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Re:Recovered virus patients retest positive due to 'dead' vi... by acqq on Wednesday April 29, 2020 @03:21PM (#23023046)
> somewhat more lethal than influenza

My understanding is that most evidence points to order of magnitude more lethal even when the hospitals aren't overflown.

Regarding "testing negative then positive" the experts already expected that there were no real reinfections.

Re:Recovered virus patients retest positive due to 'dead' vi... by throwaway894345 on Wednesday April 29, 2020 @03:29PM (#23023162)
> My understanding is that most evidence points to order of magnitude more lethal even when the hospitals aren't overflown.

If those mortality estimates were based on the number of positive test cases, then they're very likely overblown. Recent seralogical studies indicate that the number of positive test results are likely a small fraction of the total number of cases, and likely the most severe subset at that. None of this is to say that it's less lethal than influenza, only that the situation is developing rapidly and any given mortality estimate may well be outdated.

Re:Recovered virus patients retest positive due to 'dead' vi... by pbhjpbhj on Wednesday April 29, 2020 @04:21PM (#23023760)
Well UK deaths from flu are about were 500 deaths per 66M for the most recent year of published cause of death statistics, which I understand (from a couple of papers on annual infection rates) represents about 500/13M infections.

Covid19 figures in the UK are 26,000 [hospital] deaths for 165,000 confirmed infections. Even if we assume the entire population is infected ... that makes it a minimum of 10x as deadly as flu. We're at a slowly falling ~5000 deaths per day; when care-home and other Covid deaths get added ...

I think perhaps you're down-playing it a little too much.

Re:Recovered virus patients retest positive due to 'dead' vi... by throwaway894345 on Wednesday April 29, 2020 @04:34PM (#23023924)
To reiterate the third/last sentence of my post, I'm explicitly not down-playing anything--I'm not asserting anything about covid WRT the flu, only cautioning against drawing conclusions based on potentially outdated information.
Re:Recovered virus patients retest positive due to 'dead' vi... by JoeAltmaier on Wednesday April 29, 2020 @03:34PM (#23023203)
In any case, we can all agree that regardless of the value of the number, its "way too many fatalities". My family has lost several colleagues/classmates already. This did not happen in other years. This year is very different, and concerning.
Re:Recovered virus patients retest positive due to 'dead' vi... by throwaway894345 on Wednesday April 29, 2020 @03:40PM (#23023278)
I'm terribly sorry for your losses. It's an awful disease, and loss of life is terrible. It is indeed concerning, but if we can understand whether these fatalities are due to high morbidity or "simply" because it is highly contagious, we can make better decisions about treating the disease, setting policy, etc which can all drive down the amount of suffering and death. That's perhaps a small consolation to those who have lost friends and family already. :'(
Re:Recovered virus patients retest positive due to 'dead' vi... by acqq on Wednesday April 29, 2020 @03:44PM (#23023313)
> Recent seralogical studies indicate that the number of positive test results are likely a small fraction of the total number of cases

No: the antibody tests were done with the expectation that the total number of the infected would be much higher. The tests have such false positive rates that with the results actually observed the tests in most of the cases say nothing -- in most of the locations the numbers would be similar even if nobody would be a real positive. And there where the results are above these "noise" thresholds we also have a big numbers of deaths which do confirm my claim of order of magnitude deadlier than flu.

Even observing the pure death statistics we can see that, even in spite of all the measures actively taken throughout the world. Without them it's obvious it would have been again the difference of some orders of magnitude:

https://www.euromomo.eu/graphs-and-maps/

See also here:

https://www.ft.com/coronavirus-latest

the "Death rates have climbed far above historical averages" graph.

Re:Recovered virus patients retest positive due to 'dead' vi... by throwaway374810 on Thursday April 30, 2020 @07:05AM (#23029583)
Going by the death rates, it's definitely deadlier than any flu of the past five years, but not by a magnitude. Not even close.

Saying that it would've been a magnitude higher without any of the measures is pure speculation.

Re:Recovered virus patients retest positive due to 'dead' vi... by talaketu on Wednesday April 29, 2020 @04:49PM (#23024107)
So? I haven't read any of this studies either, but I'd expect seralogical studies to likewise indicate that positive flu test results are a small fraction of the total number of cases, and likely the most severe subset.
Re:Recovered virus patients retest positive due to 'dead' vi... by throwaway894345 on Wednesday April 29, 2020 @05:51PM (#23024834)
We have decades of data about the flu--we pretty much understand its morbidity. We don't need to make guesses based on positive test results like we were doing with covid.
Re:Recovered virus patients retest positive due to 'dead' vi... by talaketu on Wednesday April 29, 2020 @07:34PM (#23025855)
Your argument is invalid.
Re:Recovered virus patients retest positive due to 'dead' vi... by rocha on Wednesday April 29, 2020 @03:42PM (#23023294)
My understanding is that the current estimated IFR from those studies (NY specially) is between 0.6% and 1.2%. I think flu is around 0.1% (however I am not sure if that is the CFR or the IFR). The second factor to consider is the attack rate, how many people are likely to get infected. For flu is around between 10% to 15% of the total population, while for Covid it is, potentially, larger than 80% (no natural immunity and no vaccines). It is however unlikely that it will reach that level given the current containment and mitigation measures. But if it reaches something like 40% (double of the latest NY estimate), it will mean covid is between 16 to 48 times deadlier than the flu.
Re:Recovered virus patients retest positive due to 'dead' vi... by Lewton on Wednesday April 29, 2020 @03:47PM (#23023337)
I believe 0.1% is the CFR for the flu, and the IFR is close to 0.04%?
Re:Recovered virus patients retest positive due to 'dead' vi... by votepaunchy on Wednesday April 29, 2020 @04:57PM (#23024192)
IFR for flu is less than 0.1% according to the CDC.

https://www.cdc.gov/flu/about/burden/index.html

Re:Recovered virus patients retest positive due to 'dead' vi... by Lewton on Wednesday April 29, 2020 @05:04PM (#23024280)
That's not the IFR since they're not counting asymptomatic cases (based on a quick read)

They don't mention IFR anywhere as far as I can see

Re:Recovered virus patients retest positive due to 'dead' vi... by rocha on Wednesday April 29, 2020 @04:12PM (#23023629)
Thanks. I have seen serious estimates of 0.1% CFR for the 1957 and 1964 flu pandemics, but only notes saying that the seasonal flu CFR is <0.1%. Do you have a source for the 0.04% IFR?
Re:Recovered virus patients retest positive due to 'dead' vi... by Lewton on Wednesday April 29, 2020 @04:19PM (#23023725)
No (hence the question mark), I'm seeing 0.04% pop up everywhere but I haven't found the source for the number.

But it seems plausible if the CFR is <0.1% as there are both asymptomatic cases of the flu and people don't always go to the doctor even if they have symptoms. It seems like caring about IFR was rare before this pandemic and the lockdown

Re:Recovered virus patients retest positive due to 'dead' vi... by rocha on Wednesday April 29, 2020 @04:43PM (#23024030)
Got it. Thanks. I think it may be because the IFR is less reliable, since for most diseases it requires a gross estimation the real number of infected persons. It is probably more popular these days because people are putting a lot of effort into the comparisons with the seasonal flu.
Re:Recovered virus patients retest positive due to 'dead' vi... by throwaway894345 on Wednesday April 29, 2020 @03:46PM (#23023335)
Yes, sorry, I thought we were comparing IFR and not CFR.
Re:Recovered virus patients retest positive due to 'dead' vi... by rocha on Wednesday April 29, 2020 @03:51PM (#23023376)
No worries, I had made the same mistake. I just wanted to point out that the attack rate is also part of the fatality equation, and it is commonly not taken into account.
Re:Recovered virus patients retest positive due to 'dead' vi... by f38zf5vdt on Wednesday April 29, 2020 @04:52PM (#23024149)
You found my favorite part of that whole comment. I hereby announce my support for redefining "somewhat" to mean "an order of magnitude" for all subsequent HN discussions.
Re:Recovered virus patients retest positive due to 'dead' vi... by manfredo on Wednesday April 29, 2020 @04:17PM (#23023705)
This is due to testing methods that undercount the denominator. Countries conducting random testing have yielded an IFR of about 0.4%. 4x deadlier than the flu.
Re:Recovered virus patients retest positive due to 'dead' vi... by Lewton on Wednesday April 29, 2020 @04:21PM (#23023762)
You're comparing the IFR of the corona virus with the CFR of the flu
Re:Recovered virus patients retest positive due to 'dead' vi... by manfredo on Wednesday April 29, 2020 @07:40PM (#23025901)
No it's not. The IFR of the flu is 0.1%. The CFR is higher. The Case Fatality Rate will always be higher than the Infection Fatality Rate. The people who present cases will be a strict subset of the people who are infected.

Early studies treated the Case Fatality Rate as the Infection Fatality Rate, by virtue of the fact that the only people getting tested were people with symptoms. Random testing in Germany has indicated that ~20% of the population was infected or has been infected, and the corresponding death rate yielded an IFR of 0.37%.

Re:Recovered virus patients retest positive due to 'dead' vi... by Lewton on Thursday April 30, 2020 @03:33AM (#23028379)
What's your source for the 0.1% flu number? People are linking to the CDC website which explicitly only looks at symptomatic flu cases. Which means it's NOT the IFR. The flu also has asymptomatic cases!
Re:Recovered virus patients retest positive due to 'dead' vi... by manfredo on Thursday April 30, 2020 @07:40AM (#23029775)
If you're talking about this CDC website, it does track CFR [1]. And as I said, the CFR rate is higher than the IFR rate. Several years the seasonal flu has a CFR above 0.13%.

Measuring IFR is inherently speculative, unless 100% of the population is administered a test with no risk of false negative or positives. In order to compare the IFR of COVID-19 to the seasonal flu, we'd need to use the same estimation techniques. I've only found a few experts that have done comparisons of IFR rates of the flu and of COVID-19. The most reputable source on this reported an estimated IFR for the flu of 0.04%, but also an estimated IFR for COVID-19 of 0.2-0.3% [2]. This is "many times deadlier" if by "many" you mean 5 to 8 times deadlier. This is nowhere near the multiple orders of magnitude deadlier that was reported initially (IFR rates of 2-3% and above).

1. https://www.cdc.gov/flu/about/burden/index.html

2. https://www.bloomberg.com/opinion/articles/2020-04-24/is-cor...

Re:Recovered virus patients retest positive due to 'dead' vi... by acqq on Thursday April 30, 2020 @08:39AM (#23030158)
> unless 100% of the population is administered a test with no risk of false negative or positives.

Actually, the "risk" of false positives or false negatives is dependent on prevalence, 100% is not always required. If you have a test where 5 of 100 cases are false (i.e. 95% times is not wrong), and nobody of these tested is actually infected, you could incorrectly believe that 5% of population is infected even when nobody is, meaning such a conclusion would be completely false.

But if the population is actually already e.g. 50% infected, the same test can "lie" only 5%, giving you 47% or 53% but still being "mostly true" (from the engineering point of view).

So it is important to ignore the test reports as long as they are close to their false positive rate, which they were in a lot of antibody tests done up to now.

Also "false positives" and "false negatives" can lead to wrong handling of the cases, but that's another topic.

Re:Recovered virus patients retest positive due to 'dead' vi... by Lewton on Thursday April 30, 2020 @08:16AM (#23030008)
Thank you for the sources!

Initially you were implying that the IFR of the flu was 0.1% and comparing it to an IFR of 0.4%, this is what I disagreed with strongly

The bloomberg link you're giving is showing that the vast amount of randomly sampled serological studies are showing IFR of 0.5%-1%. And importantly, looking at how the random sampling has been done for each case and ranking by quality, >0.5% results rank at the top (he studies with the biggest sampling problems show the lowest IFR)

0.2-0.3% is by far in the bottom range of estimates

I think the data shows a pretty clear single order of magnitude difference between the IFR of the flu and novel corona. But I agree that >1% IFR is extremely unlikely

Re:Recovered virus patients retest positive due to 'dead' vi... by manfredo on Thursday April 30, 2020 @12:27PM (#23032709)
How, exactly are we ranking by quality? The only anti-body study that's been published in a peer reviewed journal has indicated an IFR ranging from 0.12% to 0.2%. The author did make note of these criticisms that the infected rate was over-counted, but even when using an infected rate of 1.5% instead of the paper's estimated 2.5% the IFR would turn out to be 0.33%.

Plenty of the >0.5% results have serious sampling problems of themselves. The Dutch study sampled people who were donating blood. The subset of the population that donates blood is could easily have different behavior than the general population: like being more health-conscious and thus less likely to be infected, which would inflate the infected fatality rate.

And when we compare against the flu, we also have to consider that there are different methods of estimating the infected fatality rate. More conservative estimates on infections of the seasonal flu yield higher IFR values. The epidemiologist being cited here is providing relative estimates of 0.04% and 0.2-0.3%. We could go with more conservative estimates on the infected rate for COVID-19, but we'd have to be similarly conservative when measuring the IFR of the flu.

Re:Recovered virus patients retest positive due to 'dead' vi... by Lewton on Thursday April 30, 2020 @01:03PM (#23033175)
I was ranking "randomly selected" higher than "people volunteering" (which was one of the main issues with the santa clara study, mixed with the test used being so imprecise the error bars were big enough to include a 100% false positive rate. That is by far one of the worst designed studies I've looked at, even if it has been peer reviewed)

I'm not sure the blood sampling would skew the direction you think it does, healthy individual could just as well mean that they're more likely to have had it since they're less likely to sit at home and stick to a quarantine. But you are right, it definitely counts as a sampling issue and I'll concede that ranking by quality is a lot less clear cut, I should not have been so confident