For the unfamiliar, John Ioannidis is one of the most respected data scientist physicians in the world, a man whose opinions may not be correct but are definitely we'll thought out and should be paid attention to.
The pediatricians up here in Seattle started coming around last week to the theory that COVID-19 presents as GI in peds. It's been "a weird flu season" and mostly what they've been seeing are a bunch of rogue pukers under the age of ten who don't have flu. lo and behold. The common refrain up here is "yeah that thing that bugged me all through February was probably Coronavirus" followed by "did you get tested?" followed by "lol." If you follow the gastrointestinal theory we've had community transmission in Seattle since early December. In November 1992 my sister spent three weeks in intensive care. Massive respiratory collapse. Tested negative to everything they could test for. They told us to get ready for her to die, age 14. She pulled through and none of us talk about it. What was it? Who the fuck knows. It certainly wasn't Hantavirus because it hadn't been "discovered" yet.
"Given the severity of what we’ve already seen and the uncertainty of where we might be headed, the prudent approach is most definitely not to wait to sharpen our estimates. "
One issue I take with this article is that it doesn't address the hospital saturation issue appropriately: Italy is nearing a 10% death rate atm, and as far as I know, heart attacks, strokes, and the like aren't the issue. COVID-19 seems to result in a large number of people that need intensive care for several days, and not a small number that need to be on a ventilator. Even if COVID-19 has a flu-like death rate, all signs point to it being far more infectious. Overwhelmed systems seem to result in significant numbers dying from COVID-19. I agree that we need more data, but what is going on in Italy doesn't look anything like a flu season.Yet if the health system does become overwhelmed, the majority of the extra deaths may not be due to coronavirus but to other common diseases and conditions such as heart attacks, strokes, trauma, bleeding, and the like that are not adequately treated.
I agree that it seems completely abnormal to the point it's hard to make a flu comparison. But I guess we have to wait for the numbers to catch up. Part of me also wonders what part bad government plays in this saga. Neither Italy nor Spain have had a stable government since the financial collapse of 2008. You can see what damage 3 years of terrible leadership has wrought here. What does 12 years (or way, way longer if we're not being generous) do? I could be totally off base, but places with a swift, sensible government response seem to have faired the best so far (e.g. Taiwan, Singapore).
This seems a reasonable comparison based on current data: It looks like we might be trying the “let it run its course” approach, however: https://www.cnn.com/2020/03/24/politics/donald-trump-coronavirus-strategy/index.html/cdn.vox-cdn.com/uploads/chorus_asset/file/19816388/flu_covid_comparison_1_high_res.jpg)
I would caution against reading too much into the hospitalization and case fatality rates, because we don't know the infection rate, without which those numbers are close to meaningless. It is reckless to say we have a 3% CFR without knowing the IFR (infection fatality rate). The flu has been around long enough, and testing for it is routine enough, that we pretty much can make a really good guess about the CFR/IFR. Since we're sailing in uncharted waters wrt covid, I think we're in danger of making some wildly inaccurate speculations (like the WHO's reckless and irresponsible pronouncement about a 3.4% CFR). I despise the president as much as the next guy, but I hope our collective hate for him isn't going to make us knee-jerk react against anything he suggests (even the proverbial blind squirrel can find a nut from time to time). I think reopening for business is very premature, but I also think that he's correct about his statement that if it were up to "the doctors" (probably meaning Fauci) we'd be closed for business for a year. We've got to balance somehow. I don't know enough to know what the right balance is, but I do know that a major depression is going to cause way more deaths and diseases to the most innocent among us (poor children) than covid ever could. We have enough history behind us to be very certain of that.
We don't have the infection rate pinned down, but signs suggest the R0 range is higher than flu. We also have some confidence that the hospitalization rate is greater. We aren't flying blind in terms of genomic epidemiology, which does provide clues of the infection rate and the physical spread. https://nextstrain.org/ncov?c=country No doubt, doctors shouldn't decide when the economy is reopened. But I don't expect Trump to make a data-driven call. My guess is the sweet spot is somewhere between 15 days and one year. Just giving enough time so that everyone has a supply of surgical masks could get us closer to striking a rational balance. In China, you need to wear a mask if you are out in public, not so much to protect yourself, but to reduce your chance of infecting others. We know that works. If everyone in the US returned to work with ample supply of surgical masks, that could increase economic activity while minimizing the burden on hospital systems.
South Korea seems a good example for what COVID-19 looks like when managed in a reasonable way. They had a flare up, tested like crazy, and have managed to keep the death rate around 1% while staying open for business. https://www.msn.com/en-us/news/world/how-south-korea-flattened-the-coronavirus-curve/ar-BB11AJwA https://abcnews.go.com/International/south-korea-takes-measures-face-masks-domestically-amid/story
This article's writer is statistically challenged. It make me angry the article age so bad, it is funny (I mean very sad) to look at only a few day later 21 march: 388 death Yeah, they were right to worry: it grow fast (x6 in 5 days). I cant wait for tomorrow when it will probably be at 680, and in 2 week when it will be around 6800 Ok that's the point I stopped paying attention. You have data from dozen country to check. BUT he decided the only relevant information is the diamond princess. Forgot to say that 15 people on the boat are still in a critical state. Diamond Princess population is so small, any death/recovery drastically change the stats. 10 more people die (out of the 150 still ill) and you're at the 3% death rate used by WHO. Using only Diamond princess data is disingenuous at best, criminal at worst... because I cant help but suspect that this guy has an agenda.. nobody can be so insincere Not only he took the smallest death rate of all country: 1,4% . Then rounded it to 1% then assumed the boat population is elderly (is it? Do he know the medium age on that cruise, or he watched "love boat" and make his assumption? Arent those cruise population also known to be wealthy, and probably very healthy to go traveling for weeks?.. I watched Love Boat too!), then he cut the rate to 0.3% .. really?! That is not mathematics, it is magic My guess, this guy must be a Russian spy trying to get people to not care.Some worry that the 68 deaths from Covid-19 in the U.S. as of March 16 will increase exponentially to 680, 6,800, 68,000, 680,000 … along with similar catastrophic patterns around the globe. Is that a realistic scenario, or bad science fiction?
If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis —
Whether you agree or not, he knows more about this than you. Here's a link to his pubmed page. Statistically challenged, indeed.
This is not about agreeing. I'm already agreeing with him. Covid probably isn't deserving of such a governmental reaction. But he is statistically wrong. You don't exclusively use 712 data point, when you have 200 000 available. Then make guesstimate around those 712 point. This is deceit. So if he knows math, then he has an agenda and he is purposefully lying about statistic to fulfill it. Seriously the CIA should check this guy
I don't think that's what he's saying. I think he's saying there are so many degrees of freedom here that the uncertainty range is enormous, and one can construct any money if arguments that this disease isn't close to the apocalypse. Therefore, without data, we don't have any basis on which to judge the damage we're causing by all but closing society relative to what we're saving in terms of fewer infections.
He use the old "we are not sure" argument. It's a scam parading as science https://en.wikipedia.org/wiki/Manufactured_controversy death rate on the ship just went up to 1,7 %.. And a simple wiki search would have debunked his assumption about infected being old: If the young crew was exposed to covid, his all argument fall even more flat. I cant wait till we find who paid this guy to spurt this non-sense of an articleOpponents of public health and environmental regulations often try to “manufacture uncertainty” by questioning the validity of scientific evidence on which the regulations are based. Though most identified with the tobacco industry, this strategy has also been used by producers of other hazardous products.
Honestly we need a controlled experiment, gather volunteers and infect/monitor on a cruise ship or isolated island. Then we can understand how it spreads how many symptomatic vs not, critical care rate, resource allocation per infection etc. all the hard questions we have no data on
Just yesterday, I asked and did not receive an answer to the question: Why do I have to be sensitive to everyone's anxiety and nobody ever has to be sensitive to actual knowledge? It was a sort of crass answer to being more or less accused by my sister-in-law of trying to kill her parents by having the gall to be in the same room with them. People are fucked, and they don't want to and don't know how to have a rational conversation about complicated issues.