I also think that a lot of people who feel a bit ill will now stay at home, rather than call the local number (111 in the UK) causing a team to come round and drag them out to a hospital. Only those quite ill will ask for assistance.
“Flu” mortality is way more than 0.01-0.02%. This new virus is probably 10x worse than normal flu, and importantly it is a lot more contageous.
I have never actually heard of anybody dying from flu 
The mortality rate has to be really really small is my estimation
Peter wrote:
I also think that a lot of people who feel a bit ill will now stay at home, rather than call the local number (111 in the UK) causing a team to come round and drag them out to a hospital
That’s true. There are talks hear to use bomb shelters to isolate persons. I mean, you have to be pretty crazy to test yourself if you risk being locked up in a bomb shelter for a couple of weeks or more.
172driver wrote:
the big problem with estimating the fatality rate is that many people who carry the virus either don’t develop symptoms at all or symptoms that are so mild that they don’t see a doctor or get tested
That effect will apply same way to normal flu as corona, so it just vanishes when comparing the two, differences in incubation period may impact transmission scale and the base of infected people but less the fatality rates
Quoting myself with some real life flu data I posted some time ago…
Based on the CDC data for the 2017/18 US influenza season, and rounded a bit
- an unknown number was infected with influenza
- approximately 15 percent of the population developed symptoms (45 of 330m)
- around half of these sought medical help (21 of 45m)
- 2 percent of those were hospitalised (810k of 21m)
- 8 percent of those then died (61k of 810k)
overall, it killed 0.02 percent of the population. That was a bad year, about twice the average.
Death rates – 0.15, percent of infected (61k of 45m), 0.3 percent of those who were ill enough to seek help.
So how does Covid-19 compare?
- it appears to be quite infectious – probably the same magnitude as influenza, or worse (given that we have influenza vaccines)
- death rates appear to be an order of magnitude higher (single digit percent of those who develop symptoms, not 0.x percent)
So at this point, if it becomes pandemic, we can expect around 10 times as many dead than in a bad flu year as the BEST case. And if it becomes endemic after that, every year (unless we develop immunity / an effective vaccine / the strain dies out between seasons)
The latest published case fatality rate of around 5% is in line with the above.
Because of an unclear definition of what constitutes a “case”, we are at least one order of magnitude above a bad influenza year, and maybe two.
LeSving wrote:
I have never actually heard of anybody dying from flu
Sure you have only you never knew… death announcements usually do not have a pathological report attached. But it is well known that the common flu kills lots of senior citizens every year. But nothing in the dimension that this thing does, where up to 20%, that is two out of 10 die. With the flu, it is much less, but still significant numbers.
The problem is, only countries which are totalitarian enough and people have enough fear from retribution can install the drakonian measures needed to really contain this thing. What would have done the trick at the stage where the thing got known would have been to totally isolate China and to close borders indefinitly for any country where the thing rages. North Korea managed, the South is going down the drain fast, most of asia too. And if they are willing to send people home to work if they’ve been to some places, then they should not have been allowed back in or if so quarantained at the airport. Right now it is too late, even tough those countries still clean should finally act and close their borders and disalow any flight from/to any infected area. Those who have the virus should impose a strict curfew and close down TOTALLY until this is under control.
As that is not going to happen, we will have to live with this new virus and more to come for the forseeable future. Maybe in 10 years we have a vaccine or people grow resistent. But up to then, who will take responsibility for the millions which will die in the next years because nation states do not have the balls to impose unpopular measures…
A bit of sad perspective, and leaving absolute numbers out for the moment.
- in a steady state population with 80 years life expectancy, 1.25% of the population die every year. - globally, around 0.8% of the population die every year, with an increasing trend as growth is slowingUsing the 0.02% of the population in the US season 17/18, influenza accounts for around 1.5% of all deaths.
If this is 10x as bad, 0.2% of the population will die, and around 15-25% of all deaths will be from Covid-19. This will make it the #2 or #1 cause of death (cancers are 9% and cardiovascular disease are18%) – see here.
If it is 100x as bad, more than twice as many people will die than in a normal year.
If this becomes endemic, it is likely that the reality will be between these two, hopefully towards the bottom.
I don’t think the issue is one of authoritarian governments versus non-authoritarian governments. If we were talking about something as lethal as Ebola with the infectiveness of the common cold, I suspect our governments would have done much the same as the Chinese government. Even in Britain there are some pretty draconian powers hidden away in the legislation about communicable disease.
The issue is rather that many states only barely have a government. Even in relatively developed India, there aren’t good records of who’s Indian and who’s Bangladeshi. The nationality of some of the kids rescued from the cave in Thailand was equally in doubt. Anybody fancy imposing restrictive measures on the people of Afghanistan? You’re going to need a bigger army.
Once a virus like this spreads to a country without an effective and well resourced government, it is likely to form a reservoir for the virus which will lead to outbreaks however effectively it is quoshed in richer nations.
To be honest, I’m not convinced they will have completely suppressed it in China, despite the draconian measures. The illness lasts long enough that you would need a long duration of quarantine to allow the infection to subside completely. Once they lift the lid, will it pop out again?
Mooney_Driver wrote:
Sure you have only you never knew… death announcements usually do not have a pathological report attached. But it is well known that the common flu kills lots of senior citizens every year. But nothing in the dimension that this thing does, where up to 20%, that is two out of 10 die. With the flu, it is much less, but still significant numbers.
It’s still debatable what is the actual cause of death. Is it a virus or is it a deteriorated immune system or general poor health (due to old age or some other illness). In the end everybody has to die from something. This is a bit weird in the statistics. You will only die if you catch A, B and C at the same time. If you catch A and B first, then later catch C. Is it C that kills you? or is it A and/or B? What if you catch B and C first, then later you catch A ?
LeSving wrote:
It’s still debatable what is the actual cause of death.
According to this logic AIDS is not lethal because the HIV virus itself doesn’t kill you – you die because of deteriorated immune system.
You do get young 30-somethings who die of ‘flu in intensive care. We see one every few years. Of equal interest is the number of 30-somethings who would die if they didn’t go to intensive care.
I agree that by the time you get to a state of extreme frailty it is debatable what actually kills you. A lot of medicine is about balancing the harms of different treatments against their benefits. e.g. treating heart failure might screw up your kidneys. Arguably medicine is practiced to perfection when a patient dies of the failure of all of their organs at once. i.e. you have balanced the harms perfectly.
British death certificates allow you to put multiple diseases on the certificate. For example, if you have atherosclerosis you might get atrial fibrillation which will cause you to have a stroke which will interfere with your ability to swallow which will cause you to inhale some food which will cause you to develop a chest infection (aspiration pneumonia) which will cause you to die. As a by-the-way you can mention the chronic obstructive pulmonary disease which may have made you more susceptible to the pneumonia.
