And two presumptive cases in Washington (Snohomish and King counties) just announced at an 8pm press briefing. One a high schooler with unknown origin. The other a person returning from Korea on Tuesday.
The same is true for a normal flu. It seems the incubation time is rather long with this virus which is why you might want to wait before visiting them again.
Beavertonian here, so not that far from you. Since this teacher started showing symptoms on the 19th that means it's been passing around for maybe 2 or 3 weeks already - bit of a scary thought.
Since kids are only developing a very mild illness from this, it seems most likely that this teacher caught it from one of the students.
I've noticed people in Beaverton/Hillsboro are really bad at washing their hands in public. I'm at the movies a lot and every single time I go to the bathroom there's someone walking right out. I've been seeing a few people with masks on (although way more when I was in Toronto three weeks ago), but like those wont help you at all if you're not washing your hands.
While I appreciate the firsthand information, I think this is true of practically anywhere. Frankly, trying to prevent catastrophe through changing individuals’ behavior is practically impossible. Consider the amount of people who still smoke cigarettes as an example.J
Also on the MAX, cough and sneeze without covering it or on hands then touching everything that others will be also touching. Maybe all trains are like this?
Oh that sucks. I'm so sorry to hear that. Every day I drop one of my children off at school and I feel like I'm playing a very macabre form of lottery. But it's illegal here to keep your children out of school and of course there will have to be some disaster first before they will close the schools.
For what it's worth, I was surprised to see not just that there's age skew in mortality (no children have died) but also age skew in diagnosed infection (far fewer children are reporting symptoms than you'd expect).
Of course, we can still worry about children infecting high-risk groups, etc.
but how would you know if you have covid-19 if you have symptoms of a common cold and you haven't been exposed to the reported high risk items.
Although as it gets more widespread it could come from anywhere.
Will we get to a point where if we have cold like symptoms we are expected to consider the virus and act accordingly?
Well, isn't that the case today with the flu? We always think 'it's just a cold, I'll tough it out', but we could be (and often are) fighting the first symptoms of influenza. Shouldn't we treat it as such, to avoid spreading it to the most at-risk? Influenza is basically as deadly as this new virus, and a much more present danger. But we don't treat it with anywhere near the same degree of caution. Why is that?
Around ten times more deadly, not basically as deadly.
Around 2% mortality for COVID-19 vs. 0.2% mortality for influenza, with a chance that the COVID figure is underreported because many of the people who are not counted as having died are currently seriously ill.
To put things in perspective, the annual mortality rate in the US is 1 in 115 people.
2% mortality for COVID-19 would be 1 in 50 people. So if, hypothetically, everyone in the country got infected over the course of one year, and 2% of them died, the deaths from COVID-19 alone would happen more than twice as fast as we're used to seeing people go.
There are some assumptions and simplifications there, but it helps me get a feel for what a "2% mortality rate" might seem like, given everything else being normal.
Thinking about it this way has really made me appreciate life and the people I've been blessed to know during my time here.
> the annual mortality rate in the US is 1 in 115 people.
Kind off topic, but my brain was wandering. If 1 in 115 people die per year, then you have a 1 in 115 chance of dying per year. Which means your average expected lifetime is 115 years... which is a bit high. But I guess that it's because there are more people being born than die per year and being young (and in a rich country in a modern era), their life expectancy is quite long. Still, I would have expected a higher mortality rate off hand.
You're comparing to different measurements. The ~2.0% figure for Covid-19 is the case fatality rate. Case fatality rate is number of deaths over number of people infected. Mortality rate is deaths over people at risk. A case fatality rate will always be higher (or equal, if everyone in an at risk population gets sick) than the mortality rate for same disease, often considerately higher depending on the disease's infection rate.
Sure, fair point. We don't know if this will spread to the entire population, nor do we know much about the rate it would do so, or if people can develop long term immunity, etc.
But my point wasn't to accurately model mortality, it was to get a feel for what it might be like to lose 2% of people over the course of a year. What might it be like socially, psychologically, spiritually? Most people see "2%" and have no inclination to think "1 in 50". I think it's useful to do this.
That's why I set up the simplified scenario of "100% of of the US getting infected over one year".
I live in a country with - so far - only two reported cases. And I consider us to be at that point. So, I take basic precautions and have done so for weeks.
Of course, we need never reach the point if everyone would act with just a basic level of thought and consideration.
Sadly and infuriatingly, hardly anyone does.
They can still get infected and bring it home as well as to the rest of their extended family. And they can still get very ill even if they don't die. I've had pneumonia in the past and I don't wish it on anyone, least of all my kids.
Covid-19 reproduction strategy is to use kids as carriers by making sure that kids (and other people with a strong immune system) are not getting too sick when they are infected.
That suggests that Covid-19 is, actually, not as deadly as initial reports suggest. Most likely the number of infected people is heavily underreported.
If number of infected people is underreported 10x, and number of people who died from Covid-19 is reported accurately, then Covid-19 mortality is overeported by 10x.
It is possible that Covid-19 mortality is comparable with mortality of a regular influenza.
(which of course could kill still many millions of people, assuming you mean that the mortality rate is comparable to flu once you're infected, but that the transmissibility is much higher)
I think pretty much anyone that’s not living in an isolated part of the us should assume that it’s spreading near where you are.
The only reason we haven’t found cases in the us is that we haven’t been testing. There’s probably 100 people for every person that they’ve tested positive at this point, maybe more.
I think this is 100% true for the west coast. We know this virus has been in the wild for at least two weeks, likely more. It's more likely than not that most large cities nationwide have been exposed at this point.
If you make a working-class wage in the USA and you don't have health insurance, it's pretty unlikely you'll check in to a hospital for any reason that doesn't scare the hell out of you.
In addition to being expensive, medical costs in the USA vary wildly between different hospitals, cannot be predicted based on symptoms alone, and are essentially not discoverable during an emergency. Even if you have insurance, some parts of the medical attention you receive will be covered but others may not. For example, you may have a procedure that is covered by your insurance company, but the diagnostics needed to address an urgent complication of that procedure may not be covered.
Given that. I don't understand how the US can fight a viral epidemic.
You have the best medical services in the world; but if a significant part of the population is not going to use that because of the threat of financial ruin, then you are never going to get on top of an epidemic.
We don’t have the best medical in the world. That’s just marketing.
A doctor in the US can prescribe an expensive medication or a generic, but they are completely unable to inform you of the price difference. And their employer is contractually prevented from posting the prices that an insured patient would pay. American patients probably suffer as much from dealing with errors in hospital bills, debt collections, insurance companies denying claims, etc as they do from disease. And our health care system is entirely fee-for-service rather than optimized for outcomes. Doctors may be idealistic, but I don’t see how they can do more good than harm in our current parasitic industry.
Depends on how you grade "best medical in the world." If it's how many people are covered and how easy it is to access healthcare, it's pretty low. If it's access the specialists and quality care, regardless of cost, it's top of the world easily. Problem is that only makes a difference for rich people.
The best medical service is also an affordable one.
That aside, I see a lot of health operation shopping to Leuven ( Belgium), but I have never met someone doing a surgery at the US because "they are the best", so I don't agree with your standpoint.
With a sane government they might agree to pick up the COVID costs as I think is mostly happening in the rest of the world. Though with the current lot I worry it'll be a mess.
With any luck, this pandemic will reveal to US companies, voters, and state+federal legislators how perverted the current incentives are and make some of the incumbents think a little more about their mortality and what health system they leave behind more than who will primary them from the outside next cycle.
I agree that our health care system is a mess in terms of incentives. The most vulnerable group (65+) is covered nearly universally. So the main issue will be to control the spreading and prevent overloading of the medical system. From that perspective while the younger people are not as vulnerable there is no way to stop the spreading unless they seek help at the earliest time. And they will be vastly cheaper to treat than someone on ventilator for weeks. So even from an economic point of view, making all transmissible respiratory diseases free to diagnose and treat has a very high ROI.
With now 3 cases of unknown origin, it's pretty obvious that widespread community transmission is inevitable - because it's already happening.
SXSW is scheduled to start in Austin in 2 weeks. There will be tens of thousands of people flying into Austin, many of whom will be coming from places where coronavirus is circulating in the community. They will hang out with tens of thousands of other people from around the world, often in packed-to-the-gills music venues where they are at various levels of intoxication. They will all fly home to their places of origin a week later.
I haven't been in ages, but the "SXSW Crud" used to be a common concept. Too much booze, lack of sleep, lots of handshaking, + cold and flu. It knocked me out hard 2 years in a row. After that I started getting the flu shot yearly and avoiding physical touching at events. Hosting SXSW during this inevitable pandemic is a terrible terrible idea.
Ballots are sent to registered voters in the mail. They can either be mailed back or dropped off in voting boxes that are scattered around. Compared to other states, it’s relatively uncommon to see large groups congregating on Election Day.
Are you sure about that? The Secretary of State website makes it seem like they need to be requested:
"Any registered voter may vote using a vote-by-mail ballot instead of going to the polls on Election Day. To request a vote-by-mail ballot for a single election or to request a vote-by-mail ballot for all elections (permanent vote-by-mail voting), follow the simple process described below."
I wonder how Oktoberfest will turn out this year. It's like 6 million people coming here each year to share all kinds of things for 16 days. It wouldn't surprise me if the city would at one point decide to cancel it for 2020.
Construction usually starts in the beginning of July. They'll have to get to a conclusion at one point in the near future.
Can‘t imagine that Munich would ever decide to cancel. I would expect that by then, all containment measures have failed and we have widespread infections all over the place and people will let it run.
I really hope they do. In reality they will probably only cancel if they can get insurance to pay out. Does anyone know if event insurance pays out for "not a pandemic but actually it is"?
I mean.. there are tons of conferences happening every weekend. Widespread dispersal is not inevitable, just like everyone doesn't get the flu every year, despite new viruses appearing [1].
Wash your hands often, don't touch your face, and carry alcohol sanitizer.
> A flu vaccine is needed every season for two reasons. First, a person’s immune protection from vaccination declines over time, so an annual vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, flu vaccines may be updated from one season to the next to protect against the viruses that research suggests may be most common during the upcoming flu season. For the best protection, everyone 6 months and older should get vaccinated annually.
Realistically, widespread transmission in the US (and the world over, honestly) _is_ inevitable at this point. Not everyone gets the flu every year because we have natural immunity to it; that's not the case with this virus because it's new.
Your advice is good though - take preventative measures!
That being said, most cases are mild! The logistical concern is to minimize the number of severe cases that require hospitalization at any given time so that the health system isn't overwhelmed. It's important to slow the spread as much as possible so that those with severe symptoms can get the care they need.
Not everybody gets coronavirus either. The Diamond Princess cruise ship is pretty close to a worst case scenario, and even there "only" ~700 of 3700+ (20%) have tested positive.
Note that this number might be kinda deceptive both ways. Because they were forced to stay on the ship abnormally long under quarantine.
There's a paper that estimates that if they were allowed to leave the ship right away (on Feb 3rd) 2% would have been infected, and if they were not taking special measures (isolation, etc) but on the ship for a similar amount of time (until Feb 19) that 80% of the passengers would have been infected:
It's true, you might be exposed and not get infected. But given the relatively high rate of infection coupled with lack of natural immunity, you should probably assume that you will become infected once it becomes widespread in your community.
But seriously, most cases are mild - and that's just the reported ones, which will almost inevitably skew to more serious symptoms.
Technical question: I'm not super familiar with this virus, for how long will you still test positive after you've recovered? And could that be impacting the statistics from the cruise ship?
So why do we cancel so many million-dollars events? It seems we’re voluntarily halting our economies, stopping the production of some goods but also of some code and research, in front of a tide that will come anyway.
Edit: I see the downvotes but that is actually a question, not a suggestion to not shut down them.
It's a reasonable and well phrased question, so it's unfortunate that people are down voting it.
There are a few reasons as far as I understand it. Bear in mind how quickly our understanding of the virus (symptoms, transmission, infection rate & severity, etc) has evolved.
Initially, the only sensible thing to do was to attempt containment if at all possible. In my opinion, the US demonstrated a complete lack of preparedness and coordination here. Remember, we didn't know how bad it might (or might not) be. If it had turned out to be as deadly as SARS (it's not), things would be very bad right now. You have to assume the worst until you know for certain (within reason, of course).
There's also a preparedness aspect to things. Buying only a little more time can sometimes allow you to be much better equipped to handle the situation.
Then there's the logistical aspect. The tide may be inevitable, but how suddenly it arrives will make a huge difference in the quality of care (and thus outcomes) that is available to the few who exhibit severe symptoms. There are only so many hospital beds in the country, and we can only manufacture supplies so quickly. Imagine the difference between everyone in the country coming down with the flu on the same day, versus spread out over the course of a year.
This is analogous to saying “big O notation doesn’t matter because the code is going to get run either way”.
There’s a massive difference between each hospital dealing with 3 dozen severe respiratory cases at a time and 3 thousand. Part of the game is to run out the clock before cold season ends so hopefully the rate of infection drops.
For those (like me) not super familiar with Washington:
The two reported cases are in King County and Snohomish County. King County is where Seattle is. Snohomish is the county bordering it to the north.
So this is basically "in and around the Seattle area."
I'm around two hours or so by car from there. We get a lot of weekend vacationer traffic from that general region. This is not comforting news for me.
Edit: as of about twenty minutes ago, I have an email from Washington Department of Health saying in part:
Two people from Washington state treated for COVID-19 at Providence Sacred Heart Medical Center in Spokane have been discharged and are now resting at home.
Live in the Portland area and am coming down with a bad cold that started this morning and is getting progressively worse. I know I’m in a state of paranoia, from checking the news too often, but I can’t help but to have fears of the worst.
Over here in Norway, people who suspect Covid-19 are urged to call the doctor instead of visiting the emergency room. If there are any local phone numbers for information, I'd call those first. They'll give you a check-list of stuff to verify if you're even a candidate. And if you are, then most likely a health crew will come and visit you with tests. Note: How they go about this may be different depending on your local area's response plan for the disease, though, so listen to local media, or official announcements, or find official information online if you know where. Anyway, if you haven't visited areas known for having outbreaks, then you're most likely just suffering a regular flu. Media coverage of this thing really spreads more anxiety than it's worth. Even in China there's only cases in the tens of thousands, and China has a total population of 1.4 billion people, so the chance of you actually having it is still pretty small. ^^
> most likely a health crew will come and visit you with tests
Pahahahahahahahaha
I'm sorry, but that's not how things work here. A man in Miami had to pay $3000 for being administered a Coronavirus test. At a hospital he'd driven himself to.
Sounds like he is in a communist medical system. Pandemic prevention is something each person should price in, paying to test themselves individually, in a free market. Externalities are really just regulatory capture from being communist in one way or another, and don’t exist once truly free as in Ayn Rand. /s
Dude! I live in Norway! Bernie speaks highly of my country all the time! xD
On the other hand, even in the USA, it is in the interest of the state, and not least your many companies, to defend against this epidemic. Without workers, or much less customers, then I'm afraid a lot of companies are going to go bankrupt. Moreover, supply chains may break down, and you might see shortages. The implications are pretty serious, and so testing shouldn't be a matter of who can afford it. With such a disease, it's everyone's business.
You make the assumption that China's numbers are accurate. Given the obfuscatory nature of mandatory cremations and a ban on funerals, it's hard to imagine that China has been forthright about the statistics on its domestic outbreak.
You're probably right, though even if one million Chinese are infected (the official number is stell less than 100k), this still means that only about 0.7 per mille of the entire Chinese population are infected. The chance of contracting it even if you're in an outbreak area is still pretty small.
Girlfriend is picking one up at the store right now. A little surprised how hard and fast this came on. Was at a launch party (unfortunately) four hours ago and just had the scratchy throat. Thanks for the concern!
Even if you get a fever, still more likely influenza than this coronavirus (though that can still be pretty terrible!). Drink lots of fluids and get plenty of rest. Call your doc tomorrow if you’re getting significantly worse. I hope you feel better.
Well, the reason I say this is I caught seasonal flu in the fall, a few months before the coronavirus was discovered in China. It was one of the worst flus I have faced. It was a very body-achy kind of flu, which afaik is not a covid symptom.
Native Oregonian here. It's probably the flu; read the linked FAQ:
> Right now, influenza is still circulating in Oregon. It is a much more likely cause of cough and fever than coronavirus. The symptoms of novel coronavirus are similar to flu and other respiratory viral illnesses. Symptoms can include fever, cough and shortness of breath. Illness can range from mild to severe. The only way to tell what specific germ is causing illness is through laboratory testing. We recommend people with fever and cough be tested for respiratory germs. If a person meets criteria for novel coronavirus testing, providers should call their local health department.
It's good to pay attention. Be alert, but do not panic.
Don't fall into the trap of thinking "it couldn't happen to me". It can happen to you, so pay attention, and figure out what your best course of action is while you are able.
Pay very close attention if you have it more than a week and your symptoms start taking a turn for the worse. That's one of the hallmarks of a Covid-19 case going bad.
Flu generally should be pretty cleared up by day 10.
if you sneeze and have a running nose, it's likely not the covid-19 virus - those start with high fever and dry coughing, but no runny nose or sneezing
So far it seems to be isolated to the west coast. Unfortunately I don't expect it to stay there. At some point (if not already happened), somebody will get on a plane headed to the midwest, south, or east coast and spread it.
In this case the person was showing symptoms back on the 19th - 9 days ago. They could have been exposed up to 2 weeks before that. No way this is isolated to the West Coast now.
I really don't get why people get so worried about this. Especially on a science oriented forum like HN.
At this moment, even if we assume that there are 100 times more unreported cases than reported cases, the odds are so low that there is simply no reason to be worried, even if attending an international conference. It's true that people do get sick, and die, and it can happen to anyone. But people also get into all types of unlikely accidents, and we don't let this affect our daily life. Besides, symptoms are mild for most people. We're not talking about Ebola here.
I'm blaming the media. They make a "good" job at reporting each new individual case, making you feel that "this could be you" but IMHO this is noise. What I want to know is, how are countries prepared, what steps will be followed if this gets out of control, what is currently the probability of catching the virus, what do we know about the virus, how could the situation evolve in one week, one month and so on....
There are effective ways to mitigate the virus propagation other than canceling all events and stopping our economy, with all the adverse consequences we can imagine. For instance, starting by following the recommendations from health organisations. Such as stay home when showing symptoms, washing hands and so on. This is not followed by most people in Europe (and I suspect the US too). I see people coughing all the time in public transportation (compared with Asia where people wear masks).
EDIT: I'm not saying that we shouldn't be concerned or prepared, but I wouldn't go beyond the recommendations from the CDC, and I think that catching the virus now is extremely unlikely.
Go check out the case fatality rate and estimated r0 for the Spanish Flu of 1918-the deadliest pandemic of the past several centuries. You'll note that its characteristics are fairly similar to what we know of Covid-19. The only break we get is that young adults don't seem nearly as susceptible to Covid-19 as they were to Spanish Flu. But everything else points to the possibility of a pandemic along the lines of Spanish Flu. That's why we are so concerned.
Media aside, the CDC isn't prime to exaggeration, and China isn't prone to completely shutting down the economy of entire provinces of millions of people without dire need.
And there's every reason to believe we will have a similar experience to China's.
Diamond Princess cruise ship shows that it’s not even close to Spanish flu in mortality. Because the symptoms are mild for 80% of people, the reported cases are severely underreported. Only when a whole populace is tested do we
see the true infection rate.
OK, you've mentioned two different measurements: infection rate (I'm guessing you're referring to R0) and mortality (do you mean mortality rate or case fatality rate, because I was referring to the latter one).
The cruise ship had a strict room-based quarantine, so that would not infect the R0 of a general community-based outbreak, unless we institute similar measures (confining people to their houses, which is likely not feasible).
If you're referring to case fatality rate, I'm really interested in that data. Do you have a link? The case fatality rate from the cruise ship is a very small sample, and a very specific population, so it's susceptible to all kinds of bias. It's unlikely to be an accurate reflection of case fatality rate in the general population. Still, I'm interested in those numbers. I've not been able to find them online. Did they test all the people on the cruise ship?
Diamond Princess cruise ship shows nothing yet. Most those who got sick are still sick. You cannot do the mortality math until people are either dead or cured.
>every reason to believe we will have a similar experience to China's.
With a bit of luck you may have an experience more like Singapore, the UK or Vietnam (30 active cases, 72 recovered, 15 active, 8 recovered, and 0 active, 16 recovered respectively)
China got off to a bad start due to the thing starting there and being unexpected.
More people died from the Spanish Flu than from combat in WW1 and WW2 combined. That was the first global pandemic due to soldiers traveling around the world. What's a modern version going to look like in an era of airplane travel?
People died from the Spanish flu because they were malnourished and because the general conditions were bad. The Spanish flu would be nothing like that if it happened today ... In Europe at least.
That article doesn't seem to support "because they were malnourished" at all... it correctly points out that the 1918 pandemic was unique in having high mortality among the young (under 30) due to "Lack of pre-existing virus-specific and/or cross-reactive antibodies and cellular immunity in children and young adults" which doesn't seem to be the case with the current virus which seems to affect mainly the elderly.
Famously, the disease hit soldiers in basic training hard before they were deployed. These were not malnourished people. It's entirely likely that malnourished populations suffered greatly under Spanish Flu, but it's clear that completely healthy young adults were highly vulnerable to dying from the disease.
Even this year… 16,000 people have died from the flu so far, and this is a particularly mild year, save for the high amount of childhood deaths.
COVID-19 seems to be almost completely manufactured hysteria based on fuzzy math which includes using very low estimates of the number of infected to artificially increase the fatality rate.
When all of the top epidemiologists, public health officials, and physicians from around the globe are sounding the alarm to take something seriously - it's probably a good idea to take it seriously. If it turns out that Covid-19 is a dud in terms of impact, it will be because of not in spite of the substantial steps people are taking to be prepared.
All the headlines seem menacing but then I look at the data and stand back and say WTF.
It already is a dud. Relatively speaking, very few people die from this. 80%+ of confirmed cases are so mild you have to wonder why they were even tested. It seems to not spread as fast as the flu. No children have died.
Basically, it’s been three month and 2,000 people over 70 have died globally.
More people died from the flu LAST WEEK IN THE US ALONE.
If I sold you a car for $1.00 the first day, $2.00 the first day, $4.00 the third day, ... It would look like a pretty good bargain the first few days compared to what people typically pay for cars. Eventually, on day 14, you start to reconsider how good the deal is when you make a $16,384 payment and face making a $32,768 one tomorrow.
If COVID-19 spreads exponentially, it will result in basically everyone getting it. Yes, it will take a little while (and maybe spring/summer will do enough to put on the brakes to let us have more treatment options). The fatality percentage, means if everyone gets it, it will be like several years of flu concentrated over a year or two.
Besides that, it's likely to overwhelm public health systems and have societal/economic consequences from the amount of sickness and attempts to contain the virus.
Eh, I've spent like 15 hours fitting various models to the different datasets of case counts and seeing quadratic growth under containment measures some places and what looks like exponential growth others... Maybe that's "parroting media FUD."
Yes more people have died from the flu so far, but Covid-19 was only officially identified last month and is growing exponentially. Based on the studies we have seen so far, it is more contagious than the flu (R0 of 2.2 vs 1.3), and significantly more deadly (fatality rate of 2.3% vs 0.1%). We're still in the early stages of this and it is continuing to spread.
Looking only at the total numbers paints a misleading picture.
It is no longer growing exponentially in China because they have quarantined millions of people. It was growing exponentially prior to the quarantine.
It is growing exponentially in other countries with recent outbreaks. Look at the growth charts for South Korea, Italy, and Iran.
While it is good news that the growth can be contained via quarantine, it is incredibly misleading to claim "this is just like the flu". The flu doesn't require the government to force people to stay locked up in their homes in order to prevent outbreaks.
You seem really hung up on the fact that the flu has killed more people. But based on all the studies we've seen so far, this virus is more contagious than the flu, and more deadly as well. If it infects the same number of people as the flu does every year, a lot more people will die.
Look at the ex-China infected graph here, and click the "logarithmic scale" toggle. Looks pretty close to a straight line to me. https://www.coronaviruschart.com/
China's growth in case count has slowed down. Whether that's because of massive control efforts (literally welding people in homes, etc), or because of inaccurate reporting / missed cases, or both-- is unknown.
If major world governments started saying they were about to nuke one another it would not be valid to say "Why are you so worried about nukes? Car accidents killed a million people last year and nobody died due to nuclear weapons."
A pandemic from a novel virus is a black swan event that is not well represented by looking at recent statistics. The risk is not the recent past, but the possible future where this infects a significant percentage of the world's population, overwhelms our healthcare system, and kills millions if not more.
Everything else doesn’t point to that. Media FUD points to that.
If we have a similar experience to that of China it seems like it won’t be a big deal.
In 2018-2019 80,000 people died from the flu in the United States. 80,000. No one really cared.
The death rate for the current coronavirus seems to be about 2%, but it’s likely even lower than that since so many cases are going unreported since the symptoms are so mild in most people.
I see this whole thing as some kind of bizarre media externality. The disease here is a social one. It’s like the media has evolved in such a way that FUD has manifested into something that is almost tangible.
It’s not the coronavirus you need be worried about, but the meta-coronavirus. It’s making people crazy.
> The death rate for the current coronavirus seems to be about 2%
The United States has about 2.7 hospital beds per thousand people. Hospitalization and attentive care is the biggest contributor to survival rates for COVID-19 patients.
This is why medical professionals are concerned that is spreads effectively without presenting symptoms. One day you are going to wake up and every primary care facility will be overwhelmed.
I’ll start to worry after the first 80,000 people die.
The US has shit medical care for most people. People will get sick and die before thinking about going to the hospital. I wouldn’t worry about them being overwhelmed.
Agree with you 100%. I have a family member that specializes in communicable disease - she's got 25+ years of experience working on the front lines specializing in responding to disease outbreaks like this. She literally writes the policies and training material for professionals in this area. She's absolutely livid at the way the media and politicians are dealing with this. The CDC and WHO are being forced to respond the way they are because of the political and social pressure. They're trying to keep people from panicking but they just get accused of trying to cover up 'the truth' if they try to downplay the media driven frenzy.
I've never really been worried about disease outbreaks in the past but this is different.
> she's got 25+ years of experience working on the front lines specializing in responding to disease outbreaks like this. She literally writes the policies and training material for professionals in this area.
This isn't the right set of qualifications when it comes to understanding the total impact. Aside from the front line staff often not having a high-level understanding of epidemiology, I also don't think she understands the economic costs of containment.
Early on, there was a huge amount of complacency because we've been successful in the past and nothing like this ever came to pass. Expertise in some narrow field can only go so far - unless they are familiar with this particular case, how different it is from other pathogens they have experience and sufficiently mathematically inclined to be able to extrapolate beyond the existing data. We have a once-in-a-life type of pathogen IMO and 25-years of experience may not matter much if they are merely looking back in their experience to find similar situations.
> She's absolutely livid at the way the media and politicians are dealing with this. The CDC and WHO are being forced to respond the way they are because of the political and social pressure. They're trying to keep people from panicking but they just get accused of trying to cover up 'the truth' if they try to downplay the media driven frenzy.
How people tend to respond to events like this is part of the reality of the situation. You can't simply hand-wave away the social, political and economic consequences of the expected responses and how that affects the disease-fighting efforts.
This reminds me of the financial crisis - if you did a top-down analysis, it pointed to an unprecedented situation and it was easy to see how the market actors would response in a way that would compound the crisis but but most experts had never seen something like this, didn't have a comprehensive understanding of how things work, had never seen true panic and had some flawed models telling them that in some perfect world, things are fine and some of the earlier market movements were irrational overreactions.
I have to confess that im not following the entire situation but your statement brings me some hope so I'm asking- can one get affected and still not get sick at all?
I'm also hearing that people can get and ARE getting reinfected.
The majority of cases are mild or don’t have any symptoms. It’s 10 times deadlier than the flu, but that just means 4 out of 1000 40 year olds will die from it compared to 4 out of 10,000 for the flu. 95% of people under 18 have no symptoms. There are no reported deaths of children.
But if you have heart disease or diabetes or other health issues, or are over 70, you’ve got a 1 in ten chance of dying or worse.
I'm extremely skeptical of a 17% case fatality rate (likely not death rate, which is different). That's almost certainly high due to under-reporting of cases. Iran's public health surveillance system is likely not as good as China, and they've not acted with the alacrity that the Chinese have.
But it doesn't have to be a 17% CFR rate to be a disaster. The Spanish Flu of 1918 just had around a 2-3% CFR, but it was easier to transmit than the common flu, so it spread quickly and lots of people died. Covid-19 appears to share the relatively high r0 of Spanish Flu. So there's ample reason to be concerned.
Iran was also at the tail end of 4-year, 3-sided war that killed around 2M people. The very fact that there's 1.5M people (!) leeway in the numbers tells you something about the state the country was in, and how difficult it is to attribute those deaths specifically to one thing like the flu.
There’s no reason to believe the Iranian number is anywhere near accurate. On the contrary, it’s likely that the cases confirmed number is too low everywhere except maybe the diamond princess. Quoting 17% as the possible death rate is just inciting panic. It’s likely much lower. Which is not to say you should not worry; I think it’ll reach most people and end up killing millions.
But what about selection bias? The mortality rate is an upper limit at the moment. Is it just wishful thinking that maybe in reality 100 times more people are infected but show no to very little symptoms? The number of people that can be tested is very limited, so only the cases are tested which are above a certain threshold in severity.
Every person infected on the Diamond Princess was identified (~800 people, older cohort than the general population), and 6 people have died so far, with optimal care. That's a strong indicator that it's much worse than the usual flu, though hardly Captain Trips.
I just finally read the The Stand a couple months ago. Not the best timing in retrospect. Also had just started playing Pandemic Legacy, but I had to stop when the cover image of the game started looking the same as the front page of the newspaper.
Valid point! This is indeed already much higher, and only sets a lower bound. So we should keep an eye on this well controlled sample.
So we have a lower bound of somewhere around 1% and an upper bound of somewhere around 7% ( https://www.worldometers.info/coronavirus/ ) at the moment. Not very reassuring.
This is a very silly post, especially for one claiming to be focused on being "science-oriented." Do you not understand incubation periods and exponents?
> what is currently the probability of catching the virus
Yes, that is the sudden cause for concern: we don't know. The incubation period is as long as 2 weeks before showing any symptoms, and there are now cases that have lost any connection to known vectors. To suggest that there isn't at least cause for worry is a bit ridiculous. We don't know how those people got it, we don't know how many other people got it, and we won't know for some time.
Some spread is thought to be possible before any symptoms manifest, which paired with a long incubation period with no symptoms, and the exponential way in which people interact is potential cause for concern...
From the CDC:
> The virus that causes COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in some affected geographic areas. Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected.
For the sake of example, suppose I live in a country with 100 millions inhabitants, with 100 reported cases. Suppose that there are currently 100 times more cases. What do you think is the probability to get close enough to one of these cases to get infected? how does it compare with something like having a car accident, or getting complications for the common seasonal flu?
This virus is going to be a concern. A rough estimation tells us that number of cases increases tenfold every 10 to 15 days, depending on containment measures. It could peak at 10-20% of the population. We also expect the mortality rate to be something between 0.5% and 1%. So yes, there will be causalities, and we'll need to be especially vigilant in the near future, especially April and May. But right now, the probability to be infected if virtually zero. There is also not much we can do besides following CDC recommendations. The virus is going to spread no matter what.
Car accidents don't increase in incidence exponentially in a matter of weeks.
The chances of being infected right now are kind of irrelevant to this discussion; I don't see very many people panicking that they're necessarily concerned about this very moment, so I think you're arguing against a strawman. People are simply extrapolating a bit, and the trajectory is giving some cause for concern.
The short answer is the combination of a high transmission rate and the ability to transmit the virus while asymptomatic means the number of infected people will grow exponentially. The Spanish flu had a transmission rate lower than Covid-19 and ultimately ended up infecting a third of the world's population, and that was before mass air travel was a thing. If Covid-19 reaches anywhere near that level there will be millions of deaths.
It is true that if you are young and healthy the mortality rate is low, but a 15% mortality rate in 80+ year olds and 8% in 70-80 year olds is pretty serious.
It's extremely unlikely for an individual, perhaps, and I'm honestly not particularly afraid for my life. (If anything, I'm worried about my convenience, whether I get sick or just people in my area.) However in aggregate if we act in a conscientious manner, we can slow or stop the spread in our own areas, and/or head off a run on supplies by doing some shopping early. I agree we need to be measured. I'm not changing my behavior much yet since community spread hasn't hit my area. Once it does I might try to reduce my time in public. Even now I may consider staying away from conferences that bring travelers, etc.
> I really don't get why people get so worried about this.
The virus has overwhelmed the healthcare system in multiple places (Hubei, Iran). Hospitals operate at or near capacity (empty beds don't make money), and do not have the resources to handle a 4-5x uptick in flu patients.
The mortality rate is strikingly different with and without quality medical care. You can see there is a stark difference in the mortality rate within Hubei (previously 4-5%) vs rest of China (0.4%). The mortality rate in Hubei has gone down in recent weeks (to 2.9%) as China has moved thousands of doctors/medical staff to
the area and built tens of thousands of patient beds.
> Besides, symptoms are mild for most people.
This is an extremely deceptive talking point the media has been promoting. The WHO reports 80+% of cases have been mild or asymptomatic, but 14% have been serious and 5% severe [1]. As the virus is projected to infect billions of people this year, that would lead to tens of millions of serious cases, of which many would die due to lack of medical resources.
I would strongly recommend reading this article by an Australian professor explaining why the Australian medical system will be overwhelmed in the coming pandemic. It applies to most other western countries as well.
https://www.theguardian.com/world/2020/feb/28/australian-doc...
Given the long incubation period for this disease, and the fact that it has a—give or take—3 percent lethality (though less for the young, but more for the old), then IMHO people should take it very seriously.
Some people even report a total of 3.4 percent lethality. To put that in perspective; that's one in about thirty people(!).
No, it's not "Ebola," but it's still contageous and deadly. In that regard, the media is actually helping. If it's perhaps making some people more anxious than they really need to be, then it's a price worth paying.
As for how serious people take hygiene, IDK, man. I'm taking it very seriously myself, and so should you. If you see people caughing or sneezing without covering themselves, I'd politely ask them if they can please use the bent elbow in instead.
It depends on the kind of care you can get. With early detection and ample care it is likely 1% or lower. Chance for serious pneumonia (meaning having oxygen issues) is around 14% for the current mix of patients. In an overwhelmed medical system mortality rate will be higher than even what Wuhan experienced.
> I really don't get why people get so worried about this. Especially on a science oriented forum like HN.
That is downright obnoxious. Consider the following facts:
1. As another poster pointed out, millions of people in the US don't have health insurance. If they get a mild flu-like illness there is no chance they are getting tested. They'll pass it on to others in their community.
2. Millions in the US also have no paid sick leave, which is why I just roll my eyes when I hear the "stay at home when showing symptoms" advice you give. It's the ultimate oblivious "just let them eat cake" response to the dishwasher who won't be able to make their rent payment if they don't come in to work.
3. The death rate of those over 70 is in the high single to low double digits range. My parents are in their 70s, and otherwise in great health. I would be devastated if they were killed by coronavirus. Equating the significant possibility of them dying if they contracted the disease, something thousands of times higher than them dying in a random accident, to me shows that your line of thought is "Well, I'm in my 20s, 30s or 40s, so I'll be fine."
People are rightfully concerned because they are able to see the future impact the disease will have on others besides themselves.
I'm not personally worried, but today I cancelled my hotel reservation for RubyKaigi in April. Do I think I am going to get Corona Virus? No. It's very unlikely. Do I think I am going to catch Corona Virus at the conference? No. It's very unlikely. However large numbers means that the chance it happens to someone at some conference is incredibly likely. Indeed, there were just 8 cases in Hokkaido that seems to have originated from a trade conference.
There is no real need for me to go to a conference. I can wait until next year. If we avoid unnecessary interactions in large numbers then it will make a difference. Some people need to meet, but I certainly don't need to get together with a whole bunch of strangers in a remote location to talk about Ruby, so I'm not going to.
So why aren't you worried? My worry is that I'm hearing we're weighing the economic loss versus the health of people. The disease is spreading MAINLY because of air travel, and I don't see countries really doing thorough checks, or at least discouraging air travel for now, or keeping a list of people who returned from those countries.
Spreading fear in the media at least has the cheap virtue of encouraging people to wash their hands, avoid going to those countries, without the government spending money. The drawback is that people view this as fear-mongering.
Wash your hands often, don't touch your face, and carry alcohol sanitizer. Maintain your mental health as well. Remember you have far less chance of catching this than the common flu, and most people will recover from both.
I'm a lot more worried about the economic effects of the pandemic than about the actual disease as I'm young and healthy. But I think now is the time to buy a big sack of rice and beans, just in case.
If your portfolio is diversified, e.g. via an index following the S&P 500, I don't see a reason to worry. Trying to time the whole market with short-term bets is a gamble, not a long-term strategy.
The stock market is not the economy. Many businesses and schools will be closed down. That massively impacts people who often don't even have a few hundred dollars on hand for an emergency.
I live in the Portland area and I’m doing my very best to not panic. My family has stocked up on a couple weeks worth of food and medicine gradually over the last few weeks and we have an “earthquake kit” that we already had in place. I feel like we’re relatively prepared for a quarantine situation if it comes down to it.
The main reason I’m anxious, however, is that I have asthma and one of my biggest fears is suffocating to death. I remember going to the ER as a kid and blacking out because I basically stopped breathing. I still have nightmares about it.
This is not a great time for someone with anxiety. If you’re like me, please remember to take deep breaths, get enough sleep, and remember that in the vast majority of cases things will be okay.
I read that somewhere (couple weeks before the first reports from Wuhan actually, a toilet in our office building in Germany had it on a poster) but I don't know why this works. Why isn't it sufficient to rub over every part (between fingers, back of your hand, etc.)? Soap isn't anti-viral, what does longer exposure do? Am I supposed to just rub over every part of my hand N times until 20-30s have passed or does it just need to sit there for the time?
The soap also takes time to work. Soap binds to or encapsulates nonpolar molecules in a polar envelope, allowing nonpolar things to be washed away by water. That encapsulation takes a little bit of time.
I have a feeling that at this point more people have put more time into planning for zombie virus attacks than real actual virus attacks ... it may be we have to study zombie attack plans to figure out what to do next .....
In related news, apparently I don't have enough shotguns
At this point I wonder why won't the government mail everyone a N95 mask to slow down the spread. I mean IRS knows everyone address with the price of each mask of 65 cents it would be few million buck at the most. But would raise awareness across the US.
Because n95 masks don’t really help unless you use them perfectly and most people wouldn’t even wear it anyway.
What the government should be doing is drastically increase testing. Test anyone whose been to any country with a current case. And anyone they’ve been in contact with. And anyone whose been in an international airport in the last two weeks.
There's already community spread, it's too late to test only people who visited infected countries.
Testing everyone, including asymptomatic people is not feasible, there aren't nearly enough testing supplies (right now, California has 200 test kits for the entire state). And even if they had the supplies, finding the staff to do the tests is nearly impossible.
How can testing help when people don't have symptoms for 5 days during this time they can pass it on to many other
people. Unless you want somehow to test all 300 mil people overnight?
Masks will really help because this virus mostly is spread thru touch of soiled surface. And people tend to touch everything and then touch their face, nose, lips etc. Mask will limit that.
Masks primarily protect others from you, if you are sick. They generally do not protect against others having the disease. If there are aerosols with the virus nearby, a mask won't help you, because your eyes are still exposed.
I agree that testing is the way to go, but there are only so many tests you can do (physically, depending on supplies), so you really have to prioritize those who have actual symptoms.
I've heard this repeated many times over the last few weeks. Never heard the aerosol angle.
On the surface it makes sense that masks wouldn't help. The more I think about it I come to a different conclusion.
Masks do cut down water vapor being absorbed through the nose/mouth. It's not 100% but this isn't anthrax where a tiny droplet could kill everyone. Many people would use it improperly but simple public service announment instruction could solve that issue. Instead they use valuable public serivce announment time to tell everyone not to use a mask. I believe they do this to get people to not buy masks because they are afraid of supply issues. If we had a huge supply of masks people would be encouraged because it would cut down on spreading.
Some countries do have a huge mask supply: in Japan for instance, wearing a mask if you have a cold / in the cold season / in the pollen allergy season / … is very normal, and almost everybody has a box or two of masks laying around the house. If masks are even remotely useful, telling people not to were the masks they already own (because you touch your face or something) is also pretty nasty.
China produces 200,000 N95 respirators per day [1]. So it would take China about 5 years to produce the asked-for 370 million N95 respirators.
I can't find numbers for the US, but most people seem to assume that production is lower than in China. Whether that could be quickly ramped up, I also don't know.
Most suppliers will prioritize government over civilians and I know this because I was purchasing 700 masks for my company. Besides, government can setup its own factory. I know enough how these masks are assembled to tell you its not a rocket science.
Aside from the problems with training 300M people to use a mask (and guaranteed, most people won't wear them properly - a properly fitting mask is uncomfortable), it's not just "1" mask, it's at least one mask a day.
So to cover the USA for 10 days, that's 3 billion masks. There aren't that many masks available.
In shortage situations, one mask reused properly is better than no mask.
I work at a medical center in Korea and we are under the following instructions:
1. Place masks for reuse in a specific place to avoid cross contamination.
2. Treat the outside of the mask as contaminated. Don't touch.
3. Wash hands after wearing a reused mask.
4. Throw out masks if they get wet, damaged, or (N95 only) folded.
I was assuming an N95 respirator and some sources say they can be used for a workday as long as they haven't become contaminated from direct exposure to bodily fluids -- there's no point in equipping the country with surgical masks since they won't offer any significant protection from the virus anyway.
https://www.oregonlive.com/health/2020/02/2-new-coronavirus-...