Hacker News Reader

Comment by nostromo | Hacker News Reader

I've been comparing this with the Swine Flu pandemic of 2009.

H1N1 ended up not being as fatal as SARSCoV2, but we didn't know that at the time. People were saying it had a CFR of >1% in Mexico (where the original outbreak was). That number dropped way down as better data came in after the outbreak.

But still, up to 575,000 people may have died from it. That's not nothing.

And... nobody cared? People were calm. It was on the news, but there was no panic.

I think part of it was how social media has changed the way we consume and respond to information. I've seen extreme panic on FB, Reddit, HN, Twitter -- which seems to cause more panic. Everything in the media is turned up to 11 now.

https://en.wikipedia.org/wiki/2009_flu_pandemic

It's interesting to go back further and read this Bird Flu article from 2005, where a UN Health Official warned of 150 million possible deaths, and said things like, "It's like a combination of global warming and HIV/Aids 10 times faster than it's running at the moment." So, the media has always turned things up to 11, but something about the current era has exacerbated the issue.

http://news.bbc.co.uk/2/hi/asia-pacific/4292426.stm

View on HN

SARS doesn't even come close to the infectiousness of COVID-19. China only registered like 8k patients by the end of it, even you times that by 10, that still dwarfed by the COVID-19 on global scale, and it is only the beginning.

The reason COVID-19 get singled out might not be the mortality rate alone (it looks edging close to 10% right now in Italy, which is alarmingly scary), but more on its impact on paralyzing our health care system with a swarm of people requires hospitalization. And it achieves all this in record time.

I don't agree this is a perception problem, the threat is real. Social media can panic, but you can't really tell people it is OK when patients are lying/dying on the floor of hospitals.

I'm confused as to what this comment is replying to - the GP never made any comparison between SARS and COVID-19.

I suspect that you might have confused SARSCov2 for SARS?

I imagine most of the people reading it made that mistake. I've only ever seen it referred to as COVID-19 or Coronavirus. I assumed SARSCov2 was a more specific name for the virus involved in the early 2000s SARS outbreak.

SARS-CoV2 is the name of the virus for the 2019 Coronavirus. The previous one was just SARS-CoV.

> it looks edging close to 10% right now in Italy, which is alarmingly scary

Please stop dividing deaths by confirmed cases and reporting that as mortality rate.

The number of confirmed cases is much, much larger than actual cases, in particular in outbreak zones where testing is very limited.

Suspected cases

I've been using this[0] page as a reference, which seems to back up those numbers. It currently shows 82,424 recoveries and 8,697 deaths. Can you recommend a better resource I should be looking at?

[0]https://nssac.bii.virginia.edu/covid-19/dashboard/

It’s not this simple. It takes a longer time for people to recover than it does for people to die. Particularly when you consider that people stop having symptoms, so “recover” in the ordinary sense of the word, but still test positive for the virus, so are not marked as recovered.

That would only list those recoveries that have been bad enough to warrant a test in the first place. With health care systems being overwhelmed the world over, almost no country is doing extensive testing of all people who suspect they might have been infected, meaning there will be a huge number of mild cases going unreported. South Korea is perhaps the only exception.

Look at the mortality specifically in places which overtest: South Korea, Japan, Taiwan. There it looks closer to 1%. There are additional factors to consider like population age, but there Italy is the outlier, not South Korea.

South Korea has done the most extensive testing of any country and there death rate is running around 5%. But here we are playing "I’m not an epidemiologist but".

This is false. Please stop.

Current fatality rate is less than 1% of confirmed cases.

I think you're wrong. I explained more here https://news.ycombinator.com/item?id=22622231

I love how you are basically going around the thread with bold statements with 0 data to backup your claims regarding the fatality rates.

Currently experts are giving us data and people are giving us sources.

[1] Countries like Iran literally have mass graves at this point and here you are claiming this is overblown by social media.

You really need to stop.

[1] https://youtu.be/eWUT1V6WrRA?t=12

What should they be using?

If someone understands this crude metric as "If you catch it and you show symptoms and you test positive, your likelihood of dieing is roughly (deaths divided by confirmed cases)" then that seems reasonable to me.

"Try to avoid catching it." is reasonable advice, as is "Be aware that you could catch it and be asymptomatic while still being infectious." to discourage people from visiting their grandparents this month.

I don't feel like I'm being misinformed if I divide deaths by confirmed cases, I feel like I'm getting a rough worst-case estimate.

It's worth remembering that the "fatality rate" you're quoting accounts only for people who have been tested and then died. We have no idea what the denominator in an accurate fatality rate calculation would be. Many thousands of mildly symptomatic infections aren't recorded.

Imperial college says it's about 0.8% with the data available at this point.

Yeah, heavily skewed towards people 70 and up.

Fuck those people right?

Nobody is saying that. The data gets harder to interpret for older people because they're very frequently weak and about to die of something. Some part of why stats seem to vary between countries may be due to differences in recorded deaths, which can be somewhat arbitrary when there are multiple conditions. Sort of like how a lot of HIV+ people die of pneumonia but was the cause of death that or the underlying condition of HIV?

John Ionnadis has been writing about this:

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-a...

He's a medic, epidemiologist and author of "Why most published research results are wrong", probably one of the most influential papers of the last 20 years across all of science. He says:

even some so-called mild or common-cold-type coronaviruses that have been known for decades can have case fatality rates as high as 8% when they infect elderly people in nursing homes. In fact, such “mild” coronaviruses infect tens of millions of people every year, and account for 3% to 11% of those hospitalized in the U.S. with lower respiratory infections each winter. These “mild” coronaviruses may be implicated in several thousands of deaths every year worldwide, though the vast majority of them are not documented with precise testing.

The whole essay is worth a read. It has more to say about questionable use of data and analysis than SARS-CoV-2 itself but is worth reading regardless.

What really matters is how fast will the serious (but perhaps not fatal if treated) cases completely DDoS your healthcare. After that point, the mortality rises for both the illness and everything else that's more serious than that illness.

This.

20% of cases require hospitalization. Once the hospitals are taken out, the fatality rate skyrockets and we're in the nightmare phrase - 400+ people died in Italy, today.

On top of that - and I think this isn't seriously reported on just yet - you start bleeding doctors and nurses, especially as nobody in the West has enough PPEs to keep them safe. There are only so many of them to go around.

Indeed, yesterday, more people in Lombardy died of COVID19 than on an average day from all causes combined. And they are on a lockdown for 11 days already

No. Nobody knows how what the actual proportion of cases require hospitalisation. That's the point being made in this entire thread.

It's clearly very hard to let go of what looks like data and say "actually, we don't know". That's a driving cause of current events. There's a lot of analysis out there right now quoting things we "know" about SARS-CoV-2 and when you dig in, it's not real knowledge, it's a garbled or misused statistic. We have lots of epidemiology but not enough epistemology.

South Korea does exhaustive and they get a fatality rate of 1%. WHO gives 1% max + 20% needing hospitalization. The various cruise ships also give a good idea.

At the start, the "Many thousands of mildly symptomatic infections aren't recorded" claim had plausibility. Now it needs to die in fire. This stuff has demonstrated it's qualities at scale and we need to get with it.

Also noted, SK's infected populations are overwhelmingly skew towards young population during their 20s from the cult cluster.

This won't be the case for other countries. 1% is way too optimistic at this point.

The Princess Cruise has nearly perfect data as everyone in a controlled population was tested. (This is not true for South Korea, which has tested less than half a percent of their population.)

The fatality rate was 0.8%. The majority of their passengers were over 60 years old, so even this number is too high compared to the global population.

Yes, the Princess Cruise tells 0.8% might be the best case fatality rate with a functioning medical system.

Even that would be catastrophic for if the virus infects a large percentage of the population, as it is rapidly moving to do. Thus we cannot be even in the least bit sanguine on this and need to move with speed against it. This is in no way comparable to 2009 or other recent events (contrary to your ggp).

As I mentioned, the cruise ship was full of old people, so no, it's not the best case scenario. It's likely the worst case scenario.

No, the worst case scenario is not medical system to help the people who become seriously ill, which 20%, according to WHO and multiple other authorities and statistics.

It doesn't matter if 1% is "optimistic" or not. 20% infection + 1% best-case fatality rate is enough to knock the health care system and begin knocking out the whole of society.

Basically, there's enough information currently to tell people who pay attention and consider rationally that we need to spend every possible effort confining infections and quarantining, basically the entire earth. There is no alternative.

Lots of smokers though

> At the start, the "Many thousands of mildly symptomatic infections aren't recorded" claim had plausibility. Now it needs to die in fire.

Do you have an argument against this other than die in a fire? In the UK the government is literally advising people to NOT call the NHS if they suspect they are infected but stay home and self isolate unless they become severely ill and cannot cope. It's pretty reasonable to assume the denominator is much larger from this behaviour.

The UK plan is insane and could result in massive deaths. But hopefully will just be rolled once the deaths begin.

You can read the discussion of the reasons to be pretty certain of the 1%+ fatality rate and how that's catastrophic on the rest of my thread and in more detail elsewhere. As to the UK plan, look here:

"I'm an epidemiologist, when I heard the UK plan, I thought it was satire":

https://www.theguardian.com/commentisfree/2020/mar/15/epidem...

We don't need to take UK's number. There are whole pack of other countries using much more active methods to combat this virus.

"I'm not an epidemiologist but" that South Korea number is misleading because it's calculated as death/"people that tested positive". That undercounts the death rate because some of the people that tested positive are still sick and might die. The correct formula is death/"closed cases" which takes into account only people that have recovered or died. That number in SK is currently around 5% though trending down as cases are closed. https://www.worldometers.info/coronavirus/country/south-kore...

That's not quite right.

Your link shows the seriously ill among the unclosed cases as 59 people. If those dies, it won't increase the death significantly - maybe bump it to 1.5%.

But an increase to the base death rate doesn't matter. We should know a 1% death rate is going to be catastrophic and take action.

Edit: originally read you as arguing the death rate as too high so different argument. It's probably better to assume a higher death rate regardless anyway so I changed "you are wrong" to "not quite right" too.

Also need to take into account that people will die a long time before the cases close. Also not all cases will be closed because of limited testing. Right now the ratio of deaths to closed cases in the US is about 60:40

https://www.worldometers.info/coronavirus/country/us/

I'm looking forward to the day when the dust has settled and I can see deaths/total population. To be useful it has to run its natural course, rather than being stopped by a vaccine.

The only out way is to test everybody in a large random sample. Even South Korea doesn't do that - people volunteer or a pushed to get tested. The end result is all testing to date has been done on the parts of population who are more likely to be feeling the effects of covid-19.

That skews everything. Even "every person infects 2.3 others" becomes suspect if there is a large reservoir of people out there who have it, are infectious but don't know it. Kids in particular, being the little germ bags they are, areseemingly mostly unaffected by it and so could be a huge vector.

Counting the dead after it's over is one way to by-pass that measurement problem. In Australia, a bad flu season kills 0.015% of the population. My gut feeling is we don't as yet have any idea where covid-19 will end up. Italy is currently sitting at 0.0083%, so they aren't up to the flu levels yet. The current overwhelming of the hospitals could be caused by an extraordinarily high infection rate coupled with it being very, very mild for most people, particularly kids. Or it could because it's as horrible as the media paints it. We simply don't know.

The nursing home in Washington is a good isolated case that shows how deadly it is for older people. It has had 26 deaths so far and 50 people who tested positive https://www.businessinsider.com/coronavirus-deaths-washingto...

For a highly-contagious disease like this, we can safely assume the number are somewhat accurate as long as tests are being performed. Why? If we missed one case, they will continue to infect more people, as such, becoming much more noticeable. We can safely say fatality rate data from China would be an accurate overall estimation where its spread is contained.

I mean, if you're curious about differences in reaction I don't think you need to look any further than the handling and messaging going on. When Ebola was a concern Obama acted quickly to contain the threat and put a lot of resources into addressing the issue immediately - so much so that his administration was strongly criticized for wasting resources on a "non-issue".

This time around the outbreak originated in China that covered up the issue initially and ended up making the issue a lot worse than it could have been. Additionally, once everyone should've been paying attention on a global scale, Mr President down there in the US just tried to downplay the possible effects of a pandemic and it looks, at the moment, like he again just made everything worse.

Usually we can sit safe and confident at home that the government is overreacting to the situation and everything will be fine, this time around the authorities most globally visible (the US and China where the outbreak started) have obviously bungled their response and we're seeing a lot of panic because people don't have faith in the ability for the globe to respond in a unified manner.

Trumpian rhetoric aside, it's really unfair giving the histrionic media a pass on this. The toilet paper outages were stoked by the media. Instead of seeing op-eds with "stop raiding stores for toilet paper," all we saw (and still see) is "this president is incompetent."

Just this morning, CNN was frothing at the mouth at Trump calling it the "China virus" -- I mean, yeah, it's a virus that came from China -- and they have an op-ed on how this term is stoking xenophobia.

Honestly, "China Virus" is just xenophobia and deflection - it wasn't a term adopted by the populace at large - pushing it as a name for the virus has been a right wing effort.

The usage of that term is solely to try and deflect responsibility for anything domestic to China and pass the buck... it also has the potential to cause hate crimes in a time when we really should be unifying as nations.

> Just this morning, CNN was frothing at the mouth at Trump calling it the "China virus" -- I mean, yeah, it's a virus that came from China -- and they have an op-ed on how this term is stoking xenophobia.

That's because it is. There have been many reports of harassment and assaults on Chinese Americans, and this kind of label doesn't go away. The term "Spanish Flu" is still used 100 years later, not because it originated there (it didn't -- it almost certainly originated in midwestern USA) but because the media paid more attention there.

The terms we use matter.

> That's because it is. There have been many reports of harassment and assaults on Chinese Americans

This is an extreme, uncited, and frankly inflammatory extrapolation. There have been only a handful of such attacks -- I believe 5-ish (reported by The New Yorker and CNN). It's just the typical race-baiting we've seen that generates outrage clicks. Calling it the "China Virus" has no more societal impact (which is: minor at best) than the "Spanish Flu."

Really, it just strengthens my point about the nonsense the media is peddling, instead of asking the populace to remain calm, take precautions, and stay safe.

> There have been only a handful of such attacks

How many are an acceptable number? Or tolerable number?

You can't control every agent in the world. You literally have to have a tolerance for the existence of a few stupid ones.

You can avoid stoking the flames and creating scapegoats. Just for reference when the Nazi party initially started to scapegoat Jewish and Romani people they used disease and hygiene concerns as an early way to paint people poorly and it's hellishly effective - blaming "mexicans taking jobs" is a pretty weak (relatively) scapegoating when compared to "mexican rapists" and trying to play to actors that may be causing a more personal harm. Painting the disease as being Chinese/Jewish/Romani is sort of the ultimate scapegoating - people feel personal pain from seeing sickness in their community and have no direct way to see that the attribution of that sickness to a people group is entirely bullsh.

Dogwhistling for racism isn't an innocent action and deserves no understanding, it is hate filled and driven out of self-interest by those doing it.

> Just for reference when the Nazi party...

This is an absolutely insane analogy -- not to mention grossly off-base. No one is scapegoating the Chinese people (or, even less so, Americans that happen to have Asian ancestry). Calling it the "Chinese Virus" simply points to its geographic source, i.e. Wuhan, China.

> insane analogy

Yeah, Godwin's Law strikes again. Not everything is literally Hitler.

> This is an extreme, uncited, and frankly inflammatory extrapolation. There have been only a handful of such attacks -- I believe 5-ish (reported by The New Yorker and CNN).[0]

So nobody is doing this? Or have there been incidents that you yourself have previously acknowledged?

I tried civilly engaging in discourse with you earlier[1]. But now it seems like you're arguing with people just to argue, not to actually discuss these topics.

Also, you can correct people who are mistaken about where it originated without saying "Chinese flu". E.g. "actually, the coronavirus originated in China". I remarked on this to another user who said they just wanted to stick to the facts about its origins.[2]

If you're intent on making sure China is regarded as the source and/or culprit, you can emphasize further by adding something like, "and that's why the majority of cases and deaths from [coronavirus/covid-19] were in China. It started there." And that can be said perfectly fine without "Chinese virus".

[0]: https://news.ycombinator.com/item?id=22621821

[1]: https://news.ycombinator.com/item?id=22622069

[2]: https://news.ycombinator.com/item?id=22622774

Why are you looking to what you refer to as nonsense peddlers for evidence that there have been attacks? I actively avoid and dislike the media too, but that means I discount everything they say, not just the things I dislike.

How about I provide some personal anecdata instead?

My (Asian) parents -- who prefer Fox over CNN and vote right, in case anyone fears they're under the spell of frothing journalists -- have been more nervous about going about in public. My dad's car's mirror was smashed a couple nights ago.

In a similar way that I'm not as deeply affected by the current economic environment as a low wage worker is, you're not as affected by the cultural perception as people like my family are. With that in mind, I ask that you acknowledge that such acts could very well be more common than the sensationalized ones that liberal media eagerly pounce upon, and thus more common than you personally might be aware of.

> Instead of seeing op-eds with "stop raiding stores for toilet paper," all we saw (and still see) is "this president is incompetent."

Well, if one believed that both these things were equally true, which one would be more worthwhile writing about?

Toilet paper? Even if one believes the president to be incompetent, that's not news. (The details of how that incompetence plays out today may be...) But toilet paper, last week, was making an actual difference in actual peoples' lives, right then, in a way that was new.

> Instead of seeing op-eds with "stop raiding stores for toilet paper," all we saw (and still see) is "this president is incompetent."

I've seen a LOT of stories about the problems of hoarding, pleas to stop hoarding, etc...

I just assume bad cases of confirmation virus when I see claims like this, now.

Some (read: Trump supporters) say we should trust the government (read: the Trump administration) during this crisis, but how can that be possible when we've been lied to and this crisis has been downplayed over and over again?

Imagine if you're about to go skydiving and I'm responsible for packing your chute. As I pack, you notice a cord looks badly frayed. I tell you, "The cord is totally not frayed! They all look like that." Then I tell you, "Don't worry, we'll replace it before you go out." Then you find out we didn't actually replace it, and you look up on the internet that it can easily kill you. Then I say, "I knew it was a problem all along but we have a plan in place to handle that."

Would all of that make you feel less or more afraid of your skydiving experience?

The intelligent skydiver knows better than to allow the government to pack his chute.

Obama's response to the ebola crisis reminds me of the trolley problem. By making an attributable action to avert a bigger disaster for a smaller one he became accountable for the outcome. As the larger disaster never materialised he never received due credit.

It seems like Western democracies are very ill-equipped to deal with problems of this nature where all future outcomes are bad and the chosen executive has to deliberately choose the least worse. Facing such scenarios it's often the case our leaders choose not to take any political damage and do nothing until we are at the edge of catastrophe or take half-hearted measures that solve nothing. To take any deliberate and effective action would be not seen be seen as prescient aversion, but considered a wasteful diversion. The social, political and media environments, in particular the "news of the day" media, of the West are suited to guiding executives towards quick and decisive actions in the midst of the crisis because they are biased towards describing the here and now rather than the where and when. For most problems a society faces this may be a sufficient means of dealing with those issues. However in pandemics there are two catastrophes happening simultaneously, the one people think is happening in their midst based on the here and now, and the far more severe catastrophe epidemiologists know is happening based on the where and when. At the start of this crisis Western governments reacted to the former in the expected manner, that is with half-hearted measures and a dismissive attitude, what we needed was for them to react to the crisis epidemiology was describing.

There is very little excuse for Western governments during this pandemic. They caught a lucky break with the SARS outbreak in 2003 and became complacent, choosing not to bolster responses to epidemics as Japan, Taiwan and S.Korea have done. Then they wasted the time lag between the virus outbreak in China to it reaching their countries by declining to take effective actions.

I am not sure if you can infer from two past epidemics that this one will be the same. Every epidemic is different. This one spreads way faster than H1N1 and is harder to control because of asymptomatic carriers.

Sure, information (and misinformation) travels much faster now, but I am not sure if that is necessarily a bad thing. It might have done more help than harm in this case for all we know. I think that is the case because this one is not as deadly, so sensationalization and fear-mongering is not easy. If the fatality rate was like 50% (as it was for Avian flu, I found recently to my surprise), it could have been way worse with the media.

Do you have a source for asymptomatic carriers?

From https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmissi...

>>> Can someone spread the virus without being sick? People are thought to be most contagious when they are most symptomatic (the sickest). Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.

Doesn't seem to indicate asymptomatic carriers are a big concern?

There are people getting sick without having been in contact with other people who are sick. How else would that happen?

"Most contagious when symptomatic" is not even remotely the same thing as "not contagious unless symptomatic". We also don't have a good picture of what symptoms look like aside from the most serious cases.

How would you possibly know reliably they were not in contact with anyone sick?, particularly when being in contact means touching any surfaces where the virus landed hours or it seems even days ago

There is a lot of uncertainty, doubt, and imprecision in those statements. "Some spread might...", "might be possible...", "this is not thought...", etc. These really mean: yes, it's possible.

I would say asymptomatic carriers are the biggest concern.

There's a big difference between 'yes, is technically possible' to having proof (and therefore certainty) that this is a big factor and a differentiator from other from other viruses.

I think the proof is out there: https://www.infectioncontroltoday.com/covid-19/asymptomatic-...

Thank you for the links. I found it before as well with some quick googling but I felt the title deceptive after reading the actual studies linked [0] [1].

>>> The sequence of events suggests that the coronavirus may have been transmitted by the asymptomatic carrier.

>>> If the findings in this report of presumed transmission by an asymptomatic carrier are replicated, the prevention of COVID-19 infection would prove challenging. The mechanism by which asymptomatic carriers could acquire and transmit the coronavirus that causes COVID-19 requires further study.

>>> Considering the reported similarity in viral loads between asymptomatic and symptomatic patients [14] and that transmission of SARS-CoV-2 by asymptomatic or paucisymptomatic cases may be possible, even though there is no clear evidence as yet of asymptomatic transmission, the relatively high proportion of asymptomatic infections could have public health implications

No clear evidence of asymptomatic transmission. A lot of 'probably', 'suggests' as before. It's certainly a growing possibility, but not I'd not call it proven yet as a big factor.

[0] https://www.eurosurveillance.org/content/10.2807/1560-7917.E...

[1] https://jamanetwork.com/journals/jama/article-abstract/27620...

Honestly, I think GP's post is an example of the danger of amateur punditry.

On the other, I think Tomas Pueyo's medium blog is really important and correct imo as another amateur pundit. The thing about it is, even with people saying useful, what you really need is the CDC and other authorities being with it enough that they command the most credibility and with them failing to achieve that, even good punditry can only do so much.

We also had China set the tone with the largest quarantine in history. Leaders are looking at the precedent on how to act.

That is very true.

Keep in mind the original SARS had a death rate of 10%, so obviously there was a tremendous amount of fear that this new related virus would be similarly lethal.

> Leaders are looking at the precedent on how to act.

No, they aren't US policy of suppression was an abrupt policy turn that came with this report: https://www.imperial.ac.uk/news/196234/covid19-imperial-rese...

The Chinese example didn't change overnight, the information available about predicted outcomes of different policy approaches in the US and UK did, and that's what drove policy change, including the Trump Administration flipping from claiming it was a hoax cooked up by political opponents to treating it as a serious issue.

Well, at least the situation in Italy is not simply a (social) media phenomenon; the health system is overwhelmed for real. Stuff like this has not been the case with the 2009 swine flu pandemic, or has it?

I know from personal experience social media amplification is making people sick in itself.

2009 h1n1[1] was aggressively pushed by the WHO as having a 60% CFR[2]. Similar issue to corona19, basing everything on literal test results. Meaningless! Presumably why WHO telling the world to test everything.

[1] http://news.bbc.co.uk/1/hi/8094655.stm [2] https://jech.bmj.com/content/62/6/555.abstract [3] https://www.independent.co.uk/life-style/health-and-families... [4] https://www.theguardian.com/world/2009/jul/16/swine-flu-pand...

I think a major difference between Swine Flu and SARS-2 is that it did not affect as many countries simultaneously as now, and, we did not see so many people ending up in the ICU. As I understand the numbers being: 10-20% end up in a hospital, 5-10% end up in ICU, half of them die. I don't remember anything similar for the 2009 pandemic.

I'm not an epidemiologist, but... isn't it a little early to say "H1N1 ended up not being as fatal as SARSCoV2"?

Thanks for the clarifying question. I was talking about case fatality rate, or the number of people that die from the disease out of total cases.

It's certainly possible that SARSCoV2 will have fewer total deaths than H1N1.

> number of people that die from the disease out of total cases.

Out of confirmed infections. The fatality rate would only decrease as more people are discovered to have been infected.

Thank you for clarifying, but what I'm thinking is that our CFR denominator is off by a whole lot right now. Could be wrong, of course, I'm still not an epidemiologist.

My, also not epidemiologist estimate, would be that the only way to have any measure on the spread today when comparing countries is the number of deaths per capita compared to the strain of the healthcare system. Add some factor for the mean time from infection to death and you have it.

Everyone who is ill enough to be about to die will end up in a hospital, with the virus already being transmitted in the society the point in testing everyone else is trending towards negligible.

Sure if the measures taken allows the rate becomes low enough again, then contact tracing might become worth doing again.

You can also try to do statistical tests on some cohorts of population and extrapolate from there but if the resources are limited then saving lives counts more.

Yeah, the problem is that diseases have effectively 2 different fatality rates: one for those who get medical attention, and one for those who don't. As a medical system approaches saturation, it becomes harder to get medical attention to those who need it, and the fatality rate rises to the second value. That's why fast-spreading illnesses end up deadlier.

Hopefully we can avoid saturating the medical system in the US.

The number of death from air pollution alone is much higher (4.6m/year https://www.google.com/search?q=number+of+death+from+polluti...) than from those viruses

With quarantines and traffic, activity, consumption slowdown, the air quality is getting much better, did we just discover the solution for global warming indirectly? which is a much more important problem than those human viruses by the way

Hey. 4.6m over the course of a year is not much compare to this. 50-150m lives could be lost in a matter of a few months if this virus get out of control.

The actual differences in CFR have non-linear effects on the scariness of the outbreak: COVID-19 has demonstrated an ability to crush the healthcare system of a modern, wealthy G7 nation, and that has (rightly) spooked people.

Schools and businesses weren't shutting down for months during the swine flu pandemic. Experts are treating this as a serious threat and that's not something the media is responsible for.

They did in Mexico.

Did we ever run out of ventilators during the 2009 pandemic? 5% of untreated cases (e.g: no ventilator) end up being fatal -- if you look at the numbers in Iran.

> ... up to ... may have ...

Now, that's some hard facts you have there!

If you want rigid certainty, you're not going to find it in epidemiology so you should turn back now.

Nobody knows how many people died from H1N1 in 2009. The CDC has only estimates and the range is huge:

https://www.cdc.gov/flu/spotlights/pandemic-global-estimates...

And that is why I used the words I did.

There was a vaccine for H1N1.

> People were calm. It was on the news, but there was no panic.

Because it wasn’t an election year in the US.

Reply on news.ycombinator.com