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Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

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Re: Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

#41
post #7

Doesn't the median age of 60 years for positively diagnosed patients suggest a huge number of non-detected cases?

Probably tens of thousands of undiagnosed, asymptomatic. Aka super carriers. The virus is smart and has evolved from an evolutionary standpoint. Infect younger and asymptomatic patients with the goal of spreading and infecting as many as possible. Eventually, the more infected, the more that will die. The young are just carrier pigeons and don’t even know it.

> The virus is smart a

You're making a mountain out of a mole hill. The virus spreads as it's possible, and those who carry the virus experience the infection differently depending on some traits.

Re: Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

#42

Earlier quoted context omitted.

Assuming this was true, and there's not tons of dead young people, it also would seem to back up that people under 60 are at far less risk.

Right. One issue we’re having globally is that we simply cannot get an accurate fatality rate. We’re only seeing the sickest, most critical patients and the most overwhelmed hospital systems in cities. I think MOST patients being tested in hotspots like Lombardy are those who are already at the hospital, and if you’re at the hospital you’re not in good shape. Probably tons of positive cases at home with a fever, or m…

Germany currently looks to be an interesting case. As of CNN this morning, they have 13,957 cases confirmed, and 31 deaths. The deaths may of course crank up to a "normal" level, but I wonder if it's possible that they are testing many more people and getting a more accurate view.

(of course, this comment will probably age poorly)

Re: Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

#43

This is encouraging for healthy youngsters BUT age and health are also the criteria for receiving treatment in Italy at the moment. As the epidemic grows the categories of people that get ventilation decrease and the deaths will get younger and healthier.

Even if a youngster as a higher change of survival, there are serious effects reported. Fibrosis (damage of the lung tissue) lasts for much longer (over 4 weeks) than it is known in any typical flu. And what happens after 4 weeks is still totally unclear. As we don't know yet of the long term effects, please don't take that lightly!

[deleted]

Re: Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

#44

Earlier quoted context omitted.

Assuming this was true, and there's not tons of dead young people, it also would seem to back up that people under 60 are at far less risk.

Right. One issue we’re having globally is that we simply cannot get an accurate fatality rate. We’re only seeing the sickest, most critical patients and the most overwhelmed hospital systems in cities. I think MOST patients being tested in hotspots like Lombardy are those who are already at the hospital, and if you’re at the hospital you’re not in good shape. Probably tons of positive cases at home with a fever, or m…

We have enough data from closed experiments (Diamond Princess) to say that COVID sends 5% or more to the ICU. That’s the number that matters right now, not CFR. Fatality rate itself is much more dependent on whether the ICU beds are full (Italy, Iran) than anything else. Unfortunately, beds are about to be full in several US cities.

Re: Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

#45
post #35

Earlier quoted context omitted.

> The virus is smart and has evolved from an evolutionary standpoint. Infect younger and asymptomatic patients with the goal of spreading and infecting as many as possible. I think you are giving a bit too much agency to the virus. It has evolved in such a way that optimises for further spreading for sure, but I do not think it has a sneaky strategy to use young people as attack vectors. What's more likely is that it…

Another important insight is that Viruses, and germs in general, try to evolve and adapt inside the host. They don’t gain if they end up killing the host because that ends them too. Not to sound apocalyptic but I think their holy grail is something like what the machines do to humans in the movie Matrix

> Another important insight is that Viruses, and germs in general, try to evolve and adapt inside the host.

That assumption has no basis at all. Evolutionary pressures don't happen due to a intentional guidance from the evolving species. Individuals mutate by chance and replicate as they can. That's it.

Re: Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

#46

Earlier quoted context omitted.

Right. One issue we’re having globally is that we simply cannot get an accurate fatality rate. We’re only seeing the sickest, most critical patients and the most overwhelmed hospital systems in cities. I think MOST patients being tested in hotspots like Lombardy are those who are already at the hospital, and if you’re at the hospital you’re not in good shape. Probably tons of positive cases at home with a fever, or m…

Germany currently looks to be an interesting case. As of CNN this morning, they have 13,957 cases confirmed, and 31 deaths. The deaths may of course crank up to a "normal" level, but I wonder if it's possible that they are testing many more people and getting a more accurate view. (of course, this comment will probably age poorly)

Oh. This article says it way better than I could: https://www.ft.com/content/c0755b30-69bb-11ea-800d-da70cff6e...

Sorry about the paywall. If you search for it via google and click it from there that's how I found it (and why I didn't realize it was paywall)

Basic summary: Too Early to tell. But Germany is doing 160,000 tests/week, which is more than lots of countries. They may be getting a more complete picture of who is all infected.

Re: Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

#47
post #35

Earlier quoted context omitted.

> The virus is smart and has evolved from an evolutionary standpoint. Infect younger and asymptomatic patients with the goal of spreading and infecting as many as possible. I think you are giving a bit too much agency to the virus. It has evolved in such a way that optimises for further spreading for sure, but I do not think it has a sneaky strategy to use young people as attack vectors. What's more likely is that it…

Another important insight is that Viruses, and germs in general, try to evolve and adapt inside the host. They don’t gain if they end up killing the host because that ends them too. Not to sound apocalyptic but I think their holy grail is something like what the machines do to humans in the movie Matrix

I think their holy grail would be to become part of our genome like many others have:

https://www.nytimes.com/2017/10/04/science/ancient-viruses-d...

Re: Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

#48
post #18

Earlier quoted context omitted.

Plus lots of Italians live with their extended families well into their 30s.

Good point and totally unnoticed. The young who live with extended families are the perfect carriers as they’re asymptomatic and elderly are close by, infected surfaces, etc.

Not entirely unnoticed, cfr: https://voxeu.org/article/intergenerational-ties-and-case-fa...

Re: Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

#49

Earlier quoted context omitted.

Right. One issue we’re having globally is that we simply cannot get an accurate fatality rate. We’re only seeing the sickest, most critical patients and the most overwhelmed hospital systems in cities. I think MOST patients being tested in hotspots like Lombardy are those who are already at the hospital, and if you’re at the hospital you’re not in good shape. Probably tons of positive cases at home with a fever, or m…

We have enough data from closed experiments (Diamond Princess) to say that COVID sends 5% or more to the ICU. That’s the number that matters right now, not CFR. Fatality rate itself is much more dependent on whether the ICU beds are full (Italy, Iran) than anything else. Unfortunately, beds are about to be full in several US cities.

But that's not reliable either. Average age on the Diamond Princess was 58. With 1/3 being over 70. Average age in the US is 38, with 15.2% being over 65.

Given that age is a very large component here, I don't think you can extrapolate data from the Diamond Princess to the general population.

Re: Report on the characteristics of Covid-19 positive deceased patients in Italy [pdf]

#50
post #11

I found page 3 most remarkable: 48% of those who die of covid-19 in Italy also suffer from three or more other diseases (or did recently), and 99.2% suffer from one or more.

A very high fraction of folks past age 75 have one or more of these diseases.

Before concluding that they contribute, the next question should be, how many people in that population at that age have ZERO comorbid diseases? Likely, it's very few. So these comorbidities may actually have little causal role leading to mortality. We can't know from just this data.

Until we learn more, we can't conclude 1) that comorbidities were causal, or 2) WHICH comorbidity really matters.

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