50% – 75% of cases of Covid-19 are asymptomatic • Hacker News Board

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

#281

Post by barrkel » Tue, Mar 17, 2020, 5:20 PM UTC

thu2111 wrote: post #226

8fingerlouie wrote: post #211

Earlier quoted context omitted.

Yesterday the news was that anybody over 80 is not treated. They simply don't have the capacity for it, and survival chances are better for people under 80.

Are you sure? https://www.reuters.com/article/us-health-coronavirus-italy-... Lombardy intensive care coordinator Grasselli said he believed that, so far, all patients with a reasonable chance of recovering and living an acceptable quality of life had been treated. I wonder if we're getting mixed messages here; that is, it's inevitable doctors give up on some cases and unplug them from the ICU but that is always a ri…

How does that quote contradict the parent? If you were a doctor, and you wanted to communicate the concept of triage without baldly stating that people are being left to die, how would you phrase it?

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

#282

Post by gourabmi » Tue, Mar 17, 2020, 5:20 PM UTC

bart_spoon wrote: post #258

travmatt wrote: post #247

Earlier quoted context omitted.

Or it could be like the 1918 Spanish flu - a bad first wave that was most dangerous to the elderly, and a second wave that mutated and killed mostly young adults.

I don't know why there would be any reason to believe that would be the case. Generally viruses become less deadly over time, not more. The Spanish flu was an outlier.

If only optimism could kill viruses.

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

#283

Post by ncallaway » Tue, Mar 17, 2020, 5:20 PM UTC

encoderer wrote: post #87

ncallaway wrote: post #54

Earlier quoted context omitted.

I'm not sure if you're quoting something or paraphrasing a position you disagree with. If it's a paraphrase, I'm not so sure it's a fair one. In the United States, for example, we are urging people not to be tested unless they have severe symptoms. The reason for that is not to save money, but it's for a lack of testing capacity. As a policy we would much prefer to be testing even the mild suspected cases. But we don…

The lack of testing capacity was a choice.

Yes, absolutely. The lack of testing capacity was a total failure of the government.

After the acute phase of the crisis, we should investigate what happened in great detail.

But the advice about who should get a test is based on the testing capacity we have now. If we hadn't failed at testing capacity, we would be recommending more users get tested.

So, if the critique is: "we failed to produce adequate testing capacity", then I absolutely agree. If the critique is instead: "The recommendation of who gets a test is bad", then I disagree. The recommendation is correct given the test capacity failing.

The solution is not to recommend everyone gets tests, because they can't! Those tests are being rationed. The solution is to rapidly improve out testing capacity.

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

#284

Post by spookthesunset » Tue, Mar 17, 2020, 5:21 PM UTC

lostapathy wrote: post #271

spookthesunset wrote: post #256

Earlier quoted context omitted.

Meh. An actual leader would clearly articulate what is going on—he hasn’t done that. An actual leader would tell people not to panic—hasn’t done that. An actual leader would take strong, very visible action against people hoarding supplies or worse reselling them for profit—toilet paper memes are funny until you run out. And quite frankly a real smart leader would have started testing the fuck out every person with a…

I'm not really a trump fan - but at the same time, these people have to have time to do the work, they can't spend it all in press conferences. At a practical level on the hoarding - what can the president do, declare martial law? There aren't enough police/solidiers to enforce it anyway. Far better to get to work on the source of the panic, especially if you believe it can be contained if you prioritize that. It's c…

They can make clear, well publicized examples of people hoarding goods for resale. They make well publicized examples of people getting arrested in stores who are loading their carts up with every hand sanitizer bottle on the shelf.

It doesn’t take more than a few very visible examples to clamp down on that kind of behavior.

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

#285

Post by vonmoltke » Tue, Mar 17, 2020, 5:21 PM UTC

woah wrote: post #212

easytiger wrote: post #196

Earlier quoted context omitted.

> and push it higher than a normal flu season. last major flu season in Italy killed 24k people. We didn't immolate the global economy as a result

Why didn’t the hospital system collapse because of the flu?

Based on the CDC's numbers for the US[1], less than 2% of seasonal flu cases require hospitalization at all. This disease is at about 20% (based on detected infections). Even if 75% of infections are really undetected and asymptomatic, we're still looking at about 3 times the number of hospitalizations as seasonal flu.

[1] https://www.cdc.gov/flu/about/burden/preliminary-in-season-e...

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

#286

Post by andrewseanryan » Tue, Mar 17, 2020, 5:21 PM UTC

This article on hacker news a couple of days ago could explain a lot of this. There is a possibility that a very large number of the asymptomatic positive tests are in fact false-positives. This could be good news for the world, but I'm not betting on that yet. https://www.ncbi.nlm.nih.gov/pubmed/32133832.

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

#287

Post by snapetom » Tue, Mar 17, 2020, 5:21 PM UTC

notahacker wrote: post #187

easytiger wrote: post #163

Earlier quoted context omitted.

The WHO predicted that 150 million people would be killed by avian flu https://www.google.com/amp/s/amp.theguardian.com/world/2005/... Using the same logic that had lead to the severe predictions for cv19. For swine flu they promoted and stood by a CFR of 60%. Again turned out to be nonsense; nonsense known at the time to others https://jech.bmj.com/content/62/6/555.abstract

Overestimates of the severity of the threat have much less harmful consequences than underestimates. For a start, actual casualty statistics are not independent from mitigation actions taken.

Definitely agree, but at a certain point, WHO is going to be seen as crying wolf. They've already taken a large credibility hit in this crisis. They can't afford to ignore their perception in the age of populism and social media.

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

#288

Post by leftyted » Tue, Mar 17, 2020, 5:21 PM UTC

warabe wrote: post #237

I live in Japan and I experience mild symptoms since last Wednesday but not sure if my symptom is due to Covid-19. In Japan, You have meet two conditions to take a CPR test. 1. the symptoms with fever of 37.5 degrees or more continue for 4 days or more (for the eldery and those with underlying disease, "4 days" becomes "2 days") 2. you have strong laxity (malaise) or breathlessness (dyspnea), or you have underlying d…

Sounds like the government is correctly rationing tests.

My sense is that the vast majority of the healthy population shouldn't get tested even if they might have the virus because the infrastructure doesn't support widespread testing (anywhere -- as far as I know). They should act as if they have the virus and stay home, rest, drink a lot of water, and take NSAIDs if the pain gets out of hand.

I've been sick since last week (much improved yesterday and today) and it could definitely be covid-19. But there's no point in trying to get tested. If I felt the symptoms were serious (significant difficulty breathing) then I'd go to an ER or call 911.

Also, 37.5 is a fairly low fever.

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

#289

Post by barrkel » Tue, Mar 17, 2020, 5:21 PM UTC

thu2111 wrote: post #267

bob33212 wrote: post #249

Earlier quoted context omitted.

Doctors "Give Up" on people all the time. If you have advanced pancreatic cancer, are 85 and a heavy smoker, most doctors are going to suggest you go home and spend your last few days with loved ones.

Yeah, that's what I'm getting at. What I see at the moment on HN and elsewhere is a lot of people who seem to believe that in Italy the hospitals are already overrun and people are being turned away in large numbers because all the beds are gone already days ago. But this doesn't match what is actually happening there, according to the Italian government. What they're saying is so far they've had to turn away noone;…

> What they're saying is so far they've had to turn away noone; that everyone who needs treatment is getting it.

> all patients with a reasonable chance of recovering and living an acceptable quality of life had been treated.

These two quotes from you are mutually contradictory.

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

#290

Post by m-watson » Tue, Mar 17, 2020, 5:23 PM UTC

beatgammit wrote: post #234

robocat wrote: post #140

Earlier quoted context omitted.

> In the United States, for example, we are urging people not to be tested unless they have severe symptoms. They should test randomly: e.g. use a hash of the person’s name. Otherwise there is a huge risk of missing cases that matter...

Testing randomly gets us a better picture of how widespread it is then testing to confirm severe cases. I'd much rather know that X% of the population has it with an error of Y than Z% of severe cases are due to this virus.

Yes from the research/understanding perspective but a lot of the testing is also to provide healthcare to those most in need. You test the most severe to make sure you can treat them effectively.