Further thoughts on mortality rate

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  • Tue, Feb 11, 2020 - 12:52pm

    #1
    RebelYell

    RebelYell

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    Further thoughts on mortality rate

This article: https://www.zerohedge.com/health/death-rate-5-harrowing-admission-wuhan-doctor, and the source paper: https://jamanetwork.com/journals/jama/fullarticle/2761044 provide us with good data points which allow us to be erasonably confident that, with good medical care, approximately 25% of patients admitted to hospital will require admission to ICU, and about 5% will go on to die.

The article also notes that many patients do not require admission to hospital and that the overall death rate is therefore lower than this, but there is no accurate data for how many patients do not require admission and the outcomes for them.

As a slight note of caution the doctor is quoted as saying: “Many serious patients died of choking. Others died of the failure of multiple organs following complications in their organs resulting from a collapse of the immune system.”  This does not quite ring true as a reference to just five fatalities – but is probably an either artefact of translation, or the doctor was referring to the totality of fatalities here, not just his own patients.

I am also beginning to think that this virus is a LOT (orders of magnitude) more widespread already than has been admitted for three main reasons:

1.  If the virus can indeed be transmitted as an aerosol it could well have an R0 of much higher than 2.7 – perhaps well over 10.  This would lead to massive numbers of cases by now and would indicate to me that the rate of hospitalization is much lower than the 15 – 20% most estimates have used and therefore that the overall fatality rate is much lower: conceivably far below 1%.

2.  A report I saw yesterday that 2/3 of tests in Wuhan were positive a few days ago.  If we assume that on average a Chinese person gets a cough or fever once every four years during a four month long winter, that would lead to ~20K such cases per day in a population of 10 million.  This would imply that there must have been ~40K per day people getting corona virus in Wuhan itself and the number of cases could easily be at 1 million+ by now.

3.  The number of locally transmitted cases discovered in other countries (e.g. Singapore, Hong Kong + cruise ship) leads me to think that (a) it spreads much more easily than we have previously assumed and (b) it’s not killing all that many people.  The reason it seems bad in Wuhan is because *so many* people (way more than any other estimate that has been discussed) now have it that enough people are dying that its causing problems at hospitals.

It wouldn’t surprise me at all if the eventual fatality rate (assuming access to good medical care) were significantly lower than 1%.

  • Tue, Feb 11, 2020 - 01:13pm

    #2
    RebelYell

    RebelYell

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    And the latest Chinese study suggests fatality at ~1%

https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1.article-info.

The authors have accounted for patients remaining in hospital.  There is a chance that the number is still too high based on not counting mild cases who stay at home, but the authors believe that many more of these people are being detected and hospitalized now, so this number is more reflective of all patients than other studies from Wuhan where milder cases were not included.

 

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