> But even if the actual case fatality rate were 10 times lower – about 5% – it would still be a serious virus to contend with. The case fatality rate for the ancestral strain of Covid-19 was estimated to be around 2.6%, for example.
Ugh. The news media never learns [1]:
1) The IFR for Covid-19 was not 2.6%. Less than a tenth of that, actually (yes, even for the ancestral strains).
2) "CFR" is a made up number, because it depends on what cases you count. If you count only a sample of people in the ICU, you can make the CFR look horrible for pretty much any illness. We made this mistake during covid!
3) You can see the same mistake in progress here, because you can't just take this sample of deaths you looked for, divide it by the cases you know about, scale it down by a random factor (that you pulled out of your butt), and then panic about the result [2].
[1] or more likely: never wants to learn, because fear drives clicks.
[2] for those who wonder: the right way to do this is random sampling -- you at least have to sample the population randomly to estimate seroprevalence correctly.
- "for those who wonder: the right way to do this is random sampling -- you at least have to sample the population randomly to estimate seroprevalence correctly"
There was a recent experiment that found 7% antibody prevalence in US diary workers,
The death rate of people that are noticeably sick is interesting actually, especially if lots of people are getting noticeably sick.
Like probably not interesting enough to start shooting people you think might be sick (panic), but maybe interesting enough to encourage voluntary social distancing measures (a measured response).
> Like probably not interesting enough to start shooting people you think might be sick (panic), but maybe interesting enough to encourage voluntary social distancing measures (a measured response).
...a "measured response" that caused huge harm, did generational damage to children, and shouldn't be used casually. Certainly not without proof that it works for some important, clear goal [1].
[1] for reference: "because we're scared and we think it might help" is not a clear goal.
There should be an incapacitation rate metric which quantifies what percentage of the population becomes unable to function for some significant period while infected.
A 1% IFR is very bad, but you're still going to have serious problems with a virus that doesn't kill anyone but makes most of the population very ill for a month or so - showstopper lights-go-out kinds of problems.
The problem now of course is that a significant percentage of the population has been propagandised into irrational lunacy, and will refuse to wear masks and get vaccinated even if their close relatives die.
We should really have spent some time trying to prevent mental and emotional contagion in populations, as well as physical illness.
> The IFR for Covid-19 was not 2.6%. Less than a tenth of that, actually
If we take the number of Covid deaths for, for example New Jersey (the whole state) or New York City from Wikipedia as: 26,795 [1] and 40,000 [2] and divide by the total population (9.5M and 8.8M), we get IFR estimates of 0.28% and 0.51% for NJ and NYC.
[1] "As of January 11, 2022, 1.63 million cases were confirmed in the state, incurring 26,795 deaths."
[2] "As of August 19, 2023 the city's confirmed COVID-19 deaths exceeded 45,000 and probable deaths exceeded 5,500."
I can't tell if you're agreeing or disagreeing, but: yeah, don't do what you're doing. There are lots of good publications on this question now. You don't have to make stuff up.
> we identified 40 eligible national seroprevalence studies covering 38 countries with pre-vaccination seroprevalence data. For 29 countries (24 high-income, 5 others), publicly available age-stratified COVID-19 death data and age-stratified seroprevalence information were available and were included in the primary analysis. The IFRs had a median of 0.034% (interquartile range (IQR) 0.013–0.056%) for the 0–59 years old population, and 0.095% (IQR 0.036–0.119%) for the 0–69 years old. The median IFR was 0.0003% at 0–19 years, 0.002% at 20–29 years, 0.011% at 30–39 years, 0.035% at 40–49 years, 0.123% at 50–59 years, and 0.506% at 60–69 years. IFR increases approximately 4 times every 10 years. Including data from another 9 countries with imputed age distribution of COVID-19 deaths yielded median IFR of 0.025–0.032% for 0–59 years and 0.063–0.082% for 0–69 years. Meta-regression analyses also suggested global IFR of 0.03% and 0.07%, respectively in these age groups.
This is concerning, but not worth panicking about yet. The person had direct contact with infected birds, so there is no evidence of human-to-human transmission.
For those wanting to learn more about bird flu, and flu in general, I highly recommend the recent Scott Alexander post:
This article is great - enlightening and quit funny:
> Pigs can be infected by both human and bird viruses, so they are a common place for this reassortment to take place. If reassortment is sort of like viral sex, pigs are sort of like Tinder.
I am not going to panic about it at this point. But, if it does develop into a pandemic, I am quite certain that the initial response will be more along the lines of "let's just see what happens. Gotta keep the economy going, right?"
Neither was Covid - it was always a silly idea with zero actual evidence for it. The steel man case for a lab leak was a leak of a natural virus, but even that has no evidence.
I don't know if this will help anyone, but my sister is an expert in this area. She is an infectious disease epidemiologist with a couple decades of experience. She was the head of vaccine-preventable epidemiology for one of the states in the U.S., and is now the head of epidemiology data and informatics for that state.
Over the holidays, I was asking her about bird flu because some of the things I was reading were frightening, but I wasn't sure what to make of them.
Everyone will react differently to the flu. There are kids in her exact situation that have that kind of reaction to the normal flu. However, it is still concerning. If the virus does cause more severe illness overall and it does mutate to become person-to-person, we are in trouble.
That is the hardest thing about public health—you just don't know which way things will swing. So you are always on the edge of either overreacting or underreacting.
The sister's answer is the answer pretty much any doc knowing the bare minimum about flu would give. This was already the case before the last pandemic. The flu virus is closely monitored for this exact reason: medical authorities and the WHO have been expecting a problematic flu pandemic for at least two decades. No one can know when the 'big one' will appear, but this one's a good candidate.
Can we just preemptively start vaccinating against this strain? we have the vaccine and seems like a low risk thing to get started on. even if no evidence of human to human transmission.
There is however some promising work on designing antibodies which might be broadly effective against all flus including H5N1: https://pubmed.ncbi.nlm.nih.gov/21320540/
But that's a decade away from deployment - though fortunately likely highly motivated if it works because the other promise is long-term immunity, rather then yearly boosters.
Readit News
Ugh. The news media never learns [1]:
1) The IFR for Covid-19 was not 2.6%. Less than a tenth of that, actually (yes, even for the ancestral strains).
2) "CFR" is a made up number, because it depends on what cases you count. If you count only a sample of people in the ICU, you can make the CFR look horrible for pretty much any illness. We made this mistake during covid!
3) You can see the same mistake in progress here, because you can't just take this sample of deaths you looked for, divide it by the cases you know about, scale it down by a random factor (that you pulled out of your butt), and then panic about the result [2].
[1] or more likely: never wants to learn, because fear drives clicks.
[2] for those who wonder: the right way to do this is random sampling -- you at least have to sample the population randomly to estimate seroprevalence correctly.
There was a recent experiment that found 7% antibody prevalence in US diary workers,
https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a3.htm
Like probably not interesting enough to start shooting people you think might be sick (panic), but maybe interesting enough to encourage voluntary social distancing measures (a measured response).
...a "measured response" that caused huge harm, did generational damage to children, and shouldn't be used casually. Certainly not without proof that it works for some important, clear goal [1].
[1] for reference: "because we're scared and we think it might help" is not a clear goal.
A 1% IFR is very bad, but you're still going to have serious problems with a virus that doesn't kill anyone but makes most of the population very ill for a month or so - showstopper lights-go-out kinds of problems.
The problem now of course is that a significant percentage of the population has been propagandised into irrational lunacy, and will refuse to wear masks and get vaccinated even if their close relatives die.
We should really have spent some time trying to prevent mental and emotional contagion in populations, as well as physical illness.
If we take the number of Covid deaths for, for example New Jersey (the whole state) or New York City from Wikipedia as: 26,795 [1] and 40,000 [2] and divide by the total population (9.5M and 8.8M), we get IFR estimates of 0.28% and 0.51% for NJ and NYC.
[1] "As of January 11, 2022, 1.63 million cases were confirmed in the state, incurring 26,795 deaths."
[2] "As of August 19, 2023 the city's confirmed COVID-19 deaths exceeded 45,000 and probable deaths exceeded 5,500."
https://pmc.ncbi.nlm.nih.gov/articles/PMC9613797/
> we identified 40 eligible national seroprevalence studies covering 38 countries with pre-vaccination seroprevalence data. For 29 countries (24 high-income, 5 others), publicly available age-stratified COVID-19 death data and age-stratified seroprevalence information were available and were included in the primary analysis. The IFRs had a median of 0.034% (interquartile range (IQR) 0.013–0.056%) for the 0–59 years old population, and 0.095% (IQR 0.036–0.119%) for the 0–69 years old. The median IFR was 0.0003% at 0–19 years, 0.002% at 20–29 years, 0.011% at 30–39 years, 0.035% at 40–49 years, 0.123% at 50–59 years, and 0.506% at 60–69 years. IFR increases approximately 4 times every 10 years. Including data from another 9 countries with imputed age distribution of COVID-19 deaths yielded median IFR of 0.025–0.032% for 0–59 years and 0.063–0.082% for 0–69 years. Meta-regression analyses also suggested global IFR of 0.03% and 0.07%, respectively in these age groups.
For those wanting to learn more about bird flu, and flu in general, I highly recommend the recent Scott Alexander post:
https://www.astralcodexten.com/p/h5n1-much-more-than-you-wan...
[Edited for clarity]
Essential context. That's the equivalent of a 5'4" (163cm) woman at >=205 lbs (93kg).
> Pigs can be infected by both human and bird viruses, so they are a common place for this reassortment to take place. If reassortment is sort of like viral sex, pigs are sort of like Tinder.
This made me laugh: "If reassortment is sort of like viral sex, pigs are sort of like Tinder."
Dead Comment
Over the holidays, I was asking her about bird flu because some of the things I was reading were frightening, but I wasn't sure what to make of them.
When I showed her this paper that is linked to in another comment here https://www.nejm.org/doi/full/10.1056/NEJMc2415890, she responded with this:
Everyone will react differently to the flu. There are kids in her exact situation that have that kind of reaction to the normal flu. However, it is still concerning. If the virus does cause more severe illness overall and it does mutate to become person-to-person, we are in trouble.
That is the hardest thing about public health—you just don't know which way things will swing. So you are always on the edge of either overreacting or underreacting.
But that's a decade away from deployment - though fortunately likely highly motivated if it works because the other promise is long-term immunity, rather then yearly boosters.