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Re:Open letter from Italy to the international scientific co... by fattire on Saturday March 14, 2020 @10:14PM (#22580612)
Leaving aside the fact that here in the US tests are literally not happening on an epic scale that will be the subject of numerous investigations, hearings (, and prosecutions?) in the years to come. And forget that even if we had legit numbers, those numbers we can see are a tip of the iceberg, representing at most 20% of the actual more-serious cases.

Put that all aside.

Remember-- the numbers we see now are a look at the PAST. The infection incubates silently for a median 5 days. Then symptoms present. Then a week goes by with relatively mild illness. THEN shit gets real. THEN comes the hospital visit, the fight for a test, the time it takes for the test results to come back (if it happens). THEN the number gets added. Then you see it on wikipedia or the news.

These numbers we're seeing today are a time machine view backwards to recognize infections from 14 days ago. So infections spreading TODAY will show up AFTER the current Italy-like situation has already taken hold in the United States.

If it is possible, STAY HOME.

Re:Open letter from Italy to the international scientific co... by zozbot234 on Saturday March 14, 2020 @10:22PM (#22580664)
> Don't forget-- the numbers we see now are a look at the PAST. The infection incubates silently for a median 5 days. Then symptoms present. Then a week goes by with relatively mild illness. THEN shit gets real.

And the "shit gets real" part only occurs 20% of the time, give or take - which means the virus might spread quite a bit while showing symptoms no more severe than a common cold. That also introduces some further unpredictable lag between any social distancing behaviors being introduced and their effects on the actual numbers.

Re:Open letter from Italy to the international scientific co... by fattire on Saturday March 14, 2020 @10:28PM (#22580687)
Yes, exactly. I said 14 days but again, that's the median. The US is flying blind right now.

We're using a cracked, dirty camera lens to film a small fraction of the tip of a rapidly growing iceberg.... And the photo processing time is two weeks.

Re:Open letter from Italy to the international scientific co... by MetalGuru on Saturday March 14, 2020 @10:39PM (#22580765)
It gets hospital-level serious for 20% of cases? I thought the lethality rate wasn’t even that high for the most at-risk demographics (something like 14%).
Re:Open letter from Italy to the international scientific co... by nostrademons on Saturday March 14, 2020 @11:27PM (#22580990)
Yes, hospital-level serious for 20% of cases. 5-10% require ICU care. The ~2% fatality rate is with ICU support and ventilation. When the hospitals get overrun it increases to ~7%, which is what we saw in Wuhan and now Italy. Your chance of dying if you do need hospitalization but don't get it appears to be > 50%.

Death rates by age range also assume ICU care. It's virtually unheard of for healthy middle-aged people if they have access to good medical care, but plenty of 30- and 40-somethings can and have died from it once the hospitals are overrun.

Re:Open letter from Italy to the international scientific co... by Retric on Saturday March 14, 2020 @11:49PM (#22581094)
It’s far from clear how accurate those numbers for Italy and China are. China essentially gave up on testing the general population in Wuhan and their numbers mostly represent the most serious cases. Italy’s infections seem to be mostly centered around the elderly with 40% of infections in the 70+ age range despite 65+ year olds only representing 21.53% of their population.

https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I...

https://en.wikipedia.org/wiki/Demographics_of_Italy

Re:Open letter from Italy to the international scientific co... by gvjddbnvdrbv on Sunday March 15, 2020 @12:04AM (#22581162)
The WHO has verified China's numbers.
Re:Open letter from Italy to the international scientific co... by inferiorhuman on Sunday March 15, 2020 @02:02AM (#22581653)
The WHO has verified China's numbers.

Source?

China plainly lied about the outcomes of the SARS epidemic and reported about half the fatality rate of nearly every other country. Hell, no Chinese person I've talked with recently believes the official numbers.

Re:Open letter from Italy to the international scientific co... by zhte415 on Sunday March 15, 2020 @03:09AM (#22581905)
The Lancet unverified those numbers quite a while ago https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
Re:Open letter from Italy to the international scientific co... by gvjddbnvdrbv on Sunday March 15, 2020 @03:42AM (#22582015)
I flagged this because it was published in January nearly a month earlier than the WHO's verification.

Essentially this was not in bad faith when it was published but it is now so out of date and misleading and sharing it now is dangerous in that it may cause people to ignore safety advice.

Re:Open letter from Italy to the international scientific co... by zhte415 on Sunday March 15, 2020 @05:14AM (#22582323)
It was a nowcast. It's intended to be out of date after a while. And provide an estimation at the time. I don't understand how it is dangerous, could you explain that?... earlier action would have been better.
Re:Open letter from Italy to the international scientific co... by gvjddbnvdrbv on Sunday March 15, 2020 @09:50AM (#22583470)
You are claiming that a study published in January supercedes a study in February.

Given that people are making difficult choices right now that will impact the course of the epidemic we should be very careful sharing outdated information that could lead to people becoming infected.

China's numbers are a minimum. Many people are saying online they are a maximum. I.e. claiming that there are lots of hidden mild infections when there are not.

Re:Open letter from Italy to the international scientific co... by zhte415 on Sunday March 15, 2020 @11:11AM (#22583868)
> You are claiming that a study published in January supercedes a study in February.

No, I am no. I am saying the study supercedes numbers reported by authorities. The point of the study was to scatter information on very opaque reporting.

> China's numbers are a minimum. Many people are saying online they are a maximum. I.e. claiming that there are lots of hidden mild infections when there are not.

That doesn't parse.

Re:Open letter from Italy to the international scientific co... by gvjddbnvdrbv on Sunday March 15, 2020 @11:50AM (#22584077)
A lot of people are claiming that China's death rate was under 1%. That is one of the reasons everyone is delaying action.
Re:Open letter from Italy to the international scientific co... by nostrademons on Sunday March 15, 2020 @08:25PM (#22588317)
Death rate was under 1% outside of Wuhan and in South Korea. It's over 5% within Wuhan and in Italy.

The way I interpreted that discrepancy is that in the presence of full testing and good ICU care, the death rate from COVID-19 is about 0.7-1%. When the hospitals get overloaded, as they've been in Wuhan and Italy, the death rate skyrockets to 5-10%. This also squares roughly with the number of people who need ICU care in places where the death rate is low. If you need ICU care and don't get it, presumably you'll be dead.

Re:Open letter from Italy to the international scientific co... by Retric on Monday March 16, 2020 @12:21AM (#22589920)
Median death is 14 days after first symptoms with many cases taking significantly longer. That combined with an exponential growth curve looks significantly less deadly. A major discrepancy is the under detection of cases as full population testing has been rare outside of the cruse ships which also have an elderly population.
Re:Open letter from Italy to the international scientific co... by mirimir on Sunday March 15, 2020 @01:16AM (#22581486)
Sure, but they didn't go back in time to test more people.
Re:Open letter from Italy to the international scientific co... by emmelaich on Sunday March 15, 2020 @02:42AM (#22581806)
Populations of China and Italy are ageing and have a lot of smokers.
Re:Open letter from Italy to the international scientific co... by asdfasgasdgasdg on Saturday March 14, 2020 @10:41PM (#22580779)
> It gets hospital-level serious for 20% of cases? I thought the lethality rate wasn’t even that high for the most at-risk demographics (something like 14%).

Well, substantially all of the cases that end up dying go to the hospital first, and many more besides that and up recovering. It shouldn't be surprising that the hospitalization rate is higher than the fatality rate.

Re:Open letter from Italy to the international scientific co... by fattire on Saturday March 14, 2020 @10:58PM (#22580841)
About 15-20% require hospital care of some kind. Then depending on how prepared/overrun the health care system is, 0.6-5% cases are fatal. These numbers are ballpark and the lack of data makes it hard to know with confidence. The CFR gets more severe with age and comorbidities.
Re:Open letter from Italy to the international scientific co... by sneak on Sunday March 15, 2020 @12:45AM (#22581349)
I have been telling a lot of my friends this, but many are scheduled to work on Monday (most in public-interacting roles) and if they don't go to work, they lose their job and can't make rent next month.

This is a real issue, and I have no solutions. The only thing I've been saying to them is that all bars and restaurants will be closed here in 2-3 weeks and that their bosses will understand then. They are understandably worried that in the aftermath of all of this, there will be so many unemployed servers/bartenders/cooks/drivers that it will be difficult or impossible to get their job, or any other job, back, with no way to pay rent in April or perhaps May either.

Re:Open letter from Italy to the international scientific co... by mtsr on Sunday March 15, 2020 @02:52AM (#22581846)
This is not going to be over in April or May, except maybe in the worst case scenario. The point of social distancing etc is flattening the curve and spreading the load on healthcare systems over a longer time.

The only thing that might help there is if warmer weather reduces the spread. But then it could very well come back in the fall.

Re:Open letter from Italy to the international scientific co... by CydeWeys on Saturday March 14, 2020 @11:14PM (#22580911)
> If it is possible, STAY HOME.

People need to stay home, period. Unless you work in healthcare, a grocery store, or some essential service, or are going to one of the same, you need to stay home. I know there's lots of reasons people aren't staying home yet, like they don't have paid sick leave, but still, none of this overrides the sheer importance of stopping the pandemic.

So the phrasing should be "Stay home, period." Not "Stay home if possible".

Re:Open letter from Italy to the international scientific co... by fattire on Saturday March 14, 2020 @11:42PM (#22581055)
I initially had said simply "STAY HOME", but it's just not possible/advised for people in situations such as the ones you mention.

But your point is right. "If possible" means "unless it's absolutely essential for your survival or the survival of others".

Re:Open letter from Italy to the international scientific co... by solidasparagus on Saturday March 14, 2020 @11:41PM (#22581046)
I wonder if you'd be so absolute if this meant your job ceasing to exist.
Re:Open letter from Italy to the international scientific co... by fattire on Saturday March 14, 2020 @11:43PM (#22581059)
Yes, it's a risk vs. benefit calculation where the risk is very very high. And not only risk to yourself but risk to others...
Re:Open letter from Italy to the international scientific co... by solidasparagus on Sunday March 15, 2020 @12:49AM (#22581366)
The risks of large portions of the economy shutting down and millions of people losing their jobs is also very significant, particularly in a country where so many live so close to the edge of disaster. It's a difficult balance, but it feels like the economic fallout is sometimes lost on the readers of HN, most of who would quite comfortably live through a period of complete lockdown.
Re:Open letter from Italy to the international scientific co... by sdkaufman on Sunday March 15, 2020 @02:21AM (#22581718)
Forget losing jobs - without a lockdown, millions of people will lose their lives. Including many of our loved ones. We already know this from Italy and Wuhan, where entire families have died one by one in their homes. The only way to save some of these lives is to flatten the curve to avoid overrunning hospitals, and reduce deaths before a cure or vaccination is widely available.
Re:Open letter from Italy to the international scientific co... by CydeWeys on Saturday March 14, 2020 @11:46PM (#22581071)
People's jobs are going to cease to exist on account of this whether they want it or not. What anyone wants or feels has nothing to do with it. This is what is going to happen, period.
Re:Open letter from Italy to the international scientific co... by sdkaufman on Sunday March 15, 2020 @02:25AM (#22581741)
Exactly - I'm tired of hearing people say "oh but the economy". How good do you think millions of dead people are going to be for our economy? Would you rather lose your job or your parents?
Re:Open letter from Italy to the international scientific co... by sdkaufman on Sunday March 15, 2020 @02:27AM (#22581754)
I'd rather my job ceased to exist than my parents or grandparents. Because that's the choice we're making now as a society.
Re:Open letter from Italy to the international scientific co... by solidasparagus on Sunday March 15, 2020 @03:22AM (#22581953)
Easy to say when you don't seriously have to face your children becoming homeless. While it certainly isn't as dramatic as a pandemic, there are severe human consequences of completely shutting down the economy. I'm sure I don't need to repeat the stats that showcase how close to the edge much of America lives - 40 million Americans don't consistently have access to enough food[1]. 1 in 6 children don't have access to enough food (which has massive effects on development and long-term health). 22 million children rely on school lunches as their primary source of nutrition[2]. Food insecurity is directly correlated with higher rates of diabetes and obesity[3]. Half of America has a negative net worth. Unemployment is correlated with alcohol and drug abuse[4].

Pretending that the only disaster we are facing is medical is blinding yourself to the reality that we are trying to navigate our way between twin catastrophes.

[1] https://www.usnews.com/news/healthiest-communities/articles/...

[2] https://www.nytimes.com/aponline/2020/03/13/us/ap-us-virus-o...

[3] https://www.feedingamerica.org/sites/default/files/2019-04/2...

[4] https://www.theatlantic.com/health/archive/2017/07/how-job-l...

Re:Open letter from Italy to the international scientific co... by sdkaufman on Sunday March 15, 2020 @04:40AM (#22582211)
And there aren't severe human consequences from millions of people dying in the next few months? Easy to say when you don't seriously have to face the possibility of your parents and grandparents dying, I guess. Remember that the mortality rate for people 80+ is 1/7, which isn't far from a game of Russian roulette.

Plus, all the school districts that have shut down so far have continued to offer meals for students AFAIK.

Source: - https://www.buzzfeednews.com/article/lamvo/coronavirus-death... - https://www.santaclarausd.org/site/default.aspx?PageType=3&D... - https://www.sfgate.com/news/article/Bay-Area-school-closures...

Re:Open letter from Italy to the international scientific co... by solidasparagus on Sunday March 15, 2020 @04:59AM (#22582282)
I actually very much do need to seriously face that possibility. And I still think complete isolation is too extreme.
Re:Open letter from Italy to the international scientific co... by CydeWeys on Sunday March 15, 2020 @08:31AM (#22583091)
This is where the government needs to step in and guarantee healthcare, paid sick leave, and improve unemployment. It's already starting to happen. We'd be in much better shape if we were already closer to European countries in this regard, though.