Is a 1% Case Fatality Rate for COVID-19 Bad News or Good News?

It depends on how widely the virus spreads, which is difficult to predict.


During congressional testimony yesterday, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, estimated that the case fatality rate (CFR) for COVID-19 will prove to be about 1 percent. Is that good news or bad news? It depends on how you look at it.

Fauci's estimate is less than one-third the commonly cited CFR calculated by the World Health Organization and one-tenth the CFR for SARS, another disease caused by a coronavirus. But as he noted, it is 10 times the CFR for the seasonal flu, which is not as readily transmissible. And it is higher than President Donald Trump's guess that the share of infected people who die from COVID-19 will turn out to be "a fraction of 1 percent."

The basic problem is that the total number of cases is unknown, since the vast majority involve mild symptoms that would not necessarily cause people to seek medical attention or testing. The ratio of known deaths to identified cases, which currently yields a CFR of about 3.6 percent, is therefore apt to exaggerate the lethality of the disease. Studies of patients in China and infected cruise ship passengers indicate a substantially lower rate of 2.3 percent, but that is also likely to be an overestimate, since the denominator includes only people who are known to be infected.

Fauci's estimate is close to the CFR in South Korea, which has an aggressive testing program with the capacity to process 20,000 samples a day. So far, more than 200,000 people have been tested there, compared to fewer than 10,000 in the United States, a country with a population more than six times as large. As of yesterday, South Korea had reported 7,755 cases and 60 deaths, which implies a CFR of about 0.8 percent. As in China, the death rate varied widely by age, ranging from 0 percent for patients younger than 30 to 7.2 percent for patients 80 or older. But overall, more than 99 percent of patients survived.

While those odds seem pretty good, even a relatively low CFR can result in many deaths if the infection rate is high. German Chancellor Angela Merkel yesterday warned that 70 percent of her country's population could ultimately be infected by the COVID-19 virus. It's not clear how Merkel arrived at that estimate. But if that worst-case scenario came true, a CFR of 0.8 percent would mean more than 400,000 deaths in Germany. If 70 percent of the U.S. population were infected, the number of deaths would be nearly 2 million.

Is the infection rate likely to be anywhere near that high in the United States? That depends on the effectiveness of measures aimed at curtailing the spread of COVID-19 and developing a vaccine. It also depends on whether COVID-19 follows a seasonal pattern similar to what is seen with the flu. Fauci said that is possible but warned that "we can't proceed under that assumption."

So far epidemic control measures in the U.S. have included isolation of patients, quarantines of potential carriers, cancellation of large-scale public events, school closures, increased reliance on telecommuting, "social distancing," hygienic precautions such as frequent hand washing, and international travel restrictions such as the ban on visitors from China and Iran imposed last month and the ban on visitors from many European countries that Trump announced yesterday. Fauci said Phase 1 clinical trials of about 10 different vaccines should begin within a month or so, but vaccination probably will not begin until "a year to a year and a half" from now.

"We will see more cases, and things will get worse than they are right now," Fauci said. "How much worse [it] will get will depend on our ability to do two things: to contain the influx of people who are infected coming from the outside and the ability to contain and mitigate within our own country."

The 1918 Spanish flu pandemic, which involved a virus with a CFR somewhere between 2 percent and 5 percent, affected about a third of the world population and caused some 50 million deaths, including about 675,000 in the United States. The world population is more than four times as big today as it was then, the U.S. population is about three times as big, and international travel is much more common. But the CFR for COVID-19 appears to be much lower than the CFR for the 1918 pandemic, and disease control measures a century later are much improved.

Fauci declined to predict how many Americans will eventually be infected by the virus. "It is going to be totally dependent upon how we respond to it, so I can't give you a number," he said. "I can't give you a realistic number until we put into [the calculation] the factor of how we respond. If we are complacent and don't do really aggressive containment and mitigation, the number could go way up and [reach] many, many millions."

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  1. One percent?

    This virus will never see a one percent fatality rate.

    Because NO ONE is dying from it.

    They’re dying from illnesses they already had, of from illnesses that took advantage of a compromised immune system.

    By itself, COVID-19 can’t kill anyone.

    But it CAN spread enormously.

    When this panic finally peters out, we’re going to find that millions more people turned out to have had it……and that the death rate from complications brought on by the coronavirus are exactly the same as those brought on by the common cold.

    1. I think you’re quibbling. If those people already had illnesses but weren’t dying from it, then it’s fair to say that the incremental deaths were ’caused by’ COVID-19. It’s a “but for” standard, not a “sole cause” or even a “proximate cause” standard. ‘But for catching COVID-19, the patient would have lived.’

      To that end, I agree that we should be talking about incremental deaths, not total deaths. That is, we should be backing out the fraction of people who were dying from their underlying condition. That’s the only way we’ll understand the real danger of this virus.

      1. I think it is a little more complicated than that. 10% of 80 year olds die every year. So it is not “But for COVID, they’d have lived.” In some cases, it is “But for COVID, they’d have died of something else.”

        1. But at a slightly different time.

      2. I, and some others around here, were saying as much about the flu shot; we were only building a pool of individuals who were otherwise susceptible and that the harvesting effect is a bitch.

    2. Isn’t AIDs the same. You don’t die from AIDS you dies from whatever you catch while your immune system is suppressed.

      Coronavirus doesn’t kill your immune system in the same way, but it is legitimate, if harder to identify statistically, to blame a disease for killing you if you wouldn’t have died from other causes if it hadn’t been there.

      1. “Isn’t AIDs the same. You don’t die from AIDS you dies from whatever you catch while your immune system is suppressed.”

        It is not remotely the same.

        1. Of course not. AIDS had civil rights, and anyone suggesting quarantine was social media lynched.

          1. Is that your level of understanding?

    3. Please stop spreading disinformation Azaroth. You are not helping anyone. You are part of the problem.

      1. He’s more or less correct on the facts. That the people dying are dying from complications affecting other health conditions. In the same way that this happens with other respiratory illnesses. That’s why there are a high-risk groups. I would only add that because these types of illnesses are taxing on your system, very old people can be severely affected even without outstanding illnesses. So it’s the ill and the elderly.

        You have a problem not with his facts, but his tone and message. Yet saying that’s disinformation is itself not helpful to getting the facts out.

      2. Please stop spreading disinformation Azaroth. You are not helping anyone. You are part of the problem.

        I do not spread disinformation.

        I read and research.

        The COVID-19 virus doesn’t kill. It uses your cells as breeding material. This causes an immune response. If your body is already fighting something else, or if you are exposed to a more serious ailment during this immune response, your condition can become critical or the opportunistic infection can spread unhampered.

        But, if you are just infected with COVID-19 and nothing else you will be in the 80+ percent of people who either have no symptoms at all or who suffer a cold.

        This is what all the literature says.

        But, if you want to show that I’m ‘spreading disinformation’, please provide examples.

        If you can’t, shut the fuck up.

        And it’s Azathoth.

        1. Your understanding of infectious disease is just amazing.

          Thanks for sharing.

          I will let readers here judge information available for themselves.

          To say that NO ONE is dying from this virus is pure bunk. You have no idea. Did you pass a course in biochemistry, cell biology, molecular biology, immunology, pathology, let alone clinical experience and certified in intensive care medicine and diagnostics have you?

          Stay safe Aza whatever.

          1. i did and i am absolutely for certain that this entire COVID-19 “pandemic” is a ridiculous charade.

        2. My understanding is that the virus itself infects and damages the lungs and other organs. My understanding also is that those with underlying conditions are less able to defend against infection and damage, hence succumb, usually collapsed lungs, or pneumonia as in many flu deaths. Also, CoV-2 attacks the cilia, which help remove fluid from the lungs.

        3. My understanding is that the virus itself infects and damages the lungs and other organs. My understanding also is that those with underlying conditions are less able to defend against infection and damage, hence succumb, usually collapsed lungs, or pneumonia as in many flu deaths. Also, CoVid-19 attacks the cilia, which help remove fluid from the lungs.

        4. You aren’t wrong, but when people say “he died of disease X”, they mean that X was the thing that put them over the edge.

    4. With that logic, the Flu has never killed anyone.

      1. The cause of death on the certificate is rarely flu. For influenza they do exclude deaths due to related causes such as pneumonia from the official numbers. If we are going to compare them, then we need to calculate them the same way.

        As far as the Chinese numbers there are some things that have been left out of the reports. They were/are undergoing a flu outbreak in that area – and the vast majority of their case count is based not on tests but on symptoms. This becomes problematic in a situation where the symptoms of a newly discovered virus (or newly jumped) are almost identical to an existing outbreak. There is a real possibility that the numbers are higher than they should be – which may explain the difference between test-confirmed case outcomes and non-test confirmed cases.

        To really understand what is going on, and what is not, I highly recommend reading the actual reports being published rather than rely on media people who are basically relying on each others’ lack of reading the source material.

        1. I am reading the reports and doing my best to ignore the media. That doesn’t change the logic. If the hospitals are filling up from not-flu, but instead filling up because of bacterial pneumonia, it’s not prudent to just say, “Huh, lot of pneumonia cases popping up, strange…” and move on. CV19 clearly exacerbates and causes systemic problems that people with co-morbidities can’t deal with.

          It’s like saying, “Cause of death, lack of oxygen to the brain” for everything.

    5. They’re digging mass graves in Iran.

      1. So, business as usual.

        1. Zing!

    6. BINGO!!!!!!!!!!!!!!!!!!!!!

      Remember this quote when the smoke clears, because they said this about all the other fake epidemics & it was no where close to millions!

      Fauci declined to predict how many Americans will eventually be infected by the virus. “It is going to be totally dependent upon how we respond to it, so I can’t give you a number,” he said. “I can’t give you a realistic number until we put into [the calculation] the factor of how we respond. If we are complacent and don’t do really aggressive containment and mitigation, the number could go way up and [reach] many, many millions.”

      This guy has been spot on for years now & I would heed what he is saying about the crapola virus:

      1. See the thing is, I don’t think it’s a ‘fake epidemic’.

        It’s real.

        And I think that the ‘cure’ for this particular epidemicwill eventually be moving it into the family of other human coronaviruses that cause the common cold.

        If we’re exceedingly lucky, this hysteria might fuel a wave of research into figuring out some vaccination or medication that provides protection against these 200 plus viruses (human coronaviruses being among them).

        1. Trial vaccines are already on the way. People might not know but vaccines were already developed for SARS, but were never tested since the SARS virus was effectively eliminated. Because covid-19 is structurally similar to SARS and attaches to the body in the same way, the SARS research has allowed quick development of covid-19 vaccines, which some companies already claim to have.

        2. Given the already apparent disparities in the numbers we are likely to learn a lot about how coronavirus spreads and how it harms – there are obviously social, and environmental, as well as health factors at play.

      2. Holy shit get that ignorant, anti-science, conspiratorial nonsense out of here.

        I bet you were one of those people who thought Y2K was a fake crisis too because nothing much happened, while ignoring the massive effort by tens of thousands of people to deal with it.

        This is serious, and it’s going to take major global discipline to get it under control.

        1. You’re funny when you’re mad.

        2. Ignoring all the millions of people who did nothing to their personal or small business computers and had no problems either.

          1. US companies and government spent $130B on fixing the issues. There absolutely would have been more damage caused if not for preparation.

          2. Another ignorant response. You know nothing about Y2K.

      3. 2009 pandemic was not fake. And a case fatality rate is not the same as infection fatality rate. You can only get IFR from randmoized antibody test surveillance. Nobody is doing that. I will say that this is definitely removing ears from people’s lives. It’s increasing the rates of pulmonary fibrosis in survivors. It’s probably significantly worse than the flu and definitely worse than the 2009 pandemic.

    7. This post isn’t aging well.

  2. When you talk about how deadly the 1918 flu was, it’s helpful to point out some of the other exacerbating factors. For instance, there was, rather famously, a war happening, which means wartime mobilization. Lots of men crowded into boats, train cars, etc in tight quarters, and then being sent various places around the world. That greatly accelerated the spread of the disease.

    And with war, you also have wartime shortages. There’s insufficient medicines, there’s dietary restrictions, and so on. Even healthy individuals aren’t as healthy as they might otherwise be because they aren’t as well-fed as they could be.

  3. So far, more than 200,000 people have been tested there, compared to fewer than 10,000 in the United States, a country with a population more than six times as large.

    And a land mass more than 100 times as large. The absolute population number isn’t as important as the density or rather, mathematically speaking, the absolute population number doesn’t get you any closer to an answer or making sense than the density does.

    S. Korea can get to a larger percentage of tested easier and it’s ability to do so makes/means it’s more dependent on it.

    1. Although, I guess it’s my fault for expecting a magazine who’s central political position is “borders are just a figment of people’s imagination” to understand geography.

      1. I still think it’s far to say that burdensome FDA regulations and a botched test have slowed testing here. But there’s also the factor that the epidemic hit S. Korea quite a bit earlier than it did the US.

        I wonder, though, what the downsides to widespread testing are. People who know they have it will likely alter their behavior, and seek treatment if symptoms start emerging. But if people are flocking to centralized hospitals for testing, it means people who may not have the virus are showing up at places where people almost certainly DO have it, so it may facilitate spreading.

        Which once again shows that decentralization is powerful. Imagine if people were capable of administering tests in their homes.

        1. +1,000,000!!!!

        2. Countries that tested LEARNED from that experience. Korea implemented drive-up testing a few weeks ago. Everything about their experience was based on what they learned from their MERS outbreak – which started when someone sick went from hospital to hospital trying to get diagnosed/treated

          Once the news of those drive-up stations in Korea became public, other countries have now implemented on a large scale. Ron Bailey linked to that info a week or so ago here. Really interesting idea. Germany and UK and I’m sure other countries are now rolling that out. Some states here – mine CO is one – are now doing the same. But it’s obviously pointless to do that when you can’t actually test.

          Same way a start-up has to roll stuff out. Just get the damn thing out there. Stop tinkering and imagining and hyping the perfect. And start learning from that experience to make the changes that need to be made. And be transparent and open source about it – so that others can learn faster and maybe do something that you can learn from.

          Along similar lines – echospinner had an idea a couple days ago about libertarians self-organizing ‘community’. To SHOW what an alternative can look like and share focused ideas of what is working and not in our local communities rather than just tell and imagine what we might do as theory. Covid19 is exactly the sort of crisis that can create that opportunity. I’ve got a decrepit old blog that I’m willing to repurpose into a libertarian discussion form along those lines. If anyone is interested in helping get that started, post a comment there

        3. I wonder, though, what the downsides to widespread testing are.

          Widespread testing or widespread commercial/private testing?

          I see widespread testing and the calls for it in the face of an epidemic like this as little different than the talk of a gun registry in the immediate aftermath of a mass shooting. Sure, there are probably some honest people looking to garner some attention to an underfunded corner of the diagnostics market… maybe a few entrepreneurs and sales people looking to attract some cash to their business or project… but there are almost certainly a good portion who are explicitly going to use the test data to project the billions of people who will die in the next outbreak if we don’t provide universal healthcare and start vaccinating everyone right away.

          If knowing is half the battle, I know no one who is losing a battle to COVID-19 and lots and lots and lots of people who are losing the private/healthcare information battle to statist and statist-sympathetic corporations.

    2. Right. Because all of those testing kits need to be delivered by horse-drawn wagons.

      And let’s keep in mind that around 130,000,000 Americans live in the 25 largest urban areas in the country comprising a total of around 33,000 sq. miles. And it’s in and near those areas where you are going to find most potential cases to test. A country with as sophisticated a transportation network as the US should be able to easily surmount whatever logisitic difficulties arise from these areas being spread out all over the country.

      1. I commend you in your ability to both be wrong and absolutely miss the point dumbass. I’d use big words like permeability and permittivity but I’m not 100% sure you’d follow along. So, I’ll ask using smaller words:

        What’s the point in bringing tests, by car or horsedrawn wagon, to a place that is effectively self-quarantined anyway? You do know what self-quarantined means, right?

  4. Assuming the squirrels are never going to let my links through:

    “If 70 percent of the U.S. population were infected, the number of deaths would be nearly 2 million.”
    The annual mortality rate in the US is about 2.8 million:
    (Google “nvss mortality data”)

    We can assume a large overlap between COVID-19 victims and people who were likely to die anyway because the virus tends to kill the old and the infirm. If you assume a 90% overlap between COVID-19 victims and people likely to die anyway, the additional deaths per year look more like 200,000 or so.

    Also, the so-called “Spanish” flu tended to kill the young and healthy, which made it especially catastrophic:
    (Google “Age-Specific Mortality During the 1918 Influenza Pandemic”)

    So-called because:
    (why called the spanish flu. Look for the history period com link)

    1. One link per post.

  5. But the CFR for COVID-19 appears to be much lower than the CFR for the 1918 pandemic, and disease control measures a century later are much improved.

    All of this is true, but I need to say it again, the 1918 Spanish Flu virus killed young healthy people, unlike CV19. Medical science still hasn’t figure out why and to this day, there are still researchers trying to find an answer. Even in 1918, flu season was looked upon as a minor annoyance. We weren’t in a state of medieval medicine where simple diseases we take for granted kill people in large numbers. The Spanish flu was an anomaly and according to the best research, there’s little to suggest it wouldn’t happen again. Yes, perhaps with a lower mortality rate than in 1918, but anytime a Novel (operative word, here) flu virus shows up, it’s cause for concern.

    Also, it bears repeating, even if the CV19 flu ends up with a fairly small mortality rate, it’s the fact that a concerning percentage of people who do get it, require hospitalization and critical care. Italy is currently in that perfect storm where their healthcare system has been overwhelmed, and they’re seeing a CFR of 6.7%. Yes, they have an aged population– but that sidesteps the point. Your CFR can rise if your health services become overwhelmed with sick patients who’d otherwise be perfectly savable.

    1. “it’s the fact that a concerning percentage of people who do get it, require hospitalization and critical care”

      Curious, what percentage qualifies as “concerning” for you? The percentage that become critical and require hospitalization is quite low – even in China where you would expect a higher rate simply due to it being “ground zero” that rate is around 5%.

      I don’t put much stock to estimated CFRs during an outbreak. It boils down to a difference in calculation. There two basic ways to figure a mortality rate:

      1. Deaths in proportion to Confirmed cases
      2. Deaths in proportion to confirmed cases that have had a resolution.

      The first one is CFR and is the napkin math employed by the media. The problem is that at any given moment in an outbreak like this the number of cases as a whole includes more cases that have not had a resolution – ie. death or recovery. If the rate of spread is faster than the rate of resolution you will see a flexible estimate trending upward in mortality rate.

      The second takes the approach of cases that have ran their course, and it more precise. That number tends downward and increases in precision as cases resolve regardless of the infection rate.

      Of course, left out of the coverage of “how bad can it spread?” is its ‘R0’ value (“basic reproduction number”) – basically the number of people an average person with it can/will infect. Basically think of it as how well it actually spreads. The current value for this is in the range of 1.3 to 2.2; meaning one person will on average infect 1.3-2.2 people. If you like, think of this as how contagious a disease is in a population.

      The higher that value, the faster and more broadly it will spread. A value under 1 means it will quickly peter itself out. The range of 1.3-2.2 is on the low side. Since the 1918 outbreak has been referenced, I’ll note that its R0 is estimated to be in the 1.4-1.6 range.

      Important to know about this is that it can be greatly altered by available treatment and control of the spread – such as isolation and quarantine or antiviral agents. The current R0 values for SARS-COV-2 given above are global, thus include China. Indeed the figure is dominated by the data from China.

      For comparison Pertussis (known colloquially as “whooping cough” has an R0 of about 5.5, SARS-CoV has 2-5, HIV 2-5, Mumps 4-7, Ebola 1.5-2.5, and measles weighs in at 12-18.

      Now, this is still a complex and inadequate number, and should only be used in the broad sense. What should be done to turn this more practical is you have to apply it against the susceptible portion of a given population. This is generally known as the effective reproduction number.

      You don’t see it early in a novel infection because you don’t know the particularly susceptible population determination. This is where things like age and health (such as pre-existing conditions) really come into play. For example only, lets say that people over the age of 70 are the primary susceptible population, and that they constitute 10% of a larger population. With an R0 of 1.5, That would produce an effective value of .15.

      Again, I am not saying that is the R value for SARS-CoV-2, just using something to illustrate the determination. This is why Italy having both an aged population (and a woefully unprepared medical system) matters and is not sidestepping the point.

      As of today, the latest CDC figures for the U.S. are:
      total cases: 1,215
      deaths: 36

      Now, it is important to note that the 1,215 figure includes presumptive cases. Note that this does not limit it to resolved cases, so attempting to generate a mortality rate from those numbers will not be accurate in the slightest. From what I’ve been able to gather the confirmed case count is around 1004.

      Notice that the rate of spread is significantly lower than the global values, as well as for the notable nation such as Italy and Iran.

      The catch is the total numbers are still quite low, too low to generate reliable metrics even. Even worse, the majority of those deaths are in a single county: King County, Washington. And the majority of those were from a single elderly facility. This really skews attempts to quantify what is going on.

      To illustrate this: So far only only about 41 cases in the U.S. have a resolution. Of those 31 ended in death. I think we can all recognize that the virus does not have a general mortality rate of 75%. The aforementioned King County situation is what is screwing up the numbers – because it hit a particularly vulnerable and contained population. If you exclude Washington entirely, you are looking at 9 recovered and 2 dead for a rough rate of 18% – still far from the overall rates. The curse of small numbers hits hard.

      We need about another two weeks to even really begin to understand how the rates change in the U.S. And as far as overwhelming services, over half of confirmed cases are in Washington and New York. The rest are spread so thin we are unlikely to see the same effect as the much smaller are and more dense population level of Italy.

      1. Curious, what percentage qualifies as “concerning” for you? The percentage that become critical and require hospitalization is quite low – even in China where you would expect a higher rate simply due to it being “ground zero” that rate is around 5%.

        it’s not concerning for me, it’s concerning for health officials. The LOWEST death rate of any country has been South Korea, which has had the highest rate of testing in the civilized world. Their death rate is .7, or well over 3x “just seasonal flu”.

        Again, not every country has the same healthcare system or demographic breakdown. We look at Italy, and they’re in big trouble over this virus.

        Nothing you say counters my point. You make valid points, and I haven’t made any grand pronouncements of absolute CFR.

        1. Right. So far, 0.7% is the best known number.

          But nobody has done a cross-sectional study yet. It is too early and they are still dealing with fighting the fire. Eventually, they’ll get a good estimate. Maybe it comes down by less than that 3x number, but it isn’t out of the question.

          The SK numbers put it solidly in the ballpark of Flu (which fluctuates from year to year in lethality and transmissibility. ) But the reaction is based on 6-8% fatality rate and a super-high transmission rate.

          In order to justify this response, we’d need deaths in the quarter million to half million range in the US. But if it even rises into the tens of thousands (equal to the flu), it will be touted as proof that this is the worst thing ever and the government is the reason so many people died.

    2. Interesting factoid about the “Spanish Flu” – it actual came out of Asia and most tracing puts it as coming out of China. It was called the Spanish Flu because most papers didn’t write about it and the overwhelming majority of coverage was from Spanish language papers.

      1. I came here to say similar.

        A key distinction between today and 1918 that makes the ‘perhaps with a lower mortality rate’ more like an ‘almost certainly with a lower mortality rate’ is information transfer. Broadcast news was available, but the general bandwidth of information to the individual was massively lower.

        A big part of the reason we’re having this debate is because we’re effectively analysing the data from around the globe in at or near real time.

        But, I don’t think any of us have to tell D.R.(P.) that.

      2. Another interesting fact(oid) I learned was about widespread aspirin poisoning. Apparently, once they discovered that the disease was exacerbated by inflammation, they (as in the Surgeon General of The Army) started prescribing high-dose (like 10-30g doses of a drug that is normally consumed in 100-500 mg doses) of aspirin.

        As someone who was into the high-dose anti-inflammatory (aspirin, fish oils, etc.) craze in the 90s (and wound up with a ~6 hour long nose bleed), I’ve gotta say that the whole thing sounds absolutely insane. However, given the data and choice between dying of Spanish Flu or dying of aspirin poisoning, I can’t say I’d definitively know any different.

    3. Good point.

      Also interesting, people in the “above 80” cohort have a roughly 10% chance of dying over the course of a year. That’s a pretty high number. I wonder how much a respiratory virus with a high mortality rate going through the population moves that number (in the aggregate).

      If you are Florida or Arizona with huge retired populations, you could be facing an overtaxed medical system. Probably need to hold off on having that heart attack or cancer bout if you live in a high retirement area.

      1. This is why most every nursing home in the US currently has the front door nailed shut.

    4. Fact is there has been no research on the PRE-1918 flu epidemics. That outbreak is considered year zero for flu research. It’s (the H1N1) just simply been assumed to have been a novel virus that jump the zoonotic at that time. Which is the sort of assumption that does raise questions about why it had such a disparate impact on young adults. There is a hypothesis that older folks may have still had some remaining immunity (from either 1896 or 1899 flu epidemics). Which would explain why younger adults were hit harder in 1918 (but kids weren’t because they were quickly quarantined at home – so they were never exposed). But that hypothesis also requires looking at those earlier epidemics to see whether they were H1N1. In which case, 1918 was just about a deadlier mutation of that virus that year but it was already human so some people had immunity.

  6. Oh, Biden “has a plan” to combat the Coronavirus, and he’d like to activate the FEMA camps.

    So… some unemployed old codger is babbling on TV about having answers. Bugger off.

  7. Close everything for the rest of the month. Live on the cases of soup and TP you all hoard-bought last week.

    This is so elementary and basic that even Trump could understand it, but the man-child can’t be dragged into doing it because it means there’s a problem in his sunshine and sparkles fantasy world.

    1. First, he doesn’t have the power to do that. Second there is no way in hell that would be enforceable. Thirdly, entirely unconstitutional. Fourth, is this the plot of a stupid Hollywood made for TV movie, because no one with any sense of reality believes you could do anything of the sort? Next you’ll be talking about Cuba Gooding Jr and Dustin Huffman facing down a C-130 in a helicopter to stop them from dropping a thermal device on Seattle or New Rochelle, NY.

    2. “This is so elementary and basic that even Trump could understand it, but the man-child can’t be dragged into doing it because it means there’s a problem in his sunshine and sparkles fantasy world.”

      And so STOOOPID that it takes an imbecile with a raging case of TDS to suggest it.

  8. This is a good article, thanks for doing the research. I’ll be passing it along.

    The South Korean rate of .8% is also likely to be high, as only people who think they are sick with the COVID-19 disease are likely to be tested. So now we really are getting down toward seasonal flu numbers.

  9. I’ll reiterate… 80k Americans died just the year before last from the seasonal flu. That’s 20 times as many as have died worldwide thusfar from the new Coronavirus.

    And we didn’t cancel “the Bachelor”, let alone every sport and all optional travel.

    It remains an open question, but every single time one of these killer viruses comes out, the initial numbers are too high by a very large margin. As more information comes in, the numbers always come down. This was even true for ebola, which is among the nastiest and most lethal (to the infected individual) viruses known.

    1. I don’t know where you get the 80k number from. CDC reports between 12,000 and 52,000 Americans died last year from seasonal flu.

      However, I’ll repeat: We close entire school districts over norovirus outbreaks, and it kills only about 800 people a year.

      As more information comes in, the numbers always come down.

      This is also true, see South Korea. But South Korea is still reporting a CFR of over 3x the rate of standard seasonal flu.

      This was even true for ebola, which is among the nastiest and most lethal (to the infected individual) viruses known.

      Lots of stuff is more lethal than CV19. But they don’t spread as quickly or are anywhere near as virulent.

      Any time you have a novel flu virus, I think extra precautions are prudent. I’m not advocating for any particular policy or reaction, but the world has been hit with “novel virus” outbreaks in the past that did in fact, kill a whole lot of people.

        1. So, 2017. Was that the year of Ebola, the year of Zika, or the year of H1N1?

      1. “This is also true, see South Korea. But South Korea is still reporting a CFR of over 3x the rate of standard seasonal flu.”

        And supposing that number stays the same, isn’t it a good guess the 3x rate is only because there’s no vaccine and no herd immunity?

        Because of the novelty of the virus and the fact that there is no vaccine, I think some of the safety precautions that are being taken are wise, but I think there’s still a bit of miseducation going on because of the constant fight against the “this is not like the flu” argument. We’ll get more certain as it progresses, but all indication *is* that it is like the flu, except for the fact that with the flu we have a vaccine. The strongest evidence of this that the deaths are with high-risk populations.

        So, I wish people would stop fighting against the “this is not like the flu” argument. It is like the flu, except we have a flu vaccine, and we don’t have a covid-19 vaccine.

      2. “However, I’ll repeat: We close entire school districts over norovirus outbreaks, and it kills only about 800 people a year.”

        Which is interesting, because we don’t shut down EVERY public school when roughly 29,000 students are sexually assaulted by teachers each year…

  10. Coronavirus: President Donald Trump handed gift by Fabio Wajngarten, Brazilian press secretary with Covid-19

    President Bolsonaro of Brazil’s press secretary, who met and handed a gift to President Trump on Saturday, has tested positive for the coronavirus. Fabio Wajngarten was pictured standing next to Mr Trump at the president’s Mar-a-Lago resort …He gave Mr Trump a cap that had the slogan “Make Brazil Great Again”. Mr Trump was holding the cap that he had just been given … Later that evening Mr Wajngarten, 44, attended a party at the resort hosted by Kimberly Ann Guilfoyle, 51, who is working as a senior adviser for President Trump’s re-election campaign, and is the girlfriend of Donald Trump Jr, the president’s eldest son.

    The White House says that Trump and Pence refuse to be tested.
    This leaves two possibilities.

    Likely: Trump and Pence will both be tested, but deny it.

    VERY remote: Nancy Pelosi, the first female President, now second in the line of succession to the Presidency

    Wpuld Trump risk even death, to avoid admitting he ever made a mistake?

    1. Getting tested would do exactly what to Trump’s chances of dying?

      If you want to be snarky, try not to be a moron at the same time.

      (The snark in there somewhere if you want to hit testing would include that the Brazilian dude should have been tested before he was allowed to have contact with the President. Testing the President after he catches it doesn’t help the President at all. Not even a tiny amount. This isn’t an “early detection” disease. You treat the symptoms. That is all.)

      1. Dumbfuck Hihnsano is freaking out because he’s in the cohort that has a 1 in 5 chance of biting it if he comes down with the virus.

        1. Or worse yet for him, he could remain alive.

      2. “…If you want to be snarky, try not to be a moron at the same time…”

        That’s Hihn; being a moron is all he can do.

    2. Wpuld Trump risk even death, to avoid admitting he ever made a mistake?

      I must say, while one act doesn’t make the man admirable, compared to Eisenhower, Kennedy, or even Bush, it’s rather admirable to have a President willing to lay his own life on the line at the risk of admitting to making a mistake.

    3. Trump isn’t risking death by not getting tested. He’s risking the lives of his close contacts. Would he do that?

      1. This! And yes!

    4. Walls are closing!

      We finally have the motherfucker!

      Pelosi will then in a Gallic ceremony with Holy Roman Emperor pomp hand the reigns too…..Hilary on the DNC channels ABC, CBS and NBC!

      I get it now!

      1. Ack. Messed that up.

        “Pelosi will then, in a Gallic ceremony with Holy Roman Emperor pomp, hand the reigns to….Hilary!”

        1. Reins, although I’m sure Hillary likes your spelling better.

  11. One upside to no fans at the NCAA tournament, the next time they pull the horseshit shenanigans and threaten to pull out of a state because of their bathroom policy, the state has yet another reason to tell them to cram their basketball up their ass.

  12. Now would be a good time to throw a big cocktail party in New York or Washington, and invite every single Reason writer you know. #Covid-19Wedding

    1. Well, you can probably get a hell of a deal on a venue. I don’t think it would be a very effective way to murder them, though, if that’s what you are after, as your hashtag suggests.

  13. 1 percent of what denominator?

    Plain old influenza as the example why choosing (or even knowing) the denominator is important.
    50,000 deaths per 50,000,000 estimated all flu cases= 0.1%
    50,000 deaths per 5,000,000 laboratory proven flu = 1%
    50,000 deaths per 500,000 hospital admissions = 10%
    50,000 deaths per 200,000 intensive care unit admissions = 25%

    Since we don’t know for COVID hardly anything what the denominator looks like for any of these positions, it is hard to say what the case fatality rate is. But then it is equally hard to say what the influenza fatality rate is without very clearly stating prior definitions of which population you are assessing. With COVID there is a gross underestimate of actual cases due to lack of ability to test. So as we find more cases, the apparent fatality rate will drop.

    1. Yep. Numerator is much easier to lock in on than denominator. But the size of the denominator only moves one direction as data comes in.

    2. Well said.

  14. Cancelling large gatherings of people is not over-reacting. Even if it’s only people with co-morbid conditions that are at high risk, transmission to a lot of those people could overload our health systems and ICUs with older or sicker people getting more sick all at once. “Social distancing” is the right thing to do in order to spread the cases out over time.
    Also there are a lot of people with underlying conditions which weaken their immune systems (e.g. Type 1 diabetes or Lupus) who are not about to die and who would live long lives otherwise. A lot of the above conversation sounds extremely callous.

    1. Do you remember the world shutting down in 2017?

      Big numbers are hard to wrap your head around. There are 350 million people in the US. That is a huge number.

      In 2017 there were 80,000 deaths due to the seasonal flu.

      And nobody stocked up on toilet paper. There was no panic. We carried on just fine. There were not mass graves. The hospital system did not collapse, even though 900,000 people were hospitalized. (see link above for CDC numbers)

      Now, how bad did you imagine this getting.

      Did you imagine a million people hospitalized? Because a million people hospitalized in the US would be pretty close to the US flu season from 2017. And our current reaction would have been an over-reaction in 2017.

      So…. how many people have to be hospitalized for this reaction to be worthwhile?

      Remember – the main goal of the “social distancing” strategy is to slow the spread of the virus – thereby reducing the strain on the health care system and allowing them to do their work of saving lives. The number of people infected shouldn’t really change all that much – it is very contagious after all. Just the time over which those infections occur.

      So, a million hospitalizations wouldn’t be big enough to fit your “not over-reacting” number. But how many would it take? I don’t really know. 10 million? That’s a big number, and it would imply 800,000 deaths. That probably would justify this reaction.

      The initial numbers out of China might support that order of magnitude. But more recent numbers probably wouldn’t. The Korean numbers probably wouldn’t, and they are likely the most accurate to date (if still quite preliminary).

      It is hard to know.

      But I do know this…. almost all of the talking head doctors I’ve seen on TV are being hysterical and fear mongering. They are not being rational or scientific.

      And the few who actually are being scientifically cautious seem to be caught in the whirlwind of panic, afraid to be too contrary to the herd, lest they risk being labeled as the idiot who claimed there was no problem.

      There is a big difference between “there’s nothing to see here” and “I don’t think everyone needs to run to their nuclear shelter for 3 months”.

      The big enemy here has been uncertainty. This is an unknown, so caution is warranted. Cancelling large meetings might actually be prudent.

      But my little league just cancelled their season. This is not being prudent. This is being afraid. And not just afraid of the virus, but being socially afraid of being seen as “not doing enough”. (Little League Baseball is probably the perfect sport for this virus – you are spread out across a field, outdoors, a tiny number of fans who can maintain their distance and generally speaking no old people around)

      We are unequivocally losing our minds.

      Our school system just cancelled all after-school clubs. For the kids who just spent all day in class together. But 8 kids building a VEX robot together is a bridge too far.

      We have lost our minds.

      The school system cancelled all field trips. So my daughter’s 4th grade class can’t go to dinner at the fancy restaurant on Monday. They were slated to learn manners and have a fun outing together. The same kids that just spent the day together with the same teacher, in a back room at a restaurant. Yeah… that would have been a virus spreading disaster….

      The ACC cancelled all athletic activities, after having first decided to hold their basketball tournaments without fans. But having a bunch of 18-21 year old elite level athletes together is a bridge too far. The very people who are not at risk in the slightest from the disease (in terms of mortality). Why? Because the Big East cancelled their tournament completely at halftime of a game. And the ACC looked like they were not doing as much. So they bowed to the social pressure of their peer’s actions and cancelled even more…. no practices or anything!!!

      Yes. We are undoubtedly over-reacting.

      1. Once one league canceled the fate of the rest was made.

        You don’t want to be that ‘derelict’ league.

        No question it’s an over reaction. It’s an over reaction because public officials struck a deer in the headlights pose not knowing what hit them.

        As usual, we see how much of an illusion government can get. The left wants to further concentrate health power into its hands when in reality it should be far more decentralized in order to effectively mobilize and respond in my view.

        What the fuck do people want Trump to do exactly? Then he does something and they piss on him. It’s, what I’ve come to term, the ‘do something, anything but not THAT do something, anything’ fallacy.

        1. An FDR style fireside chat, with a level headed president sticking to facts, not ‘going with his gut’.
          The presidency is about much more than simply doing something, it is about setting an appropriate tone for the national response. The president’s blythe dismissal, focusing on his numbers (of confirmed cases), and ignorance of the degree to which public and business uncertainty is all driving the fear is his chief failing.

          1. Sucking on the corpse of FDR’s dick like that, I hope you’ve had your polio shot.

            1. Pretty tough to defend Trump on the issues, I know.

              1. Are you seriously suggesting that Gasman’s comparison was based on “the issues” and not on just ACTING “presidential?”

                Because I fail to see how a guy who:
                -Sided with JOSEF STALIN
                -Threw Japanese, German, and Italian-Americans in CONCENTRATION CAMPS (only ignored or called “internment camps” when Dems do it)
                -Threatened to stack the court if he didn’t get SCOTUS decisions he wanted
                -Declared a “Bank Holiday”; a.k.a prevented Americans from accessing THEIR money
                -Lengthened the Depression
                -Denied asylum to Jews escaping Germany
                -Issued E.O. 6102
                -Openly admired Mussolini (and his fascism)

                Is REALLY better on “the issues” than the Orange Man who says mean things on Twitter…

          2. Ya! A fireside chat, with a level headed democratic socialist explaining why he threw 120k Japanese-American, 11k German-American, and 1.8k Italian-American citizens and residents in internment camps because “he couldn’t trust them.” You know, just sticking to the “facts,” not “going with his gut.”

            The fact that anybody uses FDR as an example of anything more than a totalitarian, racist, socialist (but I repeat myself) is incredible…but I guess acting “Presidential” is all that’s important to leftists…

      2. Yeah, there’s a whole lot of ass-covering going on now.

        Which is pretty understandable, especially when kids are involved. Parent’s are not good at taking the broad view when their children are involved.
        But that doesn’t make it any less of an overreaction. Especially considering that the risk to children appears to be very slight.

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  16. GOOD NEWS.. all of the people who recover from COVID19 are contributing to the herd immunity which will beat this virus back in a few months. All of the experts are ignorant as usual. This virus is not serious for healthy people.

    1. Not so fast. We don’t know the re-infection rate.

      1. There is no reinfection rate….none! Any stories of such are false test results, which are super common in testing. The seasonal flu test only has an accuracy of 50-90%, depending on the year. So having a few false test results out of a few .million…is not surprising.

  17. So, my totally unprofessional understanding of viruses is that in order to thrive, they can’t be easily transmittable and extremely deadly. If they are both, they would kill out their hosts and then they themselves would die out.

    With viruses such as rabies, AIDS and ebola, it takes direct placement of the virues into the body but they are almost always deadly. The common cold just requires someone to be in vacinity of someone who has a cold and is breathing but it’s never deadly (unless there are underlying factors).

    Every time we get one of these scares and we told that the newest disease is both deadly and easily transmitted, I don’t fall for it. COVID seems to be following this pattern too.

    1. COVID-19 is a human coronavirus, 15% of that highly infectious, never deadly cluster of viruses you mentioned are caused by human coronaviruses.

      Medically, it’s pretty obvious by now what COVID-19 is.

      Hysterically, it is the plague/it is the thing that’ll finally bring Trump/capitalism/the west/humanity to it’s knees/to extinction/to heel.

    2. I’ve always heard that bit about viruses needing to find an equilibrium with their host. It is used to explain why no viral disease will ever wipe out the host – being too virulent kills off the hosts and thereby eliminates the virus.

      Of course, the counter example would be a mutation that causes the flu to be 100% fatal after a 1 month generalized viremia with high contagion. It would spread rapidly and wipe out all host animals. Then the virus would cease to exist.

      There is absolutely no reason for this not to happen… it is just a rare occurrence and would not be often observed, as all circulating viruses are by definition not that type.

      But we do see something similar with zoonotic infections. Ebola is extremely fatal in humans, but not their animal reservoir. Measles was a livestock disease before jumping to humans, where it killed millions.

      It is an interesting area of discussion and quite a bit of interesting research.

  18. Poor Italy. Always at the crossroads of barbarian invasions and plagues.

    It was (apparently) a German in the north who first brought the disease in as well as Chinese tourists who flock to that country more than any in Europe.

    Someone mentioned a perfect storm. Indeed. Plus history…..repeating itself! Ta-dah!

    My friend in Rome sent me links of how quiet it is. Eerie. Rome is NYC. It never rests. But to see it in that state was profoundly sad.

    No one enjoying the Trevi Fountain especially hit. If you’ve been, you see the glee and joy it brings to people. It’s a strange piece of art that resonates with people.

  19. How do you calculate a fatality rate for a disease where governments are lying and the press is either lying or deliberately mis-reporting, and there are no facts, just estimates and speculation?
    It will take months for open countries to have enough testing available to begin to develop believable survival rates.
    In the mean time, wash your hands with soap and hot water; just like you already should.
    Grandma was right all along.

    1. I don’t think everyone is lying, but I do question every number I’m given.

      Found this little tidbit in a tangentially related article:

      When China ran short of tests, early on in their epidemic, they used CT scans to diagnose cases.

      Ok, even assuming they actually did imaging on all those people (be it CTs, or x-rays – which I doubt) that means pretty much every case of pneumonia (of which they already had a lot) got counted as COVID.

      Hard to say exactly how badly this skews the numbers, but safe to say they are skewed.

    2. How does anyone know anything about anything?

      We mostly have to go on what other people tell us.

      But you are right, taking any fatality rate now at face value is dumb and people need reminding that it definitely doesn’t represent the proportion of people infected who die and only has one direction to move in.

  20. Looking at in terms of the number of deaths a one percent fatality rate is bad. Although, so far, it appears the deaths are mostly in the elderly and/or people with significant pre-existing conditions.

    Looking at it terms of years of life lost it might not be as bad as H1N1 which, has a lower CFR, but tragically kills the young and otherwise healthy.

    1. 2.8 million Americans die each year of natural causes. The vast majority of those are over 70. Dying of the flu/pneumonia is part of that stat. A large number of the victims of this disease, would have likely succumbed to illness in the next 12 months regardless. The U.S. and the world should do what they can to help those in need, but crashing the world economy is going to have dire effects, not just financially, but on the environment and on public health for years to come.

  21. The article implies that COVID-19 is more contagious than the flu, when the opposite is generally believed — it has a hyperlink to a story that does not address the question.

  22. My observation is, the ChiComs have been given all the information they will ever need on how to bring the world to heel. I’d suggest they work their biological labs 24/7 on the evil soup they are known to stir. If an issue as mundane as the fucking flu can disrupt the minds of the entire globe to this level, something actually serious ought to put it in the tank for good. Much ado over little.

    1. ^This^

      They don’t even have to kill anyone. Just keep inducing flu panics like this, plausibly infecting a few thousand people, and they’ll cripple economies, have those people begging for socialized medicine, and have their press saying “See? Socialized medicine saved us from a projected million+ deaths!”.

      I’ll say it again, COVID-19 has thus far worldwide killed fewer people than 2 *days* of driving. Long after COVID-19 is gone the same number of people will die driving every day. Moreover, just like with COVID-19, we could call off all sporting events, social gatherings, etc. and severely reduce the number of traffic fatalities. Why don’t we? Because we all give relatively zero shits the risk of being killed driving and the considerably more immense years of life lost.

    2. I know it sounds conspiratorial, but who’s to say that’s not what they did…

      1. It would be a pretty stupid move, seems to me. The Chinese Communist Party depends on a healthy, mostly capitalistic, world economy for it’s power and existence.

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  26. Italy: 37,500 cases, 3,000 deaths. Raw mortality rate: 8%
    Although raw mortality rates for COVID-19 do not account for the hundreds of thousands of untested – and thus unconfirmed – cases that are already out there – which would obviously bring the rate down – CDC, NIH and WHO all believe that that actual mortality rate is between 3.5% and 5%.

    1. South Korea has tested the greatest number of people, 300k, and has a Mortality rate of 1%. That will be the number. Quit being a drama bug.

  27. Six million people a year die in auto accidents in the US. I don’t see them imposing a national speed limit of 10 mph.

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