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Comment by eanzenberg | Hacker News Reader

The disparity of death rates among countries has more to do with infrastructure than the virus. Germany and Switzerland are proving this is just a flu, albeit a pretty bad one (0.1-0.5% death rate). More testing will prove this out by increasing the denominator by 10x.

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Testing is the biggest variable.

More testing = lower mortality rate.

The alarming mortality statistics from Wuhan and Italy turned out to be extremely high due to lack of available testing and mild cases that were never reported.

Statistically there are likely already thousands of unreported cases in Seattle, but nobody can get tested. If you have a fever, people are being asked to stay home and not go to the hospital at all. So they’re not even counted in the official numbers.

Exactly, and then this hysteria becomes the flu.

This is also showing in UK already, where mortality rate seems to be ~3% now. And it is already announced that people who don't need hospitaliztion won't be tested. So number of confirmed cases will appear relatively low but death rate will go up.

> More testing will prove this out by increasing the denominator by 10x.

Source? You're ignoring the fact that the number of deaths lags behind the number of people infected, which means the numerator is also being underestimated. Assume people either will/will not die three days from diagnosis. Then the naive case fatality rate is (for small t)

    CFR_naive = [D exp(t - 3)] / [I exp(t)]

with D and I appropriate constants and t the number of days. The corrected CFR becomes

    CFR = CFR_naive * exp(3)

That is, in this simple model, the true CFR is underestimated by approx 20.

The numerator is unaffected by testing. When you die, you die, you can’t hide it and can’t hide the cause. If anything, testing may slightly decrease the numerator as at risk individuals may get treatment sooner.

The numerator is underestimated in a way separate from testing. People don't die immediately after they're diagnosed. They die some time after, during which the number of cases increases. Since the naive CFR is just the total number of deaths divided by the total number infected (assuming perfect knowledge of both -- the latter is also underestimated, for reasons you mentioned), this will always underestimate the true CFR until the spread reaches a steady state.

Germany is not at the point where the dying start. That will, most likely, take us 2-3 more days.

Look at the “serious cases”. https://www.worldometers.info/coronavirus/

At least in the moment we can still hope that the death-toll in germany will be lower than in the other regions... i think the phrase goes "The hope dies last..."

Can you explain this further? I looked at the charts for both of those countries and I still see an exponential rise in cases.

Do you mean that the limiting factor is e.g. ventilators and that these countries haven’t exhausted their capacity yet?

The number of cases is exponential, like any infectious virus. I’m focused on the denominator, which is increasing with testing. The numerator doesn’t change because deaths are deaths, testing doesn’t change that.

the problem with saying "just a flu" is that you need to also say "but of course, people get vaccinated against flu if they are at risk", which we can't do for this.

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