Looking forward to reading more analysis from you on this topic, based on your professional expertise. I’m trying to synthesize expert opinion and public reaction and it is a moving target as more data is collected but also as more public awareness spreads.
The inherent problem with mortality statistics is that there really is no one answer - “mortality rate” is basically an index value designed to deal with this issue.
Most of the public wants to know what sounds like a straightforward piece of information: “how dangerous is this to me?” Or basically “how much should I worry?”
The actual answer is, unhelpfully, “it depends.” And the public hates that because it requires digging into way more variables than anyone has time for. I could sit you down with 17 different analysis frameworks and still not arrive at a clear answer that indicates specific action.
It’s a constant battle to communicate information effectively to the public. We need people to pay attention without panicking or spreading racist misinformation, but if you don’t make it severe enough they won’t care enough, and that itself will create gaps that make the outbreak worse.
The take-away for now, and generally, is:
- Don’t panic.
- Take reasonable precautions.
- Wash your hands more (and for longer) because you don’t do it enough
- If you are at-risk for complications due to flu (elderly, respiratory disease) be extra cautious
- If you’re really concerned, a mask is a good piece of PPE that will lower your risk without being too onerous
- Don’t look for scapegoats
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Would it also be fair to say that MR (and to some extent CFR) are over estimated in this situation because we don’t have a solid estimate of the exact number of likely infections at the moment? For example, we could have significantly higher mild or even asymptomatic cases of COVID19 which skew this value down. I would imagine that for seasonal flu for example, we have fairly accurate statistical models for infection rates, even if we don’t test everyone.
I would actually say that the mortality rate is likely to be higher than officially reported (in china) due to severe supply limitations and facility limitations in Hubei and other hard hit areas in china coupled with political motivations.
This is probably more reflected in the multiple models mentioned above, you can break it down not just by age, but by region as well. However, I’m not sure if the overall lethality of a disease is really a function of the material conditions in which you are sick vs. just the biological risk factors inherent in the patient.
It is if there are no hospital beds to put you in or testing supplies to actually confirm your Covid-19 infection so instead you die at home and the local administration signs your death warrant with “died of flu” and you are cremated and never enter the official statistics for the disease.
Right, but the argument I’m making is that I don’t think (or at least I’m unsure) taking into account the material conditions of where you are (how many hospital beds, respirators, etc) is actually scientifically measured as part of a disease’s lethality, or if they are rather, a case based fatality where it’s just another variable.
The answer is both and then some. Mortality is an intersection biological factors (the pathogen and the patient), environmental factors, socioeconomic factors, and cultural factors. That’s why public health is an integrated discipline - shit’s real complicated and not at all straightforward.
The good news is that modeling is very sophisticated and can account for things like underreporting and small datasets - that all factors into uncertainty.
The bad news is that, indeed, mortality was actually underrepresented because China didn’t share all the facts. Whoops.
WHO’s sitrep 31 (about a week old now) revised their IFR estimate upwards from 0.33 to 0.94% (with an upper bound of 2.9%):
2.9% current highest fatality rate estimate might not sound catastrophic (because it’s not), but it’s bad, doubly given how infectious this appears.
We have more confidence with flu precisely because we have more experience with it. We probably won’t have really clear answers until long after this outbreak is over.
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I’ve seen some takes similar to this that attempt to tamp down or balance the panic level the public warnings generate. Not saying the virus isn’t a big deal, but adding context to the talk about how many are hospitalized and have died. What I wonder is how it compares to other public disease outbreaks, especially ones like influenza that kill thousands every year.
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Hank Green is one of the best science communicators out there right now. On point.
We’ll get comparisons to influenza eventually. You have to be careful with comparisons, though, because one of the things keeping COVID19 from being worse is the containment effort - which includes public awareness. So, spreading awareness about its actual risks is very important for mitigating those risks, but saying “it’s really not that bad” as a method to keep people calm might result in lax behavior that can take it from “not that bad” to “actually pretty bad.”
This is an aggravating phenomenon in public health, actually. One of the biggest advantages the field has gained in the last several years is an unprecedented ability to communicate information to the public. You can hear about things in real-time, to minute detail.
This leads to a sort of overreporting bias, where if you hear about a thing more often, it must mean that it’s worse than things you don’t hear about - but actually, the fact that you’re hearing about it so much is one of the strategies that prevents it from getting bad.
And then over-saturation becomes an issue too. Too much noise and people will ignore the message, to their detriment.
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Aside: Why share a static image of a tweet instead of the link to the tweet?
Just used to screenshoting interesting things I find on my phone. When I went to share it here I had it more readily available rather than going back to find the tweet and get a link.
If 10 is the worst pandemic imaginable, this is still like a 1 right?
https://imgs.xkcd.com/comics/pain_rating.png
I have been telling people that it generally isn’t any worse than the common cold. Am I being misleading by saying that?
Yes, you are incorrect. Physically able medical staff infected with the virus have died in China.
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Yes, you are objectively wrong and actively downplaying the severity of a disease that is literally killing people.
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Additional to the prior comments saying you’re wrong, I want to add that the “common cold” is not just one disease but rather a group of viruses, some unrelated to one another, that cause similar symptoms. To compare a single disease which is killing people to a collection of them is dangerous.
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Very well. Is there a more apt comparison or should I stick to how the symptoms have been minor in the majority of reported cases?
Don’t give any definitive answer and instead recommend people to follow the WHO and CDC guidelines and data. They have very good primers on the virus
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