This is a humanitarian crisis. We may weather the storm at home, but this virus knows no boarders and will decimate populations in the most vulnerable corners of the world until we develop and internationally deploy a cure.
The rhetoric of war time may become a stark reality if this continues unabated on our planet.
Around 15% require hospitalization. What do you think happens if they can't get it? My assumption is they die. Decimation (1/10 die) is accurate, if not an underestimation.
Edit: you also have to take the infection rate into account. Also indirect deaths. My point stands
That would only happen if 100% of the population becomes infected at once. But when 60% has had the virus there will be so much immunity that the virus won't be able to spread anymore. So 10% mortality may happen in countries without healthcare, but not in modern countries.
Like Italy/Spain? When the system is overwhelmed death rates rise.
The reports from wuhan tell a story of difficult recovery. Young people 2 months recovered can't walk up stairs. 30% reduced lung function. If 60% get it that's a huge amount of people..
They may be inferior and insufficient, but poor countries do have hospitals too. Let's not overstate that either. Though yes, ultimately decimation seems likely.
But also poverty provides something of a barrier to travel, slowing coronavirus down. If it takes long enough to hit them, developed countries will be able to assist a lot more.
Inside the Wuhan quarantine zone the mortality was 5.8%. The virus has an R0 of 2.3, so herd immunity will kick in around 60% (2.3 * 0.4 < 1). That would result in an overall population mortality of 3.48%.
The initial Wuhan outbreak is completely inadequate for estimating the mortality of an unchecked wave. It was weathered with massive outside help, being surrounded by the most powerful and agile economy in the world and all that. The rest of the planet is hit concurrently, there are no unaffected regions left who could send help. And that local wave was successfully interrupted long before reaching anything close to herd immunity, so peak medical demand was still far below worst case.
Inside the Wuhan quarantine zone the ability to actually test for the disease was extremely overwhelmed. I know there's a paper somewhere estimating the actual number of cases and actual mortality rate based on the infection rate amongst people repatriated from Wuhan, and it wasn't that far above the ~1% everywhere else has seen.
Everywhere else? Germany is the only country at or below 1% for top countries with the outbreak. China only had 4% Spain has 6% Italy 9% the US climbed to 1.3 this morning and will probably climb.
We can take the age profile of Venezuela[1] and the estimated hospital rates and general virus profile from the Imperial College report[2].
Assume 80% infection, and assuming that 100% of people who would have needed hospitalization die.
This is 720,000 people, or 2.5% of the population. However, if we just take the working-age population (65 and lower), and assume 50% survival rate instead of 0%, the deaths are just 0.79% of the total population.
So decimation is absolutely inaccurate and the higher-up poster is correct. Developing countries like Venezuela cannot afford to and should not shutdown their economies or societies.
A lot more people already fled Venezuela than the virus will ever kill there, that's for sure.
Also, as a correction... Venezuela is not a developing country. It is de-developing.
This creates additional problems you are not seeing.
Anyone still left in Venezuela now has the virus or had the virus. The virus is still going around in 6 months. Everyone outside of Venezuela has gotten rid of it. Wouldn't the country be a isolated because no other country could allow travel to avoid another outbreak.
Years down the road it would be still spreading probably morphing to something even more dangerous.
You would only do this if you were counting on a vaccine.
Check current Italy numbers and projections and then keep telling yourself about overdramatizing. Then add the effects of ongoing lockdowns and travel bans on economy. Them add the effects (short and long term) of redirecting a lot of health care system's resources to deal with the pandemic. We are only at the beginning of pandemic and it already looks like a complete clusterfk.
This is not a static situation - it is very fluid and dynamic.
The 2% rate is only for those with access to sufficient medical attention. People in localities where that is no longer possible are having a much worse outcome.
And keep in mind that death is only one possible negative outcome. This disease attacks the cells in the lungs and can permanently damage them. It also attacks the intestines.
It will be a while before we will know what the damage is.
Thing is we can change 'the economy', as in the way we choose to support or hamper people's living conditions, at will, not without huge efforts, but it is under our control.
We can not change the spread of the virus or how our bodies respond to it at will.
How many people do you think that quarantine and economic trouble will kill? Because if 20% of the population gets Covid19 and 1% dies that's 15 million people. More realistically if we don't quarantine 60% will get it and 4% will die. That's 180 million people. That's more than twice as many people as died in WW2.
We may have a wave of elders die this year if we don’t quarantine them immediately. (And the next year or two we’ll have fewer elders die than ever.) But there is no need to quarantine the whole world. The young and healthy need to start building up antibodies.
Yeah, a prior illnesses like high blood pressure or diabetes with which you can live many more years and which are very prevalent in the 50+ age bracket.
We're still very early in the epidemic. The people dying now are naturally the weakest. Even among young people a percent or two needs hospitalization. If you cumulate up to 50 years, 10% or so need hospitalization and 2% need critical care. Good luck providing for them when millions are infected.
You're also discounting all the additional deaths caused by a healthcare system that runs way over capacity.
But how much earlier are they dying than they otherwise would have? After all, anything that kills you is just killing you before something else would have killed you. It’s not very satisfying to say “they would have died anyway” without giving some time frame on that, since that’s literally always true.
If you don't quarantine everyone, you spread the disease. Hospitals are already crowded, look at Europe. If you, 30's something, have severe a health issue for some reason, you won't be treated properly. You'll die or crowd the hospitals more. As will hundreds of thousands. Your antibodies are useless against an heart disease or an accident. Don't spread the disease, don't be a selfish idiot.
Here in Czech Republic hospitals are not overwhelmed yet and all is done to keep it that way - all elective surgeries have been cancelled, same for regular medical checkups and non critical medical consultations.
Also 3 hospitals have been selected as main treatment centers for coronavirus patiens & capacity in them cleared as much as possible. Also in paralle ventilators have been ordered, about 500 so far with first 50 hopefully ariving early newt week.
BTW, for the current numbers here in Czech Republic: 15584 tested, 1047 infected, 6 recovered and 11 vonnected to ventilators. And so far no one died.
That's inefficient, ineffective and stupid because you're suggesting playing god and Russian roulette with people's lives when you don't know what you're talking about. This disease also causes the young to die, robbing them of life and earning potential, and it leaves survivors with permanently-damaged lungs, possibly to the point of permanent disability or needing lung transplantation. It's thankful you're just some ill-informed keyboard warrior because you would get people killed and disabled out of ignorance.
If you continue to break the site guidelines like this, we will have to ban you. Please review https://news.ycombinator.com/newsguidelines.html and stick to the rules. We've had to ask you about this before.
>> The average age of fatalities in Italy is over the median life expectancy of an Italian man
And that is probably because they give preference to younger people. If they did not, they'd likely have fewer fatalities overall, but slightly more fatalities in the lower age ranges. Someone made the tough call that if you're 80+ you are "already dying".
Not without CT scans of COVID-19 patients and doctors' reports, I couldn't. We do have those, however.
We can't know what percentage end up with lung scarring. With CT scans, we need to wait to see how lungs recover with time. With doctor's reports, it's anecdotal; we have no statistics.
It might be 1%, or it might be 20%. I'm betting on the 5-6% range. That's an educated guess, based on hospitalization and ICU rates and how the disease progresses.
The cases in critical care in Sweden are younger. This indicates spread in Italy has been different due to social differences in contacts between age groups.
You basically present the herd immunity argument with the caveat that it's okay for people older than the median life expectancy to die if they become infected.
I agree this would be a solution, with the huge caveat, that it becomes socially acceptable to euthanize the old instead of dedicating medical resources trying to save them. As others point out, those resources will be needed to maintain normal healthcare operations and treat younger Covid-19 victims who require it.
With the current "save everyone" strategy, I think it should be a fairly easy argument that the older generation, for whom you convincingly argue benefit most from the measures, pays for it. You do this by printing a huge amount of money (diluting those who hold savings) and transferring to the workers whose livelihoods are being destroyed. Increasing public debt should be seen as unacceptable, no bank would ever make a loan for end of life care.
Edit: PS, in Europe printing money will require Germany to allow the ECB to fire up the printing press, which would be fascinating to see.
> If you die of Covid-19 you were already dying. This illness was simply the straw that broke the camel’s back.
People with covid-19 need ventilators and intensive care. This isn't just old people with severe comorbid illness, it's younger relatively healthy people too.
If we ignore for a moment the old people who were going to die this year with or without covid-19 we're still left with huge numbers of younger people needing intensive care and ventilation. This has knock-on effects: many healthcare systems have cancelled almost all elective healthcare. You might say that a cancelling a knee replacement doesn't matter, but these kinds of surgeries transform life and allow people to live independently for longer.
Covid-19 is flooding our hospitals with very ill people, and some of them are going to be pretty poorly when they're ready to be discharged, and some community care or care homes are going to have to deal with a larger number of ill people.
The jargon word for this is "acuity". Increased patient acuity increases costs of healthcare, increases risks of harm, increases rates of HCP burnout, decreases access to health care etc etc.
Covid-19 is going to have long lasting effects on healthcare systems even though it's mostly killing people who would have died anyway.
We could all stop driving tomorrow and save millions of lives over an extended time.
We could ban alcohol and save more.
Banning sex could surely prevent the spread of HIV which has killed tens of millions.
My point is that we are always balancing risk of injury and fatality with costs, and this should be no different.
HN, I suspect, may start to feel differently when they start getting laid off. Google and Facebook ads will decline; Apple stores are closed; venture rounds will dry up. You’re not immune.
I'm not the OP, but the world just lost hundreds of trillions of dollars of wealth over the past month. When people start going hungry because of a lack of income, then we can really start comparing the harm of containment to the harm of the pandemic itself.
I'm not the OP, but the world just lost hundreds of trillions of dollars of wealth over the past month
Folks wealthy enough to own equity lost wealth, that's a pretty small minority though. That it's a eye popping amount of money just goes to show how unequally wealth is distributed.
When people start going hungry because of a lack of income, then we can really start comparing the harm of containment to the harm of the pandemic itself.
Dead people don't eat. People too sick to work in America won't have any income. With enough incapacitated and dead you'll still have your economic harm, only this time with a lot more dead bodies. If your customers are incapacitated / sick, dead, or too destitute (as a result of expensive medical care) they're not going to provide you any income either.
Folks in the UK/EU will have some safety net, what happens if/when this explodes in India? Iran has a rather large middle class (especially considering the region). With the mass graves that they're building, how much economic productivity do you think's been sucked out of Iran? Do you think the CCP quarantined 100 million people on a whim without a care in the world for their economy?
In the immediate term there's also a price war going on between Russia and Saudi Arabia. That is a much bigger deal right now.
Longer term we've already got a number of high profile politicians (and immediate family) with the virus (e.g. wives of the Spanish and Canadian PMs, various American congress critters, UK MPs, etc., etc.). What's a power vacuum going to do to the economy? My guess is: nothing good.
Ask the German and Japanese survivors of WW2. India has gone through its own share of unimaginable trauma such as Partition. Travel around the Balkans today or Russia and talk to people about their memories of War and Collapse.
Its hard to imagine how society recovers from such events, while in the midst of one.
No one knows what's happening right now, so it's natural and inevitable that are different views. As long as people express their views thoughtfully and respectfully, that's within the site guidelines.
I understand it's frustrating to be representing a minority/contrarian view, but please stick to not being inflammatory. That's critical, given the levels of stress, fear, and anger right now. And you've mostly been doing a good job of it.
I'd say that's a bit of a false dilemma. Countries like South Korea and Taiwan have dealt with this problem far better than other countries despite having very few lockdowns [1,2]. Instead they have made use of government funded distribution of free masks and testing and now have a low or declining number of active cases [3,4,5].
Yeah, people in SK and Taiwan seems to be more sensible than the people who are partying like there is no tomorrow.
On the other note I am kind of bit understanding how climate change can be tough sell. Here the effect of COVID is almost visible and people are/were in denial. Think about the effects of climate change which is into future.
South Korea passed new laws after MERS which allowed them to publicize personal health information. People get alerts telling them someone of a certain gender and age was tested positive and gives their prior activities. I suspect a lockdown would be easier to pull off in the US.
Taiwan has been passing new laws since SARS that allowed them to quarantine people. They also track people on quarantine via their phones.
If anything, I'd say the common denominator in handling this outbreak well is having experienced a similar outbreak recently and adapting to it, at least in part by swinging the pendulum further away from civil rights towards protecting the populace. Both SK and Taiwan's govts were also embarrassed and criticized after those respective previous outbreaks, prompting quicker action next time around.
You’ve been downplaying this on HN for weeks now. I find it disgraceful that you’re still at it. You’ve got zero expertise, you disagree with the vast majority of experts, you’ve been wrong about almost everything, and your take on this is dangerous and would cost the world tens of millions of lives and still destroy the economy. Please stop talking.
Venezuela running out of gas would be laughable if it weren't so tragic. They've got the largest proven oil reserves in the world. More than Saudi Arabia.
The comment they responded to was not a serious comment, which is what they were mocking.
That is t to say that relatives of yours went through horrible things, with some American responsibility. As a nation, America has done some awful things, and we don’t do enough to acknowledge our mistakes.
This is yet another instance of misguided incentives causing systemic failure, much like famines that happen alongside modern farming in developed economies. Keep in mind that most people don't pay for gas in Venezuela, they just go to the pumps and fill up. Institutions handle the rest and those institutions never functioned well and have been breaking down for some time.
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[ 3.5 ms ] story [ 120 ms ] threadThe rhetoric of war time may become a stark reality if this continues unabated on our planet.
Edit: you also have to take the infection rate into account. Also indirect deaths. My point stands
The reports from wuhan tell a story of difficult recovery. Young people 2 months recovered can't walk up stairs. 30% reduced lung function. If 60% get it that's a huge amount of people..
But also poverty provides something of a barrier to travel, slowing coronavirus down. If it takes long enough to hit them, developed countries will be able to assist a lot more.
Assume 80% infection, and assuming that 100% of people who would have needed hospitalization die.
This is 720,000 people, or 2.5% of the population. However, if we just take the working-age population (65 and lower), and assume 50% survival rate instead of 0%, the deaths are just 0.79% of the total population.
So decimation is absolutely inaccurate and the higher-up poster is correct. Developing countries like Venezuela cannot afford to and should not shutdown their economies or societies.
[1] https://www.populationpyramid.net/venezuela-bolivarian-repub...
[2] https://www.imperial.ac.uk/media/imperial-college/medicine/s...
Anyone still left in Venezuela now has the virus or had the virus. The virus is still going around in 6 months. Everyone outside of Venezuela has gotten rid of it. Wouldn't the country be a isolated because no other country could allow travel to avoid another outbreak.
Years down the road it would be still spreading probably morphing to something even more dangerous.
You would only do this if you were counting on a vaccine.
The 2% rate is only for those with access to sufficient medical attention. People in localities where that is no longer possible are having a much worse outcome.
And keep in mind that death is only one possible negative outcome. This disease attacks the cells in the lungs and can permanently damage them. It also attacks the intestines.
It will be a while before we will know what the damage is.
We can not change the spread of the virus or how our bodies respond to it at will.
If you die of Covid-19 you were already dying. This illness was simply the straw that broke the camel’s back.
99% of fatalities in Italy are among people with a prior illness. About 50% of the deaths were people suffering from at least three other illnesses.
The average age of fatalities in Italy is over the median life expectancy of an Italian man.
https://www.bloomberg.com/news/articles/2020-03-18/99-of-tho...
We may have a wave of elders die this year if we don’t quarantine them immediately. (And the next year or two we’ll have fewer elders die than ever.) But there is no need to quarantine the whole world. The young and healthy need to start building up antibodies.
We're still very early in the epidemic. The people dying now are naturally the weakest. Even among young people a percent or two needs hospitalization. If you cumulate up to 50 years, 10% or so need hospitalization and 2% need critical care. Good luck providing for them when millions are infected.
You're also discounting all the additional deaths caused by a healthcare system that runs way over capacity.
This hypothetical situation people keep referring to hasn’t happened in Wuhan or Italy.
Young people didn’t die there in large numbers, despite a strained healthcare system.
China built sixteen new hospitals in Wuhan in two weeks.
Italy is overwhelmed. Listen to any Italian doctor. https://www.independent.co.uk/news/world/europe/coronavirus-...
Also 3 hospitals have been selected as main treatment centers for coronavirus patiens & capacity in them cleared as much as possible. Also in paralle ventilators have been ordered, about 500 so far with first 50 hopefully ariving early newt week.
BTW, for the current numbers here in Czech Republic: 15584 tested, 1047 infected, 6 recovered and 11 vonnected to ventilators. And so far no one died.
And that is probably because they give preference to younger people. If they did not, they'd likely have fewer fatalities overall, but slightly more fatalities in the lower age ranges. Someone made the tough call that if you're 80+ you are "already dying".
Also, we don't need to kill our economy:
https://docs.google.com/document/d/1YbtJGn7ida2IYNgwCFk3Sjhs...
We can't know what percentage end up with lung scarring. With CT scans, we need to wait to see how lungs recover with time. With doctor's reports, it's anecdotal; we have no statistics.
It might be 1%, or it might be 20%. I'm betting on the 5-6% range. That's an educated guess, based on hospitalization and ICU rates and how the disease progresses.
No, this is simply untrue. For some patients the comorbities were things like diabetes.
Also, death is only one outcome. We know covid-19 can affect the lungs, fertility, and can cause neurological damage.
I agree this would be a solution, with the huge caveat, that it becomes socially acceptable to euthanize the old instead of dedicating medical resources trying to save them. As others point out, those resources will be needed to maintain normal healthcare operations and treat younger Covid-19 victims who require it.
With the current "save everyone" strategy, I think it should be a fairly easy argument that the older generation, for whom you convincingly argue benefit most from the measures, pays for it. You do this by printing a huge amount of money (diluting those who hold savings) and transferring to the workers whose livelihoods are being destroyed. Increasing public debt should be seen as unacceptable, no bank would ever make a loan for end of life care.
Edit: PS, in Europe printing money will require Germany to allow the ECB to fire up the printing press, which would be fascinating to see.
People with covid-19 need ventilators and intensive care. This isn't just old people with severe comorbid illness, it's younger relatively healthy people too.
If we ignore for a moment the old people who were going to die this year with or without covid-19 we're still left with huge numbers of younger people needing intensive care and ventilation. This has knock-on effects: many healthcare systems have cancelled almost all elective healthcare. You might say that a cancelling a knee replacement doesn't matter, but these kinds of surgeries transform life and allow people to live independently for longer.
Covid-19 is flooding our hospitals with very ill people, and some of them are going to be pretty poorly when they're ready to be discharged, and some community care or care homes are going to have to deal with a larger number of ill people.
The jargon word for this is "acuity". Increased patient acuity increases costs of healthcare, increases risks of harm, increases rates of HCP burnout, decreases access to health care etc etc.
Covid-19 is going to have long lasting effects on healthcare systems even though it's mostly killing people who would have died anyway.
Technically, half the US is already dying from obesity, but I don't think that means they should be all killed off at once.
We could ban alcohol and save more.
Banning sex could surely prevent the spread of HIV which has killed tens of millions.
My point is that we are always balancing risk of injury and fatality with costs, and this should be no different.
HN, I suspect, may start to feel differently when they start getting laid off. Google and Facebook ads will decline; Apple stores are closed; venture rounds will dry up. You’re not immune.
Folks wealthy enough to own equity lost wealth, that's a pretty small minority though. That it's a eye popping amount of money just goes to show how unequally wealth is distributed.
When people start going hungry because of a lack of income, then we can really start comparing the harm of containment to the harm of the pandemic itself.
Dead people don't eat. People too sick to work in America won't have any income. With enough incapacitated and dead you'll still have your economic harm, only this time with a lot more dead bodies. If your customers are incapacitated / sick, dead, or too destitute (as a result of expensive medical care) they're not going to provide you any income either.
Folks in the UK/EU will have some safety net, what happens if/when this explodes in India? Iran has a rather large middle class (especially considering the region). With the mass graves that they're building, how much economic productivity do you think's been sucked out of Iran? Do you think the CCP quarantined 100 million people on a whim without a care in the world for their economy?
In the immediate term there's also a price war going on between Russia and Saudi Arabia. That is a much bigger deal right now.
Longer term we've already got a number of high profile politicians (and immediate family) with the virus (e.g. wives of the Spanish and Canadian PMs, various American congress critters, UK MPs, etc., etc.). What's a power vacuum going to do to the economy? My guess is: nothing good.
Ask the German and Japanese survivors of WW2. India has gone through its own share of unimaginable trauma such as Partition. Travel around the Balkans today or Russia and talk to people about their memories of War and Collapse.
Its hard to imagine how society recovers from such events, while in the midst of one.
But we do.
https://news.ycombinator.com/newsguidelines.html
https://news.ycombinator.com/newsguidelines.html
[1] https://www.scmp.com/week-asia/health-environment/article/30...
[2] https://chinapost.nownews.com/20200317-1094238
[3] https://www.taiwannews.com.tw/en/news/3869320
[4] https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_T...
[5] https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_S...
On the other note I am kind of bit understanding how climate change can be tough sell. Here the effect of COVID is almost visible and people are/were in denial. Think about the effects of climate change which is into future.
Taiwan has been passing new laws since SARS that allowed them to quarantine people. They also track people on quarantine via their phones.
If anything, I'd say the common denominator in handling this outbreak well is having experienced a similar outbreak recently and adapting to it, at least in part by swinging the pendulum further away from civil rights towards protecting the populace. Both SK and Taiwan's govts were also embarrassed and criticized after those respective previous outbreaks, prompting quicker action next time around.
https://www.bbc.com/news/world-asia-51733145
https://news.ycombinator.com/newsguidelines.html
Can you not mock serious things? Please?
That is t to say that relatives of yours went through horrible things, with some American responsibility. As a nation, America has done some awful things, and we don’t do enough to acknowledge our mistakes.