What if there is no cure?

DeVore

Ok, 3.5% is the CFR (case fatality rate) worldwide. (https://ourworldindata.org/coronavirus#the-current-case-fatality-rate-of-covid-19 ) Theres some indication that that will drop to closer to 1% (optimistic) over time.
Thats 40k dead over the 4M pop. Lets say it reaches herd immunity (somewhere around 2.6M) and we'll just conveniently ignore the rest of the pop. Thats still 26,000 dead. So somewhere between 26,000 and 40,000 at the best possible CFR.

Now the CSO recorded about 8-9k people died in Q1 of 2019, in Ireland, of *anything at all* (https://www.cso.ie/en/releasesandpublications/ep/p-vs/vitalstatisticsfirstquarter2019/) , so we're talking somewhere in the region of 32-36k deaths for the year from every known source.

So what we're talking about is *at best* a years worth of deaths.

Now, the italians have been recording a CFR of about 11% since they blew through their healthcare maximums. This is basically the current worst case but since it also includes the period before they exceeded the maximums, its probably going to continue to tip upwards. Now, this is the worst case scenario but its what will happen if we were to release lockdown prematurely and abruptly. (And yes, I understand there is a middle ground but I want to establish the upper and lower limits first).
So in that case we're looking at a lot more deaths, somewhere in the quarter million region at least. Or a decade of our usually death rate.


I dont have info on the future economics but I'd be interested in any "discussion" which shows statistical basis for economic impact which would justify an alternative course of action.

This is the discussion you want to have I believe.

Wibbs

GM228 wrote: »

From the Zoo themselves:-

https://newsroom.wcs.org/?_ga=2.73784145.2118705509.1586164888-971338039.1586164888



If that's not enough the US Department of Agriculture has also confirmed it:-

https://www.aphis.usda.gov/aphis/newsroom/news/sa_by_date/sa-2020/ny-zoo-covid-19



There has also been officiial confirmation in two dogs released by the Agriculture, Fisheries and Conservation Department in Hong Kong previously.

Viruses can jump species, but one that infects humans, likely bats, maybe pangolins and now three different species of felines(tiger, lion, domestic) and is symptomatic in each? That's unusual I would have thought? Though rabies can infect and kill loads of mammals so not really I suppose.

El_Duderino 09

DeVore wrote: »

I dont have info on the future economics but I'd be interested in any "discussion" which shows statistical basis for economic impact which would justify an alternative course of action.

This is the discussion you want to have I believe.

Yeah. The discussion about whether we stay in lock down or accept that there will be a higher rate of deaths if we go back to work and try to get things back to normal.

Trump is talking about this but purely from the selfish perspective of his re-election prospects. So it a pity that he is the main proponent of getting things back to normal and accepting the higher rate of deaths.

I suppose the discussion would have to start with the simple sounding questions like; "when/ under what circumstances would we like to stop the lock down?"

For example, with an average infection rate of 20,000 per week, and a population of 5m on the island. How many weeks would it take to everyone to get it? And how many weeks would it take for about 66% of the population to get it and begin herd Immunity?

P.s. It would take 250 weeks for everyone to become infected and it would take about 150 weeks for herd immunity at about 66%.

For context, we have about 5,000 TOTAL conformed cases in the Republic so far so we're talking a massive increase in infections.

Wibbs

DeVore wrote: »

Now the CSO recorded about 8-9k people died in Q1 of 2019, in Ireland, of *anything at all* (https://www.cso.ie/en/releasesandpublications/ep/p-vs/vitalstatisticsfirstquarter2019/) , so we're talking somewhere in the region of 32-36k deaths for the year from every known source.

So what we're talking about is *at best* a years worth of deaths.

You're leaving out one obvious factor; those who will die from Covid19 that would have otherwise died from other morbidities anyway. Yes it will most certainly speed up that process and lower longevity among some demographics, the majority being elderly, but it won't be a case of 30,000 "new" deaths. Of course that's of zero comfort for loved ones who lose an already ailing grandparent or parent earlier than expected, but big picture here and let's look at the wood, not the trees, it's not armageddon either.

Take Italy's deaths at least in March. Here's a study by Italy's HSE Google translate may be required. Anyhoo, over 99% of people who died had underlying conditions(0.8 had none). 75% had high blood pressure, over a third had diabetes and another third were being treated for heart disease. The average age of death was as close to 80 as makes no difference, less than 20 people died under the age of 50 and every one of those who died under 40 had serious underlying conditions.

Now these were all of course deaths and hospitalisations, we have no clue how many caught and recovered from the virus and won't know until the dust has settled way down the line, any other claim is supposition at this stage.

Now this is a serious time and a serious virus and people will die, including those who might not be able to get medical attention because the hospitals are overwhelmed. And yes we need to keep a lid on it as much as we can and save as many as we can, but we also need not lose the run of ourselves with projections that in the face of a lot of unknowns and suppositions are little more than intellectual exercises.

Idbatterim

[articularly in relation to the above post, read this... many who have died, would likely die any way. I am not saying what the Americans and english did is right, it wasnt, but this lock down, is not viable for long either. I think they should start re-opening some businesses, absolutely building supplier and builders, you cant just take several hundred thousand out of jobs, on top of several hundred thousand others, the latter makes sense, not the former in my opinion. Or only for a very brief period, to put stuff in place with health...

https://www.stuff.co.nz/national/health/coronavirus/120805778/coronavirus-to-swedes-its-the-rest-of-the-world-engaging-in-a-reckless-experiment

Nermal

DeVore wrote: »

Ok, 3.5% is the CFR (case fatality rate) worldwide. (https://ourworldindata.org/coronavirus#the-current-case-fatality-rate-of-covid-19 ) Theres some indication that that will drop to closer to 1% (optimistic) over time.

Come on - this CFR and quotes of 11% in Italy are absolute nonsense. Both the numerator and denominator are meaningless, we cannot identify who has the disease and cannot agree how to define who died from it.

The only nation that has conducted randomised testing has a CFR of 0.25%, per your own link. This wasn't antibody testing, so it's an overestimate.

That's the starting point for discussion.

Wibbs

Idbatterim wrote: »

https://www.stuff.co.nz/national/health/coronavirus/120805778/coronavirus-to-swedes-its-the-rest-of-the-world-engaging-in-a-reckless-experiment

I'd not be looking to Sweden for a good example. They have a younger demographic and a first class health system, but their prime minister has started to warn them of the number of deaths coming.

Like I said we're all in WTF mode in this, with a large side order of we're not actually sure what's what. And you mention construction. We need to look at jobs and businesses as far as risk goes. Online businesses are much lower risk than pubs for example. Callout and delivery services that never cross a threshold of a dwelling are lower risk. How risky are building sites and even what type of building site. EG building a factory/hotel/business centre with no "civilians" on the ground or going in and out of a site is less risky than extension work on an existing used site. Is the government even looking at this kind of risk evaluation? Or how to reduce it.

Gretas Gonna Get Ya!

snoopboggybog wrote: »

It's an interesting question.

The normal flu can cause up to 1000 deaths a year in Ireland and even with vaccines etc. people still catch it.

Even if we do get a vaccine there will be different strains and no one will ever be fully immune like the chicken pox.

I think people with underlying conditions and the elderly will need to wear face masks and goggles whenever they are out in public for a long long time.

Its horrible to think about to be honest but i reckon it will be around the 1% mark whoever catches it.

We can't put the country on hold forever.

On average, the flu kills about 200-500 people in Ireland annually. We've almost reached that figure with this virus after a few weeks!

Also, early research seems to indicate that this virus does not mutate particularly quickly... so any vaccine could be effective for many years. It's unlikely to mutate like the seasonal flu.

s7ryf3925pivug

The objective is not to prevent people catching it. The objective is to prevent too many people catching it at once. They are trying to avoid overwhelming the health service. If the health service is overwhelmed then not everyone who is critical can be treated and the fatality rate increases greatly.

Enough people will eventually catch it and recover that fewer humans will be susceptible to infection and therefore those who are susceptible will be exposed less. This does not depend on immunity being permanent. Even if it becomes endemic it will not continue to have the same impact at that point.

The general view seems to be that it's reasonable to expect a vaccine to be developed sooner or later. I don't think colds are a good comparison. There is less motivation to develop a vaccine for a cold. I read somewhere that vaccines are generally not particularly profitable so developing vaccines for relatively trivial diseases seems like a waste of resources whatever way you look at it.

Gretas Gonna Get Ya!

Nermal wrote: »

Come on - this CFR and quotes of 11% in Italy are absolute nonsense. Both the numerator and denominator are meaningless, we cannot identify who has the disease and cannot agree how to define who died from it.

The only nation that has conducted randomised testing has a CFR of 0.25%, per your own link. This wasn't antibody testing, so it's an overestimate.

That's the starting point for discussion.

Clearly the numbers must be very high in Italy and Spain in particular, otherwise how do you explain their hospitals being completely overwhelmed?

Just exactly how high is debatable, of course, but you cannot ignore the obvious signs that they were hit with something huge that took them by surprise. It's definitely well out of normal proportions.

Also, the % of healthcare workers dying must also be quite alarming too. I can't imagine it would be too common for doctors and nurses to drop dead at such frequency in normal circumstances in these countries.

DeVore

Nermal wrote: »

Come on - this CFR and quotes of 11% in Italy are absolute nonsense. Both the numerator and denominator are meaningless, we cannot identify who has the disease and cannot agree how to define who died from it.

The only nation that has conducted randomised testing has a CFR of 0.25%, per your own link. This wasn't antibody testing, so it's an overestimate.

That's the starting point for discussion.

Case Fatality Rate isnt calculated based on whole populations nor on those who might have it but havent been identified (think Aids etc). Its a rough metric used for comparision. I've already allowed for it being watered down over time in my post on this above.

That data/link is from the ECDC. I'll take there expertise over other peoples opinions.

biko

The chan chan man wrote: »

So what if there’s no cure for Covid-19?

I don't understand the question.
Many humans have recovered from the virus (even though it appears some have got it again..

ShineOn7

Sleeper12 wrote: »

It's already mutated 8 times, to some extent, that we know of in the last 4 or 5 months. As of 2 weeks ago there were 8 separate strains of the virus.

Source?

Hasn't the HSE worker in their AMA thread said there's only 2 strains still?

ShineOn7

begbysback wrote: »

This is probably the best explanation of the purpose of a virus, if it persists then it will most likely mutate into something milder over a period of time - so it can live with us

Sorry but who the hell is that guy and why should we listen to him?

People need to stop sharing articles and videos without:

A) making sure the source is credible, and stating where they're from when they re-share

Kivaro

Wibbs wrote: »

I'd not be looking to Sweden for a good example. They have a younger demographic and a first class health system, but their prime minister has started to warn them of the number of deaths coming.
.....

Sweden is hugely important in all of this.
We need one country where we could rely on solid verifiable reporting, and use this a baseline to determine if lock downs were indeed the correct measure. Personally, I believe social distancing is very important, but can this be practiced indefinitely into the future? We have not matured as a society (yet) to follow rules like physical distancing; meaning that there should be a very high % compliance for it to work. I believe that the Irish government is saying we only need 80% compliance, but that is not enough. We need to be in the high 90's.

quokula

DeVore wrote: »

Case Fatality Rate isnt calculated based on whole populations nor on those who might have it but havent been identified (think Aids etc). Its a rough metric used for comparision. I've already allowed for it being watered down over time in my post on this above.

That data/link is from the ECDC. I'll take there expertise over other peoples opinions.

I think you've misunderstood their post. The link you posted contained data for Iceland, which is a country that has had the most comprehensive testing.

Out of those who tested positive, there is a CFR of 0.25% - this is neither an estimate or a percentage of the whole population, it is a real CFR based on real data.

Yes, there will be demographic differences, cultural differences, climate difference and health service differences that may all play a part. But the obvious explanation for CFR to be much lower in places that have comprehensive testing is that places that have less testing are simply missing large numbers of mild cases and making the percentage look higher.

storker

Obvious Desperate Breakfasts wrote: »

I reckon a big reason for that is that the common cold is generally a very mild, self-limiting illness.

And, while I'm not a conspiracy theorist, you'd have to wonder about the money made selling cold remedies and how much that might impact the urgency given to finding a vaccine.

ShineOn7

Danzy wrote: »

It'll become milder in time so one won't know if it is a cold or Chinese Bat Flu.

Medical treatments will vastly reduce the fatality rate.

Hand sanitizer and masks will be everywhere after the lockdown.

5 minute tests, home tests will be everywhere and used for every sniffle.

All within 8 to 10 weeks.

Source?

ShineOn7

biko wrote: »

I don't understand the question.
Many humans have recovered from the virus (even though it appears some have got it again..

Sorry to keep saying "Source?", but it's so important these days to back up your statements with credible articles

Where did you see evidence of the bit in bold above?

ek motor

ShineOn7 wrote: »

Sorry to keep saying "Source?", but it's so important these days to back up your statements with credible articles

Where did you see evidence of the bit in bold above?

https://www.taiwannews.com.tw/en/news/3876197

ShineOn7

ek motor wrote: »

https://www.taiwannews.com.tw/en/news/3876197

Thanks but i stopped reading after the first part;

"It’s possible to get infected by the novel coronavirus (COVID-19) a second time, according to doctors on the frontline in China’s city of Wuhan, leading to death from heart failure in some cases."

I trust absolutely no information coming out of China on this

ek motor

ShineOn7 wrote: »

Thanks but i stopped reading after the first part;

"It’s possible to get infected by the novel coronavirus (COVID-19) a second time, according to doctors on the frontline in China’s city of Wuhan, leading to death from heart failure in some cases."

I trust absolutely no information coming out of China on this

https://archive.is/HjykE

Wibbs

Gretas Gonna Get Ya! wrote: »

Clearly the numbers must be very high in Italy and Spain in particular, otherwise how do you explain their hospitals being completely overwhelmed?

There could be a fairly "simple" explanation G. The acceleration of death in the already close to dying. The overwhelming majority of people who have died in Italy are over 70 and/or already suffering from serious underlying disease. Normally most are treatable by modern medicine, but if they weren't treatable they'd likely die in the next year, or be dead already. Kinda like a funnel. Modern medicine constricts the funnel and reduces the flow, this virus opens the funnel and all the people who might have died in the next two years are dying in a couple of months. Covid19 has in a sense brought us back to 19th century medicine overnight. A similar analogy would be if we lost all antibiotics in the morning. Which in a way we have as we don't have an "antibiotic" to this. The death rate would go way up and longevity would go down.* In effect this virus isn't killing more people, it's speeding up the process by which they die.

Also, the % of healthcare workers dying must also be quite alarming too. I can't imagine it would be too common for doctors and nurses to drop dead at such frequency in normal circumstances in these countries.

A few reasons here too I'd say. Firstly if they are infected they get a much larger viral load in one go, or over several goes. Secondly many of them are overworked to the point of near exhaustion as they try to help That's going to impact survival. Thirdly though the young doctors and nurses naturally hit the news more, many are middle aged and above and many young and older are going to have underlying conditions of their own. The doc who is running an AMA on this forum to help spread understanding has said he has an underlying illness that would likely impact his chances of surviving this, hence his massive attention to the detail of keeping him and his life free of contamination.

DeVore wrote: »

Case Fatality Rate isnt calculated based on whole populations nor on those who might have it but havent been identified (think Aids etc). Its a rough metric used for comparision. I've already allowed for it being watered down over time in my post on this above.

That data/link is from the ECDC. I'll take there expertise over other peoples opinions.

Appeals to an authority doesn't take away from the obvious fact that CFR numbers at the moment are pure conjecture. Stating otherwise especially with such confidence is a patent bloody nonsense. For all their "predictions" this can be a problem with number crunchers, they nerd out on the numbers and the pretty patterns they make and start counting trees, not the forest.

Think about your statement: Case Fatality Rate isnt calculated based on whole populations nor on those who might have it but havent been identified (think Aids etc). Its a rough metric used for comparision. It's as rough as a badger's arse for divining the true projected human cost of this. It's a CFR for an identified set of known infected people. That's as daft as just totting up the numbers for hospital patients in a nation, then coming to the conclusion and boldly stating most people are sick and in need of medical attention and the death rate is scary. It would be a nonsense. Though no doubt the diagrams would be pretty.




*though that would affect all ages. Think back on your class in school. Without vaccines and antibiotics at least a third of those kids in your minds eye wouldn't reach adulthood.

notobtuse

No cure?

As with everything else we'll merely be forced to deal with the new normal... which means more virus deaths every year in flu season.

biko

ShineOn7 wrote: »

Sorry to keep saying "Source?", but it's so important these days to back up your statements with credible articles

Where did you see evidence of the bit in bold above?

Sorry, you are very right to ask for source.

Here
https://www.newscientist.com/article/mg24532754-600-can-you-catch-the-coronavirus-twice-we-dont-know-yet/

In February, reports emerged of a woman in Japan who had been given the all-clear after having covid-19 but then tested positive for the SARS-CoV-2 virus a second time. There have also been reports of a man in Japan testing positive after being given the all-clear, and anecdotal cases of second positives have emerged from China, too.

but

Early signs from small animal experiments are reassuring. A team from the Chinese Academy of Medical Sciences in Beijing exposed four rhesus macaques to the virus. A week later, all four were ill with covid-19-like symptoms and had high virus loads. Two weeks later, the macaques had recovered and were confirmed to have antibodies to the virus in their bloodstream.

The researchers then tried to reinfect two of them but failed, which suggests the animals were immune (bioRxiv, doi.org/ggn8r8). “That finding is very encouraging, as it suggests that it is possible to induce protective immunity against the virus,” says Alfredo Garzino-Demo at the University of Maryland School of Medicine.

Wibbs

I'm near 100% certain there'll be a cure, or a treatment, or both that renders this virus below seasonal flu danger levels. It's the timeframe that's up in the air.

Idbatterim

imagine the quality of life many in nursing homes etc have, as wibbs said, this is just fast forwarding things for many and for many, its probably a more humane and dignified way to go...

Idbatterim

Wibbs wrote: »

I'm near 100% certain there'll be a cure, or a treatment, or both that renders this virus below seasonal flu danger levels. It's the timeframe that's up in the air.

agreed, imagine the resources working on this!

Wibbs

Idbatterim wrote: »

imagine the quality of life many in nursing homes etc have, as wibbs said, this is just fast forwarding things for many and for many, its probably a more humane and dignified way to go...

I dunno how humane and dignified it is ID. I've watched both my parents die of hospital acquired pneumonia. One went easy enough, the other was struggling for breath for a couple of days. The palliative care hopefully had them completely out of it, but it was fcuking awful to watch. If I'd had a revolver I'd have used it as a kindness.

saabsaab

I doubt that there will be no effective treatments or vaccine in the next 12 months or so.


If there is no cure it will burn through the world's population killing millions that are susceptible. A Darwinian survival of the 'fittest'.


I put 'fittest' in inverted commas as it is much misunderstood in that context. Simply meaning those most suited to the environment.


After a couple of years it will die out or be at a manageable level. Think of the 1918-1919 pandemic.