What I'm most interested in is the hospitalisation rate and if we can slow down infections enough for hospitals to be able to cope.
I think the death rate will ultimately depend on whether everyone who needs hospital treatment can get it. And that's why I think the Diamond Princess may not be representative of what happens in the real world.
Aren’t the hospitalization rates something like ~20% according to the main study that came out of China? Also, the cruise ship cases aren’t all resolved outcomes yet.
Edit: link to China study summary below, but including it top-level here as well.
We don't have any idea what the hospitalization rates are. We only know what the hospitalization rates are for people who have a confirmed diagnosis, which skews towards people with severe symptoms.
>Also, the cruise ship cases aren’t all resolved outcomes yet.
No they aren't, but the vast majority have been symptomatic longer than the average time till hospitalization and the number in critical condition hasn't increased in days. It's very unlikely they'll get to anywhere near 20%. And this is in a more geriatric population.
Except we do have data, that’s my point. China’s study is being cited by most experts as this situation unfolds. It doesn’t mean these numbers will hold — it’s possible that what we see out of South Korea over the coming month might be more representative — but it’s what we have, and it’s not nothing:
The data can't support your 20% hospitalization claim though, and no one in public health is using that study to make that claim. The study itself makes no such claims that this study is in any way applicable to the general population.
About 40% of the patients in that study weren't even tested. They were included based on symptoms that include severe pneumonia. The ones who were tested, sought testing because they displayed symptoms severe enough to seek treatment.
This is the very definition of selection bias, and there is absolutely no reason to pretend that a 20% hospitalization rate is a realistic outcome.
Lots of people on the ship that tested positive showed little to no symptoms. It's very likely that there are a large number of infections that have gone undetected. Until we test everyone we won't know the true number.
>Aren’t the hospitalization rates something like ~20% according to the main study that came out of China?
Yes, but the reason why the Diamond Princess is interesting is that we know exactly how many of them got infected. We don't know that about any other population.
The diamond princess is... interesting, yes, but an unmitigated disaster is how most experts have defined it. It’s unclear we can extract meaningful info applicable to the rest of the world based on the cruise ship.
Also consider my point that many, many of these cases are unresolved. Whereas the China study, which most health experts are relying on currently as our best guess - not the cruise ship — looks at resolved cases.
I said myself that I didn't believe the cruise ship numbers were representative, but the 20% figure you cite isn't a realistic hospitalisation rate either as it only includes diagnosed cases.
The number of undiagnosed cases is the great unknown that experts disagree on. It's also the basis for all the wild speculation out there.
Under normal circumstances I would say let's test a random sample of the population in some affected area. But as test kits are scarce doing that would probably be ill advised.
The same is true for the flu. People get it every year but they don’t go and get swabbed.
I also agree that there’s a wide range of possibility. But I’m responding to the claim there’s no data with a study from China’s CDC that most experts are citing as the best info we have right now. Is it perfect? No. But the Diamond Princess isn’t a scientific study — it’s a mess.
Edit: for a range of possible outcomes, this article is helpful:
> The same is true for the flu. People get it every year but they don’t go and get swabbed.
But with the flu we have large population studies, so we can estimate the number of likely infected based on the number seeking treatment. They study you are citing can't be generalized, and no one but you is claiming it should be used to estimate hospitalization rate.
Public health officials who are trying to produce estimates are using that study along with models of how many un-diagnosed cases might be out there to try to predict hospitalization rates. But they aren't naively throwing out your 20% number.
>But I’m responding to the claim there’s no data with a study
There is no data to support your claim of a possible 20% hospitalization rate. None, it doesn't exist. There is data to support a 20% hospitalization rate among people sick enough to seek treatment, and people sick enough to be clinically diagnosed.
>at the extreme high Iran, and Italy aligning roughly with China’s study.
Italy and Iran also likely have far more actual cases than confirmed.
>No. But the Diamond Princess isn’t a scientific study — it’s a mess.
The study you are presenting makes no attempt to predict the actual hospitalization rate among the general population. And the samples aren't random. It's more a mess than the numbers from the Diamond Princess.
Everyone on board the ship was tested, no sampling bias there. But even then, there is selection bias because the ship's population is older than the general population.
The 20% figure is not an imperfect estimate of the true hospitalisation rate. As far as I know the study didn't even attempt to estimate the true number of infections or (by implication) the true hospitalisation rate.
You can look at the counts by date. The majority are past the mean time till hospitalization, and the the number in critical condition hasn't increased in days.
>If 42 were critical, that doesn't necessarily mean they were the only ones who needed hospital treatment.
Percent hospitalized isn't the thing to look at. It's percentage of people who need intensive care or a ventilator that matters.
Many people were hospitalized for observation. Some people received IV fluids. How many of those people were saved by IV fluids vs. just being a nice to have is unknown. But that kind of care can be done in mass tent hospitals or even at home.
Are these numbers still updated now that many (or all?) have left the ship? Where can I see those numbers?
>Many people were hospitalized for observation
Yes, but if fewer people had been under close observation in a hospital more might have died. Admitting only precisely those who turn critical is not realistic in my (lay person's) opinion.
I agree with you about the age distribution on the cruise ship though. This is very important to note.
Still, I have to wonder what share of the population can get hospital/ICU treatment at any given time.
I don't know about other places, but here in the UK hospital bed occupancy rates are dangerously high at the best of times. I don't know how many beds/ICUs can be freed up in an emergency. But I doubt it's anywhere near enough if everyone gets sick at the same time.
I hope someone is doing some modelling to find out how aggressively we have to slow down the rate of infection so that hospitals are not overwhelmed.
I think the death rate will ultimately depend on whether everyone who needs hospital treatment can get it. And that's why I think the Diamond Princess may not be representative of what happens in the real world.