Stanford U Study: covid19 Prevalence 50-85x known cases

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Zobel
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Only people who aren't wrong sometimes are people not doing anything.

Hopefully we'll get to go to a game this fall and can have a beer together again.
ETFan
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JP_Losman said:

0.1% would be the average for the entire country obviously.

Certain areas would be way more afflicted than others.
Average together California, NY, Texas for example and it brings the average down

What would make the IFR different in NY compared to Texas? As far as I know, people aren't dying in NY because of overrun hospitals, just simply the disease. So, 0.1% dying there is 0.1% dying here. Same, same.

Maybe I'm wrong? Where the math bros at?

If you go with the belief that NY is over-counting, let's say by 25%, that's still 13.25M infected. 68% of the population.
dermdoc
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k2aggie07 said:

Only people who aren't wrong sometimes are people not doing anything.

Hopefully we'll get to go to a game this fall and can have a beer together again.


Would love it. But this time you are going to have to sit next to me. Oh the humanity!

Oh and we will play football this fall.
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The_Fox
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JP_Losman said:

Hypothetical:

IF we get enough data to overwhelmingly show 0.1% fatality rate... what are the implications?


Back to work and school full time? Back to normal? Not back to normal?

Yes. Absolutely. It would be indefensible to do otherwise.
NASAg03
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Complete Idiot said:

I'd caution everyone to read the "XX number of those tested positive were asymptomatic" articles very carefully. Many, if not most, mean asymptomatic at the time of the test. For example, a link to a homeless study was shared in another thread and the title just said "all 146 were asymptomatic" or something. But if you read further into the article there is a vague snippet about how one later got hospitalized but that "many" remained asymptomatic, implying others did not. We are interested in both - people who test positive and who are contagious but asymptomatic at the time as well as those that test positive and NEVER show symptoms, but right now I am MOST interested in the latter.

I got really excited about the study and it's findings yesterday - but after thinking about it longer I've lost some of that thrill. I still think it's a great study and that the findings seem to have merit, but I just need to see more studies like it. It's a study with some extrapolated conclusions - still somewhat theoretical - and I have to balance that with the real world impact of the disease. Not just the deaths but it's still a serious illness for many, even those who recover, as told by first hand accounts here on Texags. Still, if not as deadly as once thought and just a serious illness one can live through at home then public perception of the situation changes. Additional antibody tests will confirm the findings in this study I hope.

Let's get additional studies like this conducted across America.


Totally agree. This gets the ball rolling.

The nature of this study is going to have a lot of uncertainty, especially in the early stages. They are searching for a needle in a haystack. Just one false needle greatly affects the data. As such, I will rely heavily on experts to draw conclusions. Why? They are banking their careers in these statements.

When you write a paper called "Why Most Published Research Findings Are False," you better be damn sure your findings stand up to your own critique.

Mike Shaw - Class of '03
ETFan
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The_Fox said:

JP_Losman said:

Hypothetical:

IF we get enough data to overwhelmingly show 0.1% fatality rate... what are the implications?


Back to work and school full time? Back to normal? Not back to normal?

Yes. Absolutely. It would be indefensible to do otherwise.
We still have to keep an eye on the R0. So it is defensible, if we get more data and realize, even with social distancing, the R0 is 2+ (unlikely). If we figure out that simple handwashing, a mask for certain things, and that's it reduce the r0 to <1, with ifr of 0.1% then yeah, indefensible, get back to it.
The_Fox
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ETFan said:

The_Fox said:

JP_Losman said:

Hypothetical:

IF we get enough data to overwhelmingly show 0.1% fatality rate... what are the implications?


Back to work and school full time? Back to normal? Not back to normal?

Yes. Absolutely. It would be indefensible to do otherwise.
We still have to keep an eye on the R0. So it is defensible, if we get more data and realize, even with social distancing, the R0 is 2+ (unlikely). If we figure out that simple handwashing, a mask for certain things, and that's it reduce the r0 to <1, with ifr of 0.1% then yeah, indefensible, get back to it.
We do not do the same for the flu. Flu has a R0 greater than 1. It does not have to be less than 1 to stop shooting the economy in the face.
ETFan
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The_Fox said:

ETFan said:

The_Fox said:

JP_Losman said:

Hypothetical:

IF we get enough data to overwhelmingly show 0.1% fatality rate... what are the implications?


Back to work and school full time? Back to normal? Not back to normal?

Yes. Absolutely. It would be indefensible to do otherwise.
We still have to keep an eye on the R0. So it is defensible, if we get more data and realize, even with social distancing, the R0 is 2+ (unlikely). If we figure out that simple handwashing, a mask for certain things, and that's it reduce the r0 to <1, with ifr of 0.1% then yeah, indefensible, get back to it.
We do not do the same for the flu. Flu has a R0 greater than 1. It does not have to be less than 1 to stop shooting the economy in the face.
Fair, I misspoke on 'less than' 1. My point was there's more to consider than just the mortality.

I guess we'll know soon enough, NY state should be reaching herd immunity I think?
pocketrockets06
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I guess I don't understand the point you're making then. Many epidemiologists still believe the IFR is going to be over 1%. That's where I'm at personally. Our current CFR in the US is over 6% (using a 7 day case lag). Even if 80% of people infected are asymptomatic or not tested for other reasons, that's still an IFR over 1%. You have to start assuming we're missing 85+% of cases to get it under that number. Heck, South Korea is still showing a CFR of nearly 2% and they are testing 50 people for every 1 they find with COVID 19. Were only testing around 5-6 per positive.

My point with including the .25% numbers was simply to show that this is not "just the flu" even at that level.
Pasquale Liucci
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Most epidemiologists have stated a suspected IFR somewhere around 0.3-0.6%
TarponChaser
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nm
AustinScubaAg
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oragator said:

I have zero doubt that there are more people infected than than the numbers indicate. But the experience in NY says it isn't remotely like the flu numbers wise, and doesn't seem mathematically possible to have that high a multiple given the deaths we see in hard hit places. An average flu season kills 32k or so, NY may get to that by itself or at least get close, with social distancing in place. For comparison, an average flu season in NY should kill around 2-3k people, a bad flu season 6-7k or so. This isn't that. They will find the real numbers eventually, my personal guess based on everything is that it will be just under 1 percent fatal. Way worse than the flu at .1 percent and more contagious so a higher percentage of people are infected, with asymptomatic carriers doing the transmission damage, which will explain some of the discrepancies. But some of the prelim numbers on asymptomatic don't seem to line up to reality on the ground.
Jmo,


You really cant compare either deaths or cases to the flu. About 37 percent of the US popultion gets the flu shot each year which reduces the case count and death rate. Also ther are effective antivirals for flu that can be used if caught early. Both of those help to limit the spread of flu.
Sq 17
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JP_Losman said:

Hypothetical:

IF we get enough data to overwhelmingly show 0.1% fatality rate... what are the implications?


Back to work and school full time? Back to normal? Not back to normal?
in St johns parish the death rate is .1% *, Probably would be worth the money to test all 43,000 residents to see what percentage of the county did catch the covid in post mardi gras wave of cases

Death rate as of a few weeks ago, cause of death is of course debatable because of underlying conditions, and of course proper attribution of deaths is always up for debate
agforlife97
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Lester Freamon said:

Most epidemiologists have stated a suspected IFR somewhere around 0.3-0.6%
Based on poor data so far, but getting better. The real IFR is probably 0.1-0.3%, possibly lower. But it's also about who this virus kills. Seasonal flu can be deadly to otherwise healthy children, whereas this virus certainly is not (it's about the only great data we have right now on COVID). A huge percentage killed by COVID were nursing home residents.
PJYoung
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dermdoc said:

k2aggie07 said:

Only people who aren't wrong sometimes are people not doing anything.

Hopefully we'll get to go to a game this fall and can have a beer together again.


Would love it. But this time you are going to have to sit next to me. Oh the humanity!

Oh and we will play football this fall.

I have gone from hopeful to 50/50 to trending towards zero recently after reading a bunch of opinions this week.

I think spring football is much more likely and I'm fine with that considering everything. I think cancelling the season is impossible. Thank the Lord.
Zobel
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For an IFR of 0.1% you'd need over 17 million infections in New York State. That's 90% of their population.
dermdoc
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We will play football this fall. Trust me.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
ham98
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dermdoc said:

We will play football this fall. Trust me.
I ain't playing football. I got a bad ankle
Complete Idiot
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k2aggie07 said:

For an IFR of 0.1% you'd need over 17 million infections in New York State. That's 90% of their population.
I have to admit I got way super positive and excited after the Stanford study. It wasn't just the results probably, in large part just excited to see antibody tests starting. But seeing that actual infections could be 50 times the amount confirmed positive with a test was exciting.

But data like k2aggie07's brings me back to some realities that are hard to explain away. First hand accounts by medical personnel in hard hit areas saying yes, this is a very serious illness unlike any they have seen before.

It's true many will get it with mild symptoms, or even no symptoms. I read a study earlier today that proved even Ebola can be contracted by someone and they have no symptoms. It doesn't change how serious the illness is, and for how many.

I'm not saying this Stanford study isn't still cause for optimism, just that I allowed myself to swing way over that way. I think it's human nature, we've been waiting for positive developments for a time that seems even longer than it has really been, and for those stuck at home, maybe with kids, there is a strong desire to get back to normal.

But k2Aggie's data is concerning. If you take Spain deaths, their confirmed case count, and apply Stanford's 50 times estimate - (20043 (191726 50)) 100 - you get a CFR of 0.2 still. And applying the Stanford multiplier probably isn't fair since Spain testing per capita is 3 times what CAlifornia's is. Very very crudely we are then at a 0.5% CFR possibly?

Not trying to bring myself down but certainly want more antibody testing in various places across America.
H.E. Pennypacker
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dermdoc said:

Proposition Joe said:

dermdoc said:

Complete Idiot said:

Everybody has said mortality rate would be less than case fatality rate, and everyone has known that the number of people that have had the disease is greater, probably far greater, than those that actually took a test and were positive. EVERYONE knew that. No one could pinpoint to what degree without a study. To say you knew what it would be based on a gut feel is hilarious to me. Guessed and were right? OK. And it's still not settled, this is one study, but OK.


Fair enough. We shall see.

And it was not a "gut" feeling. I have been doing this for over 40 years. The numbers from California and Washington never made sense. And sure, I could be wrong and stated that from the get go. But I just mentioned a possibility that seems to be more and more likely and got blasted on here.

You were also steadfast in a lot of your opinions 30 days ago that now look laughably incorrect.

So I wouldn't be so quick to pat yourself on the back.


Like what? I predicted 50-100k US deaths. I said that hospitals would not be overrun and we would not run out of vents. Predicted a US mortality rate of 0.3-0.6%. I was maybe wrong on US mortality rate being lower than South Korea, but these new numbers may change that. And you can pull up my posts and please tell me if I am not remembering correctly. Never seen any folks so upset by good news:

Just "stuck my finger in the air".


You are looking right in regard to the first wave of fatalities. And that is great news. Kudos. However, like others, I'm worried there will be a second wave this year. What are your thoughts on that?

The first wave has been difficult to model. It's tough to conceptualize what a second wave will look like.

Furthermore, if there is a second wave that crests aggregate fatalities above your 100K range estimate, that will be worse than any flu season, and it will have occurred despite our economy being shutdown/smashed, and a majority of the American populace drastically altering their daily routine for the better part of a month.

And that goes for a good part of the developed world as well. I feel like that's not really being acknowledged. We almost literally can't keep doing what we've had to do so far to "beat" this thing with only 60K deaths.
dermdoc
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I think that we will get a respite due to the hot temperatures until we get a treatment followed by a vaccine.
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NASAg03
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The big factor is will people go back into lockdown? And will businesses shut down again?

We're already seeing protests in every state and we're on the cusp of reopening. More SIP won't be tolerated during summer. And that's the big season for pretty much every state outdoors, rec, etc.
Mike Shaw - Class of '03
Pasquale Liucci
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Lord I hope so
Complete Idiot
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The_Fox said:

Complete Idiot said:

The_Fox said:

Complete Idiot said:

Yes, please read the PDF which can be downloaded from the link provided.

The study seems fairly sound and it is great news to read the actual cases could be 50-85 times higher than the amount you actually tested positive (in that county). Documents the limitations and states assumptions.

The study does note that it still represents a very small portion of the population (see below), but definitely the CFR would change as a result of this find (study suggests 0.12-0.2%). All great news and I hope new and larger studies continue to confirm.

We conclude that based on seroprevalence sampling of a large regional population, the prevalence of SARS-CoV-2 antibodies in Santa Clara County was between 2.49% and 4.16% by early April. While this prevalence may be far smaller than the theoretical final size of the epidemic,27 it suggests that the number of infections is 50-85-fold larger than the number of cases currently detected in Santa Clara County. These new data should allow for better modeling of this pandemic and its progression under various scenarios of non-pharmaceutical interventions. While our study was limited to Santa Clara County, it demonstrates the feasibility of seroprevalence surveys of population samples now, and in the future, to inform our understanding of this pandemic's progression, project estimates of community vulnerability, and monitor infection fatality rates in different populations over time. It is also an important tool for reducing uncertainty about the state of the epidemic, which may have important public benefits.
If that 0.12-0.2% is correct. The people pulling for this shut down in the government need their asses beat and to be out of a job.
I don't know if it's that simple. You can't learn more at a later date and then state that decisions made early, with different or incomplete data, were so bad someone should be fired. Remember - nearly ALL countries went into shutdown. Maybe you are referring to worldwide governments but I sense you are referring to the local, state, and national governments in America. They didn't not behave uniquely in this. I get the stress and anger this situation may have caused many but it's a pandemic, looked way worse as far as how it spread that others in recent history, and people had incomplete data at hand to make incredibly difficult decisions.

I have said since day 1 that the shutdown was a mistake and that the fatality rate would be under 0.5% after widespread testing. Only a fool, a weakling, or someone with an agenda would believed otherwise.

A mistake measured in the 10s of trillions should have dire consequences.
No actions taken will cost tens of trillions of dollars. Please stop using hyperbole to make points, they lose their impact. Worse - people will just read it and believe it without researching it.

The annual US GDP is $22 trillion, worldwide annual GDP is $85 trillion. $20+trillion dollars will not be lost worldwide as a result of these actions unless they stay in place for 5+ years (if extrapolating out the predicted annual GDP loss for this year).

Also, name calling just because someone believed the fatality rate could be over 0.5% doesn't seem warranted, MERS had a 35% case fatality rate, SARS 9.6%, Spanish flu >2.5%. Someday, if not Covid, a disease both highly contagious and fairly deadly (mortality>0.5%) will surely happen. It's not foolish to believe it's possible very early in a pandemic, before any solid confirmation of actual cases is in hand, and the current CASE fatality rate is 6.9%. If 14 times the currently tested positive population has actually been infected, and assuming the current death total is accurate, then YES, we will be below a 0.5% mortality rate. This study suggest that is very possible, and that is great news.

Name calling and hyperbolic statements make make for a good soundbite but don't serve any real purpose.
HouAggie2007
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The elephant in the room seems to still be the hospitalization rate? Even if it doesn't kill people how do we mitigate the high levels of hospitalized people?
The_Fox
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Complete Idiot said:

The_Fox said:

Complete Idiot said:

The_Fox said:

Complete Idiot said:

Yes, please read the PDF which can be downloaded from the link provided.

The study seems fairly sound and it is great news to read the actual cases could be 50-85 times higher than the amount you actually tested positive (in that county). Documents the limitations and states assumptions.

The study does note that it still represents a very small portion of the population (see below), but definitely the CFR would change as a result of this find (study suggests 0.12-0.2%). All great news and I hope new and larger studies continue to confirm.

We conclude that based on seroprevalence sampling of a large regional population, the prevalence of SARS-CoV-2 antibodies in Santa Clara County was between 2.49% and 4.16% by early April. While this prevalence may be far smaller than the theoretical final size of the epidemic,27 it suggests that the number of infections is 50-85-fold larger than the number of cases currently detected in Santa Clara County. These new data should allow for better modeling of this pandemic and its progression under various scenarios of non-pharmaceutical interventions. While our study was limited to Santa Clara County, it demonstrates the feasibility of seroprevalence surveys of population samples now, and in the future, to inform our understanding of this pandemic's progression, project estimates of community vulnerability, and monitor infection fatality rates in different populations over time. It is also an important tool for reducing uncertainty about the state of the epidemic, which may have important public benefits.
If that 0.12-0.2% is correct. The people pulling for this shut down in the government need their asses beat and to be out of a job.
I don't know if it's that simple. You can't learn more at a later date and then state that decisions made early, with different or incomplete data, were so bad someone should be fired. Remember - nearly ALL countries went into shutdown. Maybe you are referring to worldwide governments but I sense you are referring to the local, state, and national governments in America. They didn't not behave uniquely in this. I get the stress and anger this situation may have caused many but it's a pandemic, looked way worse as far as how it spread that others in recent history, and people had incomplete data at hand to make incredibly difficult decisions.

I have said since day 1 that the shutdown was a mistake and that the fatality rate would be under 0.5% after widespread testing. Only a fool, a weakling, or someone with an agenda would believed otherwise.

A mistake measured in the 10s of trillions should have dire consequences.
No actions taken will cost tens of trillions of dollars. Please stop using hyperbole to make points, they lose their impact. Worse - people will just read it and believe it without researching it.

The annual US GDP is $22 trillion, worldwide annual GDP is $85 trillion. $20+trillion dollars will not be lost worldwide as a result of these actions unless they stay in place for 5+ years (if extrapolating out the predicted annual GDP loss for this year).

Also, name calling just because someone believed the fatality rate could be over 0.5% doesn't seem warranted, MERS had a 35% case fatality rate, SARS 9.6%, Spanish flu >2.5%. Someday, if not Covid, a disease both highly contagious and fairly deadly (mortality>0.5%) will surely happen. It's not foolish to believe it's possible very early in a pandemic, before any solid confirmation of actual cases is in hand, and the current CASE fatality rate is 6.9%. If 14 times the currently tested positive population has actually been infected, and assuming the current death total is accurate, then YES, we will be below a 0.5% mortality rate. This study suggest that is very possible, and that is great news.

Name calling and hyperbolic statements make make for a good soundbite but don't serve any real purpose.
Ok smart guy. What will be the final bill for all of this stimulus BS? 3,4,5,6,7,8 Trillion? How much will this cost the economy over the next several years until we return to a pre-covid economic position? 3,4,5,6,7,8,9,10 Trillion?

Care to put your money where your mouth is that the final IFR will exceed 0.5%. Money talks and BS walks.
goodAg80
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If we did nothing about this and the mortality was 0.5%, that is 1.65 million people dead. I am not sure what that is worth in $, but my guess is Americans would be a little disappointed. Besides if we had done nothing, the chaos in our hospitals would have increased the mortality a lot and it would have disabled our medical system for an extended period of time.

It is hard to believe anyone is saying that is the best response.
Not a Bot
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Video discusses the testing methodology and why it might not be accurate terms of asymptomatic spread. The false positive rate and sampling technique are under some scrutiny.
Player To Be Named Later
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Way too early to get super excited that these antibody tests mean anything. Sounds like it's well within the realm of possibility that antibodies to other common corona viruses could show up as a positive.
PJYoung
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Player To Be Named Later said:

Way too early to get super excited that these antibody tests mean anything. Sounds like it's well within the realm of possibility that antibodies to other common corona viruses could show up as a positive.


Exactly. And I understand people getting exciting about positive news.
Complete Idiot
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The_Fox said:

Complete Idiot said:

The_Fox said:

Complete Idiot said:

The_Fox said:

Complete Idiot said:

Yes, please read the PDF which can be downloaded from the link provided.

The study seems fairly sound and it is great news to read the actual cases could be 50-85 times higher than the amount you actually tested positive (in that county). Documents the limitations and states assumptions.

The study does note that it still represents a very small portion of the population (see below), but definitely the CFR would change as a result of this find (study suggests 0.12-0.2%). All great news and I hope new and larger studies continue to confirm.

We conclude that based on seroprevalence sampling of a large regional population, the prevalence of SARS-CoV-2 antibodies in Santa Clara County was between 2.49% and 4.16% by early April. While this prevalence may be far smaller than the theoretical final size of the epidemic,27 it suggests that the number of infections is 50-85-fold larger than the number of cases currently detected in Santa Clara County. These new data should allow for better modeling of this pandemic and its progression under various scenarios of non-pharmaceutical interventions. While our study was limited to Santa Clara County, it demonstrates the feasibility of seroprevalence surveys of population samples now, and in the future, to inform our understanding of this pandemic's progression, project estimates of community vulnerability, and monitor infection fatality rates in different populations over time. It is also an important tool for reducing uncertainty about the state of the epidemic, which may have important public benefits.
If that 0.12-0.2% is correct. The people pulling for this shut down in the government need their asses beat and to be out of a job.
I don't know if it's that simple. You can't learn more at a later date and then state that decisions made early, with different or incomplete data, were so bad someone should be fired. Remember - nearly ALL countries went into shutdown. Maybe you are referring to worldwide governments but I sense you are referring to the local, state, and national governments in America. They didn't not behave uniquely in this. I get the stress and anger this situation may have caused many but it's a pandemic, looked way worse as far as how it spread that others in recent history, and people had incomplete data at hand to make incredibly difficult decisions.

I have said since day 1 that the shutdown was a mistake and that the fatality rate would be under 0.5% after widespread testing. Only a fool, a weakling, or someone with an agenda would believed otherwise.

A mistake measured in the 10s of trillions should have dire consequences.
No actions taken will cost tens of trillions of dollars. Please stop using hyperbole to make points, they lose their impact. Worse - people will just read it and believe it without researching it.

The annual US GDP is $22 trillion, worldwide annual GDP is $85 trillion. $20+trillion dollars will not be lost worldwide as a result of these actions unless they stay in place for 5+ years (if extrapolating out the predicted annual GDP loss for this year).

Also, name calling just because someone believed the fatality rate could be over 0.5% doesn't seem warranted, MERS had a 35% case fatality rate, SARS 9.6%, Spanish flu >2.5%. Someday, if not Covid, a disease both highly contagious and fairly deadly (mortality>0.5%) will surely happen. It's not foolish to believe it's possible very early in a pandemic, before any solid confirmation of actual cases is in hand, and the current CASE fatality rate is 6.9%. If 14 times the currently tested positive population has actually been infected, and assuming the current death total is accurate, then YES, we will be below a 0.5% mortality rate. This study suggest that is very possible, and that is great news.

Name calling and hyperbolic statements make make for a good soundbite but don't serve any real purpose.
Ok smart guy. What will be the final bill for all of this stimulus BS? 3,4,5,6,7,8 Trillion? How much will this cost the economy over the next several years until we return to a pre-covid economic position? 3,4,5,6,7,8,9,10 Trillion?

Care to put your money where your mouth is that the final IFR will exceed 0.5%. Money talks and BS walks.
Can you point the words in my post that led you to believe I think the IFR will exceed 0.5%? I said the study suggest the mortality rate will be below 0.5%.

Just like with the scientific and medical aspects of this, I look to experts and studies rather than my gut feel. Just like with the economic impact, I look to experts to try to understand what they think will happen in the short and long term. I would not claim to be a "smart guy" in these areas since those are not the topics I was educated in at Texas A&M. I also don't claim to be able to predict the future. Only a truly "smart guy" would know how a pandemic would play out from day 1 and be able to know the future holds tens of trillions of dollars in economic impact. Rather than ask for the opinion of a guy posting as "complete idiot" on an internet forum, go read the economic predictions from those that are knowledgeable on those topics, and work in finance.
Fitch
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This seems unnecessary.
Player To Be Named Later
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PJYoung said:

Player To Be Named Later said:

Way too early to get super excited that these antibody tests mean anything. Sounds like it's well within the realm of possibility that antibodies to other common corona viruses could show up as a positive.


Exactly. And I understand people getting exciting about positive news.


We definitely need positive news. But it does none of us to use unproven data.

I've never seen anything like this where so many stats are thrown out there as gospel before they're vetted. Makes it incredibly frustrating and difficult to get to the true reality of what we are up against.
jagvocate
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"I've never seen anything like this where so many stats are thrown out there as gospel before they're vetted. Makes it incredibly frustrating and difficult to get to the true reality of what we are up against."

Hashtag Pandemic

ham98
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Player To Be Named Later said:

PJYoung said:

Player To Be Named Later said:

Way too early to get super excited that these antibody tests mean anything. Sounds like it's well within the realm of possibility that antibodies to other common corona viruses could show up as a positive.


Exactly. And I understand people getting exciting about positive news.


We definitely need positive news. But it does none of us to use unproven data.

I've never seen anything like this where so many stats are thrown out there as gospel before they're vetted. Makes it incredibly frustrating and difficult to get to the true reality of what we are up against.
Do you not global warm bro?
 
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