This is bullshit. As but one example of the guy’s cluelessness: the curve of (new) infections over time is not a bell curve. The shape is roughly similar. But it has absolutely nothing to do with the normal distribution.
If that is your only criticism, you may be throwing away a whole article over a typo. The virus caseload in China is looking bell curve-ish.
I am not on board with everything in this article, though. I am unsure about his proposition on reopening schools, for example. But I'm not throwing it all away over that one part.
Maybe you should because the fella has demonstrated sloppiness and ignorance on one issue, and that shakes my faith in the quality of the rest of it. If you are going to attempt to influence life and death policy you better be good. Compare the quality of this article to the Imperial College report last week.
“ In the mid-19th century, Dr. William Farr made the observation that epidemic events rise and fall in a roughly symmetrical pattern that can be approximated by a bell-shaped curve. ”
Yes, he got as Farr as noticing that it’s roughly bell-shaped. But just because it goes up and then down it’s not actually a normal distribution.
At the beginning, when no one is immune, infections obviously grow exponentially. But the bell curve, even though it looks similar (sigmoid) doesn’t rise exponentially.
So it looks similar, but it’s not. If you observe infections and somehow try to fit a normal distribution, you’ll get widely wrong predictions, especially at the beginning.
Farr came up with this in 1840. That’s before Pasteur formulated germ theory as we know it today, so it was probably close enough for its time. Today it’s not.
Half of the article is about making numbers relative (active/total cases, cases/population, etc).
But death toll is counted in absolute numbers. No one will think 1M deaths is victory just because this is 1% of whatever. People are right to be hysterical, we have tough times ahead.
By that logic, with those numbers (and if 1M is the total globally), then we “lose” almost as badly to the seasonal flu, every year.
I’m not saying we shouldn’t care about deadly illnesses. But the world is a dangerous place, and we’ve been pretty bad about changing that, historically.
Also, if we ruin 5 million lives to save (some percent of) 1 million, is that worth it? How about ruining 50 million lives? We can save lives with drastic measures, but drastic measures will have bad consequences too, and it seems like nobody has any perspective on that.
Well, Farr's law is all about the general shape of an epidemic, plotted as number of infected people against time. It does not say anything about the location or height of the peak. The devil is in those details.
Unrelated - is there a term for exhaustion of opinions?
I swear you could go into any HN comment thread related to this outbreak and it breaks down to; Person A saying X is going to happen and then Person B saying Y is going to happen and then Person C saying that No! Z is going to happen!
How did everyone get so opinionated about something so unpredictable and unprecedented? In any case I think we should all calm down regardless of how dangerous this situation is. Stay sane, everyone!
But how can we form an opinion while shouting at each other? We know what the answer is; and it’s called sharing. Unfortunately nobody seems to want to entertain this idea.
There are large number of government organizations, pandemic experts, medical professionals, and research groups communicating in the social media and blogs.
There is no reason to post news articles or blogs from random Joes in HN when you can post directly from experts.
This assumes that you can do that. If you are not an expert you can't possibly have the background to put things in the perspective.
This is not the issue of the ability to read and study, it's about missing variables and weighting evidence. If you don't have the background, you must spend weeks studying to get some hold of issues.
Argument from authority is fallacy of reasoning but it's not fallacy when learning and gathering relevant information. We you can reason only after you have learned the subject.
Social media is full of people who learned basic math behind SIR model and are building layman theories based on them.
I’ve talked to a lot of folks in the past few weeks who aren’t laughing at all over what might be an overreaction. It’s making their lives very hard.
If it turns out this is indeed an overreaction, they’re going to be totally pissed off, and I’m probably going to agree with them. You’re free to laugh all you want, but it’s a privilege that you probably don’t appreciate.
>I’ve talked to a lot of folks in the past few weeks who aren’t laughing at all over what might be an overreaction.
It's a no-win situation for a lot of people with a certain mindset. If we take extreme measures and the infection is worse than predicted, then they'll say that everyone should have done more.
If we take extreme measures and 'flatten the curve' enough so that the hospitals aren't overwhelmed and the number of deaths is lower than expected, then they'll say that all those measures were an overreaction to something that turned out to not be that bad. Even though that was the desired outcome of taking those extreme measures in the first place.
There is also a worryingly-large number of people that will insist that everything is overblown, everything is fine, et cetera, until they (or someone they know personally) is impacted. Until then all these things are happening to 'someone else' and can be ignored.
You’re not even acknowledging the third possibility: if it doesn’t turn out “that bad” and the extreme measures don’t make much of a difference.
This is the possibility I would be super pissed about, not the other two. Unfortunately, in either “not that bad” outcome it’s going to be very hard to prove which one it is, which of course won’t stop a bunch of folks from parading around and bragging about how they saved the world.
I’ve seen this pattern more than once in my short time alive. But assuming what we all hope, that one of the “not that bad” scenarios plays out, the difference this time will be that many millions of lives will have been directly ruined because of those extreme measures.
Yep, this is another huge potential problem. If we just wasted everyone’s tolerance for collective action on a nasty cold, that’s pretty fucking stupid.
When people are losing jobs at a higher rate than the worst recession in the modern era, while kids miss out on critical education time, and everyone is basically self-imprisoned in homes I think it’s fine to constantly question if we are overreacting. Even if that answer is mostly no, we’re not.
Emergency funding will only go so far and once we get past a month of extraordinary measures the serious pain hitting millions of people will be a guarantee. Even in countries with far wider safety nets than the US, none of them are designed to handle this sort of unprecedented event.
Then we see Hong Kong announcing 50 new cases in a single day [1] after getting down to zero for an extended period. The only certainty is that there will be no easy answers. Which I think the OP posts downplays in their ‘data driven’ recommendations.
Great, so we just make sure there’s lots of testing being done so we can focus our efforts, and hugely expand our health care system to take care of that tiny 1% of the population. And we’ve got a whole week or two to do it. So why’s everyone so worked up about it?
This one is really much worse than any other I've seen. He is the 32 yr old CTO of the California Young Republican Federation, without medical background, who is recommending that schools reopen because closing them is counterproductive. I'm not sure how this got upvoted on Hacker News to the extent that it made the front page. Why did he write this? What is his agenda?
"Our focus here isn’t treatments but numbers. You don’t need a special degree to understand what the data says and doesn’t say. Numbers are universal."
That's 180' from what I believe and have experienced repeatedly in industry settings. Transforming the numbers to meaningful data is always fundamental to success. For example here the number of cases confirmed is determined by the testing approach and process - you must know that to be able to make meaningful comparisons (there are many other aspects to epi data but that's just one).
This is an article written by a “growth hacker” who knows literally nothing about public health, claiming to explain public health to all of us.
This crap shouldn’t be on HN. This forum has become next to useless, slowly, then all at once in the last few weeks. I would assert that this community could do better, but at this point maybe it can’t.
> Still, there is a massive blindspot with this type of graph. None of these charts are weighted on a per-capita basis.
Since this is an exponential phenomenon, I don't buy that "per-capita" matters (on top of the fact that he seems to be pulling in numbers as a snapshot in absolute time rather than windowed from initial cases).
If the numbers double every 5 days, the US can have 16 times the population of some other smaller country and be only 3 weeks from the same per capita effects.
The very first chart this guy shows, and then rubbishes, is from the Financial Times. The methodology behind the chart and why they show the data the way they show it is explained pretty clearly on his twitter feed.
Starts well enough, but gets more questionable in the middle and downright risible at the bottom. Claims to be more objective, empirical, etc. than others are unrelated to actually being more objective, empirical, etc.
> driven by data from medical professionals and academic articles
...as filtered through one person's understanding and biases. Often this results in a very different picture than perusal of the original source material would.
> I’m most known for popularizing the “growth hacking movement” in Silicon Valley
That's an anti-qualification.
> Rank ordering based on the total number of cases shows that the US on a per-capita basis is significantly lower than the top six nations
This is right after he got done explaining why total number of cases of useless. So why is it here? Because it suits the overall theme of minimizing the threat.
> Daily growth rates declined over time across all countries regardless of particular policy solutions
Sounds compelling, but is it true? Note that the first chart is from SoberLook, which is definitely not one of the top-tier sources cited at the beginning of the article and not even one of those supposedly cited at the bottom (Bloomberg, Johns Hopkins). Bit deceptive, that. I'll leave it to you to figure out what kind of source SoberLook is. Oh, and we're using the "losing metric" of total reported cases again. Doesn't everyone know by now how fraught that is? The author certainly does.
The second chart already shows a very different story. There's no legend (which is suspicious) but it's clear that many of the lines do not flatten out as would be necessary to support the author's claim.
> Both the CDC and WHO are optimizing virality and healthcare utilization, while ignoring the economic shock to our system.
We're starting to see a hint of where the author wanted to go with this, probably before one word was written.
> According to WHO’s COVID-19 lead Maria Van Kerkhove, true community based spreading is very rare.
Hm. Where did van Kerkhove say this? Why is there no specific citation, as for more convenient factoids?
> The data from China shows that community-based spread was only a very small handful of cases.
Same as above. No citation. And does the data actually show that?
Don't let the digression about aerosols (which nobody has claimed to be a primary mechanism for spread of COVID-19) fool you; the experts, including those included in the author's appeal to authority at the beginning, seem to have very different beliefs than those he presents.
> Released on March 10th, one study mapped COVID-19 virality capability by high temperature and high humidity.
One study. Minimizing again. It's a very pretty temperature graph, which doesn't actually prove anything. If you follow the link, you'll see that it was actually limited to China, which might not tell us much about anywhere else. What we actually know about the temperature sensitivity of coronaviruses is that they're remarkably stable up to about 37°C, and infectivity only starts to decline above that.
"Transmission in China happened among family members and close contacts. True “community spread” was less common.
“This virus is not circulating in the community, even in the highest incidence areas across China,” Van Kerkhove insisted.
What’s the difference between spread among close contacts and community spread, you might wonder? Van Kerkhove said the data the mission saw in China pointed to the virus finding its way into households and transmitting there. One family member gets infected and infects others. The “secondary attack rate” — the percentage of people in a household who got infected after someone brought the virus into the home — was between 3% and 10%.
Van Kerkhove said true community spread involves transmission where people get infected in a movie theater, on the subway, or walking down the street. There’s no way to trace back the source of infection because there’s no connection between the infected person and the person he or she infects. That’s not what the Chinese data show, she said.
Marc Lipsitch, an infectious diseases epidemiologist at the Harvard School of Public Health, found this claim puzzling. “I have reached out to the World Health Organization to understand the basis of some of those statements. My perception is that there is significant community transmission, especially when you aren’t aware that someone is sick, because there’s not enough testing,” he said.
The trouble with an article like this is that it mixes well reasoned arguments with nonsense. The economic cost of closing schools and shutting borders is real, especially as the epidemic continues for months. The trouble is that the article downplays the seriousness of covid-19. A mortality rate of 0.6% means nearly one million deaths if covid-19 spreads to half all Americans.
The article points to South Korea as an example of a success story in the fight against covid-19. South Korea immediately began widespread testing for covid-19 as soon as infections were detected. They trace cases and isolate people suspected of having become infected. South Korea has universal healthcare, ranking first among OECD countries for access. All of this is pretty much the opposite of we've been doing in the US, which is why a lot of people here are worried about what's going to happen in the next few months.
It's reasonable to ask whether school closings or shutting borders are the right policies. But we should be discussing alternative means of containing the virus and we need to be clear what we're up against.
On the other hand, the problem with your argument is that there is absolutely no way to be sure, today, that the mortality rate is even within an order of magnitude of 0.6%. And as more evidence comes out that this thing is spreading faster and more stealthily than expected, one consequence is that the true mortality rate may be much lower than those estimates.
Have previous estimates for other diseases been off by that much? A whole order of magnitude, at this level of study? Citations please. Yes, the number is probably not perfectly accurate, but it's also converging toward what is very likely to be a correct figure. Also, how much does it have to change to affect the broader point? A hundred thousand deaths (i.e. one order of magnitude) is still nothing to take lightly. Such aggressive minimization of danger is still a worse problem than the "hysteria" the OP is supposedly trying to address.
In most parts of the world, we have absolutely no idea how far the infection spread from about the end of October to at least February, so we can’t conclusively rule out that kind of error until we can test lots of people for antibodies (this is the only way to confirm a case in a person who has already recovered).
It would require the infection to be very contagious, and it probably would require us to have been pretty unlucky with the timing, but as far as I know none of that is contradicted by the available evidence.
As of right now, Italy’s fatality rate is almost 9% [0], so saying “it might not be within an order of magnitude of 0.6%!” is optimistic to the point of delusional.
Italy is looking like a “perfect storm” tragedy no matter what. The older population, combined with rapid, widespread transmission, to the point where critical cases completely overwhelm the health infrastructure, is absolutely a recipe for horrible CFR numbers like that. The fear that healthcare infrastructure elsewhere could be overwhelmed by another sudden outbreak is really the only reason experts are freaking out, as far as I know.
Also just reported today, apparently over 99% of fatalities in Italy were folks who had existing medical conditions, but I have no idea what that really tells us.
Anyway, you could be right too, maybe it’s unreasonable to guess that true IFR is an order of magnitude lower.
The fatality rate and the total number of cases reported by Italy don't really mean much if anything at this point. Because their health system is overwhelmed they are mainly only testing people who already have severe symptoms which inflates the fatality rate as most mild cases are never identified. While it's reasonable to assume that's it's higher there than in places like South Korea or Germany it's very likely that it's still considerable less than anything close to 9%.
> Also just reported today, apparently over 99% of fatalities in Italy were folks who had existing medical conditions, but I have no idea what that really tells us.
Not a lot, without knowing the number with existing medical conditions among the infected population. How many over-70s don't have any existing medeical condition?
The South Korean testing has been quite extensive, and not just limited to the people with the most obvious symptoms unlike in the west. Given they appears to have contained the virus without resorting to a full lockdown, it seems unlikely they would have missed a large number of cases. If they had, those asymptomatic or mild cases should be constantly restarting the chain of transmission.
1.1% of their cases have died, and an additional 0.8% are in serious or critical condition. And they're a best case scenario: the health care system was not overloaded, and their diagnosed cases are skewing disproportionately young.
The Diamond Princess also has had a fatality rate so far of 1.1%. In that case we know with absolute certainty that there is no massive hidden iceberg of infected but undiagnosed people. There might be a hidden iceberg of unreported fatalities though, since once they were off the ship, the cases stopped being tracked as Diamond Princess cases. On the plus side, the demographics obviously skewed very old.
Anyway, there's very good reason to believe that the IFR is at least 0.6%. Suggesting that it's actually <0.06% seems just ludicrous. Is there any evidence at all supporting that, or are you just arbitrarily demanding "absolute certainty" in a time-critical situation?
> If [South Korea] had [missed a large number of cases], those asymptomatic or mild cases should be constantly restarting the chain of transmission.
If enough people have already recovered from mild or asymptomatic cases (it would have to be a pretty hefty percentage, granted) then that, combined with not-total-lockdown conditions, could bring down the R0 value enough to cause the same result. Do you think it’s much more likely that the virus has been totally contained?
> The Diamond Princess also has had a fatality rate so far of 1.1%. In that case we know with absolute certainty that there is no massive hidden iceberg of infected but undiagnosed people.
This might be the strongest evidence against the “mild and everywhere” theory. However, there are still something like five out of six passengers who tested negative but could have recovered before they were tested. Even if they’re not a great representative sample, testing them all for antibodies might be a good move.
> If enough people have already recovered from mild or asymptomatic cases (it would have to be a pretty hefty percentage, granted) then that, combined with not-total-lockdown conditions, could bring down the R0 value enough to cause the same result.
They're reporting basically no new cases at this point. For that to happen naturally, they'd need to have gotten like 2/3rds of the population infected. And it's quite hard to see how that could be true.
Korea had the most comprehensive testing (320k tests, available to basically anyone with even mild symptoms). They have so far confirmed infections in 0.02% of the population, and only got positive results in less than 3% of the tests. It's hard to believe that 60-70% of the population got infected, but even in the skewed sample of people who got tested only 3% being positive.
Compare that with something like Switzerland where the number of confirmed cases is at 0.08% of the population despite worse test coverage (basically only get tested if your symptoms warrant hospitalization), and there's no sign of it slowing down yet.
Or Spain which has 3x the cases of Korea on a similar population, has a health care system that's melting down, and where more than 55% of the tests are positive.
If herd immunity provided by all the undetected cases protected Korea, why is it not kicking in anywhere else even once their infection rates are obviously higher?
> Do you think it’s much more likely that the virus has been totally contained?
"Totally contained" is an exaggeration, since they are still finding new cases. But given how long the infection rate has been stable, it does look like they've managed to reach a R0 of almost exactly 1 with the aggressive testing + tracing strategy.
The only alternative that's at all plausible is that the Korean numbers are being fudged somehow, and they actually have a lot more cases than are being reported. But then why aren't the hospitals in a crisis unlike in other affected regions?
> They're reporting basically no new cases at this point.
It’s like 50-100 new cases every day, looks like. I’m getting out of my depth with what exactly that allows us to rule out, but it sounds like “constantly restarting the chain of transmission” might be the actual reality?
If that drops further, then maybe these new cases are just the ones that incubated longer instead?
> it sounds like “constantly restarting the chain of transmission” might be the actual reality?
Yes, but it's a tiny number of undetected cases restarting the chain, and those chains being detected and lopped off before they have time to go exponential. But it's just not possible that they have tens of thousands of undetected cases that are spreading the virus further. That'd spin out of control quickly.
This article has been censored by Medium. Can't say I'm surprised as it goes against the official hysteria promoting big pharma narrative. This is what I now get:
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This post is under investigation or was found in violation of the Medium Rules.
Funny How many caught the flu? and is testing positive for Corona the same as having Ebola or Leprosy ? or will you be sick for a week and recover like we normally do from the flu>? Keep in mind more people have died in the U.S. from seasonal, common flu than has died World Wide from this 'epidemic'. (Which started in the most populous country so listening to the pundits it should have had 100s' of millions deaths!) How is that possible?
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[ 0.74 ms ] story [ 111 ms ] threadI am not on board with everything in this article, though. I am unsure about his proposition on reopening schools, for example. But I'm not throwing it all away over that one part.
Yes, he got as Farr as noticing that it’s roughly bell-shaped. But just because it goes up and then down it’s not actually a normal distribution.
At the beginning, when no one is immune, infections obviously grow exponentially. But the bell curve, even though it looks similar (sigmoid) doesn’t rise exponentially.
So it looks similar, but it’s not. If you observe infections and somehow try to fit a normal distribution, you’ll get widely wrong predictions, especially at the beginning.
Farr came up with this in 1840. That’s before Pasteur formulated germ theory as we know it today, so it was probably close enough for its time. Today it’s not.
But death toll is counted in absolute numbers. No one will think 1M deaths is victory just because this is 1% of whatever. People are right to be hysterical, we have tough times ahead.
I’m not saying we shouldn’t care about deadly illnesses. But the world is a dangerous place, and we’ve been pretty bad about changing that, historically.
Also, if we ruin 5 million lives to save (some percent of) 1 million, is that worth it? How about ruining 50 million lives? We can save lives with drastic measures, but drastic measures will have bad consequences too, and it seems like nobody has any perspective on that.
1. "New thing X puts us at risk of losing Y lives every day."
2. "We lose Y lives to car accidents every day".
3. "Ergo, X is harmless!"
You now have 2Y lives lost every day.
I swear you could go into any HN comment thread related to this outbreak and it breaks down to; Person A saying X is going to happen and then Person B saying Y is going to happen and then Person C saying that No! Z is going to happen!
How did everyone get so opinionated about something so unpredictable and unprecedented? In any case I think we should all calm down regardless of how dangerous this situation is. Stay sane, everyone!
There is no reason to post news articles or blogs from random Joes in HN when you can post directly from experts.
I’d rather judge them on the merits of their contribution than some meta signals.
This assumes that you can do that. If you are not an expert you can't possibly have the background to put things in the perspective.
This is not the issue of the ability to read and study, it's about missing variables and weighting evidence. If you don't have the background, you must spend weeks studying to get some hold of issues.
Argument from authority is fallacy of reasoning but it's not fallacy when learning and gathering relevant information. We you can reason only after you have learned the subject.
Social media is full of people who learned basic math behind SIR model and are building layman theories based on them.
If it turns out this is indeed an overreaction, they’re going to be totally pissed off, and I’m probably going to agree with them. You’re free to laugh all you want, but it’s a privilege that you probably don’t appreciate.
It's a no-win situation for a lot of people with a certain mindset. If we take extreme measures and the infection is worse than predicted, then they'll say that everyone should have done more.
If we take extreme measures and 'flatten the curve' enough so that the hospitals aren't overwhelmed and the number of deaths is lower than expected, then they'll say that all those measures were an overreaction to something that turned out to not be that bad. Even though that was the desired outcome of taking those extreme measures in the first place.
There is also a worryingly-large number of people that will insist that everything is overblown, everything is fine, et cetera, until they (or someone they know personally) is impacted. Until then all these things are happening to 'someone else' and can be ignored.
This is the possibility I would be super pissed about, not the other two. Unfortunately, in either “not that bad” outcome it’s going to be very hard to prove which one it is, which of course won’t stop a bunch of folks from parading around and bragging about how they saved the world.
I’ve seen this pattern more than once in my short time alive. But assuming what we all hope, that one of the “not that bad” scenarios plays out, the difference this time will be that many millions of lives will have been directly ruined because of those extreme measures.
Emergency funding will only go so far and once we get past a month of extraordinary measures the serious pain hitting millions of people will be a guarantee. Even in countries with far wider safety nets than the US, none of them are designed to handle this sort of unprecedented event.
Then we see Hong Kong announcing 50 new cases in a single day [1] after getting down to zero for an extended period. The only certainty is that there will be no easy answers. Which I think the OP posts downplays in their ‘data driven’ recommendations.
[1] https://www.scmp.com/news/hong-kong/health-environment/artic...
That's 180' from what I believe and have experienced repeatedly in industry settings. Transforming the numbers to meaningful data is always fundamental to success. For example here the number of cases confirmed is determined by the testing approach and process - you must know that to be able to make meaningful comparisons (there are many other aspects to epi data but that's just one).
This crap shouldn’t be on HN. This forum has become next to useless, slowly, then all at once in the last few weeks. I would assert that this community could do better, but at this point maybe it can’t.
Since this is an exponential phenomenon, I don't buy that "per-capita" matters (on top of the fact that he seems to be pulling in numbers as a snapshot in absolute time rather than windowed from initial cases).
If the numbers double every 5 days, the US can have 16 times the population of some other smaller country and be only 3 weeks from the same per capita effects.
https://twitter.com/jburnmurdoch/status/1241092187577819137?...
I'll probably do myself a favour and stop clicking on coronavirus medium links
> driven by data from medical professionals and academic articles
...as filtered through one person's understanding and biases. Often this results in a very different picture than perusal of the original source material would.
> I’m most known for popularizing the “growth hacking movement” in Silicon Valley
That's an anti-qualification.
> Rank ordering based on the total number of cases shows that the US on a per-capita basis is significantly lower than the top six nations
This is right after he got done explaining why total number of cases of useless. So why is it here? Because it suits the overall theme of minimizing the threat.
> Daily growth rates declined over time across all countries regardless of particular policy solutions
Sounds compelling, but is it true? Note that the first chart is from SoberLook, which is definitely not one of the top-tier sources cited at the beginning of the article and not even one of those supposedly cited at the bottom (Bloomberg, Johns Hopkins). Bit deceptive, that. I'll leave it to you to figure out what kind of source SoberLook is. Oh, and we're using the "losing metric" of total reported cases again. Doesn't everyone know by now how fraught that is? The author certainly does.
The second chart already shows a very different story. There's no legend (which is suspicious) but it's clear that many of the lines do not flatten out as would be necessary to support the author's claim.
> Both the CDC and WHO are optimizing virality and healthcare utilization, while ignoring the economic shock to our system.
We're starting to see a hint of where the author wanted to go with this, probably before one word was written.
> According to WHO’s COVID-19 lead Maria Van Kerkhove, true community based spreading is very rare.
Hm. Where did van Kerkhove say this? Why is there no specific citation, as for more convenient factoids?
> The data from China shows that community-based spread was only a very small handful of cases.
Same as above. No citation. And does the data actually show that?
https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmissi... "The virus that causes COVID-19 seems to be spreading easily and sustainably in the community"
https://www.who.int/docs/default-source/coronaviruse/situati... "Community transmissionis evidenced by the inability to relate confirmed cases through chains of transmission for a large number of cases,"
Don't let the digression about aerosols (which nobody has claimed to be a primary mechanism for spread of COVID-19) fool you; the experts, including those included in the author's appeal to authority at the beginning, seem to have very different beliefs than those he presents.
> Released on March 10th, one study mapped COVID-19 virality capability by high temperature and high humidity.
One study. Minimizing again. It's a very pretty temperature graph, which doesn't actually prove anything. If you follow the link, you'll see that it was actually limited to China, which might not tell us much about anywhere else. What we actually know about the temperature sensitivity of coronaviruses is that they're remarkably stable up to about 37°C, and infectivity only starts to decline above that.
“This virus is not circulating in the community, even in the highest incidence areas across China,” Van Kerkhove insisted.
What’s the difference between spread among close contacts and community spread, you might wonder? Van Kerkhove said the data the mission saw in China pointed to the virus finding its way into households and transmitting there. One family member gets infected and infects others. The “secondary attack rate” — the percentage of people in a household who got infected after someone brought the virus into the home — was between 3% and 10%.
Van Kerkhove said true community spread involves transmission where people get infected in a movie theater, on the subway, or walking down the street. There’s no way to trace back the source of infection because there’s no connection between the infected person and the person he or she infects. That’s not what the Chinese data show, she said.
Marc Lipsitch, an infectious diseases epidemiologist at the Harvard School of Public Health, found this claim puzzling. “I have reached out to the World Health Organization to understand the basis of some of those statements. My perception is that there is significant community transmission, especially when you aren’t aware that someone is sick, because there’s not enough testing,” he said.
https://www.statnews.com/2020/03/06/were-learning-a-lot-abou...
The article points to South Korea as an example of a success story in the fight against covid-19. South Korea immediately began widespread testing for covid-19 as soon as infections were detected. They trace cases and isolate people suspected of having become infected. South Korea has universal healthcare, ranking first among OECD countries for access. All of this is pretty much the opposite of we've been doing in the US, which is why a lot of people here are worried about what's going to happen in the next few months.
It's reasonable to ask whether school closings or shutting borders are the right policies. But we should be discussing alternative means of containing the virus and we need to be clear what we're up against.
Have previous estimates for other diseases been off by that much? A whole order of magnitude, at this level of study? Citations please. Yes, the number is probably not perfectly accurate, but it's also converging toward what is very likely to be a correct figure. Also, how much does it have to change to affect the broader point? A hundred thousand deaths (i.e. one order of magnitude) is still nothing to take lightly. Such aggressive minimization of danger is still a worse problem than the "hysteria" the OP is supposedly trying to address.
It would require the infection to be very contagious, and it probably would require us to have been pretty unlucky with the timing, but as far as I know none of that is contradicted by the available evidence.
[0]: https://mobile.twitter.com/ARanganathan72/status/12414116867...
Also just reported today, apparently over 99% of fatalities in Italy were folks who had existing medical conditions, but I have no idea what that really tells us.
Anyway, you could be right too, maybe it’s unreasonable to guess that true IFR is an order of magnitude lower.
Not a lot, without knowing the number with existing medical conditions among the infected population. How many over-70s don't have any existing medeical condition?
1.1% of their cases have died, and an additional 0.8% are in serious or critical condition. And they're a best case scenario: the health care system was not overloaded, and their diagnosed cases are skewing disproportionately young.
The Diamond Princess also has had a fatality rate so far of 1.1%. In that case we know with absolute certainty that there is no massive hidden iceberg of infected but undiagnosed people. There might be a hidden iceberg of unreported fatalities though, since once they were off the ship, the cases stopped being tracked as Diamond Princess cases. On the plus side, the demographics obviously skewed very old.
Anyway, there's very good reason to believe that the IFR is at least 0.6%. Suggesting that it's actually <0.06% seems just ludicrous. Is there any evidence at all supporting that, or are you just arbitrarily demanding "absolute certainty" in a time-critical situation?
If enough people have already recovered from mild or asymptomatic cases (it would have to be a pretty hefty percentage, granted) then that, combined with not-total-lockdown conditions, could bring down the R0 value enough to cause the same result. Do you think it’s much more likely that the virus has been totally contained?
> The Diamond Princess also has had a fatality rate so far of 1.1%. In that case we know with absolute certainty that there is no massive hidden iceberg of infected but undiagnosed people.
This might be the strongest evidence against the “mild and everywhere” theory. However, there are still something like five out of six passengers who tested negative but could have recovered before they were tested. Even if they’re not a great representative sample, testing them all for antibodies might be a good move.
They're reporting basically no new cases at this point. For that to happen naturally, they'd need to have gotten like 2/3rds of the population infected. And it's quite hard to see how that could be true.
Korea had the most comprehensive testing (320k tests, available to basically anyone with even mild symptoms). They have so far confirmed infections in 0.02% of the population, and only got positive results in less than 3% of the tests. It's hard to believe that 60-70% of the population got infected, but even in the skewed sample of people who got tested only 3% being positive.
Compare that with something like Switzerland where the number of confirmed cases is at 0.08% of the population despite worse test coverage (basically only get tested if your symptoms warrant hospitalization), and there's no sign of it slowing down yet.
Or Spain which has 3x the cases of Korea on a similar population, has a health care system that's melting down, and where more than 55% of the tests are positive.
If herd immunity provided by all the undetected cases protected Korea, why is it not kicking in anywhere else even once their infection rates are obviously higher?
> Do you think it’s much more likely that the virus has been totally contained?
"Totally contained" is an exaggeration, since they are still finding new cases. But given how long the infection rate has been stable, it does look like they've managed to reach a R0 of almost exactly 1 with the aggressive testing + tracing strategy.
The only alternative that's at all plausible is that the Korean numbers are being fudged somehow, and they actually have a lot more cases than are being reported. But then why aren't the hospitals in a crisis unlike in other affected regions?
It’s like 50-100 new cases every day, looks like. I’m getting out of my depth with what exactly that allows us to rule out, but it sounds like “constantly restarting the chain of transmission” might be the actual reality?
If that drops further, then maybe these new cases are just the ones that incubated longer instead?
Yes, but it's a tiny number of undetected cases restarting the chain, and those chains being detected and lopped off before they have time to go exponential. But it's just not possible that they have tens of thousands of undetected cases that are spreading the virus further. That'd spin out of control quickly.
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Well yes, it fell afoul of the conspiracy. :eyeroll: Also it's crap.