John P.A. Ioannidis is professor of medicine, of epidemiology and population health, of biomedical data science, and of statistics at Stanford University and co-director of Stanford’s Meta-Research Innovation Center. He opines:
The one situation where an entire, closed population was tested was the Diamond Princess cruise ship and its quarantine passengers. The case fatality rate there was 1.0%, but this was a largely elderly population, in which the death rate from Covid-19 is much higher.
Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%. But since this estimate is based on extremely thin data — there were just seven deaths among the 700 infected passengers and crew — the real death rate could stretch from five times lower (0.025%) to five times higher (0.625%). It is also possible that some of the passengers who were infected might die later, and that tourists may have different frequencies of chronic diseases — a risk factor for worse outcomes with SARS-CoV-2 infection — than the general population. Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%.
Could the Covid-19 case fatality rate be that low? No, some say, pointing to the high rate in elderly people. However, even some so-called mild or common-cold-type coronaviruses that have been known for decades can have case fatality rates as high as 8% when they infect elderly people in nursing homes. In fact, such “mild” coronaviruses infect tens of millions of people every year, and account for 3% to 11% of those hospitalized in the U.S. with lower respiratory infections each winter.
These “mild” coronaviruses may be implicated in several thousands of deaths every year worldwide, though the vast majority of them are not documented with precise testing. Instead, they are lost as noise among 60 million deaths from various causes every year.
Some worry that the 68 deaths from Covid-19 in the U.S. as of March 16 will increase exponentially to 680, 6,800, 68,000, 680,000 … along with similar catastrophic patterns around the globe. Is that a realistic scenario, or bad science fiction? How can we tell at what point such a curve might stop?
The most valuable piece of information for answering those questions would be to know the current prevalence of the infection in a random sample of a population and to repeat this exercise at regular time intervals to estimate the incidence of new infections. Sadly, that’s information we don’t have.
In the absence of data, prepare-for-the-worst reasoning leads to extreme measures of social distancing and lockdowns. Unfortunately, we do not know if these measures work. School closures, for example, may reduce transmission rates. But they may also backfire if children socialize anyhow, if school closure leads children to spend more time with susceptible elderly family members, if children at home disrupt their parents ability to work, and more. School closures may also diminish the chances of developing herd immunity in an age group that is spared serious disease.
Flattening the curve to avoid overwhelming the health system is conceptually sound — in theory. A visual that has become viral in media and social media shows how flattening the curve reduces the volume of the epidemic that is above the threshold of what the health system can handle at any moment. Yet if the health system does become overwhelmed, the majority of the extra deaths may not be due to coronavirus but to other common diseases and conditions such as heart attacks, strokes, trauma, bleeding, and the like that are not adequately treated. If the level of the epidemic does overwhelm the health system and extreme measures have only modest effectiveness, then flattening the curve may make things worse: Instead of being overwhelmed during a short, acute phase, the health system will remain overwhelmed for a more protracted period. That’s another reason we need data about the exact level of the epidemic activity.
One of the bottom lines is that we don’t know how long social distancing measures and lockdowns can be maintained without major consequences to the economy, society, and mental health. Unpredictable evolutions may ensue, including financial crisis, unrest, civil strife, war, and a meltdown of the social fabric. At a minimum, we need unbiased prevalence and incidence data for the evolving infectious load to guide decision-making.The vast majority of this hecatomb would be people with limited life expectancies. That’s in contrast to 1918, when many young people died.
One can only hope that, much like in 1918, life will continue. Conversely, with lockdowns of months, if not years, life largely stops, short-term and long-term consequences are entirely unknown, and billions, not just millions, of lives may be eventually at stake.
If we decide to jump off the cliff, we need some data to inform us about the rationale of such an action and the chances of landing somewhere safe.
Leisure travel, vacations, bars, eating out, sports, movies, theme parks, live entertainment.
None of which are close to essential, but our economy will collapse without them.
the night away. Soon to be Piffling us all off with his poppycock and gob.
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mostly from overseas, and entertaining ourselves. The consumer needs to over spend on shit that really isn’t needed to keep the whole thing afloat and humming. If China hadn’t existed, we would have needed to invent it to keep us going.
Pretty sad state of affairs.
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Link: https://en.wikipedia.org/wiki/Mao_suit
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Deserve at least $15/hour as they are the ones propping up society right now.
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Now all the whiny little bitches complain about how their lives have been thrown into such tourmoil.
fully grasp how severe all of these closures are for workers and the overall economy.
For over 20 years, 30+ families have depended on me understanding it.
It doesn’t change the fact that much of our economy revolves around non essential BS, and if that is slowed or stopped, it has major consequences.
I think that's his point. If so, he's right. The economy relies on people trading their earned money for goods and services not shoving it into the bank. People saving their money slows the velocity down and hurts the economy (at least the way we currently measure it).
You can argue the larger point that consumption isn't the greatest thing to rely on to fuel an economy, and you'd be right too.
None of these are essential. Yet our economy is driven by them.
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South Koreans have the capacity to test 15,000 per day, we don't.
If this rate continues when do we relax?
Link: https://www.politico.com/interactives/2020/coronavirus-testing-by-state-chart-of-new-cases/
You should just go out and do your thing. When you get it though just don’t infect anyone else and don’t call for help if you need it.
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Or you can rely on West Coast’s gut feelings.
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provided is such a problem.
The human psyche finds ways to cope with the known, even if bad.
The unknown, not so well.
Goes back to the days when we were still prey for some bigger animals.
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The idol worshippers don't read between the lines, they put stuff between the lines.
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Maybe our press should have been asking these questions of our leaders years ago... when those diseases were most prevalent.
We had time and screwed the pooch on a testing program. Not political. Fact.
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Not just economic - social, political, psychological....Ive heard public health people suggest these lockdowns could continue until June. As if that is a reasonable possibility.
At some point the cure becomes worse than the disease, no?
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At some point, the cure is worse than the disease. We will need to restart soon, contagion be damned.
completely losing it.
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f you're young, be careful, but all restrictions are lifted.
God forbid the millennials can’t get together in bars and restaurants. It’s just so intrusive.
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correct? Can we really “flatten out the curve”?
That’s the problem. The issue is can we afford not to do these things for at least 45 days given the possible risks?