2% of humanity is absolutely, in no way, shape or form about to die. The Korean numbers are approaching 0.5% case fatality rate, and those numbers continue to fall. It's about the same as the flu, and no, the flu isn't killing 2% of humanity either. Y'all need to settle down and get back to work.
0.5% is still well over 5x as bad as typical flu. SK is closer to 0.7%.
SK also has a far lower recovery percentage (SK total cases: 7478, total recoveries: 118; 1.5% of cases have recovered, 0.5% of cases have died).
Compare to the worldwide CFR and recovery rate, which has a much higher CFR (3.5%). total cases 113,432, total recovered 62,494, 55% of world-wide cases have recovered.
That means SK is catching their cases through testing much earlier (which is great! This leads to both better containment and better clinical outcomes!), but it means currently they have a much higher percentage of "unresolved" cases than many other countries. We need to wait until we start seeing more recoveries in SK before we start celebrating too much.
I'm optimistic that there's a good example of a strong outcome when there's a robust response in South Korea.
The reason their numbers are lower than elsewhere is the widespread testing is catching the low-grade infections, the asymptomatic and the so on. Those cases are not reflected in, for instance, US numbers as there hasn't been any wide-scale testing. In a huge quantity of people you wind up with sniffles, a cough or mild flu-like symptoms. They don't go in, they don't get tested, so they're left out of the denominator.
That is one factor in the low CFR, but it's far too early to say it is the only factor. It totally fails to be responsive to the low percentage of resolved cases in the South Korean numbers.
If the only explanation was that they were catching far more low-grade symptoms, then we should see a lower CFR with the resolved cases rising rapidly.
I hope that what you state is the case, and their CFR remains where it is while the number of recovered grows. But it's still an unknown, and we won't actually know until more data comes in.
Absolutely, but I haven't heard anything about them being significantly more conservative than other countries in that regard.
I'm not saying the CFR will go up in South Korea. I'm saying it's still early days to make the claim that it will definitely stay at 0.7%. When we get from 97% of cases being unresolved to something like 85% of cases being unresolved, and the CFR is holding steading, I'll be much more ready to spike the football and celebrate the intervention.
None of which is to say we shouldn't be copying the South Korean playbook closely. They've done a damn-near miraculous job of keeping the number of cases from exploding, and the preliminary CFR does look good. Even if it goes up, it still seems likely that they will have a lower CFR that many other places with a sizable outbreak.
Their response is the bright-spot so far, and we should absolutely be copying their playbook. I'm just saying, it's a little early to tell whether their playbooks is excellent or just really good.
I haven’t read anything that said sniffles or runny nose was a symptom. I have a runny nose and was told by the ER on the phone in British Columbia not to worry unless I get a fever.
Looking at Korea's numbers, they are reporting 7478 cases, with 53 deaths. But they are also reporting only 133 recoveries so far. So looking at Korea's death rate so far is in no way, shape, or form accurate, as more than 97% of their cases have not yet resolved by dying or recovering. It takes time to die.
Why use S.Korea's numbers? Haven't they lead the best response in terms of testing and don't they have universal healthcare? It seems to me fatality rates would likely be higher in countries that: 1) aren't testing so aggressively and 2) don't have universal access to care.
Maybe I am wrong though and there is good reason to believe S.Korea is the best example right now to use as a statistics model to apply across the entire world.
Part of the reason their numbers are so low is because they're testing, which is revealing the stacks upon stacks of asymptomatic cases or cases which lead to the sniffles. That's why we know the actual mortality rates are so much lower than the media is screaming breathlessly about.
Think about it: not a single story about the myriad people who've recovered completely, right? There've been 114,000 documented cases so far and 66,000 have recovered. The number of active/unresolved cases remains well below its peak.
>Part of the reason their numbers are so low is because they're testing, which is revealing the stacks upon stacks of asymptomatic cases or cases which lead to the sniffles.
I don't disagree, but my point is S.Korea is not just testing they are treating...if they were not treating presumably the mortality rates would increase. In other words whereas you suggest testing is proving the mortality rate is low, who many of those who tested positive received treatment? and further, got better because of treatment?
Testing is the key to treatment and minimizing mortality rates, other countries are failing on the testing, so it can be presumed they are also failing to treat (how can you treat when people aren't being tested).
> I don't disagree, but my point is S.Korea is not just testing they are treating...
There aren't really any treatments broadly available. They're holing people up in hospital beds and providing supportive care if needed. There's a few antiviral treatments in the pipeline.
>They're holing people up in hospital beds and providing supportive care if needed.
That is pretty important for people at risk. Consider lack of supportive care is what leads to most preventable deaths from regular flu progressing to other issues that will result in death, not the flu itself. For example dehydration and lung infections can be monitored and treated.
You're wrong, but primarily because you insist on treating human life so trivially. Get to work eh? A best case scenario, one where the actual CFR is half what the evidence shows now is 0.25%. 30% of the population gets the flu in a regular year, so, for America that ends up being a flu season that kills 10 times more people than in an average year.
But you're focus on people hacking and wheezing their way to death. You're ignoring upwards of 5-15% of those people who will have to be on a ventilator OR WORSE. This is NOTHING like the flu.
You would do yourself a favor also to examine what it is that Italy, Wuhan and South Korea are going through to try and stop it. They certainly aren't "GOING BACK TO WORK."
> You're wrong, but primarily because you insist on treating human life so trivially.
No, it's because I'm not overweighting risks that are trivial for the vast, vast majority of people. Of course if you're over 80 and have 3 pre-existing comorbid conditions (as is in Italy) you should be careful. If you're under 10, nobody's died. In fact nCoV-19 doesn't really even spread between children. If you're under 40 the mortality rate is 0.2%, and that's a worse-case number including folks with co-morbid conditions.
Risk exists, and we should be comfortable with it. I recommend reading Schneier's essay on our decreasing tolerance for risk [1] and how it can often lead to us doing ourselves more harm than good.
You have a 1% lifetime risk of dying in a car accident. You've got a 2% lifetime risk of dying of an opioid overdose.
> But you're focus on people hacking and wheezing their way to death. You're ignoring upwards of 5-15% of those people who will have to be on a ventilator OR WORSE. This is NOTHING like the flu.
Yes, it is like the flu. H1N1 Influenza A has a ~10% mortality rate in the elderly, similar to nCoV-19.
> You would do yourself a favor also to examine what it is that Italy, Wuhan and South Korea are going through to try and stop it. They certainly aren't "GOING BACK TO WORK."
Really the economic and individual harm and impact there has a lot to do with what they're doing to try and stop the spread. The cure is worse than the disease here.
They probably should go back to work, though, and in China, they already are. They should wash their hands and stay home if they're sick, and get back to work.
How many deaths will warrant taking preventive actions I wonder? (preventative actions like quarantine, which, was the only way it was stopped from spreading before China "went back to work")
I'm not saying that the reaction wasn't warranted initially when we had no idea how bad the disease was. What I'm saying is the level of panic, especially now, is totally unjustified. The hoarding canned goods and battening down the hatches. Insane relative to risk.
And I'm asking you, with the number of infection doubling daily in countries that don't batten down the hatches, or quarantine because everyone should just get back to work as you said -- what is the acceptable number of deaths before quarantine is acceptable?
~20-50K deaths in the US according to the CDC in the last few months alone [1] and 95K worldwide [2] targeting up to 650K/yr from the CDC and WHO. And I did answer the question you asked: there's no hard and fast rule but it's fair to say that we should respond to threats based on the threat they pose, and use similar threats as a baseline.
FWIW, case numbers don’t double every day, they grow by 10 to 20% every day, thus doubling every week or half week, thus growing by an order magnitude every two to three weeks.
That's if you ignore all the people who recover completely and are released from hospital. We're still down ~20% from peak number of active open cases (47K open vs 58K peak).
Not the question I asked, and it's convenient that you didn't provide a citation for that stat, because you well know that was the worst flu season in 40 years, AND it wasn't "this year".
South Korea's fatality rate will be somewhere between "deaths / confirmed cases" (currently around 0.7%) and "deaths / (deaths + recoveries)" (currently around 28.5%) - those numbers will eventually converge.
What really matters though is to keep the raw number of confirmed cases low enough so that hospitals don't get overwhelmed. If hospitals get overwhelmed, fatality rates go up. So containment is key.
Yes, that's true - although I would expect that countries with widespread easy testing would have their "confirmed cases" number get pretty close to the "actual cases" number.
And "actual cases" would be the people that have the actual disease, not the people that just carry the virus. For people who are carriers but are not infected, they apparently don't want to mix those people into the numbers because that's not how other illnesses are counted either.
> What really matters though is to keep the raw number of confirmed cases low
Sure, as long as you mean "actually slow the spread of infections through responsible personal and social choices" and not "sandbag the numbers because it looks bad for you politically."
Best study I’ve seen so far (Univ Bern, Switzerland) estimates a CFR (adjusted) for Hubei province of 1.6% (or 3.3% if symptomatic). Worse above 60 yrs, better below 40 yrs.
Presumably you think Korean health care is better? Now what a about other countries?
There is no way to state with certainty what you’ve said or the opposite. It is prudent of everyone to exercise caution and avoid panic that increases the potential for harm. Being dismissive is just a destructive as being overprotective.
I realise this sounds cruel, but the age group that's most likely to die is not the most economically productive part of the population. So even if a substantial percentage would die, that does not necessarily mean the economy would be affected by a similar percentage.
the number of cases seems to have an impact on the CFR. If the health care system is overwhelmed, it'll shoot way up. That's why shutting down travel and events is important.
China shut down it's economy for two months. Mecca is closed. 8% of Iranian parliament was infected as of last week and two were dead. Democratic nations are putting millions of people on lockdown overnight (see Lombardy, Italy and the 2AM press conference).
This isn't the god damn flu and its irresponsible to say so at this point.
It is the flu, what's different is not the threat but our response to it. So far there have been 95,000 flu deaths since October and just shy of 4,000 nCoV-19 but nobody's shutting down China, Mecca or Italy over influenza A.
It is the flu, what's different is not the threat but our response to it.
At current mortality rates, if this infects a good chunk of the world then we are talking about as many people dying worldwide as died during WW II.
Making future projections based on past deaths without considering the appropriate epidemiological model is like being in a car hurtling at a brick wall and saying, "We will be fine, none of us are hurt yet!" It is literally the same category of mistake.
No, it's not, because the data shows us that the mortality rates are low. The sensationalist numbers reported by the media are downright negligent. Yes, in Italy, we're seeing 4% mortality rates because the folks there have on average 3X as many co-morbid conditions.
If you run the math with some of the most optimistic mortality rates (0.7%) and total rates of infection (30%), you still end up 23M deaths, roughly the total number of military deaths from WW2.
Yeah, that's why Italy just locked down the entire country.
This is the first time in recent history that the media has not been sensationalizing anything, and actually has been underreporting the danger, after ignoring the outbreak in China for a month.
>because the folks there have on average 3X as many co-morbid conditions
Except they're also reporting a non negligible number of young people without comorbidies requiring hospitalization. The death rate is about to skyrocket because the hospitals are reaching capacity. Even in Lombardy, which has one of some of better healthcare infrastructure, things are grave.
No nation on Earth has nearly enough surge capacity to a handle 5-15% hospitalization rate which includes people in their late 20s (though rare).
You think this is the one time the media isn't sensationalizing anything? Are you sure that's not just because it aligns with your preconceived notions?
Again, things are bad in Italy, yes, because the north is full of old folks with comorbid conditions.
There's no world in which 15% of Italy is going to be in hospital with nCoV-19. Even in Wuhan, there were a total of some 80,000 cases (an overestimate) out of a population of 11 MILLION in the city alone, and 19 MILLION in the metro area. That's (using the lower bound) 0.7% of which only a 5000 were severe or critical, or 0.045%.
A far cry for 15%. You appear to be off by 3-4 orders of magnitude.
There's no world in which 15% of Italy is going to be in hospital with nCoV-19. Even in Wuhan, there were a total of some 80,000 cases (an overestimate) out of a population of 11 MILLION in the city alone, and 19 MILLION in the metro area. That's (using the lower bound) 0.7% of which only a 5000 were severe or critical, or 0.045%.
You are continuing to not understand causes.
The cause of the spread stopping in Wuhan was because China put 46 million people on a fairly draconian lockdown. For a month now. Streets are empty, people don't go to work, etc, etc, etc.
Unless and until a large fraction of the world does the same, the rest of the world should expect exponential growth. Not the exponential decline that Wuhan is experiencing. Furthermore if the rest of the world does not, eventually China will be faced with having to choose between the nightmare of permanent economic disruption due to quarantining the rest of the world or the nightmare of mass casualties from letting the disease run wild.
And I guarantee that if your life was implemented by similar public health measures, you'd be screaming bloody murder.
I'm making two separate arguments. (1) the disease is fairly well contained at the moment due to the actions of the CCP in China -- cases dropped from 80K to 17K there (and global cases are down to 42K from a peak of 58K) and that's good numbers; (2) even if the world got it, it wouldn't be nearly as big a deal as the preppers, doom-sayers and the breathless media are making it out to be. Through a combination of actually pretty low mortality rates and the fact coronaviruses are well enough known (SARS, MERS and of course 15% of the common cold) that a vaccine and potential treatment has a big head start.
61 million folks got swine flu in America and 12,000 people died here alone. So far, 500 people have nCoV-19 and 27 people have died.
Wash your hands, don't lick things outside you shouldn't be licking, stay home if you're sick, and we'll be past this in a few weeks.
On #1, the fact that it is under control in China does not mean that it is under control globally. Nor does there seem to be an appetite for the measures that would fix that.
#2 on current data, I said that the number of potential casualties is on the same order as WW 2. Another poster gave numbers showing that this is true even with the optimistic end of current numbers. You have supplied no data to counter those numbers. Nor have acknowledged that tens of millions dead is worthy of concern.
About the rest, my sister and niece are immunocompromised. I have always had weak lungs. My father-in-law is 89. “We” might be past the epidemic but the odds are high that someone close to me will be dead. I doubt that I am alone.
You are not exactly coming across as being full of sympathy for entirely predictable tragedy.
>Even in Wuhan, there were a total of some 80,000 cases (an overestimate) out of a population of 11 MILLION in the city alone, and 19 MILLION
You are grossly misinformed if you think that number is anywhere near correct. For a multitude of reasons - people weren't being tested, test kits ran out, hospitals turned people away, cause of death listed as pneumonia, bodies burned without being tested.
The Chinese numbers are CCP PR bullshit. Once again they would not shut down the entire GDP for two months over something so benign. They would not close down Mecca - the holiest site in the world for 1-2 billion people - over something so benign.
We'll all find out soon enough. The US is quickly approaching the high derivative portion of the exponential curve.
The reality of the reported numbers are sufficient reason for the various actions that have been taken. There is no need to assume conspiracy and coverup. There is doubly no need to tell people who are using the most widely reported numbers that they are grossly uninformed.
So you're refuting my WHO data with ... speculation that the CCP was lying and other anecdotes? The WHO was overwhelmingly positive in their report about the CCP's willingness to participate and make the tough decisions necessary to contain the virus. China had 81K cases, and they're down to 17K. That's good progress.
The case fatality ratio is dependent on slowing the spread of the disease such that the healthcare system isn’t overwhelmed and so that we have time to develop treatments (possibly a vaccine).
The US is not only doing effectively nothing to slow the spread, but isn’t even testing at the level necessary to assess relative regional threats and take necessary mitigation/containment actions.
Arriving at a result anything like South Korea entirely depends on us responding like South Korea, something for which the window of opportunity may have already closed on in the US. We’ll certainly find out in the coming weeks and months.
