
2009 flu pandemic in the United States - halamadrid
https://en.wikipedia.org/wiki/2009_flu_pandemic_in_the_United_States
======
clumsysmurf
The CDC's worst case estimate was 214 Million Infected, 1.7 Million Dead

[https://nymag.com/intelligencer/2020/03/cdcs-worst-case-
coro...](https://nymag.com/intelligencer/2020/03/cdcs-worst-case-coronavirus-
model-210m-infected-1-7m-dead.html)

~~~
Taek
I'm not sure how they got 1.7 million dead as the worst case scenario. That
implies a mortality rate of 0.7%.

Mortality rates for Covid19/SARS2 are estimated to be closer to 3.5% by the
WHO, a 35x jump. At 214 million infected, the worst case scenario should be at
least 7.5 million. But I believe the 3.5% estimate also assumes that hospitals
are able to provide intensive care for all critical patients.

The US only has 100k ICU beds, and SARS2 has an ICU rate about 10%. SARS2
patients typically need 2-4 weeks, meaning that the entire US healthcare
system can only handle about 2 million SARS2 infections per month. In order to
keep a mortality rate of 3.5%, the US would need to spread out those 214
million infections over 9 years.

Conclusion: The CDC's worst case estimate of 1.7 million deaths is completely
incongruent with their worst case estimate of 214 million infections.

~~~
_-___________-_
3.5% just doesn't make sense based on any of the case-fatality-rate data we've
seen so far combined with the estimates of what proportion of infections are
being detected as cases. The UK government's chief medical adviser expects the
real fatality rate to be around 0.6%, which is a lot easier to explain with
the data than 3.5%.

~~~
Taek
[https://wwwnc.cdc.gov/eid/article/26/6/20-0320_article](https://wwwnc.cdc.gov/eid/article/26/6/20-0320_article)

"The case-fatality risks, when adjusted for a 13-day lag time from reporting
to death, were 3.5% in China; 0.8% in China, excluding Hubei Province; 4.2% in
the group of 82 countries, territories, and areas; and 0.6% for the cruise
ship (Table). Our result for China, excluding Hubei Province, is similar to a
previous estimate of 0.9% (95% CI 0.6% - 1.3%) by using a time-delay adjusted
case-fatality risk for the same area"

This is the only research data I could find. Do have other data? I have
multiple sources citing the WHO estimating 3.5%, but I was unable to find any
first hand material from the WHO that said 3.5%.

The information above - from the CDC, which I consider to be biased and
underplaying the situation - has 0.6% as the lowest number, and 4.2% as the
highest number.

But honestly none of the data I just went digging through felt comfortable.

Another thing to remember is that the case-fatality-rates we are seeing in
most areas are because the hospital infrastructure can keep up with the number
of infections. If the US gets over 1 million infections, the hospitals will
not be able to keep up and mortality rates will spike significantly.

~~~
_-___________-_
Wait, you're talking about case fatality rates. I thought the above discussion
was about the real fatality rate. Obviously CFR is going to be higher because
you're excluding all the infections that didn't become cases - which are also
the infections least likely to lead to death.

------
forkexec
Without quarantines, COVID-19 will be 280 million infected and 6 million
deaths in the US alone.

~~~
dpcan
1) Why are you assuming it will be 280 Million and not stop at around 59
Million like before?

2) Why choose a number like 6% when it's currently at 3.8%?

3) Why are we experiencing so much more panic over this virus?

~~~
echelon
> 3) Why are we experiencing so much more panic over this virus?

Italy's CFR is over 7%. They've implemented triage in Lombardy where they
won't even consider someone over the age of 65, because they're out of beds
and ventilators and want to ensure patients with the best chances for survival
make it.

Amongst those with symptoms, this virus has an 80% hospitalization rate.

This virus is a test, and we're going to be found severely unprepared.

Give me a moment and I'll go dig up my citations.

Edit: I was wrong about the hospitalization rate. It appears to be 20% [1]

One source cites a CFR of 5% in Italy as of two days ago. [2]

[1] [https://www.nbcnews.com/health/health-news/people-have-
been-...](https://www.nbcnews.com/health/health-news/people-have-been-trying-
underplay-why-coronavirus-different-flu-n1156801)

[2] [https://www.livescience.com/why-italy-coronavirus-deaths-
so-...](https://www.livescience.com/why-italy-coronavirus-deaths-so-high.html)

~~~
tcoff91
80% of symptomatic cases needing hospitalization seems very unlikely. That
sounds like a biased testing sample that’s not even testing anyone that isn’t
extremely sick. South Korean data seems vastly more comprehensive. Most data
I’ve seen puts the upper bound on hospitalization rate at 20% which is still
insanely high given how high the R0 is.

~~~
gremlinsinc
Avg age of tests in S. Korea are around 25, avg age in Italy around 65. That
makes ALL the difference.

------
eo3x0
There are 2 things happening at once that seem to be causing a rift in online
discussions:

1\. It seems like people are severely underrating the flu and always have
been. Remember when we closed all restaurants and bars and suspended all
sports events when the flu killed an estimated 1 million people in 1968-1969?
No you don’t because society seemed to have shrugged that one off. Ditto for
many years when the flu kills upwards of 600k worldwide [1] 2\. The reported
CFR (Case Fatality Rates) across different countries is all over the place
causing a lot of panic and overstated mortality rates. Countries like Italy
report almost 7% whereas in Germany and South Korea, the CFR makes Covid-19
look like no big deal (Closer to 0.1%). I suspect that’s because Italy is well
under counting the true denominator, while countries like SK have tested
thousands of people per day making their data much more comprehensive.

There’s something unique about this year’s outbreak that seems to resonate
deeply with more people. Ultimately it’s definitely not “just the flu” but
it’s closer to that then a guaranteed death sentence.

We may see more damage from the secondary effects (people losing jobs, runs on
medicine and supplies causing people to die) than from the virus itself.

[1]
[https://en.m.wikipedia.org/wiki/Influenza_A_virus_subtype_H3...](https://en.m.wikipedia.org/wiki/Influenza_A_virus_subtype_H3N2#Hong_Kong_Flu)
[2]
[https://en.m.wikipedia.org/wiki/Template:2019%E2%80%9320_cor...](https://en.m.wikipedia.org/wiki/Template:2019%E2%80%9320_coronavirus_outbreak_data)

~~~
brg
What I believe unique about this year's outbreak is that it is the first
"social" pandemic; where in everyone is connected to a nonstop stream of both
information and misinformation regarding its development.

------
smt1
From How the 2009 H1N1 Pandemic Compares with COVID-19:

[https://www.bloomberg.com/opinion/articles/2020-03-10/how-
co...](https://www.bloomberg.com/opinion/articles/2020-03-10/how-coronavirus-
compares-with-2009-s-h1n1-in-spread-and-Freaction)

For example: Why was H1N1 allowed to spread around the world more or less
unchecked, while countries are going to far greater lengths to try to halt
Covid-19? Why did the WHO call H1N1 a pandemic but not Covid-19? Isn’t 12,469
deaths a lot worse than the 26 that have been attributed to Covid-19 in the
U.S. so far?

That last one is the simplest to answer: Covid-19 is near the beginning of its
spread in the U.S., and thus cannot be compared with H1N1’s effect over a full
year. If the U.S. death toll from Covid-19 is only 12,469 a year from now,
that will likely be counted as a great success. The legitimate worry is that
it could be many, many times higher, because Covid-19 is so much deadlier for
those who get it than the 2009 H1N1 influenza was.

How much deadlier is still unknown, but of the cases reported to the WHO so
far 3.4% have resulted in fatalities. That’s probably misleadingly high
because there are so many unreported cases, and in South Korea, which has done
the best job of keeping up with the spread of the virus through testing, the
fatality rate so far is about 0.7%. But even that is 35 times worse than H1N1
in 2009 and 2010. Multiply 12,469 by 35 and you get 436,415 — which would
amount to the biggest U.S. infectious-disease death toll since the 1918 flu.
Hospitalization rates are also many times higher for Covid-19, meaning that if
it spread as widely as H1N1 it would overwhelm the U.S. health-care system.

That’s one very important reason governments (and stock markets) around the
world have reacted so much more strongly to Covid-19 than to the 2009 H1N1
pandemic. Another reason is somewhat more hope-inspiring. It’s that public
health experts generally don’t think influenza can be controlled once it
starts spreading, other than with a vaccine, whereas several Asian countries
seem to have successfully turned back the coronavirus tide, for now at least.

Influenza can’t be controlled because as much as half the transmission of the
disease occurs before symptoms appear. With Covid-19 that proportion seems to
be lower, meaning that even though it’s more contagious than influenza once
symptoms appear, it may be possible to control by testing widely and quickly
isolating those who have the disease.

------
gorgoiler
Gosh, the memories. Swine flu caused me to black out for a whole day and yet
it seemed to bounce off other people as if it were the common cold.

That’s the biggest unknown about the new coronavirus disease for me: how ill
am I actually going to get? Flu seems so unpredictable.

~~~
tcoff91
the level of viral load in the initial exposure has a lot to do with how sick
you will get. If a sick person coughs in your face that’s much worse than just
touching a lightly contaminated cardboard box and getting it that way.

------
tjoff
Why? Why is this relevant?

It seems the reason for this is to downplay covid-19. As if that outcome is
what the whole world is freaking out over.

If anything you should see those numbers and ask yourself. What if it were
exponentially worse?

That is also under the assumption that hospitals will not overrun. Which they
will.

Don't plan on having any injuries this year.

~~~
ComputerGuru
To the contrary. That one was _that_ bad and everything points to this being
significantly worse. That’s a good reason to post it.

~~~
halamadrid
This is what I felt when someone pointed me to the article. I noticed people
were still going to birthday parties and other social events when they really
should be practicing social distancing.

Even a milder flu like in 2009 could reach 59 million and COVID-19 can be
exponentially worse. That is really the only take away. We need to discuss
this in the open to bring that truth to light. I agree with some of the folks
here who said many could see it another way and take light view of the
situation. What exactly can make them see it differently though?

------
iLemming
COVID-19 is nothing like flu. There are still many unknowns about this virus.
We are still not sure of its origins. We have no idea of the long-term effects
of it. Some of those who "recovered" already in need to have lung transplants,
many have severely damaged lungs. It is difficult to predict how many of those
who recovered would live long and healthy lives.

If you are scared shitless and panicking - you should be. Protect yourself and
your loved ones. Stay home.

~~~
dingaling
> COVID-19 is nothing like flu.

It is precisely a variant of coronavirus flu. Why do you think otherwise?

~~~
Turing_Machine
It isn't any kind of "flu".

Coronaviruses are in a family that typically causes what we call the common
cold. Flu is caused by influenza virus, which is a completely separate family
of viruses.

------
dbhattar
I came across this tweet from Stephen Schwartz which he posted after the
global health security team was disbanded by John Bolton:

[https://twitter.com/atomicanalyst/status/994696175575068672?...](https://twitter.com/atomicanalyst/status/994696175575068672?s=21)

“When the next pandemic occurs (and make no mistake, it will) and the federal
government is unable to respond in a coordinated and effective fashion to
protect the lives of US citizens and others, this decision by John Bolton and
Donald Trump will be why.”

And he links to the following article.

[https://t.co/iMSzopSRaI?amp=1](https://t.co/iMSzopSRaI?amp=1)

The tweet is creepily prescient.

------
donmb
Coronavirus vs. swine flu (H1N1) – 2009-2010 Swine flu is the same strain of
flu that wiped out 1.7% of the global population in 1918. It was declared a
pandemic again in June 2009, and an estimated 11-21% of the world population
contracted it.

Fortunately, the CFR is considerably lower than in the previous pandemic, with
0.1-0.5% of cases resulting in death. 18,500 of these deaths were laboratory-
confirmed, but estimates are as high as 151,700-575,400 globally.

50-80% of severe cases were found in people who had underlying conditions such
as pregnancy, asthma, diabetes, and cardiovascular disorders.

Compared to swine flu, coronavirus:

\- is less widespread \- has caused fewer deaths \- has a higher CFR \- has a
longer incubation period \- affects young people less

[https://about.futurelearn.com/blog/covid-19-how-does-
coronav...](https://about.futurelearn.com/blog/covid-19-how-does-coronavirus-
compare-to-other-outbreaks)

