
How can a disease with 1% mortality shut down the United States? - enraged_camel
https://www.quora.com/How-can-a-disease-with-1-mortality-shut-down-the-United-States/answer/Franklin-Veaux?share=1
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ggm
A well written overview. I think what is sometimes not read well by 'why don't
we..' type comments is that the non-deterministic quality of this is quite
strong. We can say your predicted risk as an 80 yo is higher than an 8 yo but
we can't say much else. So, the 1% mortality and how it distributes over a
cohort by age, sex, (ok more men) co-morbidities (ok so overweight, type-2 and
pre-diabetic) .. but then we can't really say "oh, you're the high risk for
subsequent heart attack" or "yep: you'll face life crippling mental acuity
hits" or "we have to amputate now"

Ask anyone if they will take 1 in 100 risk and they will casually say yes. Ask
again, if you present them with real risks of life changing outcome at shorter
odds, they may reflect.

I wouldn't stand in front of a 1-in-100 russian-roulette machine personally.

~~~
ImaCake
Agreed. The penalty associated with the risk is important too. Probability
theory and statistics can get us the risk fairly easily. But putting a number
on the penalty associated with failure is a different problem altogether. If
getting sick meant a 1:10 chance of getting a really bad headache for a week,
I would take that chance. But if it was a 1:1000 chance of death I would
probably not take the chance.

------
austincheney
The problem is not the virus itself but instead it’s impact on the
availability of medical care.

If you wish to talk about statistics the death rate associated with the virus
is declining in the US even though the numbers of infection are surging. That
is because medical services are better learning what treatments are effective.
The death rate will continue to decline inversely to the growth of infection
rate only so long as medical treatment is available.

The real problems occur when medicine is over whelmed by the case volume,
particularly when hospital beds fill up. When hospitals lack the space to
provide appropriate care and triage is when the associated death rate shoots
up from declining below 0.1% to over 10% (greater than 100x). Quality and
availability of care impacts all medicine. For example appendicitis is an
easily treatable and relatively common medical problem in the US, but without
available care the patient will die of a blood infection. If that example is
not properly triaged due to lost medical capacity then it shifts from a minor
concern to a potentially fatal problem.

~~~
TheBlight
>That is because medical services are better learning what treatments are
effective.

Not sure that's true. The average age of infected is much lower than it was a
couple months ago. It's likely that more people who aren't at risk of serious
complications are being infected now and we're testing much more than we had
been -- including people w/o symptoms. A couple months ago most people who
weren't considered at-risk couldn't get a test even if they had symptoms.

~~~
therealdrag0
Anyone have a source for cases over time by age?

I’ve heard it hypothesized but never supported. I agree it’s plausible but we
need evidence before confidence.

~~~
TheBlight
[https://www.theatlantic.com/ideas/archive/2020/07/why-
covid-...](https://www.theatlantic.com/ideas/archive/2020/07/why-covid-death-
rate-down/613945/)

>In Florida, the median age of new COVID-19 cases fell from 65 in March to 35
in June.

~~~
therealdrag0
Perfect thanks!

------
hedora
Before you panic, note that this post is full of incorrectly computed
conditional probabilities.

It claims 19% of the whole population will be hospitalized at 100% infection
rate. This seems high, but let’s go with it.

It then cites a study saying 18% of hospitalized patients’ hearts showed
evidence of scarring.

Later, it computes:

> _62,358,000 hospitalized. 59,076,000 people with permanent heart damage._

Multiplying the hospitalized count by 18% gives 11,224,440, or 3.7% of the
population. I’m assuming that no people that avoid the hospital will have
heart damage. The post assumes there is no correlation between disease
severity and hospitalization.

The true rate is probably somewhere in between, and probably closer to 4% than
18%.

~~~
ImaCake
4% of patients having heart permanent damage is still 13,128,000 people.
Qualitatively, those numbers are equally hard to grasp, so why would it be any
less terrifying?

~~~
hedora
Heart scarring (what the study looked for) is extremely common. For instance,
flossing your teeth commonly leads to an opportunistic infection that leads to
heart tissue scarring.

If most of the 13M are expected to be impacted in some way by the heart
damage, then the number is terrifying, but the evidence doesn’t back that up.

Also, there’s a huge difference between 1/5 people need heart surgery, and the
more realistic 60% * 18% * 19%, which is closer to 1/50.

To help put that in perspective: ~1/2 of Americans suffer from heart disease.

~~~
aYsY4dDQ2NrcNzA
Can you provide a link for the claim that “flossing your teeth commonly leads
to [...] heart tissue scarring”?

After some googling, it appears that the opposite is true. If you don’t brush
and floss your teeth, you increase your chances of gingivitis, which can
become a systemic infection.

------
TwoNineFive
I just realized that this has similarities to the September 11th 2001 (9/11)
terrorist attack.

A relatively small investment resulted in the USA invading Iraq, which had
absolutely nothing to do with it, killing hundreds of thousands of civilians,
indebting the US population for a few trillion dollars, and generally causing
a ridiculous over-reaction in just about every way possible.

Has anyone seen any comparisons yet? If not I can't imagine it won't last.
Both are astonishing failures of civil leadership and governance.

------
forgotmypw17
[http://archive.is/JvTzm](http://archive.is/JvTzm)

------
aaron695
Sweden hasn't even been worse than the 2000 Flu season yet. The flu also does
long term damage.

[https://www.reuters.com/article/us-health-coronavirus-
sweden...](https://www.reuters.com/article/us-health-coronavirus-sweden-
mortality/sweden-records-first-week-with-no-excess-mortality-since-pandemic-
struck-idUSKBN23F1WK)

And I don't recall the 2000 Flu season shutting down Sweden/USA/World

Quora might be a good jumping point when doing research, but like 4chan and
other hive minds you still have to think.

~~~
DanBC
> Sweden hasn't even been worse than the 2000 Flu season yet.

Can you post the link to the Swedish statistics? I think you're counting flu
and covid death differently.

For flu I think you're using a mix of all cause mortality and statistical
modelling. For covid I think you're using either "died after being tested
positive for covid" or "covid was mentioned as a cause on the death
certificate".

~~~
aaron695
Ok, the article actually is in Sweden's worst month for covid (April) it was
better than 2000 and 1994.

This also talks about May -

[https://emanuelkarlsten.se/swedens-two-corona-months-are-
not...](https://emanuelkarlsten.se/swedens-two-corona-months-are-not-more-
deadly-than-the-flu-of-the-90s-but-that-does-not-mean-that-everything-is-
normal/)

~~~
panpanna
What people are trying hard to ignore is that we are seeing these numbers
_despite_ shutting down the country and everyone using masks and washing hands
and avoiding contact.

With a business as usual attitude we would see death rates 100 times higher.

~~~
umanwizard
There's no solid evidence of that.

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sunstone
From the statistics I've been seeing, _of the people who get it_ , the
mortality rate is closer to 10%. And the virus is so damned contagious that
with no counter measures taken everyone would get it with say 18 months. And
that would literally decimate the population. Not to mention all the
devastating follow on covid-19 side effects some of which, it appears, never
go away.

~~~
HenryKissinger
A breakdown of mortality by age group and prior health conditions shows that
not everyone is equally at risk.

~~~
ggm
Do you have good insight into the effect on the economy of randomly killing a
high percentage of type-2 diabetes? I know we like to ideate the poor into
this state, but have you considered the effect on the economy, if the
supersize-me generation at large in the economy at all levels suddenly took a
king-hit?

~~~
logicchains
We can roughly estimate this from the effects of the 1918 flu, which killed
way more people, and killed healthy, working age people. The overall effect on
GDP was tiny compared to the effect we're seeing from the lockdowns.

~~~
loopz
Two totally different economies. People will self-lockdown much more
extensively today. Economies were much more local 100 years ago. GDP is also a
meaningless metric when measured in currency, and is anyway antithesis of
lockdown/war times. Sweden didn't lockdown but is still hit hard economically,
and is more isolated today than surrounding countries.

