If you assume a mortality rate of 1% (which is probably in the ballpark) then you can expect 75 million deaths without intervention. So far world-wide we've had about 95,000 deaths. So doing nothing would result in about 700 times as many deaths as have occurred so far. I'd say it's probably to soon to throw in the towel.
A 1% mortality rate is much higher than the ballpark. A recent study which was featured on Hacker News estimated the infection fatality rate at 0.66%. [1]
The IFR represents how many of those who got it and ended up dead (regardless of whether their case was tested, diagnosed or confirmed). It doesn't represent the whole population.
The same study estimated 60-80% of people could eventually contract the disease. 70% * 0.66% = 0.46% mortality rate from the disease. This would equate to about 35 million people globally. (70% infection rate is not going to happen overnight and I would hope that one way or another fewer people get infected than this - on the Diamond Princess where they tested nearly everyone, only about 25% of passengers got infected - but we will see.)
It's important to understand the definitions of all the terms involved. A misunderstanding of the statistics has resulted in panic -- people see a 5% death rate from a specific group of confirmed cases and assume that translates to their demographic, or overall population etc. when it does not.
The mortality rate is the percentage of the total population that dies. The infection fatality rate is the percentage of all cases, diagnosed or undiagnosed. The case fatality rate is the percentage of diagnosed cases. [2]
Not saying it's not a serious disease, 35 million deaths is many many times more than the flu. But we aren't going to lose 1% of humanity to this disease. And personally I would advocate for a smart and measured response like we've seen in South Korea or Taiwan over a panicked and destructive response like we are seeing in the US and UK.
Actually I would argue they are not the same when your solution will force some number of people into poverty (plus in the US cause them to lose their health care).
No one wants to have to think about these numbers, but if you're responsible for making policy, it's very important to have good estimates of how many lives your policy will save and how many it will ruin. If you don't you're just reacting to the latest panic in the news cycle as sadly far too many politicians do.
You're talking about a difference between a massive number of people dying, and a massive number divided by two dying, and then arguing that a massive number divided by two is not nearly as serious.
Nobody knows what the true numbers will be, but only the rough range they'll be in, so arguing over a factor of two is meaningless. These are terrifying numbers either way.
> If you don't you're just reacting to the latest panic in the news cycle as sadly far too many politicians do.
The "panic" is caused by people finally listening to what epidemiologists have been saying for months. False calm has been far more damaging on this pandemic than panic. If politicians had listened to the panic mongers earlier, the world wouldn't be in this situation.
I don't know why you were downvoted. Frailty is an epidemic among the elderly. Once they lose muscle tone and mobility they tend to die quickly. It does little good to avoid virus infection if you end up breaking your hip because of muscle atrophy.
If there's a rigorous nationwide shutdown for 6 weeks, then the economy can partially open up again and people can go out more (people can still go outside now, as long as they stay away from people they don't live with - I know plenty of old people who are in self-imposed quarantine but still go on walks). This also requires the US to build up its testing and contact-tracing capabilities, so that it can keep the virus from getting out of control again.
Unfortunately, the short-sighted rush to reopen everything too quickly, or not to shut it down in the first place, is undermining these efforts. The shutdown worked in China, where it was strictly observed and enforced for several weeks. I hope the US can do the same.
IMF says 500 million people worldwide who were out of poverty will or have returned to poverty because of the recession.
It's a relevant perspective, but I can't seem to find any source for IMF claiming that. Do you have one or are you referring to research publicized by Oxfam[1]?
The average COVID-19 death in Italy is 78 years old and sick.
The average hunger death is going to be young, otherwise healthy, and in the developing world (likely somewhere in sub-saharan Africa).
You can draw your own measures, but I would not personally weight these lives saved equally. I would personally throw several 78 year olds under the COVID-bus to save the life of one young child. I think most people would draw similar lines.
> The first thing that jumps out from the medical history section of Table 1 is that 93% of those critically ill with COVID-19 were “able to live without assistance in daily activities” prior to developing the disease. That typically suggests reasonable health. 3/8
> Secondly, just 7% of 2,124 intensive care admissions had “very severe comorbidities”. That’s significantly less than typical viral pneumonia patients (as illustrated in table 1)
> So 19 out of 20 were free of the most severe life-limiting conditions. 4/8
> Lastly, for now, the age distribution. Most critical cases are aged between 50 and 80.
> People of this age, without severe comorbidities, could reasonably have expected to have years of life ahead of them before they contracted this disease. 5/8
>> The first thing that jumps out from the medical history section of Table 1 is that 93% of those critically ill with COVID-19 were “able to live without assistance in daily activities” prior to developing the disease. That typically suggests reasonable health. 3/8
Not making any comments on the rest of your points, but I have to heavily disagree with this one. Sure, people who have cardiovascular and heart issues, diabetes, asthma, etc. are all "able to live without assistance in daily activities". That doesn't suggest reasonable health to me at all, it just tells me that they are able to live their lives without a caretaker by their side.
And data from Italy suggests that over 99% of the people who died from COVID had existing conditions like those[0].
I think every life is worth saving. Your argument is a slippery slope.
People of old age have contributed to society their entire life and the real perversion is that we should not be at a point where such thoughts make it into public discourse.
That's a reasonable sentiment, but it's not the world we are in, and we will be making economic and health decisions over the next 18 months which will force this tradeoff.
They need to be intentional choices, with an understanding of the costs, where the costs are often paid by people we don't see or frequently think about.
Sweden has by far the worst outbreak in northern Europe, despite a later start than its neighbors. It's also has not apparently peaked yet, where the outbreaks in the rest of Europe have been flat for over a week now (and Italy has started shrinking). At the end of this, it's not at all clear that Sweden will have accomplished much of anything.
The visualization at https://91-divoc.com/pages/covid-visualization/ is IMHO the clearest to explore this stuff. It's based on the Johns Hopkins data set, which is relatively well curated.
Good luck. Sweden is a country which in large has an overwhelming trust in it's government and its intents. There is no part or cultural aspect of Sweden, which inherently believes it needs to arm itself to protect itself from its own government, and even less so as part of its constitution (grundlag)[1]. When told to behave in a certain way, Swedes will follow suit.
Separately Sweden is also a country with an extensive social safety net, where every citizen has the right to free healthcare and every employee will receive 80% of their salary for two weeks without a doctor's note at no cost for the employer[2].
Time will tell if the Swedish approach was the right one and even if so the Swedish case will end up being dependant on rather unique constraints that simply will not map to the US, at least not on a national level.
What is the “certain way” I’m supposed to behave? Sorry, I’ll listen to the governments perspective and weigh it like everything else. I don’t have a gun to defend against the government - I have it in case an individual who thinks they are entitled to my money and my resources get carried away and take it a step too far and try and take it by force.
No, because it's unlikely that 100% of the population will get infected. What disease has ever infected 100% of the population? None. Diseases hit an inflection point in spread, before they fall off. At any rate, how many people died in the wake of the Great Depression? World War 2 was indirectly caused by it. We lost 85 million people when the population was only 2 billion. And that's not even counting the people that died in the subsequent decades when communism took over China and Mao and Stalin had their reign of terror.
This line of reasoning assumes that containment is feasible at this point. Is it? Or will everyone get the virus eventually?
One ironic downside of “flattening the curve” is that it makes it longer. So, barring a vaccine or effective therapeutic treatment, we will all get the virus eventually (but in an orderly fashion, which is good for the health system), and that 75 million deaths will become a reality. Note that’s also assuming a 1% death rate which may be a vast overestimate depending on asymptomatic percentages.
That said, I tend to agree with you that we should keep social distancing in place until we are able to contain new cases, or until we have a much better understanding of the virus itself. At this point there is just too much uncertainty, so it’s better to wait it out until we can establish some clarity and have a better idea of how to approach therapeutics.
I don't think this is true, is it? Most mathematical models I've seen definitely have a much lower number of total infected when the curve is flattened significantly.
Here in New Zealand we are hoping you are correct and seeing signs that you are.
It seems odd to link to reddit graphs - but they are quite good and are up to date.
You're right. Mortality for the virus would significantly increase if emergency rooms are overcrowded. No beds/ventilators = patients that would have survived dying. Last I've heard, around 15% of infected need to be hospitalized.
Availability of hospital beds is certainly important, but about 80% of COVID-19 patients placed on ventilators die. We should deploy more ventilators but even if hospitals run out that will have only a small impact on the total infection fatality rate.
When you start selecting for patients who are the most vulnerable and suffer the most acute cases, it doesn't seem surprising that you can end with a high mortality rate.
There's more to it than that. Doctors actually treating COVID-19 patients in hospitals report that the disease progression is significantly different than the usual ARDS.
