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Epidemiologists and academics have [[LMS|status]] incentives to give overblown projections and not dial them down. The Institute for Health Metrics and Evaluation (out of the University of Washington) model for Coronavirus cases became a national standard, even cited by the Trump administration as proof of an extended lockdown.<ref>https://www.kiro7.com/news/local/uw-model-shows-number-us-coronavirus-deaths-will-peak-mid-april/4OKNGGW3PNBGLMGC3RF6JWZ324/</ref> By the end of March that model was over 4x overblown for New York for example, and had expected 50k hospitalizations instead of the 12k that actually happened.<ref>https://twitter.com/AlexBerenson/status/1245416486879051778</ref> Such overblown predictions point a political strategy that allows to conveniently claim early victory over the situation. | Epidemiologists and academics have [[LMS|status]] incentives to give overblown projections and not dial them down. The Institute for Health Metrics and Evaluation (out of the University of Washington) model for Coronavirus cases became a national standard, even cited by the Trump administration as proof of an extended lockdown.<ref>https://www.kiro7.com/news/local/uw-model-shows-number-us-coronavirus-deaths-will-peak-mid-april/4OKNGGW3PNBGLMGC3RF6JWZ324/</ref> By the end of March that model was over 4x overblown for New York for example, and had expected 50k hospitalizations instead of the 12k that actually happened.<ref>https://twitter.com/AlexBerenson/status/1245416486879051778</ref> Such overblown predictions point a political strategy that allows to conveniently claim early victory over the situation. | ||
=== Fatality rate === | === Fatality rate scare === | ||
[[File:EUoN3NhWsAAkx4M.png_large.png|thumb|right|300px]] | [[File:EUoN3NhWsAAkx4M.png_large.png|thumb|right|300px]] | ||
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Old data: | |||
Out of 3,711 passengers with an average age of 60, about 20% (712) tested positive. Only 25% of the positive cases had symptoms of a pneumonia and 1.97% (14) died.<ref name="basedthread">https://www.reddit.com/r/COVID19/comments/fno919/nonsevere_vs_severe_symptomatic_covid19_104_cases/</ref> | Illustrating data regarding the overall mortality of COVID-19 for older people in particular comes from the [[boomer]] cruise ship Diamond Princess. | ||
Out of 3,711 passengers with an ''average age of 60'', about 20% (712) tested positive. Only 25% of the positive cases had symptoms of a pneumonia and 1.97% (14) died.<ref name="basedthread">https://www.reddit.com/r/COVID19/comments/fno919/nonsevere_vs_severe_symptomatic_covid19_104_cases/</ref> | |||
This suggests, without an overwhelmed health system, the IFR for the overall population may be between 0.025%<ref>https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/</ref> to 0.5%.<ref name="basedsite">https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/</ref> | This suggests, without an overwhelmed health system, the IFR for the overall population may be between 0.025%<ref>https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/</ref> to 0.5%.<ref name="basedsite">https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/</ref> | ||
Antibody testing in a German city found an IFR of 0.37%.<ref>https://www.reddit.com/r/COVID19/comments/fxp6ux/heinsberg_covid19_caseclusterstudy_initial_results/</ref> But the overall IFR will vary based on the prevalence of old and fat people,<ref>https://www.medrxiv.org/content/10.1101/2020.04.05.20054361v1</ref><ref>https://onlinelibrary.wiley.com/doi/abs/10.1002/oby.22831</ref> as obesity is the second most common risk factor after age.<ref>https://www.businessinsider.com/coronavirus-obesity-top-factor-after-age-driving-nyc-hospitalization-2020-4</ref> | Antibody testing in a German city found an IFR of 0.37%.<ref>https://www.reddit.com/r/COVID19/comments/fxp6ux/heinsberg_covid19_caseclusterstudy_initial_results/</ref> But the overall IFR will vary based on the prevalence of old and fat people,<ref>https://www.medrxiv.org/content/10.1101/2020.04.05.20054361v1</ref><ref>https://onlinelibrary.wiley.com/doi/abs/10.1002/oby.22831</ref> as obesity is the second most common risk factor after age.<ref>https://www.businessinsider.com/coronavirus-obesity-top-factor-after-age-driving-nyc-hospitalization-2020-4</ref> | ||
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Randomized serology tests assessing the presence of antibodies can produce fairly accurate IFRs. In Denmark, such testing was done in Danish blood donors, showing a total IFR of 0.16%. Meaning the virus is less deadly than the flu assuming those who donate blood represent a random sample of the Danish population.<ref>https://www.dr.dk/nyheder/indland/doedelighed-skal-formentlig-taelles-i-promiller-danske-blodproever-kaster-nyt-lys</ref> Random blood tests of Santa Cara County Ca residents show a 0.1% fatality rate, and random blood tests of Los Angeles residents show a 0.01% fatality rate.<ref>https://paloaltoonline.com/news/2020/04/21/los-angeles-study-backs-stanford-researchers-conclusion-about-high-prevalence-of-covid-19</ref> | Randomized serology tests assessing the presence of antibodies can produce fairly accurate IFRs. In Denmark, such testing was done in Danish blood donors, showing a total IFR of 0.16%. Meaning the virus is less deadly than the flu assuming those who donate blood represent a random sample of the Danish population.<ref>https://www.dr.dk/nyheder/indland/doedelighed-skal-formentlig-taelles-i-promiller-danske-blodproever-kaster-nyt-lys</ref> Random blood tests of Santa Cara County Ca residents show a 0.1% fatality rate, and random blood tests of Los Angeles residents show a 0.01% fatality rate.<ref>https://paloaltoonline.com/news/2020/04/21/los-angeles-study-backs-stanford-researchers-conclusion-about-high-prevalence-of-covid-19</ref> | ||
In Italy, the average fatality age was 81. More than 99% of deaths were older than 50 and 99% had an existing underlying condition.<ref name="baseditaly">https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf</ref> Half of the fatalities had three or more chronic diseases,<ref name="baseditaly"></ref> so more than half of the fatal cases would presumably have died in the next few years anyhow. Further, despite extremely overwhelmed hospitals, there were close to ''zero'' fatalities younger than 30,<ref name="baseditaly"></ref><ref>https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates</ref> different from the Spanish Flu.<ref>https://en.wikipedia.org/wiki/Spanish_flu</ref> Healthy people younger than 65 only accounted for 0.3%, 0.7%, and 1.8% of all COVID-19 deaths in Netherlands, Italy, and New York City.<ref>https://www.medrxiv.org/content/10.1101/2020.04.05.20054361v1</ref> In addition, Italy has a history of overwhelmed hospitals during flu season, e.g. in 2017/2018, Italian hospitals delayed surgery and rationed care due to the flu.<ref>https://milano.corriere.it/notizie/cronaca/18_gennaio_10/milano-terapie-intensive-collasso-l-influenza-gia-48-malati-gravi-molte-operazioni-rinviate-c9dc43a6-f5d1-11e7-9b06-fe054c3be5b2.shtml?refresh_ce-cp</ref> | In Italy the early outbreak, the average fatality age was 81. More than 99% of deaths were older than 50 and 99% had an existing underlying condition.<ref name="baseditaly">https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf</ref> Half of the fatalities had three or more chronic diseases,<ref name="baseditaly"></ref> so more than half of the fatal cases would presumably have died in the next few years anyhow. Further, despite extremely overwhelmed hospitals, there were close to ''zero'' fatalities younger than 30,<ref name="baseditaly"></ref><ref>https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates</ref> different from the Spanish Flu.<ref>https://en.wikipedia.org/wiki/Spanish_flu</ref> Healthy people younger than 65 only accounted for 0.3%, 0.7%, and 1.8% of all COVID-19 deaths in Netherlands, Italy, and New York City.<ref>https://www.medrxiv.org/content/10.1101/2020.04.05.20054361v1</ref> In addition, Italy has a history of overwhelmed hospitals during flu season, e.g. in 2017/2018, Italian hospitals delayed surgery and rationed care due to the flu.<ref>https://milano.corriere.it/notizie/cronaca/18_gennaio_10/milano-terapie-intensive-collasso-l-influenza-gia-48-malati-gravi-molte-operazioni-rinviate-c9dc43a6-f5d1-11e7-9b06-fe054c3be5b2.shtml?refresh_ce-cp</ref> | ||
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Much of the media scare arose from | Much of the media scare early in the pandemic arose from preliminary ''"case fatality rates"'' which only consider the number of deaths among those who tested positive, i.e. who are known "cases". | ||
This inflates the numbers based on how extensively people are tested as mild cases go unnoticed when the limited number of test kits are used for severe cases and deaths first. | This inflates the numbers based on how extensively people are tested as mild cases go unnoticed when the limited number of test kits are used for severe cases and deaths first. | ||
For example, end of March in Italy, the CFR was at a whooping 10% because little testing was done.<ref>https://www.worldometers.info/coronavirus/country/Italy</ref> | For example, end of March in Italy, the CFR was at a whooping 10% because little testing was done.<ref>https://www.worldometers.info/coronavirus/country/Italy</ref> | ||
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There have also been sensational reports of fatalities among infected health workers, however these cases are rare (CFR 0.3%),<ref>https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/</ref> and primarily affect elderly health workers, with e.g. a median age of 69 and youngest age 50 in Italy among physicians.<ref>https://portale.fnomceo.it/elenco-dei-medici-caduti-nel-corso-dellepidemia-di-covid-19/</ref> | There have also been sensational reports of fatalities among infected health workers, however these cases are rare (CFR 0.3%),<ref>https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/</ref> and primarily affect elderly health workers, with e.g. a median age of 69 and youngest age 50 in Italy among physicians.<ref>https://portale.fnomceo.it/elenco-dei-medici-caduti-nel-corso-dellepidemia-di-covid-19/</ref> | ||
A | A meta study concluded that the IFR is very low for people younger than 55 (less than 0.2%).<ref>https://link.springer.com/article/10.1007/s10654-020-00698-1</ref> | ||
The hospitalized have a harsher and longer course of the disease compared to the flu, but not substantially.<ref>https://www.nature.com/articles/s41598-021-85081-0</ref> | |||
A study from France showed that the in-hospital mortality is only higher than the common flu for the elderly.<ref>https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30527-0/fulltext</ref> | A study from France showed that the in-hospital mortality is only higher than the common flu for the elderly.<ref>https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30527-0/fulltext</ref> | ||
Relatively high hospitalization rates among young adults (especially in the second wave) are likely due to the elderly being now better protected than the young.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875012/</ref> | Relatively high hospitalization rates among young adults (especially in the second wave) are likely due to the elderly being now better protected than the young.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875012/</ref> | ||
=== Infecting everyone instead of lockdown === | === Infecting everyone instead of lockdown === | ||