
Coronavirus: Why Everyone Was Wrong - hudon
https://medium.com/@vernunftundrichtigkeit/coronavirus-why-everyone-was-wrong-fce6db5ba809
======
nextaccountic
> Those young and healthy people who currently walk around with a mask on
> their faces would be better off wearing a helmet instead, because the risk
> of something falling on their head is greater than that of getting a serious
> case of Covid-19.

I'm healthy and young and I might not die from Covid. But if I catch it I will
almost certainly kill my mother.

~~~
tripletao
Either there's something very unusual about your personal situation, or you're
using "almost certainly" to mean "well under ten percent", or your statement
is simply false. Estimates of the household secondary attack rate vary but are
typically low tens of percent[1][2], and the IFR even for patients >80 years
old is about 8%[3]. The probability that your mother would die if you became
infected is the product of those two.

To be clear, I wear a mask and I support orders requiring that, since the cost
of mask-wearing seems very small to me in exchange for the possible benefit.
(If anyone finds a mask uncomfortable, I'd suggest a better mask. Surgical-
style masks are much easier to breathe through than fabric, and widely
available near pre-pandemic prices.) We should avoid hyperbolic, misleading,
or false statements in support of a noble cause, though.

1\.
[https://www.thelancet.com/journals/laninf/article/PIIS1473-3...](https://www.thelancet.com/journals/laninf/article/PIIS1473-3099\(20\)30471-0/fulltext)

2\. This is unintuitive given the close contact sharing a household and R0 =
2.5, but consistent with the theory that spread is driven by a small fraction
of super-spreaders, while most infected transmit the disease to no one at all.

3\.
[https://www.thelancet.com/journals/laninf/article/PIIS1473-3...](https://www.thelancet.com/journals/laninf/article/PIIS1473-3099\(20\)30243-7/fulltext)

~~~
necovek
You might be ignoring the fact that they know what "comorbidities" their
mother has. So general population percentages might not apply to them.

~~~
tripletao
I started my reply with the words "Either there's something very unusual about
your personal situation...". So can you give an example of comorbidities that
you wouldn't consider very unusual, and your estimate of the probability that
the mother would die if the child were infected in that case? Remember that:

1\. The secondary household attack rate is far less than 100%; the paper I
cited found 18% for people >= 60 years old sharing the same address. So even
if the child becomes infected, the mother probably wouldn't be.

2\. Most eighty-year-olds have a lot of comorbidities already, so the IFR for
that age group accounts for that.

Assuming only that the mother is in the oldest age category from each paper
and the probabilities are independent, I get a probability that the mother
dies if the child is infected of 1.4%. Comorbidities can indeed drive that
higher, and maybe there's some dependence (sicker people both more likely to
catch the coronavirus and more likely to die from it); but I think you'll find
it very hard to build a plausible set of assumptions that would get you to
"almost certainly", unless the mother is so sick that she's likely to die soon
regardless. (Of course, that wouldn't mean her life is without value. But it
would mean that when we decide we can't do something until a vaccine is
available, we're deciding she can't do it ever again in her life. If it were
my life, then I'd judge that calculation differently.)

Most discussion of probability of death feels rather ghoulish, and the above
is no exception. All of us will die, though, and it's a question only of what
we can do in the time before that. I'd rather plan that time using the best
empirical estimates we can make than with half-informed hyperbole. Wouldn't
you?

------
danlugo92
Less than 2% mortality for those under 65 years of age in developed countries.
I think we should have only quarantined the elderly.

~~~
NotSammyHagar
Let's separate the mortality rate from the actual impacts, which are multiple.
The hospitals in multiple places are overwhelmed for months with cv19 cases.
The mortality doesn't matter when NYC, much of Italy and Spain, and now Texas
and Florida hospitals are overfull with patients being treated for cv19, and
other patients are hurt because they can't be treated or are afraid to go.
There is excess deaths (ie more people dying than would otherwise, more than a
typical flu year).

In the us we went through a long period of shutdown and we still ended up with
this happening in several places. If we only quarantined the elderly, we'd
still have this happening, but it would have been much much worse. Even if the
death rate ends up being low, like 2%, we'll still kill a lot of people
through hospitalization overload. That's why we need to social distance and
wear masks - we don't need to wear masks only if the death rate is > 2%. It's
to decrease the whole impact.

Plus when this article was written it was back in the magical thinking period
that somehow in the summer the incidence would go to almost 0. We now see that
it's still very infectious and will be ruining people's lives for a long time.

~~~
tripletao
The IFR is far below 2% for young people--a recent meta-analysis[1] got 0.7%
over all ages. That study didn't break it down by age, but an older one that
did[2] (and got a similar IFR over all ages) got 0.14% for <60 years old,
mostly from the older end of that.

There's moderate evidence for seasonality, from studies comparing countries
with different climates and trying to control for other factors, trying to
regress against actual weather over weeks, etc. That's empirically not enough
to bring R < 1 in the summer in the USA in combination with whatever we've
been doing, but a big effect might still be there--we might just have relaxed
the social distancing by enough to more than offset. If that's the case, then
we're potentially in for a terrible fall and winter (and places that have
built up some degree of herd immunity--whether quasi-intentionally like Sweden
or accidentally like NYC--could end up better off in the end).

As to excess deaths: As far as I understand, most of those actually observed
are probably unconfirmed coronavirus deaths, rather than unrelated deaths due
to an overrun medical system or people afraid to seek care. I've seen
speculation that the latter may occur, but no strong evidence (since even NYC
barely occupied the Navy hospital ship or other temporary facilities, and
since no excess deaths have been seen in areas with the lockdowns that would
discourage people from seeking care but without big coronavirus prevalence).

To be clear, I'm strongly pro-mask, and pro-social-distancing. (I do think
stuff like factory and school closures comes at an unacceptable social cost
for the benefit to public health, though that's been reversed most places.) I
just want to make the argument with the right facts.

1\.
[https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v...](https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v4.full.pdf)

2\.
[https://www.thelancet.com/journals/laninf/article/PIIS1473-3...](https://www.thelancet.com/journals/laninf/article/PIIS1473-3099\(20\)30243-7/fulltext)

------
lbeltrame
A few good points (like the PCR detecting only RNA which does not equate to
live virus) in a sea of "interesting" spin about the current data.

I really don't understand why it's "us vs them" in either camp ("doom and
gloom" and "skeptics"). This makes things worse, since both camps tend to
quote only evidence which support their respective claim (two examples: the
Guardian saying that asymptomatic people spread more virus than the
symptomatic ones, despite the study they quote saying that it can't be said,
because they did not check for live virus; and some web page called "Swiss
policy research" which quotes only the parts of the studies which conform to
the "skeptical" narrative).

~~~
Zenst
Indeed, with so much published stuff about it and still so much in the unknown
and with that, our best evidence so far is what is published. then the ability
to cherry pick across many sources of published data/reports and stitch
together those in a way that you could make so many things appear legit, well.
It really don't help as other people will just reference the sewn together
published article and propagate from their. Vague news is after all, latent
fake news most of the time alas.

------
moistly
I find it discouraging that exceptionally little is said about the outcomes
for those who survive a bad case. IMNSHO, the big scare isn’t death, it’s
being out of breath for the rest of a considerably shorter life, or being tied
to a dialysis machine, or being perpetually foggy brained and easy to anger,
etc.

The long-term damage to the country will be from damage to survivors, not from
deaths.

------
jgilias
It's funny in a sad way to read an article like this one now a month later
when it has become very clear that the virus comes back with vengeance in
places that have lifted restrictions summer or no summer.

Also, the semantics of whether it can be called novel or not doesn't matter
one iota when the virus-caused pneumonia overwhelms medical systems in mere
weaks if left to roam unchecked.

~~~
glofish
it really sounds like the youth got sick and tired of the lock-down and would
rather get sick than continue with the never ending prison like conditions

it probably is the right course of action - even though ethically no official
can suggest that

the paper is supported in the sense that everyone is wrong about how dangerous
the disease is, and whether people should be allowed to decide what risk they
are willing to take

~~~
NotSammyHagar
I disagree with your last point - this is very infectious and because we can't
know in many cases if we are carrying it, it's incumbent on everyone to
protect others by wearing a mask. Because many don't know they have it, it's
different than the flu where ordinary flu often has clear symptoms before
infectiousness starts.

~~~
glofish
the "mask" is the red herring of every discussion. It is a talisman that
people cling to as a way to ward off any of the ills.

I happen to be convinced that some types of masks, like the reusable cloth
masks actually make you sicker.

Here is a well research piece with a randomized trial that shows how
continuously worn cloth masks are worse than using them more rarely (control)
(leading to 4% more infections):

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/)

Of course I don't expect this research to be quoted in the current hysterical
environment.

But I would not be surprised if by this time next year the world will be full
with publications on how cloth masks cause more trouble than worth with a
strong recommendation to avoid them.

~~~
tlb
You have misread the paper. It says that cloth masks are worse than medical
masks, and worse than "standard practice" which seems to be mostly medical
masks but not worn as rigorously. They didn't test against no masks, which
would be insanely dangerous in a hospital.

~~~
tripletao
Yeah. I saw that paper cited frequently back when the public health
authorities were advising against masks, and I'm afraid their decision to
characterize standard practice including medical mask wearing as the "control
arm" has caused considerable confusion and harm.

------
croes
In the middle of a pandemic he suddenly realizes why everyone was wrong and
now he is right. I totally believe him ... not. The long term effects of the
virus are still unknown, if infected have long term immunity is unknown.

------
NotSammyHagar
It's hard to get past this being another wrong medium article that doesn't
match reality. Why does covid19 attract so many quacks who cant help but argue
that it's no problem really, go on about your lives (with 130k dead in the us,
600k dead in the world). It's actually a problem. It hasn't gone away somehow,
even with massive amounts of magical thinking for the past 6 months.

Edit: we're actually a week away from reaching 600k, per
[https://www.worldometers.info/coronavirus/#countries](https://www.worldometers.info/coronavirus/#countries).
Will it take 200k dead in the us before we can stop arguing it's no big deal?
A million in the world?

~~~
glofish
The 1 million deaths are a big deal only because it may include rich white
people or even, gasp, you and I. This is the only reason this number is quoted
with such an incredulity.

Throughout history we have had and we continue to have far bigger problems
than that.

Did you know that 20K people DIE every day of hunger (9 million per year)? And
this has happened like so for the past twenty years? Where is the counter for
that? Why aren't we locking everything down until we fix that?

I tell you why, because you and I are at zero risk of dying of hunger. Stating
that 1 million deaths is a big deal sounds extremely hollow.

~~~
yongjik
"Be thankful with your broccoli because there are kids starving in Africa"
generally doesn't work even on a fifth grader - I honestly didn't expect to
see it on HN.

At this rate, I wonder when I'd see people saying "no worries" because it's
not Black Death. Or has it already started?

~~~
glofish
> no worries" because it's not Black Death.

I think mentioning the Black Death as a counterpoint weakens the argument
greatly.

This disease is far-far more similar to the flu than black death, no? So we
should probably deal with it as a flu not black death.

~~~
ddingus
I have emails from Italy saying it is like flu.

Those same people a few weeks later?

Our grandparents and families are dying.

