<story><title>CA governor projecting 25.5M COVID19 cases in CA in 8 weeks [pdf]</title><url>https://www.gov.ca.gov/wp-content/uploads/2020/03/3.18.20-Letter-USNS-Mercy-Hospital-Ship.pdf</url></story><parent_chain><item><author>bugzz</author><text>0.05% is just ridiculous.  That&amp;#x27;s half the death rate of the flu, so the only way he can justify a number like that is if he believes we are missing the VAST majority of all cases (due to them being mild) and only seeing the severe ones &amp;#x2F; deaths.  But there&amp;#x27;s a simple check to this - how many deaths does Italy have per day in a bad flu season vs how many Covid-19 deaths per day are they having now?  Worst flu year on record I could find for Italy was 25,000 deaths (average year ~15,000 deaths).  Spread those over 3 months for flu season, and that&amp;#x27;s 277 deaths per day. Italy had 475 deaths yesterday from Covid-19.  Even if you assumed EVERY Italian has contracted Covid-19, death rate would have to be at least 2x the flu.  Now, think about how the majority (80%?) of deaths in Italy are in the Lombardy region, which has maybe 1&amp;#x2F;4 the population, and thus 1&amp;#x2F;4 the flu deaths per year.  Now it&amp;#x27;s clear Covid-19 must have fatality rate at least 5-6 times worse than the flu, even assuming every Italian has it...&lt;p&gt;Edit:&lt;p&gt;Flu mortality stats for Italy: &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.sciencedirect.com&amp;#x2F;science&amp;#x2F;article&amp;#x2F;pii&amp;#x2F;S1201971219303285&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.sciencedirect.com&amp;#x2F;science&amp;#x2F;article&amp;#x2F;pii&amp;#x2F;S120197121...&lt;/a&gt;&lt;p&gt;Covid-19 deaths per day in Italy: &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.worldometers.info&amp;#x2F;coronavirus&amp;#x2F;country&amp;#x2F;italy&amp;#x2F;&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.worldometers.info&amp;#x2F;coronavirus&amp;#x2F;country&amp;#x2F;italy&amp;#x2F;&lt;/a&gt;</text></item><item><author>njarboe</author><text>This article[1] states that our best natural experiment for COVID-19 is the Diamond Princess cruise ship and its quarantine passengers. From that he estimates the the mortality rate is between 0.05% and 1%. That is, we don&amp;#x27;t really know what the rate is. The WHO giving a number with two significant digits implying some reasonable certainty about the number, is very deceiving and very likely just plain wrong.&lt;p&gt;[1]&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.statnews.com&amp;#x2F;2020&amp;#x2F;03&amp;#x2F;17&amp;#x2F;a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data&amp;#x2F;&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.statnews.com&amp;#x2F;2020&amp;#x2F;03&amp;#x2F;17&amp;#x2F;a-fiasco-in-the-making-a...&lt;/a&gt;&lt;p&gt;By:John P.A. Ioannidis professor of medicine, of epidemiology and population health, of biomedical data science, and of statistics at Stanford University and co-director of Stanford’s Meta-Research Innovation Center.</text></item><item><author>eganist</author><text>Swag maths on the business-as-usual scenario incoming, bound to be very wrong:&lt;p&gt;3.4% mortality rate among those presenting symptoms. (via WHO)&lt;p&gt;As low as 17.9% of cases asymptomatic: &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.forbes.com&amp;#x2F;sites&amp;#x2F;brucelee&amp;#x2F;2020&amp;#x2F;03&amp;#x2F;18&amp;#x2F;what-percentage-have-covid-19-coronavirus-but-do-not-know-it&amp;#x2F;#42991ddf7e90&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.forbes.com&amp;#x2F;sites&amp;#x2F;brucelee&amp;#x2F;2020&amp;#x2F;03&amp;#x2F;18&amp;#x2F;what-percen...&lt;/a&gt;&lt;p&gt;Of the symptomatic cases, 80.9% are mild (&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.sciencealert.com&amp;#x2F;large-chinese-study-finds-most-coronavirus-infections-are-mild&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.sciencealert.com&amp;#x2F;large-chinese-study-finds-most-...&lt;/a&gt;) and we&amp;#x27;re assuming only the ones that present risks are being tested.&lt;p&gt;So if the 25.5m figure stands correct, we&amp;#x27;re looking at what, a range of 195,000 to 695,000 possibly passed on in california before June depending on whether you apply it to not-mild (19.1%) cases v. all symptomatic (82.1%) cases?&lt;p&gt;I can&amp;#x27;t find any concrete sources on how anyone is calculating current mortality rates for the bug, but:&lt;p&gt;1. that swing is &lt;i&gt;unfathomable&lt;/i&gt; to me&lt;p&gt;2. those numbers are &lt;i&gt;unfathomable&lt;/i&gt; to me. Especially once extrapolated to the whole country assuming 56% of the nation contracts it.</text></item></parent_chain><comment><author>609venezia</author><text>I think Ioannidis included that very low number as an example of how ridiculous the statistics can look when using the Diamond Princess as a sample and factoring in the relevant sources of uncertainty.&lt;p&gt;&amp;lt;&amp;lt;Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%. But since this estimate is based on extremely thin data — there were just seven deaths among the 700 infected passengers and crew — the real death rate could stretch from five times lower (0.025%) to five times higher (0.625%). It is also possible that some of the passengers who were infected might die later, and that tourists may have different frequencies of chronic diseases — a risk factor for worse outcomes with SARS-CoV-2 infection — than the general population. Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%.&amp;gt;&amp;gt;&lt;p&gt;Mainly I think he wants more testing, but people are cherry picking his argument to try to downplay the risk.&lt;p&gt;His key point from the overall piece is something like &amp;quot;we need more testing, including randomly sampled data. Let&amp;#x27;s not give up on testing while we ratchet up the countermeasures.&amp;quot;&lt;p&gt;Evidence:&lt;p&gt;Second graph- &amp;lt;&amp;lt;At a time when everyone needs better information, from disease modelers and governments to people quarantined or just social distancing, we lack reliable evidence on how many people have been infected with SARS-CoV-2 or who continue to become infected. Better information is needed to guide decisions and actions of monumental significance and to monitor their impact.&amp;gt;&amp;gt;&lt;p&gt;in the middle- &amp;lt;&amp;lt;The most valuable piece of information for answering those questions would be to know the current prevalence of the infection in a random sample of a population and to repeat this exercise at regular time intervals to estimate the incidence of new infections. Sadly, that’s information we don’t have.&amp;gt;&amp;gt;&lt;p&gt;concluding graph- &amp;lt;&amp;lt;If we decide to jump off the cliff, we need some data to inform us about the rationale of such an action and the chances of landing somewhere safe.&amp;gt;&amp;gt;&lt;p&gt;---&lt;p&gt;Coming from a different angle, the latest estimate from Wuhan is 1.4% (.9-2.1)&lt;p&gt;&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.nature.com&amp;#x2F;articles&amp;#x2F;s41591-020-0822-7?mod=article_inline&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.nature.com&amp;#x2F;articles&amp;#x2F;s41591-020-0822-7?mod=articl...&lt;/a&gt;</text></comment>
<story><title>CA governor projecting 25.5M COVID19 cases in CA in 8 weeks [pdf]</title><url>https://www.gov.ca.gov/wp-content/uploads/2020/03/3.18.20-Letter-USNS-Mercy-Hospital-Ship.pdf</url></story><parent_chain><item><author>bugzz</author><text>0.05% is just ridiculous.  That&amp;#x27;s half the death rate of the flu, so the only way he can justify a number like that is if he believes we are missing the VAST majority of all cases (due to them being mild) and only seeing the severe ones &amp;#x2F; deaths.  But there&amp;#x27;s a simple check to this - how many deaths does Italy have per day in a bad flu season vs how many Covid-19 deaths per day are they having now?  Worst flu year on record I could find for Italy was 25,000 deaths (average year ~15,000 deaths).  Spread those over 3 months for flu season, and that&amp;#x27;s 277 deaths per day. Italy had 475 deaths yesterday from Covid-19.  Even if you assumed EVERY Italian has contracted Covid-19, death rate would have to be at least 2x the flu.  Now, think about how the majority (80%?) of deaths in Italy are in the Lombardy region, which has maybe 1&amp;#x2F;4 the population, and thus 1&amp;#x2F;4 the flu deaths per year.  Now it&amp;#x27;s clear Covid-19 must have fatality rate at least 5-6 times worse than the flu, even assuming every Italian has it...&lt;p&gt;Edit:&lt;p&gt;Flu mortality stats for Italy: &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.sciencedirect.com&amp;#x2F;science&amp;#x2F;article&amp;#x2F;pii&amp;#x2F;S1201971219303285&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.sciencedirect.com&amp;#x2F;science&amp;#x2F;article&amp;#x2F;pii&amp;#x2F;S120197121...&lt;/a&gt;&lt;p&gt;Covid-19 deaths per day in Italy: &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.worldometers.info&amp;#x2F;coronavirus&amp;#x2F;country&amp;#x2F;italy&amp;#x2F;&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.worldometers.info&amp;#x2F;coronavirus&amp;#x2F;country&amp;#x2F;italy&amp;#x2F;&lt;/a&gt;</text></item><item><author>njarboe</author><text>This article[1] states that our best natural experiment for COVID-19 is the Diamond Princess cruise ship and its quarantine passengers. From that he estimates the the mortality rate is between 0.05% and 1%. That is, we don&amp;#x27;t really know what the rate is. The WHO giving a number with two significant digits implying some reasonable certainty about the number, is very deceiving and very likely just plain wrong.&lt;p&gt;[1]&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.statnews.com&amp;#x2F;2020&amp;#x2F;03&amp;#x2F;17&amp;#x2F;a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data&amp;#x2F;&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.statnews.com&amp;#x2F;2020&amp;#x2F;03&amp;#x2F;17&amp;#x2F;a-fiasco-in-the-making-a...&lt;/a&gt;&lt;p&gt;By:John P.A. Ioannidis professor of medicine, of epidemiology and population health, of biomedical data science, and of statistics at Stanford University and co-director of Stanford’s Meta-Research Innovation Center.</text></item><item><author>eganist</author><text>Swag maths on the business-as-usual scenario incoming, bound to be very wrong:&lt;p&gt;3.4% mortality rate among those presenting symptoms. (via WHO)&lt;p&gt;As low as 17.9% of cases asymptomatic: &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.forbes.com&amp;#x2F;sites&amp;#x2F;brucelee&amp;#x2F;2020&amp;#x2F;03&amp;#x2F;18&amp;#x2F;what-percentage-have-covid-19-coronavirus-but-do-not-know-it&amp;#x2F;#42991ddf7e90&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.forbes.com&amp;#x2F;sites&amp;#x2F;brucelee&amp;#x2F;2020&amp;#x2F;03&amp;#x2F;18&amp;#x2F;what-percen...&lt;/a&gt;&lt;p&gt;Of the symptomatic cases, 80.9% are mild (&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.sciencealert.com&amp;#x2F;large-chinese-study-finds-most-coronavirus-infections-are-mild&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.sciencealert.com&amp;#x2F;large-chinese-study-finds-most-...&lt;/a&gt;) and we&amp;#x27;re assuming only the ones that present risks are being tested.&lt;p&gt;So if the 25.5m figure stands correct, we&amp;#x27;re looking at what, a range of 195,000 to 695,000 possibly passed on in california before June depending on whether you apply it to not-mild (19.1%) cases v. all symptomatic (82.1%) cases?&lt;p&gt;I can&amp;#x27;t find any concrete sources on how anyone is calculating current mortality rates for the bug, but:&lt;p&gt;1. that swing is &lt;i&gt;unfathomable&lt;/i&gt; to me&lt;p&gt;2. those numbers are &lt;i&gt;unfathomable&lt;/i&gt; to me. Especially once extrapolated to the whole country assuming 56% of the nation contracts it.</text></item></parent_chain><comment><author>jMyles</author><text>&amp;gt; we are missing the VAST majority of all cases (due to them being mild) and only seeing the severe ones &amp;#x2F; deaths&lt;p&gt;This is entirely possible, and is the conclusion of a different, unrelated paper published today.  [0]&lt;p&gt;&amp;gt; But there&amp;#x27;s a simple check to this - how many deaths does Italy have per day in a bad flu season vs how many Covid-19 deaths per day are they having now?&lt;p&gt;This is a good idea, and a reasonable metric, but it&amp;#x27;s not a  good way to compare the CFR, because there are too many confounding factors.&lt;p&gt;For example, it&amp;#x27;s possible that the early lockdown in Northern Italy actually &lt;i&gt;increased&lt;/i&gt; the number of deaths by expanding the window of exposure to elderly populations (whose younger relatives normally would have been out of the house all day).  It&amp;#x27;s possible that, for some reason, Italians are particularly susceptible to SARS-CoV-2.  It&amp;#x27;s possible that the weather pattern or air quality had some strange impact.&lt;p&gt;I&amp;#x27;m not saying any of these things are true; I&amp;#x27;m saying that it&amp;#x27;s not a great way to compare CFRs or speculate about the number of mild or asymptomatic cases.&lt;p&gt;0: &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.reddit.com&amp;#x2F;r&amp;#x2F;PrepareInsteadOfPanic&amp;#x2F;comments&amp;#x2F;fljzvy&amp;#x2F;a_study_shows_the_fatality_rate_for_covid19_may&amp;#x2F;&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.reddit.com&amp;#x2F;r&amp;#x2F;PrepareInsteadOfPanic&amp;#x2F;comments&amp;#x2F;fljz...&lt;/a&gt;</text></comment>