Hacker Newsnew | past | comments | ask | show | jobs | submit | sciinfo's commentslogin

The vast majority of people don't have an intuitive understanding of exponential growth.

People not trained well in math and science don't even have/know the tools to help them understand it analytically.

We need (much) better math education for people studying all majors.


One of our older neighbors are inviting everyone on the nextdoor app to go to their house for movie night to prove that this is just a flu. The entire thread is people making fun of covid19 and how they are angry their retirement accounts are getting hit.

I wish I was making this up.


"there's no point for democracy when ignorance is celebrated" - NOFX

The whole song is disturbingly accurate/prophetic.

https://www.azlyrics.com/lyrics/nofx/idiotsaretakingover.htm...

I'm completely unsurprised by what you're describing. I observed similarly disturbing behavior waiting in line @ Home Depot the other day. A customer was excited to find they had hand sanitizer in stock, and another customer told him there's a whole aisle full of the stuff and that all the covid stuff is fake news which devolved into nonsensical madness between yokels I had to just walk away from. Of course our Home Depot had some in stock, we're in rural bumblefuck middle of nowhere. Our stores only run out of things when the employees forget to do their jobs.


Yeah it's crazy. I suggested in the thread that they should take this a little more seriously and was immediately attacked for being a doom mongering idiot.

Oh well, I tried.


The last sentence applies to all stores, so. Unless people freak out and stock up for the apocalypse, in which case resupply might take a couple of days.


Geez, what part of the country if you don't mind me asking? Arrogance, ignorance, and disinformation is literally going to kill us. Thanks for sharing that.


Bay Area, CA


Thanks for the reply. I guess I'm not surprised. What movie? ;)


It might help telling him that in some regions of northern Italy, patients over 65 with arrests are not assessed any longer and are not treated in an ICU, they are left to die.

I wish I was making this up.

Edit: Source added.

https://twitter.com/jasonvanschoor/status/123714289107769753...


Darwin will solve this irresponsibly stupid behavior. Causing a lot of collateral damage unfortunately.


No, old people have likely already re-produced, and will not be prevented from reproducing if they die now.


I have to concede you're partly right. Darwin will solve more than you think though:

- Some old irresponsibly stupid males are still sexually active. Darwin would stop them reproducing.

- The old irresponsibly stupid neighbour is still a magnet for younger, sexually reproductive irresponsibly stupid people, probably more so than for others.


Please live "social darwinism" to 4chan.

Ignorance is not transmitted genetically.


The whole “people don’t understand exponential growth” thing isn’t a very good explanation, considering that it applies to any contagious disease for which every person tends to infect some constant number of other people.


Which there are few in circulation, thanks to vaccines among other reasons (which lower effective transmission rate), so most people haven't really experienced it working. Somebody mentioned noroviruses the other day as probably the closest relevant thing people may have experienced - let someone with one loose on a cruise ship, and shit literally hits the fan very fast.


Most severe cases require trained medical staff. Since ~20% of infections requires hospitalization, no healthcare system is prepared for an exponential rise in SARS-CoV-2 infections.

Most fatalities are from pneumonia. Lots of details are available all over. You may want to read up.


The numbers out of Korea are nowhere near 20%. About 0.9% of cases are considered severe, according to the most recent statements from the KCDC:

https://m.yna.co.kr/view/AKR20200307046000017?fbclid=IwAR0tl...

Someone is exaggerating, or something is fundamentally inadequate about the Italian response.


South Korea has been administering way more tests than anyone else: https://www.worldometers.info/coronavirus/covid-19-testing/

There is plenty of evidence that many cases are asymptomatic or mild which means the true infection numbers for most countries are likely understated. So the true number of infected individuals in Italy is likely much higher than the reported number of cases.

The other thing to consider, is that with more comprehensive testing, quarantines become more targeted and effective. So South Korea might be having better success in keeping the virus away from at risk populations.


>South Korea has been administering way more tests than anyone else

Also, the last time I checked, something like 75% of patients were part of the Shinjonji "religion" whose members skew very young demographically.


The SK death rate of 0.7% assumes that all 98% of the cases with outcome currently classified as "unknown" will recover. That isn't rational! You need to do proper survival analysis to account for the growth in cases.

Here's a brief analysis of the current numbers from SK: https://twitter.com/jeremyphoward/status/1237324005108924417


I think the real takeaway is from all this is that death rate is a pointless metric. It is highly dependent on the local demographics, it requires precise information which is rarely available, it is biased by the level of care available, it has numerous ways to estimate it all of which are hard to explain and not actual estimates but upper or lower bounds, it tends to naturally decrease over time, etc.

The death rate is lower in China than Italy, but the death rate is lower within each age group in Italy vs China. Most people are too innumerate to understand this statement.

As an aside, I REALLY hate how this guy on twitter says “it could be 5.0%, look at this spreadsheet that assumes 5.0%!” Then refers to a paper as a good analysis which claims 1.6% and a set of facts which differ greatly from all of his assumptions.


SK have tested 5 times more people than anywhere else so are picking up more mild cases that other countries are not detecting. So I'm hoping the SK numbers are closer to 'real'


> The numbers out of Korea are nowhere near 20%. About 0.8% of cases are considered severe.

0.7% have died, and even that's gone up in the last few days as more cases progress. I don't know the specific stats of how many were severe/critical but it's probably much higher than the mortality rate. If you take a look at the age breakdown of the infected it seems they've been good about keeping it away from the elderly, <2000 out of 7000+ cases have been 60+ years old: https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_S...


There’s a link, right there in my post, with more recent and relevant data than you’re citing, and it is directly from the Korean health services: 59 / 6767 confirmed cases were severe or critical in Korea at the time of the report. That’s a rate of 0.89%

The error bars on that estimate certainly encompass 1-2%, but they don’t span to 20%. Either Korea is doing something fundamentally different, or the 20% number is wrong.

I strongly suspect that OP simply took the “80% of cases are minor” stat, subtracted from 100%, and concluded that 20% are therefore hospitalized. This method is wrong.


The numbers part is where people are confused. Becase the baseline is scetchy, depends on testing (so you risk measruing your tsting at least as much as the spreading itself) and moving. Add to that a methodology that requires a lot of domain knowledge to properly understand these numbers, and this reaction is kind of expected. Which is basically the only point I have to call the WHO, CDC and other, similar bodies out on. Explain what you are doing, why and how these things work! Especially the numbers part, I have the impression most of the panic comes from not understanding the nmbers and less the disease itself. Then people toy around with incomplete sets of these figures, usually out of date as well, and come up with stuff like 20%.


Google translate says:

> "23 people in severe stage and 36 people in serious stage".

Which is a current snapshot, not a total of the cases that have been severe/serious. It seems like they've done pretty well at keeping it away from the elderely where the fatality rate increases dramatically: https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_S...


98% of cases in S Korea are classified as "no outcome" at this stage - that is, it's too early to make a call. It takes 11 days on average for the disease to get really severe, so we won't see the deaths for a while. With exponential growth the pct will consistently under report the severity.

Note also that S Korea has 3x the beds of the US, and covid-19 requires very high hospitalization rates and oxygen for weeks.

Tldr: don't expect US or Europe final stats to look anything like S Korea"s current stats.

Lots more detail, and responses to common misunderstandings, here: https://www.fast.ai/2020/03/09/coronavirus/


My point is that medical staff are trained to respond to many things. Training newbies to respond to one thing would probably be easy and fast. Especially if most people just need fluids, oxygen, and aspirin. Burning out doctors to maximize survival rates up front is... bad


It isn’t that easy to train someone to handle medical emergencies. They don’t typically fall into the same “path”.

As well there’s a technical skill component that takes a while to master due to variations in person-to-person anatomy. Took me about 8-10 real live intubations in life or death emergency situations (not training where I had all the time in the world) to feel comfortable enough to be unsupervised.


If all you needed is something that a person with no training could handle they’d send you home and have a family member care for you.


well it’s a good thing I didn’t suggest that


Aspirin isn't an effective treatment.


what is the treatment then?


Same treatments as usual for pneumonia, acute respiratory distress syndrome, and sepsis.


No healthcare treatment in real life can be sufficient for an exponential growth of severe cases that require skilled staff and specialized equipment.

Health service ranking focuses on treatment I suppose. We need a different ranking for epidemic prevention and control.


A hotel speeded up the international outbreak of SARS in 2003.

"The Metropole Hotel hastened the international spread of the 2003 SARS outbreak by the index case infecting visitors from Singapore, Vietnam, Canada as well as local people via close contact with the index case and the environmental contamination. The one-week quarantine of more than 300 guests and staff at the Metropark Hotel during the 2009 H1N1 swine flu exposed gaps in the partnership with the hotel industry. The subsequent guidelines for the hotel industry from the Centre of Health Protection focused largely on the maintenance of hygiene within the hotel premises."

https://globalizationandhealth.biomedcentral.com/articles/10...

"This hotel is infamous as ground zero for a SARS ‘super spreader’ in the 2003 outbreak—here’s what happened"

https://www.cnbc.com/2020/02/14/hong-kong-hotel-hosted-super...


If most people don't care to prevent infection, the hospitals and medical resources will soon be overwhelmed, the death rate will surge from 0.5-4% (no exact figure at the moment) to 10-20% like earlier in Wuhan. When viral load in the environment becomes sufficiently high, some young people will be taken away by it too, as in the case of several Wuhan doctors who sacrificed themselves under that circumstance.

Among the ~16-19% who are hospitalized and recover, you may suffer through weeks of pneumonia and your lungs could be damaged long-term.

Even if you're lucky to be among the 80% who survive without hospitalization, you could still be the vector who directly or indirectly infect someone you care about.


>the death rate will surge from 0.5-4% (no exact figure at the moment) to 10-20% like earlier in Wuhan

Those percentages come from different samples altogether and cannot be compared. 10-20% is heavily biased toward people who were admitted before there were even reliable tests for the virus or a recognition that it's novel and serious. Now you're comparing that to 0.5-4% which includes a bunch (though by no means close to all) of mild cases who got picked up by the tests but may not have required a hospital visit at all. What's the point of mentioning two numbers that aren't just unreliable and biased, but unreliable and biased in different ways?


Yes, I think I might have mixed up stats of different kinds (Posting too late at night, sorry).

However, the point stands that fatality rates will likely go up a lot if medical resources are overwhelmed. Long-term lung damage is also another risk for younger people and its rate will also go up.


Very true, the low end stats are for regions with few infections. If say, 1 million ppl get in NYC, expect a lot higher rates, as the health system cannot do much with that many people.


^This is exactly why we should take this seriously. Even if this "isn't a big deal" that attitude will get people you love and care about sick potentially leading to their death. I'm advocating that people be mindful and try to take this very seriously.


The first patient was confirmed after having been intubated for >= 4 days. On average it takes 9 days from infection to ARDS, which requires intubation, according to a Lancet study. She was confirmed 5 days ago (on Feb 23rd). So she could be infected 9 + 4 + 5 = ~18 days ago.

Since only around 20% of patients require hospitalization, we can estimate there are ~5 infected in her cohort. With doubling time outside China at 5-6 days, that means around 3 doublings: 2^3 * 5 = 40 infected today (Many of them will not show serious symptoms; some who will require admission have not progressed to that stage yet.) So far we have assumed that all hospitalized cases are detected, however.

Some who are hospitalized might still not be detected, since without a test or a CT scan, its symptoms are similar to other viral pneumonia. Let's say infected per detected is a factor of 1.5-4. Very rough estimates: ~60-160 infected in the Bay Area now.

https://www.wired.com/story/community-spread-coronavirus/

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Doubling time outside China: https://ncov.r6.no/


Curious why a CT scan is required as opposed to a more routine inexpensive chest XRay?


There seems to be many cases of young patients dying in Iran. Either because there are way more cases than being officially reported or (hopefully not) the virus has mutated to affect the young more, or both.

The first hypothesis is likely based on the number of infections found in international travellers who went to Iran. We still cannot rule out the second hypothesis though.

A 23-year-old woman soccer player: https://www.reddit.com/r/Coronavirus/comments/faadg4/a_23_ye...

A male nurse talking of 8 deaths in one night during his shift. 23-year-old female (same case?), 29- and 30-year-old males, 50-year-old female among them. (1-minute clip)

EDIT: It's just n=8, but 37.5% dying at age 30 or below is most likely drawn from a different distribution from 0.6% among the 70,000+ cases in the largest Chinese study (where the worldometers data comes from).

EDIT 2: Based on a link in a sibling comment, only 7 deaths among 20-29 yo and 18 deaths among 30-39 yo in the n=44,672 Chinese report.

https://twitter.com/AlinejadMasih/status/1232779487647031302

http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9...


Iran said it had no cases up until the moment it announced 4 people had died. Its safe to assume that the scope of the infection in Iran is either far greater than they have been able to track, or far greater than they are willing to admit. I think its less likely that the virus is killing more young people in Iran, and more likely that there are thousands if not tens of thousands of cases in Iran that simply haven't been counted/reported.


We saw the Iranian response to the airliner being shot down recently. It’ll be just as you say.


There’s something off about Iran. According to Wikipedia [0], Spanish Flu killed a much higher percentage in Iran too, in comparison with the rest of the world:

“The World Health Organization estimates that 2–3% of those who were infected died (case-fatality ratio).

[...]

In Iran, the mortality was very high: according to an estimate, between 902,400 and 2,431,000, or 8% to 22% of the total population died.” — source, Wikipedia, see [0].

I wonder if it’s genetics (immune system reacts differently?), or cultural (habits - kissing on cheeks, handshaking, large religious or non-religious gatherings) or climate, or a mix.

References: [0]: https://en.wikipedia.org/wiki/Spanish_flu

Edit: admittedly, it’s too early to draw conclusions. It’ll take a few weeks to have more realistic numbers.


It's hard to find up to date records filtered by country, but they might have higher count of the ACE2 enzyme which is thought to be an entry point for coronaviruses. Asian populations have much higher count than other populations.

https://en.wikipedia.org/wiki/Angiotensin-converting_enzyme_...


Source for Asians having more? This disagrees: https://www.google.com/url?sa=t&source=web&rct=j&url=https:/...


Would that mean Covid-19 would progress faster once inside the body? I assume that could mean an infected person’s immune system could be overwhelmed, hence resulting in a more severe case and even death.


Once the beds are all occupied it doesn't matter how many a country has.


I have a suspicion, and it sounds obvious when you state it, that there's a correlation between smoking and severity and both China and Iran are relatively heavy smokers.


For the first time since the revolution Friday prayers have been cancelled in Tehran. They are still on in Qom.

https://twitter.com/alihashem_tv/status/1233017138119659520


The Spanish Flu was a hundred years ago, I highly doubt that what happened then in Iran has much relations to what's happening now.

What's happening now has more to do with their theocratic regime that didn't take the threat seriously and doesn't care much about their people.


Wouldn't that require two unrelated explanations for higher viral-outbreak mortality rates? Isn't the explanation that doesn't require a coincidence more plausible?


> Wouldn't that require two unrelated explanations for higher viral-outbreak mortality rates?

That doesn't sound unreasonable at all when the two outbreaks are separated by a century. A lot has changed between 1920 and 2020.


> There’s something off about Iran.

Iran is a theocratic authoritarian regime under extreme international sanctions. Might have something to do with that. Iran also only has 0.2 hospital beds per 1k people.


It's in fact 1.5 beds per 1000 capita according to World Bank data.

https://data.worldbank.org/indicator/SH.MED.BEDS.ZS



A bit off topic but Iran is mostly only under American and Israeli sanctions at this point after Trump unilaterally pulled out of the Iran nuclear deal. The rest of the world can trade with Iran though many companies are still unwilling due to the American pressure.


Due to how interconnected European and American finance and business is this effectively means that Europe cannot trade to Iran.

The Europeans cannot enforce the JCPOA without either some kind of American cooperation or a major decoupling their financial systems from the US. I believe Macron has made public musing about the latter as an option, but then again Macron says a lot of things that lack pan-european support.


Specifically, the US imposes/threatens to impose secondary sanctions ie anyone who does business with Iran is also supposed to be subject to sanctions by the US, even if they are not US companies/US parent companies. So those companies can't then themselves do business with US companies or in the US.


Last I checked that still is international as it involves 2+ nations.. Not sure why you had drag Orange Man bad into this. You come off as a bit deranged.


> There seems to be many cases of young patients dying in Iran. Either because there are way more cases than being officially reported or (hopefully not) the virus has mutated to affect the young more, or both.

They could easily have had an undiagnosed underlying condition that made them more susceptible to complications. This is to be expected in places like Iran with severe limitations in their healthcare system. It might be a more useful data point if it was from the US, UK, Spain, etc.


Yes, or a specific HLA type that is more prevalent in the population.


Is it just me or is your comment really insensitive? I would think that about half of world has no better healthcare system than Iran.


It's you. That half the world has no better healthcare system than Iran is a sad reflection on the state of healthcare in world, not an implication that Iran's dilapidated and overstretched healthcare system\* is a good one. Combine that with their authoritarian government with zero communications skills and no credibility due to being habitual liars, and we should place no stock in their reassurances/projections, and very little stock even in their hard-to-fuck-up stats like # of deaths.

\* I should say this is anecdata, based on comments by several Iranian friends and acquaintances.


I'm not defending Iran's healthcare system. The info I was able to dig up places it as above average, which means that more than 50% of world population will be affected just as bad or worse. Dismissing Iran's data point as not useful takes a specific viewpoint that I consider not empathic enough for my tastes, but everyone is free to disagree.


Iran's healthcare is a lot worse than would be expected for a country of its wealth and development level because of the US embargo.


I don't see the insensitivity. This subject is not something that's very sensitive, I just see the comment as objective.


Why would you think a country under severe sanctions can have a very good health care system?


> half of world

Like he said, severe limitations.


Could be many reasons: 1. Iran has more young people. 2. Iran does not have any monitoring program of significance 3. Young people in Iran are probably more mobile and more likely to contract it.


> 1. Iran has more young people.

Just wondering if that's true. It does look like that's the case:

https://www.gapminder.org/tools/#$state$entities$show$geo$/$...


Preprint paper of Iran infection estimates the number of infected around 18k. (https://www.medrxiv.org/content/10.1101/2020.02.24.20027375v...)


Dr. Li Wenliang, who warned of Covid early on, was also only 34 years old.


Doctors and nurses are exposed to a much higher viral load than most people. In Wuhan, they may also overwork and have insufficient sleep.


> higher viral load

What is "higher viral load"? Isn't it binary - you are either infected or not?


Exposure to a virus doesn't ensure infection - there is some probability involved, depending at least partially on the number of virus particles that you are exposed to, over what period of time.

Viral load is literally a numerical expression of the quantity of virus in a given volume. It is often expressed as viral particles, or infectious particles per mL depending on the type of assay. And a higher viral load often correlates with the severity of an active viral infection.


If you’re infected by a couple of individual viruses, it’ll take a while before it starts spreading throughout your body, which will have more time to prove an immune response. Compared to essentially bathing yourself in it for days at a time.


afaik viral infections increase at an exponential rate. If the initial load is higher, the peak infection before your immune system can get things under control will be much higher/dangerous.

Ex: 3^10 v.s. 30^10


No, your symptoms are affected by the number of viruses in your system. The virus is constantly replicating and your immune system is constantly destroying them. If the rate of increase is greater than the rate of decrease, you will not recover.


Agree but they may also be constantly reinfected.


Good thing no younger adults in the western world are overworked and under rested ;)


Iran is an outlier because it has an extremely poor healthcare system for a country of its size or GDP.


Same goes for their high death rate. Either they're lying about infections (which seems to be the current shared assumption of everyone else) or their version of the virus grew some really nasty teeth.


Citing individual deaths is sort of meaningless without an idea of how many people are sick. I suspect it’s in the many thousands in Iran already.


I read that South Korea is developing them and it's close to ready. They probably need them for their own people first though.

It's a huge opportunity for a startup/company to create a home test kit for COVID-19. Massive global market for the product and growing exponentially.

Doing well & doing good at the same time.


> It's a huge opportunity for a startup/company to create a home test kit for COVID-19. Massive global market for the product and growing exponentially.

If someone has a list of materials thatwould be required to pull these affordable tests something could be put together for sure.

the worrying thing is to keep the costs down, one would think a lot of those materials and components would need to come from Chine to be cost effective.. The tangled web.

Edit: the problem wil step from China's supply chain being slowed down.


The doubling time is about 6 days for cases around the world excluding China. Graphs here: https://ncov.r6.no/

This means several people in contact with the unconfirmed infected case may not yet self-isolate and can spread it around during the wait time.


Social distancing, avoiding crowds and certain events, washing hands routinely and before meals, wearing masks when ill would help reduce the spread speed a lot.

Wearing masks also helps set a new social norm. It is now common in Taiwan subways and trains--basically everyone wears a mask.


> It is now common in Taiwan subways and trains--basically everyone wears a mask.

Not clear if it's useful to wear a mask if not displaying any symptoms. I didn't see any official recommendations for doing so. I've been traveling quite a bit in Asia these last few weeks, and I'd say 80% in planes wear masks. However, most of them don't use them properly. They take them on and off, reuse them, adjust them, touch their faces. Sometimes they don't even wear masks, but piece of clothes.


I have lived in Asia, so I am familiar with the model. Currently I am in a medium-sized city that isn't a major transit hub. I would take my own personal medical precautions, to be sure, if anyone within 2-3 counties away were a suspected case. That is the reason for my keeping an eye on the news. I don't have money to stockpile, much less concern myself with market-related shenanigans.


Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: