
CDC’s New ‘Best Estimate’ Implies a Covid-19 Infection Fatality Rate Below 0.3% - mrfusion
https://reason.com/2020/05/24/the-cdcs-new-best-estimate-implies-a-covid-19-infection-fatality-rate-below-0-3/
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PhantomGremlin
Article focuses on just fatalities. But there is evidence that infection can
cause other problems for survivors. For example, rupturing of pulmonary
alveoli. How quickly can those regenerate?

Wikipedia says we have 300 million alveoli. If you lose 10% to the virus, is
that OK? By itself that's probably not a big deal, but let's say you're a
smoker who has lived his whole life in a polluted city.

So you come out of ICU with only 50% of optimal lung capacity. Is that still
OK? What if you only have 20% left, are you barely hanging on? Do you have to
walk around breathing supplemental oxygen?

~~~
teruakohatu
It is a very good question, as well as how it compares to damage done by flu
or a bad cold how and quickly damage is repaired.

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boomboomsubban
By "best estimate" they mean

>Parameter values for disease severity, viral transmissibility, and pre-
symptomatic and asymptomatic disease transmission that represent the best
estimate, based on the latest surveillance data and scientific knowledge.

Also, the "best estimate" predicts a .4% fatality rate, below .3% comes from
the best performing model using the lower bound for disease severity...

~~~
nradov
The 0.4% fatality rate is for symptomatic patients. At least a third of
infections are asymptomatic, so the actual infection fatality rate is lower.

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ajsnigrutin
This is all great, but what is also important here is, how many of those 99.7%
of people need hospital care to survive?

As far as I understood all the "flatten-the-curve" motions, the plan was to
keep hospitals in a state, where they're able to process the patients with
complications, so they don't become the 0.3%++.

My country (Slovenia) has pretty-much zero new cases per day currently, with
2-4% of people (there was a study) with antibodies.... in a potential second
wave with exponential growth, our hospitals are basically fucked.

~~~
rpiguy
Flattening the curve to preserve hospital beds, ,at least in the US, only
really applied to NYC and northern New Jersey. Nowhere else in the country
ever even came close to overwhelming the hospitals. If NJ and NYC had shut
down public transportation the curve wouldn’t have been so bad - hotspots map
1:1 with subway and train stops.

40% of US counties haven’t had a single COVID death. Most hospitals are so
under utilized they are losing money.

~~~
dopylitty
Birmingham Alabama's hospitals are _currently_ overwhelmed[0].

This thing is going to get even uglier quickly as it tears through rural areas
that have little to no nearby healthcare options.

And as the people who are out mingling this weekend start to get ill in the
next week and start to feel bad enough to need hospitalization in the next two
to three weeks we're going to see some scenes just like in NYC with
overwhelmed hospitals and morgues being replaced by air conditioned semi
trucks (or worse, bodies piling up in the summer heat). It's already happening
in some rural areas[1].

The only counties that have no deaths are those with very few people and/or no
testing [2].

[0] [https://www.businessinsider.com/dire-coronavirus-alabama-
icu...](https://www.businessinsider.com/dire-coronavirus-alabama-icu-no-
beds-2020-5) [1] [https://www.sfgate.com/news/article/A-deadly-checkerboard-
Co...](https://www.sfgate.com/news/article/A-deadly-checkerboard-
Covid-19-s-new-surge-15292024.php) [2]
[https://www.texasmonthly.com/news/coronavirus-spread-
rural-c...](https://www.texasmonthly.com/news/coronavirus-spread-rural-
counties-university-texas-researchers/)

~~~
rpiguy
According to the Alabama department of public health as of 5 hours ago there
are only 571 people in ICU.

[https://www.alabamapublichealth.gov/covid19/assets/cov-al-
ca...](https://www.alabamapublichealth.gov/covid19/assets/cov-al-
cases-052420.pdf)

According to CDC data, 81% of deaths from COVID-19 in the United States are
people over 65 years old, most with preexisting conditions. If you add in
55-64-year-olds that number jumps to 93%. For those below age 55, preexisting
conditions play a significant role, but the death rate is currently around
0.0022%, or one death per 45,000 people in this age range. Below 25 years old
the fatality rate of COVID-19 is 0.00008%, or roughly one in 1.25 million.

I am sure some hospitals will come close to capacity in some areas due to some
case clusters, but Florida, Texas, and Georgia have been largely fine after
opening up even in rural areas.

I expect over the next two to three weeks we will continue to see drops in
deaths.

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jimrandomh
I'm pretty sure the CDC is just wrong about this, and the true IFR is about
1.0%. The CDC page in question doesn't have much of any information about
their methodology, and the claimed 0.3% is not consistent with what other
research has found. Given the CDC's extremely poor track record, I don't think
it's right to assign this estimate much weight.

~~~
svaha1728
Agree. New York fatalities are already at .3% of the population (estimating
population at 8.39 million and deaths at 23k). Antibody estimates are that
only ~20% were infected.

~~~
elcritch
NY really appears to be an outlier for the US. An IFR of roughly 1.4% does
appear more inline with that for older sicker populations. There may also be
other factors such as a more deadly viral strain, older population vs the rest
of the US, genetic makeup of the population being more prone to covid-19, or
differences in healthcare access and or application.

It really seems the fatality rate for covid-19 is bi-modal. Recognizing that
seems critical to putting resources into finding the underlying reasons to
respond with correct solutions for any given area.

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woodandsteel
Interesting, but the question is what it implies for public policy. In
particular, a lot of people on the right argue this ifr is not much worse than
the flu, so there should be no government dictated restrictions.

Well to address that we need to calculate the numbers. And to start, the flu
death numbers are as low as they are because we have a vaccine, and every year
there is an aggressive campaign aimed at the people most likely to die for the
disease.

We don't yet have a covid vaccine, and it is highly transmissible, so if we
did nothing to prevent its spread it would likely reach a majority of people.
In the US that means at least 200 million.

Now multiply that by 0.2% and you get at least 400,000 deaths, 8 times the
number for a bad flu season.

I say that is high enough to merit aggressive governmental action to halt
transmission until we get a vaccine. For those who say no, I would ask what,
if anything, would be a high enough number?

~~~
SpicyLemonZest
It's not a binary decision. Every reasonable person agrees the government
should take action; the questions are how much is needed and how severe it can
be.

~~~
woodandsteel
I agree, it's not a binary solution. But there is a significant portion of the
American public, including Trump for a good while, and off and on today, that
thinks the government should be doing little or nothing.

