Speaking for Nephrology...Originally Posted by Borderland
No it would be lower. Currently the denominator for the 2% are only people who have been sick enough to go to a doc and get diagnosed. There are probably a large number who have it with no symptoms or with very minor symptoms who do not seek medical care. If you add them to the denominator the 2% might become .7% (made up number).
The pandemic planning staff was axed two years ago. So I guess the government is going to wing it.
My fear is when this gets into the nursing homes, it’ll be pretty bad.
A 3% mortality rate in a global pandemic will be something we haven’t seen in a century.
If we have to march off into the next world, let us walk there on the bodies of our enemies.
Imagine when it it's the homeless populations in major cities...
Even if only 70% of the population contracts the virus with 0.5% of those cases becoming fatal, it will be horrible. There are about 350 million people in the USA, so 70% of the population is 245 million. If just 0.5% of that 70% are fatalities, that is 1.225 million deaths. And that is just the direct hit. Medical resources, including physicians, nurses, lab techs, rooms, respirators, labs, imaging, et al, will be diverted to handling these cases, and people suffering other ailments will not get necessary treatment in a timely manner. That concerns me as much as the coronavirus itself.
To put it in perspective, the CDC reports that the total US annual deaths in 2017 was 2.813 million people per https://www.cdc.gov/nchs/fastats/deaths.htm So the disease would increase the death rate about 43% IF (big if) 70% of the population gets the coronavirus and 0.5% of those who have the virus perish from it. Let's hope the numbers are a lot lower.
such is always an issue with a case series. of course that's what we hope although arguing against is the "diamond princess cohort" with something like 37 listed as critical.
I was just skimming the end of the thread so apologies if this was covered earlier, but conceptually, shouldn’t a mortality rate be calculated with the denominator being the population of total cases that have, for lack of a better term, run their course entirely (i.e. resulted in either recovery or death)?
It seems to me using a denominator that is the current total active case population would be misleading. In essence we are dividing a population of patients whose terminal status is determined and fixed into a broader population whose end result is variable and unknown.
Using the adjusted methodology above, one would get a mortality rate much closer to 9%, no?
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Correct. 9% if we include #’s from China. 14% if we exclude China. About 10% if we exclude China and Iran.
I am not a medical professional, so my opinion on this is worthless, but here goes. As long as the definition of fatality rate is consistent and applied equally and consistently, the exact formula does not matter to me. That being said, as someone who does a lot of planning with a ton of known unknowns, I like the concept of using the total number of cases as the denominator. The reasons for that are two-fold: 1) a prerequisite for the rate being applicable is having the virus, and 2) the denominator determines the real impact. If a disease is 100% fatal and infects only 100 people, it is not a huge issue in terms of public health even though the fatality rate is 100%. But if another disease is 1% fatal but impacts 50% of the population, there is a huge public health issue as 0.5% of the population is going to die. Your proposal also starts with the disease having a fatality rate of near 100% at first (as people will die while others are still "infected") and dropping as others reach a terminal phase other than death. That metric does not help for planning.
There is a third, not related, reason to make the denominator as big as possible; it makes the numbers look better, hopefully leading to less panic. And managing to avoid panic is going to be a big deal. Panic could kill more people than the virus as scared people do stupid stuff, especially when everyone is scared.
In any event, it is possible to find issues with any methodology, so I prefer to use ones that aid me in planning total system impacts.
I guess I just don’t understand how any math is useful here. If this thing takes up to 8-10 weeks from first exposure to full recovery, full recovery being you are healthy and can no longer spread the virus, then we don’t have any information yet. It’s clear to anyone rational that the Chinese and Iranian numbers are lies. So how can we know what the real data is until a western country has had enough cases fully recovered?
I'd say that the Iranian numbers are complete and utter lies. The Chinese ones? I'd say they might be skewed but the World's eyes are on them and if they fuck this up their economy is seriously on the line. If other countries suspect China grossly fudging the numbers the travel restrictions, etc, will continue to remain in play. At least that is my thirty second assessment.
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