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50% – 75% of cases of Covid-19 are asymptomatic

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Re: 50% – 75% of cases of Covid-19 are asymptomatic

#61

Post by ailideex »

cycrutchfield wrote: post #39
nostromo wrote: post #26

I wonder if this will be like H1N1. At first we only identified extreme cases and we had these terrifying reported fatality rates. Then we identify more and more mild or asymptomatic cases and the rates drop and drop. We’ve already seen how CFR was reported as 3 or 4%. Then on the cruise ship full of people over 60 it’s 0.7%. If there are lots of mild or asymptomatic cases it will likely be much lower. H1N1 was ident…

This is wishful thinking, and it doesn’t take much examination of the medical literature to realize this fact. Edit: it's super fucking irresponsible to say "this is going to be like H1N1" when there is no reputable medical literature that supports that position

> it's super [] irresponsible to say "this is going to be like H1N1"

Good thing the person you responded to never said that.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#62

Post by Drunk_Engineer »

Ozzie_osman wrote: post #30
nostromo wrote: post #26

I wonder if this will be like H1N1. At first we only identified extreme cases and we had these terrifying reported fatality rates. Then we identify more and more mild or asymptomatic cases and the rates drop and drop. We’ve already seen how CFR was reported as 3 or 4%. Then on the cruise ship full of people over 60 it’s 0.7%. If there are lots of mild or asymptomatic cases it will likely be much lower. H1N1 was ident…

I really, really hope so. My hope is it is way more widespread than we think, and while that means it's going to be near impossible to contain, the denominator is so large that the CFR ends up being much lower than expected.

If Covid-19 does end up being a dud, then we are in real trouble if/when an actual pandemic arrives -- because by then everyone will say the CDC is Crying Wolf.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#63

Post by lend000 »

I'm not a confirmed case, but I'm a 90% sure case based on symptoms and symptoms of people I have been in close contact with, and so far the experience has been relatively mild, in the literal sense. The primary discomfort has likely been the anxiety of how the tightness in my chest might progress (which ironically can also cause chest tightness).

I'm in a low risk group. I had lethargy and high fever the first day of symptoms (a little over a day after high contact exposure to my suspected source), then no fever (or very mild fever, can't tell because I have no thermometer), dry eyes, consistent mild chest tightness and occasional cough for the following two days (to present). The person I believe I contracted it from is also in a low risk group and had a sore throat and persistent cough for about 5 days, and is currently asymptomatic. She had been going about her business thinking it was just a cold for the duration of her symptoms.

Testing is still difficult in my area, and many folks with mild symptoms like the aforementioned aren't even attempting to get tested, so I suspect the true numbers are about 10x-50x the reported confirmed cases. This is good in that it means the death rate is also off by that factor, but bad in that there will not be enough fear/incentive for the primary carriers (young adults) to adhere to adequate social distancing. It's an unfortunate externality when an infectious disease has discriminatory consequences.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#64

Post by hellofunk »

nostromo wrote: post #26

I wonder if this will be like H1N1. At first we only identified extreme cases and we had these terrifying reported fatality rates. Then we identify more and more mild or asymptomatic cases and the rates drop and drop. We’ve already seen how CFR was reported as 3 or 4%. Then on the cruise ship full of people over 60 it’s 0.7%. If there are lots of mild or asymptomatic cases it will likely be much lower. H1N1 was ident…

But the enormous strain in the healthcare system is very unlike H1N1, so it’s probably not too far from the estimates. To see what’s happening in Italy, this is obviously much worse and unprecedented.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#65

Post by onetimemanytime »

username90 wrote: post #12

"Everyone we found to have Covid-19 had serious symptoms, so we don't want to waste money testing you if you don't!" I feel this is a trillion dollar mistake, testing more aggressively like South Korea means that you don't have to deploy the army and quarantine people. I had mild symptoms and they refused to test me, what am I to do? Self quarantine without a notice and hence without pay? I could work from home, but…

System is overwhelmed, can't really blame anyone since maintaining such, ready to spring, system would cost a lot of money. In an ideal world a drone would come and take your temp and then drop food supplies etc etc.

But I'm wondering...if we all are going to get infected (40-80%) wouldn't it better to choose the time? Early on you get all the benefits, 3 weeks later you are lucky to have someone measure your temp. Of course you might escape it entirely or new knowledge might be gained in weeks ahead, but the downside is terrible https://news.sky.com/story/coronavirus-italian-doctor-says-f...

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#66

Post by hellofunk »

Drunk_Engineer wrote: post #62
Ozzie_osman wrote: post #30

Earlier quoted context omitted.

I really, really hope so. My hope is it is way more widespread than we think, and while that means it's going to be near impossible to contain, the denominator is so large that the CFR ends up being much lower than expected.

If Covid-19 does end up being a dud, then we are in real trouble if/when an actual pandemic arrives -- because by then everyone will say the CDC is Crying Wolf.

It’s already proven not to be a dud — healthcare systems stretched to beyond 200% capacity is solid evidence of something no one has seen in recent memory. When youngish healthcare workers are dying, something is going on.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#67

Post by endogui »

confeit wrote: post #43

> "The vast majority of people infected with Covid-19, between 50 and 75%, are completely asymptomatic but represent a formidable source of contagion". The Professor of Clinical Immunology of the University of Florence, Sergio Romagnani > Asymptomatic infection has been reported, but the majority of the relatively rare cases who are asymptomatic on the date of identification/report went on to develop disease. The pro…

The Italian number (75%) comes from testing everyone in a village of 3000 people. The Chinese number (1%) comes from testing everyone who comes to hospitals and maybe their family members. I would guess that the Chinese sample was selected for people displaying symptoms (asymptomatic people will not go to the clinic), while the Italian number biases for people early in the course of the disease. For the purposes of public health and controlling disease spread, the Italian number is more meaningful.

Note also that it is possible the virus has evolved to spread more easily, which in the context of a lot of screening and social distancing of symptomatic people would mean more asymptomatic spreading.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#68

Post by hellofunk »

alexanderhorl wrote: post #34
Ozzie_osman wrote: post #30

Earlier quoted context omitted.

I really, really hope so. My hope is it is way more widespread than we think, and while that means it's going to be near impossible to contain, the denominator is so large that the CFR ends up being much lower than expected.

Maybe in the end the CFR will be the same as the regular flu.

It has already proven to be far worse than the flu in its strain on healthcare systems.

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#69

Post by cycrutchfield »

ailideex wrote: post #61
cycrutchfield wrote: post #39

Earlier quoted context omitted.

This is wishful thinking, and it doesn’t take much examination of the medical literature to realize this fact. Edit: it's super fucking irresponsible to say "this is going to be like H1N1" when there is no reputable medical literature that supports that position

> it's super [] irresponsible to say "this is going to be like H1N1" Good thing the person you responded to never said that.

that is pretty much the hypothesis in their post

Re: 50% – 75% of cases of Covid-19 are asymptomatic

#70

Post by wahern »

nostromo wrote: post #52
wahern wrote: post #48

Earlier quoted context omitted.

I don't see in that link where it shows the CFR in the U.S. changing at all, let alone dramatically. Here's a paper from 2013 that surveyed CFR reports for H1N1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809029/ After a long discussion about the varying definitions of the numerator and denominator, they had this to say: > Given that estimates of the infection fatality risk are unlikely to be available early enoug…

That report was from summer 2009, so it was written during the outbreak. Note the early CFR from WHO was 0.4% for the US and over 1% for Mexico. Later in the year it was found to be http://news.bbc.co.uk/2/hi/health/8406723.stm

AFAICT, that 0.03% is for the U.K, not the U.S. And it doesn't say what the definition of CFR was. I've read a significant number of papers (primary materials) about SARS, MERS, H1N1, and influenza over the past few weeks. IME, CFR is usually defined as diagnosed or symptomatic cases as the denominator (which, as I've said, was until recently effectively equivalent), especially mid pandemic. But it's not always so defined. One notable exception that adds to the confusion is seasonal influenza, where U.S. annual fatality rates are calculated using post hoc modeling.

Even if we pin down CFR to be # deaths / # confirmed symptomatic, there's obviously still going to be some variability, possibly significant--quality of medical interventions, age distribution, etc. But trying to shoehorn IFR and other definitions into that number would compound such problems many fold.

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