Hacker News Reader

Comment by unyttigfjelltol | Hacker News Reader

The AP pegs the average mortality rate at 1.8% for COVID-19, or 1 out of 55 cases.[1] The CDC says the mortality rate for vaccination is 0.0019%, which my imperfect math says is about 1 out of 53,000 vaccinations.[2] These statistics indicate natural immunity on average exposes the person to roughly 1,000x data-derived historical risk of death on average, when compared to vaccination, so I'm not sure what is the source of the lower figures in the earlier post. In any event, as a risk-weighted matter vaccination and weak immunity still seems better than infection and subsequent strong immunity. Just sayin'.

[1] https://apnews.com/article/fact-checking-970830023526

[2] https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/ad...

View on HN

This is not a valid comparison because you're using the case fatality rate (1.8%), and case means symptomatic illness (a majority of infections are not symptomatic). A fair comparison would use the infection fatality rate (IFR), which is the risk of death after being infected.

Recent meta analyses estimate a global average IFR of ~0.15% [1], which is extremely biased by age. All age stratified IFRs show risk that decreases by orders of magnitude with age. We're talking IFRs below 0.003% for healthy young adults and children [2][3].

I'm not advocating against vaccination, just illustrating that the risk-reward profile is different for everyone based on their age and health. If you want to derive useful probabilistic risk estimates, there are many complex factors to consider.

[1] Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications https://link.springer.com/article/10.1007/s10654-020-00698-1

[2] Infection fatality rate of COVID-19 inferred from seroprevalence data https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947934/

[3] COVID-19 antibody seroprevalence in Santa Clara County, California https://academic.oup.com/ije/article/50/2/410/6146069

I don't know where the AP is getting their numbers but the CDC estimated an average mortality rate of 0.6% for Americans.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

Most other countries have had lower mortality rates because the average American is older, and has more co-morbid conditions such as obesity.

For vaccinated patients the mortality rate is close to zero.

Maybe from John Hopkins[1]? According to them, U.S. had fatality rate of 1.6%, albeit they use confirmed infections of 38.7 million vs. CDC estimates of 120 million.

Edit: It seems like CDC is inflating their infection rates compared to almost every other source. According to this[1] they also are more in-line with John Hopkins infection rates.

To note, mortality is rather similar in all sources I can find, but only CDC says 120 million were infected.

[0] https://coronavirus.jhu.edu/data/mortality [1] https://ourworldindata.org/mortality-risk-covid?country=~USA

The CDC infection estimate is in no way inflated. If anything it's an undercount due to false negative test results.

So then why are all other sources showing much lower infection rates?

I can't find what the date ranges are for John Hopkins' data. OurWorldInData says Feb 2020-Aug 27, 2021. The CDC link from GP says February 2020–May 2021.

Your links give the fatality rate for confirmed cases, which is basically useless. For the most part only people with significant symptoms bother to get tested and counted as cases, which skews the fatality rate artificially high. What matters is the actual fatality rate over all infections. The CDC documented their estimation methods on their site if you want to get into the details.

> The AP pegs the average mortality rate at 1.8% for COVID-19, or 1 out of 55 cases.

This is nowhere near correct. The global median IFR for Covid-19 is somewhere around 0.3%. It varies substantially by region, but 1.8% is far higher than even the highest legitimate estimate.

https://apps.who.int/iris/handle/10665/340124

Your source is a sole paper with one author, the guy who "estimated that the coronavirus could cause 10,000 U.S. deaths if it infected 1%"

https://en.wikipedia.org/wiki/John_Ioannidis#cite_note-wp-28

Pardon the skepticism, but do you have any other sources?

> Your source is a sole paper with one author, the guy who "estimated that the coronavirus could cause 10,000 U.S. deaths if it infected 1%"

That's an ad hominem, and a complete mis-representation of what he said at the time. The "guy" is one of the most-cited scientists in the world, and the publication is from the WHO. You just don't like what he has to say, so you dismiss it.

But sure, how many other sources do you need? His work is entirely consistent with everyone else...

https://link.springer.com/article/10.1007/s10654-020-00698-1

> Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. Moreover, our results indicate that about 90% of the variation in population IFR across geographical locations reflects differences in the age composition of the population and the extent to which relatively vulnerable age groups were exposed to the virus.

https://www.nature.com/articles/s41586-020-2918-0

> We find that age-specific IFRs estimated by the ensemble model range from 0.001% (95% credible interval, 0–0.001) in those aged 5–9 years old (range, 0–0.002% across individual national-level seroprevalence surveys) to 8.29% (95% credible intervals, 7.11–9.59%) in those aged 80+ (range, 2.49–15.55% across individual national-level seroprevalence surveys) (Fig. 2a). We estimate a mean increase in IFR of 0.59% with each five-year increase in age (95% credible interval, 0.51–0.68%) for ages of 10 years and older.

The CDC's current best estimate for US IFR for those under age 65 is 6,000 / 1,000,000 (0.6%). Reduce that by an order of magnitude for those under 50, and another order of magnitude for those under 18:

https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

And finally, just to show you that the OP's estimate is widly wrong, here's a paper based only on China, from June 2020, citing a correct-for-the-time (but high for today) IFR of 0.66%:

https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

> Our estimated overall infection fatality ratio for China was 0·66% (0·39–1·33), with an increasing profile with age.

The CFR (case fatality rate) is based on the number of reported cases, which falls short of the total number of incident cases.

The countries with the lowest CFR consistently report about 0.1% CFR. These countries also have the best surveillance, and this is likely near the actual IFR (incidence fatality rate).

The adjusted difference is closer to a 100x benefit for vaccination than a 1,000x. Both are of course immense improvements over no vaccination, at minimal risk.

Reply on news.ycombinator.com