At 23:51 18/03/2020, Harry Feldman wrote:
>Thanks for reassuring me about the mortality rates. But I guess I
>imagined that the same thing would apply to the numbers requiring
>hospitalisation or intensive care as a proportion of the number of
>people infected when the number of persons infected is in doubt?
As I said, it's 'the number of persons infected' which is the (almost
total!) unknown but, as I also said, I don't see why the proportions
of that figure which require hospitalisation or who die ought to vary
significantly over time. Without knowing 'the denominator', we
obviously cannot calculate what those proportions actually are - but,
as I said, provided one can assume that they remain fairly constant
(which is what I would expect), I don't think that actually matters.
>If we actually knew the denominator, which definitely exceeds the
>number of diagnosed cases, and could calculate mortality rates with
>confidence, it might turn out not be as lethal as believed and
>alleviate the level of panic?
Unless some people have produced estimates of mortality which take
into account the (undoubtedly very substantial) under-estimates of
that denominator (and I haven't see that done), then I would
personally say that the 'mortality' (Case Fatality Rate) estimates
we're seeing are almost certainly considerable
over-estimates. However, I'm not sure that one could (or should)
alleviate much panic by producing more accurate figures. If the true
CFR was, say an order of magnitude less than the figures we're
seeing, that would still mean that, if the outbreak were left
uncontrolled and allowed to infect the entire population, then that
would mean something like 320,000 to 640,000 deaths in the US alone.
>Even if the rate turned out to be scarier than that, comparison of
>mortality rates might be informative about the relative
>effectiveness of different health care systems and different
>approaches to containment and mitigation, etc.?
It's hypothetical, anyway, since we're unlikely to get a meaningful
handle on the number of infected people. Knowing mortality would be
of no help in relation to "approaches to containment and mitigation
measures", since they seek to prevent people getting infected in the
first place, whereas mortality/CFR is about the risk of dying if one
DOES get infected. Attempting to study the "relative effectiveness
of different health care systems" is probaly a luxury we can doi
about at present, particularly that all healthcare systems are
undoubtedly 'doing their best' under near-impossible circumstances.
Kind Regards,
John
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