And what is your conclusion with these unknowns and the other unknowns about the exact stats about the spread/fatality rates for the virus? People have to make decisions about how to act without all the information, and I’m wondering where you come down. Do you still believe it an “over-reaction” or is it possible it is better, at this point, to err on the side of saving human lives and continuing with social distancing and quarantines? Are there certain stat levels that will make your opinion change? If it’s 2% is that enough to warrant this level of alarm? If it ends up only being .5% will that make this all look silly?
It’s probably not that overstated.
Although the data changes from day to day, Italy appears to be in the top ten countries of the world in terms of testing per capita, so it’s not as though they’re not testing.
They’ve actually tested more than Germany, yet they have a much higher fatality rate. The difference isn’t just in the number of tests; it’s also likely a matter of when the two countries decide to test. This might be inaccurate, but from what I gather, Italy’s surveillance efforts seemed to get ramped up as a result of an outbreak in northern Italy. Germany may have started testing ahead of the crisis, similar to what South Korea did.
The fatality rates for Italy may indeed go down, but they are not likely to go down immediately or dramatically. They will go down once the virus has wiped the most vulnerable people out of existence. That’s the problem that Italy has right now: the most vulnerable have been infected at around the same time that those who are more likely to survive have been infected. But those who are likely to survive are still showing up at hospitals in desperate need of healthcare.
So young Italians are simply much less likely to become infected than their elders?
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Colibri
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We don’t know for sure what the infection rate is or how many people have it.
We do know how many people have died from it. That number has doubled every 3 days. Get a calculator out and pick any day’s death count. Multiply it by 2 and repeat it 9 more times. That’s how many more per month would die without intervention. yes it will curve down naturally as we kill off all the people with added health problems but the numbers go up very quickly. So far it’s actually closer to doubling every 3 days plus 25%.
As an example, we had 115 dead on 3/17. 9 days later it was at 1,177. that’s a little over a week.
Italians under the age of 18 are a very small percentage of the cases, but the numbers start going up for adults between 19 and 50 years old, who have so far accounted for almost 25% of the total cases.
Another 38% are between the ages of 51 and 70 - aging, but hardly old. If they were in America, people at this age would be more likely to be in positions of senior management and earning the highest salaries of their lives. And if they were retired, they’d be just recently so and in otherwise good health and with some money to spend, well before their predictive end-of-life care expenditures begin to kick in. In other words, these are not the sort of people a smart economist would want to consider expendable and flush down the toilet.
That wasn’t my point at all. You said that 10% was likely to be a good approximation of the actual fatality rate in Italy. I was simply saying that the case fatality rate is very different from the infection fatality rate, and this is easily seen from the fact that there are far fewer infections reported in younger people, including the middle aged. The most likely explanation for that, especially in an overloaded health care system, is that the true number of infections in young and middle aged people is considerably higher than the number of positive tests.
Well to be accurate, I think I said that it wasn’t that much of an exaggeration and I believe I also agreed that it would go down over time.
But here’s a more important question: does that matter? If we find out later that there was an extremely high number of people in Italy who got infected but went undetected…so fucking what? What matters is what the health system was able to handle, and clearly, Italy’s health system, which by all accounts has more beds and was in some regards better equipped to handle a pandemic than our system, has been wrecked by COVID-19.
I think that’s what needs to be pointed out: who gives a shit if only 1% of the people who get infected die? If the timing and the incidence combine to shut down a health system - even if it’s for a matter of weeks - then you’ve got a serious problem.
No offense, but trying to minimize the scale and dimension of the pandemic by pointing out percentages is, frankly, not a very educated way to analyze this crisis. Look at the actual impact of the pandemic right now. That’s all you need to know.
I think a lot of people are taking false comfort in the high number of unconfirmed cases for some reason. Let’s say that all of us have the virus and 80% are asymptomatic in this sliver of time. Is this really all that comforting?
Are the 40 Italian doctors who have died after treating COVID-19 patients breathing a sigh of relief up in heaven now that they know the true number of cases?
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Its comforting because it could mean the IFR is much lower if most people who get the disease have no symptoms or only mild symptoms.
No, but maybe the tens of million of Americans who won’t die in the next few months if the virus turns out to not have a ten percent mortality rate would be relieved to hear it. It makes every difference in terms of predicting the extent of this epidemic and how long it will last.
Frankly, the thousands of new cases being reported every day in northern Italy make me very skeptical that we’re going to be able to do much to slow down the spread of this virus, given that they’ve been as “locked down” as anywhere in the USA or Western Europe for 3 weeks now. The draconian lockdown of Wuhan wasn’t only made possible because China is a totalitarian state, they needed the resources of the rest of their vast relatively unaffected country to do it. Because of how the virus is spreading, that won’t be possible anywhere else, regardless of their political system.
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I get that in relative terms, a death rate of 1% is a relief compared to a fatality rate of 4%. It’s entirely possible that the fatality rate may vary from one country to the next, and that its outcomes are very dependent on how well a country’s health system is prepared to test, triage, and treat.
It might be a folly for an American to look at Germany or South Korea’s data and say “See, the real fatality rate is 1 in 1000” if America’s health system isn’t similarly prepared to deal with it. Perhaps over time we can improve these outcomes - then again, maybe the US keeps bungling the response, never fully enforces social distancing, encourages people to return to work, and successive waves of infection perpetually wear down the health system. Maybe the virus mutates. Maybe our COVID outcomes are never as good as Germany’s or South Korea’s.
Oy!
The last thing we want is for millions of people to be relieved; we want them to practice social distancing so that they stop accelerating the spread of the outbreak. It’s the acceleration of the outbreak that is likely inflating the mortality rate beyond where it should be. Do you not get that?!
Is there any evidence that even relatively strong “social distancing” measures will be sufficient to prevent the collapse of the healthcare system, given the necessity of people circulating for food production, distribution, and essential industry? Have we actually seen this work anywhere? Like I said, for logistical reasons we can’t achieve a Wuhan level of distancing anywhere else.
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This is the straight dope. This should be one place we can freely discuss the IFR, death rate etc, putting to one side whether the true data might make the man on the street complacent.
It’s not as though millions of people are going to suddenly base their decisions on this message board (And good luck with the SD server with that increased traffic. The hamster wheel already needs oiling).
Well, IF a lot of us have mild cases and IF that confers useful immunity, then the total death toll will be a whole lot lower than if that’s not happening.
I don’t know if this had been mentioned yet, but covid 19 is particularly fearsome because of how communicable it is. You can get it just by getting coughed or breathed upon.
HIV/AIDS has also been described as a pandemic, but since its routes of transmission are so much more limited, it’s far easier for people to stay out of its way without extraordinary countermeasures like social distancing and sheltering in place.
I suspect some may be asking, “well AIDS was a pandemic but we didn’t shut everything down for that, so why do we have to do it now?”. If HIV was as communicable as Coronavirus, we certainly woukd have, especially in the early days when there were no deu3gs for it.
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Also with HIV we have medications to slow the virus from spreading inside your body. Right now we only have experimental antivirals for coronavirus.
I don’t know if we really even know ‘how’ coronavirus is spread yet. I got the impression that it was spread via respiration, but lots of other people seem to feel that it is spread through touching infected doorknobs and surfaces. Also even with respiration, there seems to be debate on what kinds of masks are effective or how effective they are.
In the early years of the AIDS epidemic, we had no idea that a virus was responsible, or how the disease was spread. We didn’t know how to “stay out of its way”, and many places, like gay establishments, were shut down because of this ignorance. There were even suggestions to isolate all gay men on an island somewhere. Or worse.
First of all, it is pretty much confirmed via community transmission with no traceability that the SARS-CoV-2 virus is spread at least in part via aerosol vectors. This isn’t the same as “airborne”, where the pathogen can actually spread in dry air without droplets, but it is still bad; it means that while cleaning door knobs and washing hands is still good practice, it isn’t sufficient to assure no transmission. Nor is just following the 6 foot/2 meter guidelines for spacing; if you are outside in a part with a light breeze dispersing any aerosols your likelihood of getting enough of a viral load for transmission, but in a confined area where an aerosol will not be dispersed, it means it could hang in the air for minutes.
There is no real “debate on what kinds of masks are effective or how effective they are”. Ordinary surgical masks that do not seal around the face are only good for stopping droplets from being openly emitted by the wearer, and do nothing to protect the wearer from inhaling aerosolized pathogen. N95 respirator masks are much better insofar as they prevent aerosols from directly entering the respiratory system but pathogen can become embedded in the mask and eventually make its way through, especially as the mask becomes saturated with moisture from the breath of the wearer and the ability for the mask to capture droplets and hold it until the moisture evaporates and the virion (virus-containing particle) desiccates degrades. This is why staff in emergency wards and ICUs–who are being required to wear the same respirator mask for days–are covering it with a surgical mask (which mostly just serves to keep it from looking soiled) and face shields (which actually protect against direct impaction from aerosols but make it very difficult to communicate with patients or perform a thorough examination).
Seven to ten days from now, when the virus is everywhere and emergency rooms and ICU wards are packed to capacity, and physicians and nurses (and receptionists, and nurses aids, and EMTs, and everyone else who is on the front lines of the response) start suffering en masse, the question isn’t going to be “Are we overreacting?”; it is going to be, “Given everything we saw from China, and Italy, and Spain, why didn’t we react quickly enough?” At this point there is no excuse other than blithe ignorance of what is happening right now in nations that didn’t respond to the warnings of the epidemiological community to argue that the current measures to just stay at home and stop mingling with people as if this is a mild outbreak of cold or some disease that only affects old people who are going to die soon anyway. There is no “debate”; there are no “both sides make reasonable arguments”; and there is no fact-based analysis that doesn’t involve the difference between a few hundred thousand deaths and millions of avoidable deaths because of a lack of hospital capacity.
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