
Ask HN: What's Missing from Covid19 Reporting? - DoofusOfDeath
What questions do you have about covid19 that seem important but aren&#x27;t being asked&#x2F;answered in public forums?<p>(I&#x27;ll post my own below)
======
DoofusOfDeath
I've heard that high blood pressure is a risk factor for the severity of a
covid19 infection. But does that mean...

(a) People who have actual, uncontrolled high BP?

(b) People who _would_ have high BP, but don't because it's controlled by
medication?

(c) People who are taking specific BP-controlling meds?

(d) Some combo of (a), (b), (c)?

~~~
dchyrdvh
Iirc, it's about ACE2 inhibitors used in many BP drugs: they mess up with ACE
receptors and the virus has an easy way in.

~~~
mrfusion
So should we treat corona with the opposite of an ace inhibitor?

~~~
dchyrdvh
You're asking a mechanic what technique we should use in this brain surgery.
As a mechanic, I'd say that a good wrench is a safe proven choice.

------
he11ow
Reliable data on asymptomatic cases. The models we have at the moment are
trying to fit parameters based on the known data, but of the known data, the
only reliable one is the death rate. So there are a lot of degrees of freedom
here with regards to the spread of the virus. (Because carriers are only
identified on a limited basis, mostly in hospitals, it presents a skewed
picture, so this data is not hugely useful) Once antibodies tests are
available, you can get a sense of how many people in a sample population have
had the disease with mild-to-no symptoms, and that can say a lot about how
it's spread.

~~~
Terretta
> _of the known data, the only reliable one is the death rate_

Back of the napkin numbers to get someone's attention:

    
    
        deaths today / CFR of 0.009 = cases three weeks ago
    
        cases three weeks ago * 7 three day doublings = cases today
    

In much more detail:

[http://hyperdrive.ca/coronavirus/index.php](http://hyperdrive.ca/coronavirus/index.php)

And in the "4 out of 5 dentists agree" category:

[https://fivethirtyeight.com/features/experts-say-the-
coronav...](https://fivethirtyeight.com/features/experts-say-the-coronavirus-
outlook-has-worsened-but-the-trajectory-is-still-unclear/)

------
zomglings
1\. How do frequency and density of exposure correspond to infection rate?

I'm assuming there are some basic principles that apply to any virus, but I
don't know what they are and have found it difficult to get find meaningful
information.

2\. If lowering frequency and density of exposure reduces infection rate - as
the papers that Google surfaces when querying this kind of thing suggest -
does this mean that social distancing could be more than a knee-jerk means of
reducing the stress of the healthcare system? Could it form the basis of a
long-term containment strategy?

3\. Would it be possible to randomly test high-traffic areas (grocery stores
and gas stations in the US) to get a better sense for how this disease is
spreading? Why are we not doing this?

------
burntoutfire
The origin of the virus. The mainstream media assumes the virus was created in
a natural process of mutation and jumping species, while there's this little
paper [1] in Nature Medicine from 2015 where authors (virologists) confirm
that they created a novel, human-transmisible coronavirus, based on a new
virus they discovered among bats. Some of the authors of the paper are from
Key Laboratory of Special Pathogens and Biosafety at the Wuhan Institute of
Virology...

[1]
[https://www.nature.com/articles/nm.3985](https://www.nature.com/articles/nm.3985)

~~~
mancerayder
"This was created in a lab" has been the whisper of conspiracy-theorists. How
likely is it? And a vial broke and it got released like in a Marvel comic?

~~~
burntoutfire
Coronaviruses are actually created in labs as part of virology research (see
my original link). It just seems that, in light of links that people posted,
it did not escape/was released from the Wuhan lab - the strain that created
the pandemic originated via natural processes.

~~~
tropo
Nah, see my comment above. Those links only tell us that we did not find
evidence of the use modern gene-editing technology in the virus. It's
misdirection with a straw man.

The lab was breeding viruses the old-fashioned way long before modern gene-
editing technology was invented. Bat coronaviruses would be mixed with other
viruses and repeatedly passed through human cells. That leaves no evidence in
the genome. It looks just like natural selection.

The virus labs in China have had several other dangerous accidents that let
viruses get out. Those previous accidents were gotten under control. With this
one, we weren't so lucky. I think the lesson is clear: don't screw around
making deadly viruses when your biohazard containment is substandard. Maybe
just don't attempt it under any conditions.

~~~
mancerayder
There's a lot of supposition here. If this extraordinary claim is true, why
isn't it screaming at the top of headlines?

~~~
tropo
Lots of reasons:

There is a difference between "seems obviously correct" and "proven well
enough to avoid a lawsuit".

China exerts control over American media companies. Ones that don't play ball
get banned in China. Remember that these companies are usually involved in
many businesses, including the sale of movies to China's large population.
Everybody is afraid to upset China.

Even the publisher of Nature has ditched about 1000 articles that were
upsetting to the Chinese government.

Much of the US media is strongly in opposition to the US president. (They even
stopped airing his virus updates, despite good ratings, because it was making
him look good.) There is no desire to spread any news that could support his
opposition to China.

------
DoofusOfDeath
We hear stories about production ramps for personal protective equipment, for
healthcare providers and regular citizens. But what are the actual projections
for the need-curve vs. the availability-curve of those commodities in various
places?

------
abstractbarista
What is the _true_ mortality rate? All the numbers are based on positive test
counts, but testing isn't being done for most people with nominal (casual)
symptoms.

This has led to a situation where we think (for example) 2% of positive cases
die, when in reality, there may be millions of positive _untested_ cases
resolving without issue.

------
tiredwired
Which medical centers are overwhelmed and which ones are operating normally.

------
fool_wolf
Numbers related to the outbreak that are meaningful without denominators
(since we don't have any and won't until long after things get back to some
semblance of normalcy). Seems like this would be hospitalizations (due to
covid) and deaths (due to covid). Those are numbers where the volume (as
opposed to the rate) are the signal.

------
orsenthil
As per:
[https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594...](https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6)

In China: Total Confirmed = 81,782 Total Recovered = 74,181 Total Dead = 3,291
\-------------------------- Remaining = 4,370

* I am assuming the number 4,370 will fall either into Recovered or Dead.

Can someone confirm this theory?

Is this going to the same for US?

Total Confirmed Cases = 69,684 Total Recovered = 619 Total Dead = 1,049
\-------------------------------- Remaining = 68,016

Does this mean the fate of 68,016 not known yet in US? A similar concerning
number exists for Italy too.

~~~
Leary
80%-85% of the 68k are probably mild cases that will recover without medical
help.

15-20% will need hospitalization. ~5% will need ICUs.

0.5%-5% will die depending on whether the medical system is overwhelmed.

~~~
amanaplanacanal
Maybe. If most are mild, how did they ever become confirmed cases? I would
assume that mild cases would never get tested.

------
rosspackard
Fully anonymized medical history/demographics data across countries and open
to the public.

This would allow crowd sourcing and statistics to be applied by the best minds
in the world.

I know regulations can make this difficult but many difficult boundaries are
being pressed now.

------
DoofusOfDeath
Some anecdotes of covid19 infection talk about people being in severe pain.
What's the relationship between that symptom and final disease outcome?

------
unlinked_dll
more granular or qualified statistics.

e.g. yesterday, Gov. Newsom went on the radio and said something along the
lines of "half of people hospitalized were 18-60" (paraphrasing, don't
remember the numbers exactly, etc). But something like 2/3rds of our
population is that age!

Another thing would be statistics on triage as the outbreak overwhelmed Italy.
I'd like to know who was going to the hospitals, who was admitted, who needed
to be in the ICU, etc, and how the profile of patients changed as beds got
filled.

Nutrition. I've already noticed food purchasing has changed at my local
stores. I would like to know if we're exasperating our public health crisis by
ruining our diets and if we should be concerned about that moving forward.

And finally, alcohol and drug consumption - particularly by millenials.
Anecdotally, many of my peers are drinking a lot more regularly than they
normally would during the day and week. There are plenty of memes about it,
but I'd like to know if we're looking for hope at the bottom of a bottle for
the next few months.

------
whb07
A detailed break down by age.

Then bonus points would be a column showing the mortality rate of a person in
that country.

For instance an 80 yo in the US has a 6% mortality.

~~~
kuczmama
Here you go. This shows a breakdown of fatality rate by age.
[https://www.worldometers.info/coronavirus/coronavirus-age-
se...](https://www.worldometers.info/coronavirus/coronavirus-age-sex-
demographics/)

------
mrfusion
Why does almost everyone I talk to report having a flu like illness in January
that tested negative for flu?

------
GoMonad
1\. What happens in the middle, between a lock-down bringing down the infected
numbers and vaccine.

I've read a few things from epidemiologists, but there seems to be little
discussion in the wider media.

[https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-
th...](https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-
be9337092b56)

2\. What's going on with the PCR reagent shortage? Where are they produced?
Why is it hard to make it quickly? etc.

------
throwaway963577
What does successful containment look like 3 months, 6 months, and a year from
now?

------
throwaway963577
What should governments be doing for maximum practical containment?

------
throwaway963577
To what extent will lies, half-truths, spin, and disinformation increase
preventable fatalities? What can be done within existing legal frameworks to
stop this disinformation?

------
DoofusOfDeath
What are the current projections of test-kit availability vs. need for
different regions? E.g., when do we expect that doctors can test everyone that
suspect of having covid19?

~~~
pmiller2
We actually need more testing than that. Yes, we should be testing every
suspected case, but we should also be mass testing everybody, or, at least
random samples of everybody. We need to know where this virus is and is not
and what the extent of asymptomatic carriers is. Information is the only
weapon we currently have against this virus, and we have shockingly little.

------
skat20phys
A discussion of how regulatory structures contributed to problems in the US
(lack of tests, number and variety of providers and services, and so forth).

------
mrfusion
I’d like to see the rumor that people can’t develop an immunity to this put to
bed. Surely we have enough data at this point.

~~~
pmiller2
Is that the rumor? Last I had heard, the best science is essentially a guess,
but the thinking is that people will develop some kind of immunity. We know
this happens with other coronaviruses, and we have found antibodies in people
who have recovered from the disease. I don't really know how we can
definitively and ethically say "yes, people do develop some immunity to the
virus" without deliberately attempting to reinfect people. Maybe an _in vitro_
study would add to the evidence, but _in vitro_ studies frequently don't scale
up to whole humans.

------
mrfusion
Why don’t we get any information on if the shutdowns are working? Why is nyc
still so bad?

------
kleer001
Why did/does China lie so early and so often about the progression of the
epidemic?

------
clircle
What is the sensitivity and specificity of the Coronavirus tests?

------
DoofusOfDeath
In early public reporting on covid19 in the U.S., when the patient died it was
common to hear that he/she had "underlying health issues".

Why be so vague? It seems like more detail would help people identify their
personal risk level.

(Edited for tone.)

~~~
tomstoms
Privacy?

~~~
DoofusOfDeath
I've heard that idea floated before, sometimes in conjunction with references
to the U.S.'s HIPAA law.

But I've only heard speculation about this - never an explanation from someone
closer to the source.

~~~
tomstoms
I don’t know about the US but at least in Norway it’s stated as a reason. Age,
geography and diagnosis is sometimes enough to identify a person, and there
are regulations governing that here.

------
mrfusion
Why do medical personnel seem to get hit harder with this?

------
mrfusion
I think we should be following all of these vaccines and clinical trials
really closely.

We all watch what the stock market does every day. Let’s start watching what
these trials are doing every day. Really put the spotlight on these folks.

I feel like as a population we’re acting too much like victims. Let’s take
charge of this.

