
Severe Outcomes Among U.S. Patients with Covid-19, Feb 12–Mar 16, 2020 - js2
https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm
======
ekidd
> _fatality was highest in persons aged ≥85, ranging from 10% to 27%, followed
> by 3% to 11% among persons aged 65–84 years, 1% to 3% among persons aged
> 55-64 years, <1% among persons aged 20–54 years, and no fatalities among
> persons aged ≤19 years._

The problem with all of these numbers is that they assume sufficient medical
care and access to an ICU.

This report here breaks down how many people need an ICU by age:
[https://www.statnews.com/2020/03/18/coronavirus-new-age-
anal...](https://www.statnews.com/2020/03/18/coronavirus-new-age-analysis-of-
risk-confirms-young-adults-not-invincible/)

> _In contrast, among people 20 to 44, 14% to 21% of 705 cases were admitted
> to hospitals and 2% to 4% to ICUs; 0.1% to 0.2% died._

If we assume that ICUs are overloaded, how many of the that 2-4% would die?

Not that this doesn't count the people who won't catch the virus because of
herd immunity. There may also be some people who are immune, or who defeat the
virus quickly enough to not show positive on an RNA test.

~~~
glibby
That report just sources the same CDC report, but I think it gets some of its
conclusions wrong.

It says:

>In contrast, among people 20 to 44, 14% to 21% of 705 cases were admitted to
hospitals and 2% to 4% to ICUs; 0.1% to 0.2% died.

But the CDC report indicates that 12% total (of all cases) are known to have
been hospitalized, and _of that_ number, 20% were age 20-44. So that would
mean that (0.12*.2=) 2.4% of people total were 20-44 and in the hospital. Now
29% of all cases were in that age group, so that would mean for the 20-44 age
group there was a (2.4/29=)8.3% chance of hospitalization.

Maybe I misunderstood something there, but I think I'm right.

~~~
dougmwne
Actually that's not correct. The CDC study has a lot of null data and there's
some very inconsistent excluding of data while calculating these numbers. I
had to work with it in Excel for awhile to reconstruct the approximate raw
numbers.

Out of 4226 cases

2449 have known ages

705 were 20 to 44

~488 of that age have a known age and hospitalization status

~101 of that age were hospitalized

~14 of that age went to ICU

(14.3% of the known # of cases for that age and 20.8% of the known # of cases
for that age with a known hospitalization status were hospitalized)

Check this against Figure 2 in the CDC study and you will see where the
StatNews article is pulling its data from.

This is very sobering information. Please stay safe!

~~~
mcbits
It says "Among 508 (12%) patients". 508 is 12% of the whole 4226, not just the
2449 with known ages. 20% (102) of those 508 were aged 20-44.

It's not known how many of the 4226 were aged 22-44, but if it's roughly the
same as the 29% of known ages, that would be 1226.

102/1226 is 8.3%.

I hate to say it, but it seems the table at the bottom is overestimating the
proportion of hospitalizations by ignoring 1777 patients who _have an age_
even if it's unknown, instead of making an estimate for them.

~~~
dougmwne
The reason that the unknown ages were excluded from Figure 2 is because the
hospitalization status is also unknown. You assumed that 0 of the unknown
cases were hospitalized. Instead, you could also assume that hospitalization
rates for the unknown cases are roughly the same as for the known cases. If
you do that you actually get the higher of the 2 numbers in Figure 2's range.
So for the 20-44 age group, that's 20.3%. If you instead assume that people
with a known age, but an unknown hospitalization status were not hospitalized,
then you get he lower number in the range, 14.3%.

It's a very fair point that any of these assumptions could be inflating the
rates. There are a whole bunch of other factors around asymptomatic, what the
eventual outcome will be in the cases that are early-stage and who gets the
limited number of tests in the USA that makes it currently impossible to know
the true infection fatality rate or infection hospitalization rate.

~~~
mcbits
I see, you're right. What I wrongly assumed was that they were receiving
spotty data about overall cases but more thorough data about cases leading to
hospitalization.

I also just noticed the age brackets for the 508 known hospitalizations only
add up to about 91%, so apparently 9% of those are also unknown age.

It's too bad they didn't publish this in a live form so we could see how it
changes as more data comes in. Maybe they will do a follow-up using the same
methods at some point.

------
chimichangga
From Gregory Rigano:

UPDATE:

Full peer reviewed study has been released by Didier Raoult MD, PhD
drive.google.com/file/d/186Bel9….

After 6 days 100% of patients treated with HCQ + Azithromycin were
virologically cured

p-value <.0001

covidtrial.io

[https://twitter.com/riganoesq/status/1240273631604809728?s=2...](https://twitter.com/riganoesq/status/1240273631604809728?s=21)

~~~
hprotagonist
note that Gregory Rigano is a lawyer with no medical training who has been
writing about this with a cryptotrader (James M. Todaro).

Distribution of preprint by google drive remains highly suspect, as does the
fact that the nominally illustrious first author communicates by a gmail
address despite google scholar listing him as having a normal educational
email address
[https://scholar.google.com/citations?hl=en&user=n8EF_6kAAAAJ...](https://scholar.google.com/citations?hl=en&user=n8EF_6kAAAAJ&view_op=list_works&sortby=pubdate)

That said, i know plenty of intensely brilliant weirdo researchers -- but i'd
take this with big grains of salt. and i have _no_ idea why a z-pak is a
booster for an antiviral therapy.

~~~
majos
I really want this study to be legit, but there are a few more weird things:

1\. the evidence-free claim of “full peer review”, 2. the fact that patients
who refused or met “exclusion criteria” for the drug served as a portion of
the control group, and were the only members of the control group from the
same region as the experimental group, 3. the removal of people from the
experiment group because they went to the ICU or _died_ (only three of first
and one of second, but a rather bizarre thing to happen before claiming 100%
cure), 4. the lack of coverage from any major news source, despite this being
reported about a day ago.

~~~
hprotagonist
i'm with you, i want this to be onto something but i'm like, constitutionally
ill equipped to reject the null on this evidence. Too much time in the lab
during normal life, maybe. To your points:

\- The twitter guy makes the peer review claim, and i think it's wrong. he is
not an author of the paper or affiliated with them, he's just shilling it to
elon musk for reasons.

\- regionality isn't something i'd considered. I can understand the exclusion
group being the control in exeptional cases, like a global pandemic.

\- of more concern to me are the either confusing or cargo-culted figures at
the end. what in the world is a t- and p value column doing next to age data?
why are there nominal p-values per day of administration?

\- there might not be coverage, but merck is shipping a boatload of the stuff
anyway: [https://www.fiercepharma.com/pharma/bayer-preps-u-s-
donation...](https://www.fiercepharma.com/pharma/bayer-preps-u-s-donation-
malaria-med-chloroquine-to-help-covid-19-fight-report)

~~~
intpx
[https://www.businessinsider.com/malaria-pill-chloroquine-
tes...](https://www.businessinsider.com/malaria-pill-chloroquine-tested-as-
coronavirus-treatment-2020-3)

------
makomk
Note the caveat here: "the initial approach to testing was to identify
patients among those with travel histories or persons with more severe
disease, and these data might overestimate the prevalence of severe disease".
One of the things that makes it frustratingly hard to tell the real
likelihoods is that almost all data has this problem to some extent, except
maybe the Diamond Princess cases, and there weren't enough young people on
there to get good numbers.

~~~
lonelappde
Another thing to remember is that the scientific medical terms are "grade
deflated"

Scientific -> what a layperson would say

Mild -> sick

Moderate -> hospitalized

Severe -> deathly ill

------
notacoward
I freaking love that summary format. What is already known? What does this
add? What are the policy implications? Boom!

~~~
yellowapple
Yep. Very reminiscent of "Bottom Line Up Front" (BLUF).

------
1996
My very naive take: could the difference in mortality between South Korea and
Italy be explained by how SK tried antiviral drugs even when there was no
strong evidence yet, while Europe stuck to anti inflammatory which we know now
to be linked to severe outcomes?

Also, the probability of receiving a prescription drug is almost linear with
respect to age.

So, could the highest death of >60 y.o. with comobidities be explained
similarly by them taking drugs that have a negative impact on the disease?

~~~
dboreham
Hypertension being a highly prevalent comorbidity seems suggestive of
something.

~~~
lowbloodsugar
On that note: [https://www.escardio.org/Councils/Council-on-
Hypertension-(C...](https://www.escardio.org/Councils/Council-on-
Hypertension-\(CHT\)/News/position-statement-of-the-esc-council-on-
hypertension-on-ace-inhibitors-and-ang)

Some threads on the internet say to stop taking ACE inhibitors because they
boost ACE2, the gate that the virus uses to get into our cells. However, other
threads on the internet says that while ACE inhibitors boost ACE2, they also
cause them to be blocked (bound) by ATR-1, so you're good. Unless you stop, in
which case now you have twice as many ACE2 and they're all unblocked.

So I'm listening to what the doctors say and not the internet.

------
rosybox
Could this be skewed at the moment due to the number of nursing homes in
Washington State that were hit early on?

~~~
blaser-waffle
I believe it was just one big one that had a lot of very old and very frail.
Staff didn't pick up on what was going on and by the time they connected the
dots people were dying.

Regardless of the number of nursing homes, the point stands that the figures
are skewed by a few clear outliers.

------
H8crilA
Please just stay at home. At all times. I've locked myself in weeks ago,
before the government of my country ordered lockdowns. Even if the true
fatality rate in your age range is low - you'll kill some old person out
there. Perhaps dozens. It's the most you can do. Bill Ackman does a good job
of explaining why you should do that (and why should all countries be shut
down):

[https://www.cnbc.com/2020/03/18/bill-ackman-pleads-to-
trump-...](https://www.cnbc.com/2020/03/18/bill-ackman-pleads-to-trump-to-
increase-closures-to-save-the-economy-shut-it-down-now.html)

~~~
6nf
Shutting down the country destroys everything. I'm not sure it's worth it.

~~~
banachtarski
> I'm not sure it's worth it.

It is. The quarantines/border-restrictions are not permanent measures, and
acting swiftly is the correct way to nip it in the bud.

> Shutting down the country destroys everything.

Empty hyperbole. Death tolls in the tens of millions is a far worse outcome,
as is stressing our current healthcare systems well beyond their capacities.

~~~
H8crilA
Mind boggling that someone could think that a month or two months shutdown
"destroys the economy", but all Americans infected and several % dead doesn't
"destroy the economy".

~~~
nostromo
We’ve had one week of shut down in Seattle and there’s already been a huge
wave of layoffs.

Two months? It’s difficult to think what will happen.

Economies don’t have a pause button. Companies, banks, and families quickly
become insolvent.

~~~
H8crilA
I agree, this clearly needs a govt bailout. Fed already rains liquidity into
the treasuries like a madman, just wait till it buys corporates and God knows
what else. Treasury should now simply guarantee salaries. The unconditional
helicopter money is a good idea too. This will bridge the discrepancy between
financial time (which has not stopped) and economic time (which is stopping,
slowly, but has to come to a full stop).

But at any rate, lives > economy. Only one of those is a renewable resource.

~~~
6nf
> lives > economy. Only one of those is a renewable resource.

Not sure I follow. Are you saying the economy is not a renewable resource?
Cause I'm creating a new life as we speak.

