
How can a disease with 1% mortality shut down the United States? - rdoherty
https://www.quora.com/How-can-a-disease-with-1-mortality-shut-down-the-United-States/answer/Franklin-Veaux?ch=1&share=d1dc67e6&srid=TVxR
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akira2501
> Three million people dead would monkey wrench the economy no matter what.

Wouldn't that largely depend on the age of the victims? If the majority of
victims are over retirement age, then this isn't likely to be true.

We've had nearly 1% of our population killed or wounded in a short period of
time before, it's impact on the economy doesn't seem that obvious.

> 18 of those will have permanent heart damage for the rest of their lives. >
> 10 will have permanent lung damage.

The extent of these doesn't seem clear either, looking back to the previous
SARS epidemic, there was significant ARDS recovery after diagnoses over a
period of several years; however, with other certain pre-existing conditions
the organ damage was permanent.

Even in those cases, the rates are significantly lower than this suggests. It
seems like a lot of small sample size studies were used to generate these
numbers. I don't doubt COVID is horrific and requires special care to address,
but I don't see any benefit in exaggeration.. particularly if your goal is to
address an already skeptical audience.

~~~
umanwizard
> We've had nearly 1% of our population killed or wounded in a short period of
> time before

In fact, more than 1% of the population dies every single year.

~~~
toomuchtodo
It’s actually a little less than 1% a year (~2.8 million out of ~329 million
people).

[https://www.cdc.gov/nchs/fastats/deaths.htm](https://www.cdc.gov/nchs/fastats/deaths.htm)

------
skeppy
Help me. I’m confused. Is the author saying that 1% of the people who are
_diagnosed_ with it will die? (That’s how I read it at first).

Or is he saying that 1% of everyone will die? Maybe that sounds like a dumb
question, but I honestly don’t know if everyone is using the term “mortality
rate” the way I think of it (which for me, until recently, was the first
option above).

I guess I don’t even know if it makes a difference. Won’t we all be exposed to
it anyway, if we haven’t already? Some of us may never know if we were, and
others (sadly) will know straightaway.

If we can assume that nearly all of the USA (for instance) will be exposed and
“catch” it, whether tested positive or not, then is the second version of
“mortality rate”, in effect, the same as the first?

I’m only asking because I honestly don’t know and there is so much speculation
and confusion out there. Hoping that someone on HN who is much experienced
(and maybe in the world of medical stats) can clarify this for me.

~~~
D13Fd
There are two categories of ways this can resolve:

(1) We beat the coronavirus. People no longer regularly get infected.

(2) Coronavirus is here to stay. We'll all get it eventually just like we all
eventually get colds and the flu.

I think it's pretty clear at this point that (1) isn't happening, at least
absent a vaccine. If we do get a vaccine, it may be a polio/measles type
situation where we can eliminate the disease, or it may be a flu-type
situation where we all just get vaccinated every year.

So focusing on (2), where we all get the virus. We don't know the exact
mortality rate for those infected. We don't know how the rate varies for re-
infections.

We do know that the mortality rate is lower if the hospitals aren't full. So
the shut downs may be logical in terms of keeping the infection rate low
enough that the hospitals don't fill up, if we think it's worth it.

Whether the mortality rate benefits are worth the economic harms is another
question, though.

~~~
lazyloop
Shutdowns also give the virus more time and incentive to evolve into more
contagious variants with much milder symptoms. If we delay it long enough it
can actually end up just being like the seasonal flu.

~~~
stnmtn
I know nothing about this, but from what you're saying it sounds like the more
contagious a virus is, the milder it's symptoms are? Is this usually true for
all viruses or did I just misread your comment

------
6nf
> For every one person who dies:

> 19 more require hospitalization.

> 18 of those will have permanent heart damage for the rest of their lives.

...

> One study published in March found that out of 416 _hospitalized_ Covid-19
> patients, 19% showed signs of heart damage.

How many other mistakes can you spot?

~~~
stoksc
I just spent 5 minutes typing this up only to see your post.. thank you for
also noticing. The other point made from this source (about permanent lung
damage) is also wrong. I don’t see sources for the other numbers.

I agree never closing the economy would’ve been a total disaster. But the math
here is bad.

~~~
me_me_me
Writing from Ireland, >20 cases a day (as of writing). The lockdown here was a
huge success.

But looking at the US numbers it seems that you got the worse outcome of
lockdown/no-lockdown. Economical hit, plus number of cases are back on the
rise due to people not isolating properly.

One could argue that for US lockdown was a mistake. Or at least very costly
move to delay/prepare for peak infections.

------
stoksc
> (out of a sample of 100 people) For every one person who dies: * 19 more
> require hospitalization. * 18 of those will have permanent heart damage for
> the rest of their lives.

> One study published in March found that out of 416 hospitalized Covid-19
> patients, 19% showed signs of heart damage.

Assuming 19 in 100 require hospitalization, according to the study: 19% of 19
will have heart damage or 3.61. Similar breakdown for other points.

Disclaimer: shutdown was the right call and the point is still valid with
smaller numbers (they’re still huge). Just pointing it out.

------
6nf
What is the mortality rate of one of the more severe stains of the common cold
or the flu? I'm sure we've had one of those that got to 0.5% or more in recent
history?

Does that mean 0.5% is too low to shut everything down?

~~~
FabHK
First, the flu doesn't have the other severe consequences outlined in the
article.

Second, basically everyone except small children has had the flu, and has some
immunity to it, while we're all "immunologically naive" vis-a-vis SARS-CoV-2.

~~~
6nf
Young people are basically at 0% mortality from covid

~~~
vicosity
Yeah but children are getting that inflammatory syndrome.. Thats pretty
devastating. A life ruined but still alive can basically be counted as a
death.

~~~
6nf
Even if you count those it will still round to zero

------
Eric_WVGG
I find it useful and illuminating to just come up with some common large
spaces and make a few estimates…

\- remember the last time you were at the movies? Three people dropped dead
during your screening of Avengers.

\- two people dying per subway car on your morning rush hour commute into the
city

\- seven of the kids in your child’s high school graduating class die. he
probably knew at least a couple by name.

… but the points this author makes about problems the survivors face even more
striking, so, yeah.

~~~
Consultant32452
Only about 1% of the people dying from covid are under 35. That's the big
monkey wrench. If it was kids dying, I think the perception would be very
different. There's other factors even more difficult to discuss than age.

The state is powerless to shape policy in a way that adequately fits the risk
due to Western culture's focus on individual rights. It's up to us to shape
our behavior. Are we adult enough to have that kind of conversation? I am
doubtful.

~~~
stnmtn
Maybe this isn't an extremely mature question and is kind of a "gotcha!"
question, but which one of your older relatives would you be willing to
sacrifice for this?

Because if this is what we are talking about, then that question has to be
thought of. It's might be easier when it's just "old people", but not when it
actually affects your life

~~~
Consultant32452
I explicitly supported protecting the high risk populations when I said it's
up to us to shape our behaviors.

------
justinzollars
[https://www.frbatlanta.org/cqer/research/gdpnow](https://www.frbatlanta.org/cqer/research/gdpnow)

Fed GDP Now Latest estimate: -35.5 percent — July 9, 2020

------
goldfeld
And how can 1% of the U.S. population shut down its wealth in their safes?

------
detaro
previously:
[https://news.ycombinator.com/item?id=23816640](https://news.ycombinator.com/item?id=23816640)

------
Apocryphon
It's shut down most countries in the world, not just the U.S.

~~~
ceejayoz
Yes, but the US is somewhat unique in having a widespread "so what if 1% of
people die?" attitude.

~~~
6nf
Sweden didn't shut down much at all either.

~~~
Apocryphon
Sweden and Japan were the major exceptions of the rule, I'm not sure who else
didn't.

~~~
logicchains
Hong Kong, Korea, Taiwan.

------
crooked-v
The tl;dr:

> So now all of a sudden, that “but it’s only 1% fatal!” becomes:

> 3,282,000 people dead.

> 62,358,000 hospitalized.

> 59,076,000 people with permanent heart damage.

> 32,820,000 people with permanent lung damage.

> 9,846,000 people with strokes.

> 6,564,000 people with muscle weakness.

> 6,564,000 people with loss of cognitive function.

~~~
ceejayoz
It becomes far worse than that, as our medical system can't handle 62M
hospitalizations.

(Nor 60-70% of that, which is more realistic, as it's unlikely to hit 100% of
the population.)

NYC's hospitals came close to the breaking point; Italy's exceeded it in
spots.

~~~
jlg23
The author addresses that:

> This model assumes that the question’s hypothetical is correct and the
> fatality rate is 1%. It also assumes for the sake of argument 100%
> infection. (In reality, of course, neither of these is a perfect match to
> reality. The infection rate will never hit 100%, but the fatality rate in a
> widespread infection is likely to be greater than 1%, because health care
> services will be overwhelmed.)

~~~
ceejayoz
Yes; I felt it important enough to warrant inclusion in the TL;DR version.

------
oliwarner
How can people consider anything else? 1% _excess_ mortality isn't acceptable.
Hospitalising 5-10% is crippling hospitals. The ongoing health issues in 20%
will haunt us for years after we have a vaccine and before we do, we face the
prospect that post-exposure immunity might be measured in months.

Only idiots think this is worth ignoring.

Coincidentally, they're the same idiots that came in a day late and a dollar
short when it was time to close borders and quarantine travelers. We could
have stopped this.

------
noxer
Can't believe people still question the shutdowns as if there would be a
scenario without. The people in power could choose between enforced but
somewhat controlled shutdowns or the chaos shutdown. No shutdown was never an
option. Most people would have long done their own "shutdown" completely
voluntary. It would just be more chaotic and less effective and it would have
needed way more people to die first.

~~~
6nf
Several countries like Sweden and Japan and Korea proved that there are other
options.

~~~
ceejayoz
Sweden appears to bear out the parent comment's point, that the end result is
still lockdown, just voluntary and less well organized:

[https://www.nytimes.com/2020/07/07/business/sweden-
economy-c...](https://www.nytimes.com/2020/07/07/business/sweden-economy-
coronavirus.html)

> This is what has happened: Not only have thousands more people died than in
> neighboring countries that imposed lockdowns, but Sweden’s economy has fared
> little better. “They literally gained nothing,” said Jacob F. Kirkegaard, a
> senior fellow at the Peterson Institute for International Economics in
> Washington. “It’s a self-inflicted wound, and they have no economic gains.”

