coronavirus death rate vs sars

  • 15 min read
  • Feb 02, 2019

January 30 coronavirus news - CNN
January 30 coronavirus news – CNN

By John P.A. Ioannidis

March 17, 2020

coronavirus disease today, Covid-19, has been called once-in-a-century. But maybe once in a century-failure proof.

At the time everyone in need of better information, than modelers disease and the government to quarantine or distancing just social, we lack reliable evidence on how many people have been infected with SARS-CoV-2 or continued infection , Better information needed for decisions and actions of monumental importance to guide and monitor their impact.

Draconian reduction has been adopted in many countries. If the pandemic disappeared – either alone or as this action – a short-term extreme social distance and lockdowns may be bearable. How long, though, should such measures would be continued if churns worldwide pandemic continues? How can policy makers to know if they are doing more good than harm?

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affordable vaccines or treatments take months (or even years) to develop and test properly. Given the schedule, the consequences of long-term lockdowns fully known.

The data collected so far on how many people are infected and how the epidemic develops a truly reliable. Given the limited testing to date, several deaths and probably most of infection from SARS-CoV-2 is being missed. We do not know if we fail to capture an infection by a factor of three or 300. Three months after the outbreak emerged, most countries, including the United States, does not have the ability to test a large number of people and no country has reliable data on the prevalence of the virus in represent a random sample of the general population.

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The evidence of failure creates tremendous uncertainty about the risk of death from Covid-19. The reported rate of deaths, such as the official rate of 3.4% of the World Health Organization, the cause of horror – and nothing. Patients who have been tested for SARS-CoV-2 disproportionately those with severe symptoms and a poor outcome. Like most limited health system capacity testing, selection bias may even worsen in the near future.

a situation where the entire population is covered tested cruise ship Diamond Princess and her quarantine passengers. The case fatality rate there is 1.0%, but this is largely elderly population, where death rates from Covid-19 is much higher.

Projecting mortality Diamond Princess to the age structure of the US population, the rate of death among people infected with Covid-19 will be 0.125%. But because these estimates are based on data that is very thin – only seven deaths among the infected 700 passengers and crew – the real mortality rate may extend from five times to lower (0.025%) to five times higher (0.625%). It is also possible that some of the passengers who are infected will die later, and that tourists may have a different frequency of chronic disease – a risk factor for worse outcomes with SARS-CoV infection-2 – than the general population. Adding additional sources of uncertainty, reasonable estimates for the ratio of deaths in the US general population varies from 0.05% to 1%.

It was a real big influence how severe the pandemic is and what should be done. A case fatality rate-wide population is 0.05% lower than seasonal influenza. If it is the correct rate, locking down the world with the social and financial consequences of potentially great might be really irrational. It’s like the elephant attacked by a house cat. Frustration and try to avoid cats, elephants deliberately jump off the cliff and die.

Could Covid-19 case fatality rate is low it? No, some say, pointing to a high level in the elderly. However, even some so-called coronavirus mild or common-cold-types have been known for decades may have a case of mortality when they infect the elderly in nursing homes. In fact, such as “light” coronavirus infects tens of millions of people every year, and account for those who are hospitalized in the US with lower respiratory tract infections each winter.

This “light” coronavirus may be involved in several thousand deaths every year around the world, although most of them are not documented with appropriate testing. Instead, they lost as the noise between 60 million deaths from all causes each year.

Although sur successveillance system has long been available for influenza, the disease was confirmed by laboratory in a small minority of cases. In the US, for example, so far this season and 222 552 (20.7%) had tested positive for influenza. In the same period, the estimated number of influenza-like illness is between 36 million and 51 million, with an estimated 22,000 to 55,000 deaths from flu

Note uncertainty about influenza-like illness death. Various 2,5-fold, according to the tens of thousands of deaths. Every year, some of these deaths caused by influenza and several other viruses, such as the common-cold coronavirus.

In tested for respiratory viruses in specimens from 57 parents who died during the 2016-2017 influenza season, influenza virus was detected in 18% of specimens, whereas other types of respiratory virus was found in 47%. In some people who died of respiratory viral pathogens, more than one virus found in autopsies and bacteria often superimposed. A positive test for coronavirus does not mean necessarily that the virus is always primarily responsible for the patient’s death.

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If we assume things mortality rate among people infected by SARS-CoV-2 was 0.3% in the general population – mid-range Diamond Princess guess from my analysis – and that 1% of the US population will be infected (approximately 3.3 million), this would translate to approximately 10,000 deaths. This sounds like a large number, but buried in the noise of the estimated deaths from “influenza-like illness.” If we do not know about the new virus out there, and did not examine individual with a PCR test, the total number of deaths from “influenza-like illness” will not seem strange this year. At most, we might have relaxed noted that the flu this season seems to be slightly worse than average. Media coverage will be less than for an NBA game between the two teams most indifferent.

Some worry that 68 deaths from Covid-19 in the US will increase exponentially to 680, 6,800, 68,000, 680,000 … along with a pattern similar disasters worldwide. Is that a realistic scenario, or a bad science fiction? How can we know what the point of the curve may be stopped?

The most valuable part of the information to answer these questions will determine the current prevalence of infection in a random sample of the population and repeat this exercise at regular time intervals to estimate the incidence of new infections. Unfortunately, we do not have the information.

In the absence of data, prepare-for-the-worst of reasoning leads to extreme measures of social distance and lockdowns. Unfortunately, if these measures work. Closing schools, for example, can reduce the rate of transmission. But they can also backfire if children socialize however, if the closure of schools leads children to spend more time with family members vulnerable elderly, if the children in the home impairs the ability of the parents are working, and more. School closure can also reduce the chances of developing herd immunity in this age group were spared serious illness.

This was the perspective behind the different attitudes of the UK, at least until the time I write this. In the absence of data on the real course of the epidemic, we do not know whether this perspective is brilliant or disastrous

to avoid overwhelming the health system is conceptually sound -. In theory. A visual that has become viral on social media and show the media how to flatten the curve reduces the volume of which is above the epidemic threshold of what health systems can handle at any time.

But if you do not become overwhelmed health systems, most of the additional deaths was not possible because the coronavirus but for other common diseases and conditions such as heart attack, stroke, trauma, bleeding, and the like untreated. If the level of the epidemic did not overwhelm health systems and extreme measures have only modest efficacy, the curve flattening can make things worse: Not overwhelmed during a short, acute phase, overwhelmed health systems will remain for a longer period of protracted. That is another reason we need data on the exact extent of the epidemic activity.

One of the bottom line is that we do not know how long the social distancing measures and lockdowns can be maintained without major consequences on the economy, society, and mental health. unexpected evolution may occur, including the financial crisis, unrest, civil war, war, and the crisis of the social structure. At a minimum, we need to contain data for the prevalence and incidence of infectious load evolved to guide decision making.

In the scenario of the most pessimistic, I do not support, if it infects the coronavirus only 60% of the global population and 1% of those infected die, which will be translated into more than 40 million deaths globally, match the influenza pandemic of 1918.

most of this massacre will be the ones with a limited life expectancy. Which is in contrast to 1918, when many young people died.

We can only hope that, as in 1918, life will continue. Conversely, with lockdowns months, if not years, the lives of most of the stops, the consequences of short-term and long-term fully known, and billions, not just millions, life may ultimately be at stake.

If we decide to jump off a cliff, we need some data to inform us about the reasons of such actions and the possibility of landing in a safe place.

John PA Ioannidis is professor of medicine, epidemiology and population health, science biomedical data, and statistics at Stanford University and co-director of Stanford Meta-Research Innovation Center.

Hi, I love reading your articles. Your writing gives concise accounting of the possible outcomes of the SARS-CoV-2. Proofreading is not easy given the current state of our print media, and one can see you struggling to get every detail right, so I want to tell you about the only fault I found in your reports. It’s about the midpoint (perhaps a little further), but the text reads as: “interferes with the ability of their parents to work.” parents lost a possessive plural.
I hope no offense taken. I interrupted just because your writing is so good.

Thanks,
David Adams

If we assume that there are no data to support the measures being taken, why not do a general survey of the population by introducing questions and bias control which allows to build a larger database that may have been infected? This would not be the direct method but it may be helpful to make another estimate …

I do not agree with the author at some point. First, it is common vehiculated information that flu kills 20-30 thousand people per year. I have seen more than 25 flu epidemics each winter and recorded patients died from the flu die from severe / their terminal condition, heart failure, COPD, etc. Flu just push them into eternity, because they do not have a backup to additional stress. Some will die with staph pneumonia after flu frustrate them. Hardly anyone who is killed by the flu virus per se … People do not make much fuss about the numbers because most of the people who should / presumed dead.
Instead, Cov kill people directly, information from China and Italy points for ARDS with SDC possibility of viral myocarditis as well. We have been told that the victim was old and sick, such as flu … but they did not. The most comorbidity found was hypertension, followed by diabetes, aka 60% of the adult American population. Death for people in their 50s or younger is much higher than the flu. Anyone heard of people older than 65 who were left to die because there is not enough ventilator in a flu epidemic, as is happening now in Italy?

The assumption of death in this article is very debatable and the article does not discuss numbers generated from South Korea, by far the country’s most tested. After more than 200k test, they identify 8k positive, with 80 victims for credible mortality of 1%. As an accurate marker of their work, the numbers have been quite stable recently. Cruise cases do not have sufficient numbers to reach any conclusion but too they have a positive 700 and 7 died, for death … 0.1%

Last, the authors anticipate 1% of Americans to contract Cov. I think it’s a typo, as the ratio of infectivity worse than the flu, with all the simulation runs for 100mil plus. It turns out that is not a typo below, the author even able to come up with a total of 10,000 people died in the United States, when all will be done. Now, let’s think about it: Italy had 3000 killed around 3weeks and United have five times as many people …

Did you know that 4.5 million people die from pneumonia every tear

Just a note:covid 19 deaths were missed. While South Korea implemented a program of epidemiological surveillance, they certainly missed infected patients. You will need to estimate the percentage of positive throughout the entire population to conclude that includes the true positive cases of known and unknown. Data from China show in each case that are known to exist six unknowns. It is based on sophisticated mathematical models published in the journal Science on March 16. The reality is that the CFR in South Korea the possibility of an order of magnitude off. In China, outside of Hubei Province, which includes Wuhan, CFR was 0.1%, the equivalent of influenza. This utility is known + positive note based on mathematical modeling. In Hubei, CFR was 0.5%, and we can conclude that this might do to the strain on their system. So yes, I believe that shutting down of covid-19 are similar to influenza, but that it happened fast deployment in society and master the health system resulting in a higher percentage of deaths than we would otherwise be expected based on the virulence of course.

“Whoever heard of people older than 65 who were left to die because there is not enough ventilator in a flu epidemic, as is happening now in Italy?” Who said that?
Here is what happened in Italy with info to the contrary above:

Your analysis of mortality Diamond disabled daughter. Unless you know the age distribution of those infected, these numbers seem a little off. The average age of cruise passengers typical low 50s. About 40% of those on board are workers who are mostly in their 20s or 30s. And cruise ship passengers are healthier than their age peers. So the 700 infected and seven dead (with potentially more deaths considering that 15 is still critically ill), at least 1% case-fatality rate that may very well be the lower range for the US. When the case-fatality in Korea amounted to 1% (and higher will be given the lag time for those who are critically ill to die). Korea is a country with good COVID-19 surveillance. Taking these two examples together, folly to think that the US CFR would be something less than 1%.

It has NO state has collected a random sample you suggest to monitor events? I’m disappointed if this is true and agree that it seems like the basic information we needed.
I was somewhat surprised by your hypothetical estimate of 1% of the US population is infected, because my impression is that COVID-19 is much more contagious than that, and a much higher% of the population will have some level of infection. If COVID-19 only lead to a ‘blip’ death, something that will be considered as nothing more than a bad flu season if we do not identify the virus, then why Italy ICU overwhelmed far beyond any normal flu season? What am I missing in your logic?

This article suffers from group to individual mistakes … and individuals to mistake the group on how to understand and interpret statistics. It is surprisingly lacking in substance and signifies into fact checking, but missed a key to understanding the context of the facts or evidence to support the central thesis.

First, according to the overall consensus of the doctors and nurses who work in patients, they said they had never seen anything like this before. You fail to remind the reader that the FACT VERY IMPORTANT. Is this MD panic just this year? If so, what is the cause of the panic group that emerged this year, and the year before? Were you treated patients covid-19 and can you provide evidence that doctors who treat the virus that over-reacts to specific symptoms or outcomes? If not, what are you really trying to say here … ..

Second, the 34-year-old doctor who discovered coronavirus die from it. The young nurse died from it. Is it normal for young health workers to die from the virus that turned into “no-biggy”? Can you quote the study of other viruses are easily transmitted to Heathcare workers and kill those who are “not like a big problem”.

Third, according to doctors and experts virus, which does not compare to the flu and flu is the wrong comparison. So, why did you make that comparison? We have a vaccine for the flu virus and do not have (the Freakout that). You pointed out that many people die each year from flu. Do you think the fact that we have a vaccine for the flu and still kill many people actually negate your main thesis considering we do not have a vaccine for this coronavirus. Its like saying HIV is not a big issue because people die from flu. Just as many people died from other causes does not mean that the corona virus causes of death are more or less significant. However, you are implying that we should take into account the assumption that the coronavirus is less significant. What evidence do you have that we should not worry about viruses we do not have a vaccine for?

Fourth, according to the more adjacent to all accounts from leading health organizations and MD to treat the patient. He went through a nursing home in Washington and killed a group of parents really fast. An article on March 3 reported four deaths, last 7 days, on March 10, it was 18 deaths. On this comment, it might be more. This is a key factor. We have to stay out of a specific location or it will spread and kill many people, according to people who work against this virus. If it is confined to the spring 20 yr olds we might be okay. Although there is some evidence was hospitalized upwards of 20% of the “youth” (loosely defined depending on the research article), and that the virus causes permanent scaring of the lungs. Do you have evidence that we can apply the spring quarantine by age in virus? If so, I’m game to hear policy advice.

Fifth, and most important, say in your path. A panic is a sociological phenomenon. It is described. It is responsible to imply that this is a panic without proof. For example, the physician and virologist lost their jobs in large enough quantities that they may be motivated to create a crisis in order to legitimize his career and position in their communities all around the world? Are they some kind of job stability panic we are not aware of? Or, is there evidence that doctors and virologists lose status in society around the world to levels that might motivate them to create a crisis in order to legitimize their careers and their position? They are some kind of panic among MD respect we are not aware of? Or, is there evidence that doctors and virologists lose significant income in communities around the world to levels that might motivate them to create a crisis as part of an effort to increase the salaries of their slack? They are some kind of food-stamp-MD-panic we are not aware of? Or, is one of the leading physicians and physician stating crisis has so much influence that others do not dare question? When was the last time the medical profession all over the world stop and then like … .. “ahhh, a funny thing … .so bad … we all kinda got wrapped up in the whole virus thing cuz we all have just returned from watching a movie transmission and so on … would you laugh about the past … but aaaaaahhh … no big deal, we’re all just a little … you know .Yes panic …. “

If you would making the kind of argument …. you need to bring the heat … .this article is weak sauce. If this is panic, it was the biggest mess up ever by a group usually really competent people. I really hope you’re right for two reasons. First, we all live !!! Secondly, Im gonna research and write about it for the rest of my entire career. Sociologists will have a field day with this. But, come-on ….

You’re writing this from your office, behind R, SPSS, STATA or SAS program (if it is, given the simple statistical analysis is presented). Do you seriously think all the countries and major medical organizations worldwide panic and you are the only one to see clearly? Its possible, the majority are not necessarily correct. But, what evidence, from the perspective of behavioral science that there is panic. Maybe you just did not get the memo on all the other doctors and virologists who say, “Hey, we were tired of making 15 dollars and hours and do not get the respect of people who are so time for freakout coronavirus.” Check your spam filter and generate email. It’s embarrassing. You better come up with something better than the statistical analysis of paper-term master degree level if you are going to make the argument that the physician and virologist panic. Also, in the mean time, get a PhD in sociology, and you will understand how to support this type of argument. Notice how I did not challenge the professional opinion of the professionals in the medical field in this strike, cuz Iz don’t haz MD …….

Big Papa- you really have a lot of time on your hands to write a lengthy response that no one will ever read? I hope it makes you feel better to perpetuate unnecessary hype and fear

Yes the data may not be reliable.

Do we believe that the future of reliable data would not say we have to take proactive steps we are taking now?

What are the consequences of not doing something when we should have?

You sense. I am in a state where everything is closed, even out the patient’s medical facilities, and most people do not have jobs. I am a physician and I’m out of a job as restaurant workers, hair dressers, substitute teaching etc and they suffer great financial collapse and depression. The governor has decided that destroy the economy by putting his thin data in league with the big kids and do not have an objective view. I usually see patients with heart failure, diabetes, chest pain, the risk of cancer and many more, but tell them to call again in June or July, or offering telephone visits, no accepted medical practice. However, the hospital system I work for and I work in the country have decided to gamble with people’s lives without having enough real facts to support their decision. There is a more reasonable approach, but requires high intelligence and a lot of research. Something politicians today seem to lack

Some of the points were very good and in-depth analysis

Question – Are there in the community .. Biomed develops anti-coronavirus based enzyme limit? It will at least stop the spread of the virus in the body. In bacterial cells, restriction enzymes cleave foreign DNA, thereby eliminating the infecting organism.

With Mireille Jacobson and Tom Chang

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