumonia-like and it mainly kills the elderly. Is this is a new strain of pneumonia? If so, this seems like an overreaction?

Edit:

Not sure what the downvotes are about. I asked a question. So you can't fight it with drugs, it's highly contagious, hard to initially detect, its long-term effects are unknown, most have recovered and it's largely fatal to the elderly or those with existing conditions.

A 1% death rate in people without known complications (even 0.2% which seems pervasive in every age group) is orders of magnitude higher than for instance flu. And it spreads easily and is contagious before symptoms. Sounds like something you should be aware of.

Actually, multiple orders of magnitude...The Flu has a mortality rate of 2 per 100k [1].

[1] https://www.cdc.gov/nchs/fastats/flu.htm

[edited - reformatted numbers to avoid localization issues]

Commas and decimals are not interchangeable

They are if you switch between Spanish and English.

Don't design planes.

And US doesn’t set worldwide standards for their use.

That's 2 per 100k of the overall population, not 2 per 100k who get sick.

>The Flu has a mortality rate of 2 per 100k Nope, it doesn't. Mortality rate is not the same as annual deaths per capita. The number you quoted refers to the same context as traffic-related deaths per 100,000 population, which is 3.1 per 100,000 in the UK. This doesn't mean that if you are in traffic-related incident, you only have a 0.0031% of dying! Same with influenza - the mortality rate is 0.1%-0.15% (average season) up to 1.25%-5% (pandemic flu) [1]

[1] https://www.globalsecurity.org/security/ops/hsc-scen-3_flu-p...

Yes, and maybe? It's very similar to seasonal flu, but seemingly with a longer incubation period and more dangerous. On the other hand, seasonal flu also kills a lot of old people.

Another aspects not so much raised is that, where people can afford it, most people at risk are vaccinated against the seasonal flu.

Take a nursing home with people in the 80 to 100 years old range, all residents and staff are vaccinated against the flu. Even if the protection is not perfect there is some sort of herd immunity at play<

Now take the same nursing home, and for some reason someone from the staff is bringing the Coronavirus in, you are likely looking at a very high death rate.

Whatever the estimation of the death rate is, this is not a flat 1%, this is highly non linear depending on the context.

It's more severe and the ease of how it spreads is what is alarming.

Any virus that really cannot be controlled other than quarantine is never an over-reaction, infact often is the case people under-react to them.

People are dying, at a low rate, but they are dying, so it's much better to be pro-active.

The mortality rate may seem very low, but the symptoms are far more severe. When you get the flu it's rare you get pneumonia, not so much with this virus. The biggest problem is that it spreads without symptoms. That is, you can be infected & contagious for days (some Dr's suspect up to 3 weeks) and not have a clue because you seem perfectly healthy. So this has the potential to spread like wild fire. Further, 2 days ago some numbers out of China stated that up to 14% of previously infected became infected again. Lastly, a recent report also mentioned that detections in hospital were only able to detect 45% of the cases on the first try. So many are given clean bill of health and go on to infect many more.

Watch Italy and South Korea carefully, this thing is about to spread like crazy, even if mortality rates are negligible for young and healthy.

Lastly, SARs supposedly left some people with lung and brain lesions, it is unknown what the long term effects of this one will be.

> Lastly, SARs supposedly left some people with lung and brain lesions, it is unknown what the long term effects of this one will be.

This is in itself just unnerving too. A few weeks ago I was overlooking this too, but the more and more that comes out, the more concerning it becomes.

The mortality figure being shared in this thread is a baseline of 2 per mille. That's not what I'd call negligible.

And that's with proper healthcare, and functioning food/water/electric .. if 40% of is need hospitalisation and the rest daren't leave the house; how long until food supply chains are broken?

> Further, 2 days ago some numbers out of China stated that up to 14% of previously infected became infected again.

The numbers weren't that 14% became infected again. They were that 14% were found to still have the virus after being declared recovered. Many are speculating this doesn't mean reinfection, but could be an indicator that the tests have a higher false-negative rate than previously believed, or that people's bodies purge the virus in spurts as recovery takes place.

yeah, I couldn't find a source for this either. There are a few cases apparently, and there's still a lot about the virus that is unknown, but it doesn't look to be that high.. it could also be false-negatives that might explain this.., but it could theoretically also be that the virus is "bi-phasic", "meaning the disease appears to go away before recurring."

https://www.reuters.com/article/us-china-health-japan/japane...

Outcomes are worse. While we had a pandemic of flu last year (really!) the death rate among those hospitalized with pneumonia was something like 10%. This one is 14% among some groups, and not just those sick enough to be hospitalized. Those stats are for the elderly (who also matter). Its a similar multiplier for other age groups.

stats: https://www.cdc.gov/flu/about/season/flu-season-2017-2018.ht...

Pneumonia isn't a disease in the same sense as any specific virus or bacteria. It's a condition brought forth by various things. Covid-19 sometimes causes pneumonia.

So it’s just a coincidence that Dr. Li Wenliang, who was 34, died and he only had a 0.2% chance of dying? I find this too much of a coincidence. There is no way these numbers can be correct.

My tinfoil hat wonders if he actually died from other causes.

Causes like not eating and drinking enough and not sleeping enough while already pretty sick?

Just because the statistical probability of something happening is very low does not mean that it is physically impossible.

Flipping a coin 100 times and having the results all be heads is extremely low but still physically possible.

We can be skeptical about China's official numbers but just because something is statistically unlikely to happen and it happens does not mean immediately that there is foul play.

There's reporting bias. Would you have heard of him if he had survived?

He was in the news well before he died:

https://www.standardmedia.co.ke/article/2001359040/police-ar...

Ok, time for a rant.

If you looked at that table and went like "Oh, just 0.2% for me, great! No need to worry!" you are a terrible person.

Even just at 0.2%, a billion people infected would result in more casualties than most recent conflicts.

Eradicating diseases is possibly the most noble, the most obviously good behavior that humans can have. And here we have the opposite, people spreading it because of carelessness, because it is likely to not impact them too much, because their holiday plans are too important.

Damn.

And damned Hollywood for making people think that an epidemic has to kill a high percentage to be deadly.

I am less afraid of hearing of an Ebola outbreak than about a new strain of seasonal virus that did not have any opportunities to combine with others yet.

"If you looked at that table and went like "Oh, just 0.2% for me, great! No need to worry!" you are a terrible person."

Or, with a bit more empathy, they just haven't put it in the right context yet.

Any death from this is unfortunate, but many things can kill you and many people have accepted a low mortality percentage for lots of things. They may just initially perceive that smallish number as another one among many (e.g. the normal flu, biking). It may be a big number compared to other stuff, but it looks small and I can see how people might be dismissive. That doesn't make them terrible people, they just don't (yet?) have the perspective that you do.

I disagree. you're not a terrible person for thinking that. There's only so much you can do, and the disease and the deaths it leaves in its wake is totally out of the reach of your intention or actions.

Worrying about something like that does not award you good person points. Actually, contributing to the general panic is far worse in terms of your real impact on what's going on. So, in this sense, you may be an actually worse person to think like you're proposing.

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