I think the author forgot the punchline.
"As one of the first few people to arrive in the US of A under quarantine, I survived with a team of hazmat clad expert clinicians and round the clock medical care in a biocontainment facility and you can, too!"
It reminds me of some of the social media that came out of Wuhan. ...people begging for care for their loved ones, only to watch them die at home or in the waiting rooms because no respirators or beds were available.
Once respirators run out, the fatality rate jumps from 2% to 5%.
While it's nice to hear from someone that's recovering well, this blog doesn't give me much solace since it's a form of selection bias. The people that have COVID-19 and are intubated and on a respirator in a hospital likely aren't blogging about it.
Given that 10-15% of people that get it end up in the ICU on a mechanical respirator, and that even those that survive end up with permanent lung damage, I would argue that selection bias at a time like this is almost criminally negligent reporting.
"So far" is doing a bit of work, but ignoring that...
We know that COVID-19 has a high mortality rate (and a high rate of requiring ICU care). "High" doesn't mean 50% or higher; it means high compared to influenza or high compared to the capacity the US health system is intended to handle.
This article shouldn't be reassuring. Read this line in particular:
If I were at home with similar symptoms, I probably would have gone to work as usual.
Not really, we've built a culture around pushing ourselves to work even when we are sick.
What would be more constructive than being scared is to work positively to end this culture.
Edit: to be really explicit, staying at home for several days when you feel sick and even after you think you have recovered should continue, even after the fear of the Coronavirus dies down.
Agreed that that should be a cultural change, and it'd be good for individuals, individual businesses, the economy, and society at large.
The fact that that viewpoint is representative of a broader cultural trend is genuinely terrifying, though. Even ignoring people who have to go to work in order to pay for food and housing (no legal requirement to offer paid sick leave!), there will be a very large group of people who believe it's virtuous to toughen up and go to work anyway, even if they feel like death incarnate.
> So far" is doing a bit of work, but ignoring that...
Exactly. He and his wife felt fine when they left the ship after 16 days. Meanwhile, six passengers who had symptoms earlier are dead. The author could easily have his worst days ahead of him and this article does everyone a disservice.
The Spanish flu infected about 500 million people and killed about 50 million according to most estimations. That's a death rate of 10%.
It should also be said that the 1% rate for COVID-19 is probably too high because a lot of cases appear to be hardly symptomatic. The cruise ship had 3 deaths up until now, all over the age of 80.
> It infected 500 million people around the world,[2] or about 27% of the then world population of between 1.8 and 1.9 billion, including people on isolated Pacific islands and in the Arctic. The death toll is estimated to have been 40 million to 50 million, and possibly as high as 100 million
You're nitpicking for no reason; they're close approximations. maybe it was 2.1% or 1.9% maybe it was 40 million or 60 -- record keeping 1918 globally may not have been exactly computer-perfect. There was a war being recovered from, the world was still poor, and medical science inexact.
>>um mortality rate is something like 1% ... hardly high
Mortality is 100%...for the person that dies from it. And that 1% rate is so far, I hope we don't see what happens if 46 million people in USA get it and try going to the hospital.
3711 passengers and crew on board total. 709 tested positive for COVID-19. So sub 1% mortality for the infected. And that's in a population that's likely much older and less fit or healthy than the rest of us. And in pretty ideal conditions for the virus to spread (close quarters, shared living spaces etc).
They walk through two doors at the end of the hall, recovered or dead. For many of them, they have only started, we'll find out the real numbers when they have finished being sorted out.
Also there are a lot of people who are "recovered" and tested negative, but a few days later were testing positive again. Either the testing kits are testing for the wrong things or are defective in some way, or there is the possibility the disease is biphasal or/and retreats to a reservoir in the body.
I haven't been able to find good sources on this, not that I'm disputing it, plenty of other viruses remain in people's system long after they are "cured".
Either way, I think any hope of containing and exterminating the virus is long gone. We will likely all get this eventually. The question is whether we can manage that process so that hospitals are not overrun by the people who need inpatient care.
The Diamond Princess is pretty reassuring, in a way, because it shows that if appropriate healthcare ends up delivered to every patient, you can effectively fight the coronavirus and prevent a Wuhan situation.
But the most salient factor of the Diamond Princess is this: everyone did receive top-notch treatment, and no healthcare system was put under strain by treating the patients. That will be hard in the real world, as opposed to the petri dish case.
The key thing right now is slowing down the spread as much as possible, so the medical system doesn't end up overloaded.
I think your comment is a very good assessment of the issue: healthcare availability decides mortality it seems...
It seems to me that we will all eventually get this virus. It's on all continents, it's infectious and hard to diagnose before it's spread. So the question is whether we can manage it so it hits slowly enough that everyone who needs inpatient care can get it. I wonder how tmit will look when it hits western countries in full. I hope its OK.
I am not sure what is your data source. The one I linked shows 6 deaths, 10 recovered, and 36 in serious or critical condition. There is no information about the status of the other 653.
Unlike many outbreaks, covid-19 appears to disproportionately favor the young
That wording seems ambiguous, from the dictionary:
favor - feel or show approval or preference for
While I can see how you could say that since children are spared, the disease "favors" them, that doesn't sound quite right. If I said "The serial killer favors young women", I think most people would assume that young women were his target.
"Old" is ambiguous, but I meant that COVID-19 mortality risk increases steeply with age.
If they're 60, their risk is slightly higher than 3% because they're male and on the edge of two age groups.
Their previous state of health would be the biggest variable.
80+ years old 14.8%
70-79 years old 8.0%
60-69 years old 3.6%
50-59 years old 1.3%
40-49 years old 0.4%
This preliminary data from the Chinese officials maybe wildly high or low because dividing current deaths by current cases is invalid within an active event due to the two week incubation period. Additional math would be needed to estimate a range of total current unknown infections in order to make the percentages accurate.
What is known, is that like the flu or pneumonia, very old, males and unhealthy have elevated mortality rates.
as you go up the age--I know it sounds cruel--but a lot of them would be dying anyway.
So 15% of 80+ year people dying of any cause is probably not far off normal dying rates (without the virus). Anyone know the age group stats of % of people dying of any "regular" causes?
Looks like 6% of 80-84 and 14% of 85+.
Someone better at statistics than me could probably say what the relative and absolute risk increase is for contracting COVID-19 at those ages is.
Search for "all cause mortality by age" if you want to do some more research.
Are you male and have a chronic cardiovascular or pulmonary condition?
--- CFR (males and females) ---
50-59 years old 1.3%
40-49 years old 0.4%
30-39 years old 0.2%
Male 2.8%
Female 1.7%
These are averages across ages, and they maybe wildly inaccurate because of the on-going situation has unknowable data on those who are sick but won't seek help or those who will become sick before it's over.
Figure 24% higher if male, so roughly 0.5% (1/200) or 24% lower if female 0.3% (1/300) if female, and average health for both. Health condition makes it too unpredictable to guess further, but good health appears strongly correlated with good outcomes and vice-versa.
You do realize that if those death rates [0] hold up, when you take today's global population by age demographic and tally up how many people are expected to die within each age group, you get a total of 90 million dead.
Given that top epidemiologists are predicting 40-70% of adults will be infected this year, that would mean roughly 35 to 62 million people would die this year.
That sounds like a lot of people, but it's not likely to cause real, noticeable problems in society. I think there's a good chance that our reaction to the virus is more damaging than the virus itself.
If 40-70% of people will be infected this year and 35-62 million will die, that's 1-1.5% death rate. The average person will probably know a few people that die from it, but the average person probably knows hundreds of people. This is going to be similar to the number that die from car accidents or HIV, and neither of those have wrecked society. It's going to be sad, but probably won't change life as we know it, unless we let it.
Personally, I think we're all overreacting a bit, and the overreaction is what's going to cause the problems, not the disease. The Spanish flu caused problems, but that was ~10x deadlier than COVID-19. We all just need to worry less and be a little more proactive about visiting the doctor.
I see these stats popping up when people express fear and it's crazy to me that we've hit the point where saying "Well, you probably won't even die!" is supposed to assuage concern.
Sure, I probably won't die if I get it.
I'd rather not be laid up in the hospital (or at home even, really), missing work and other important events as I accrue a larger and larger financial burden because of the US's expensive health care. And that's not even considering the impact this could have to my elderly family and friends.
Exactly. "Mid-forties" probably means friends and associates in the fifties and sixties, parents in the seventies at least. Just knowing someone who is affected can be harrowing, even if it's not you. But I guess a lot of people here don't ever think about anyone who's not them.
>My chest feels tight, and I have coughing spells. If I were at home with similar symptoms, I probably would have gone to work as usual.
This makes me legitimately angry. If you are sick, please stay home, I don't care if you feel "well enough to work". Keep your viruses away from me and everyone else you work with. You're not getting any brownie points for "being a trooper", everyone is just going to be annoyed at you for getting them sick.
You are also harming other people when you do; maybe your immune system is all fine and dandy, but plenty of people don't have that luxury. Going to work despite feeling sick means you think your desire to portray yourself as a hard worker takes priority over other people's lives.
You sure you'd get in trouble, or are you just assuming? Especially if you still worked from home?
Possibly I've just hit the boss jackpot 11 times in a row, but I've never been punished for staying home when sick. When I've felt capable, I've worked from home when sick, but sometimes I haven't even done that.
Assumptions aside, the rest of the people you're endangering don't care what your boss thinks, so, maybe everyone should reevaluate their priorities. Bosses included.
The irony of judging someone for "maybe assuming" that they might get in trouble, yet completely assuming that they can work from home.
It's kind of hard to pull bricks at the building site or sell groceries at the shop from your living room, you know, cause of the distance and all that.
Most importantly, we ought to prohibit requirements for medical documentation in all but the most extreme cases. My service worker friends are legally entitled to paid sick leave, but are unable to use it without a doctor's note. But none of them are provided insurance through their employer.
I know in general the users of this forum are generally loathe to accept government intervention, but the current mechanisms of American capitalism are antagonistic to public health and civil defense.
I’m not sure, do people really feel this way, and does it weigh up against the ‘this guy is never coming to the office’ and ‘we won’t pay you if you don’t show up’?
Can somebody tell me why I was downvoted? This was a serious question.
I read about multiple people in the US who are not sure if they had coronavirus or not, but didn't go testing. Also it seems like flu is supposed until proven proven that a person has coronavirus.
Most cases will be like a cold. As many as 8% may require ICU care to survive. Unless protocols improve, at least a quarter of those will die. We need a lot more ventilators, immediately. And aggressive use of existing antivirals, protease inhibitors, with thorough data collection.
Don't have links, and there is much debate. The tricky part is people die quicker than the recover, so any death and recovery totals measured on the same day are measuring different populations.
But as people learn more they are getting better ideas on the disease progression. Every number has many assumptions built into it.
Seems like very little is known about how many people have had it and were either asymptomatic or minimally symptomatic. So the actual mortality rate is highly debated, without much real info. Not enough testing kits anywhere (in particular the USA and China) is making this difficult. Even with testing it's hard because and unknown number of people can just shrug it off.
But if you do go to the hospital and they are completely overwhelmed, treating people in hallways, etc the death rate is 10%. There were times in Wuhan where this was true.
If somewhat overwhelmed, able to treat, but not put on a full ventilator, but able to do supportive care (anti-virals, fluids, oxygen, etc) looks like the mortality rate (again for those that go to the hospital) is under 5%. Wuhan has been like this for some days now.
For those that go to the hospital where they aren't overwhelmed and you can get full supportive care up to and including a full ventilator the mortality rate, again for those that go to a hospital, is under 1%. This is seen in numerous countries that have very few cases.
To add on to your point, this is an argument for taking it very seriously right now, not shrugging it off. Good policy decisions right now can save lots of lives; a million people requiring hospitalization over a year is far, far better than a million people requiring hospitalization over three months. Slowing down the rate of infection isn't just kicking the can down the road, but something that will save countless lives.
