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it doesn't contradic Ioannidis at all. He might be right in the end, and that would be an incredibly bitter pill to many.

We are getting closer and closer to the flu fatality rate.

from 5% to 3%, then 1% now 0.5% - smart money (and common sense) would bet that the rate will continue to drop,

I would expect that people living in healthier environment than NYC will fare even better. No way NYC IFR is the upper bound for the rest of the country. You could just as well expect it to be 10x higher than other places.

the flu rate is 0.1%, thus we already hit the order of magnitude.



NYC is a younger, healthier city than the national average. NYC also has one of the best medical systems not just in America, but in the world.

Roughly 0.2% of everyone in NYC has already died of COVID-19. So 0.2% is pretty close to a hard lower bound on the IFR for COVID-19.

And I don't think anyone serious suggests every NYC resident has had COVID. I don't think anyone seriously suggests even half of NYC has had COVID.


That it's a lower bound for IFR in NYC. With how widely that changes based on age alone, it could also vary based on location. Such that NYC could conceivably have the highest value for that in the US.


NYC is younger and healthier than the US average so these are lower bounds for national average outcomes.


A datum that is hard to square when the deaths are still dominated by the older population. If you had convinced everyone over seventy to move out of NYC last year, their CFR would be a fraction of what it is now.


So the IFR will be lower in the rest of the country than in NYC because... they are going to send everyone over seventy to the Moon or something?


No. I was not claiming it would be lower. Apologies if the framing said it that way. I was just pointing out that we really don't have bounds on this anywhere else.


I'm not sure how that matters. We have a lower bound for an optimistic demographic representation of the country. If NYC is younger and healthier than average and is at 0.2%, why would the lower bound for the country as a whole be lower?


I am actually having a hard time squaring the claim that they are younger than the average. The number of people over 70 that have died in NYC is above the number of people over 40 in many cities across the nation.

That all said, my point is that we don't know the bounds. Period. It could be higher. It could be lower. That is why I said it is conceivable. Probably it is about that value in most places. I am interested in where the data falls.


NYC is on average younger than the broader US population.


And the deaths are concentrated on the older population. They do have younger people. They also have more nursing homes and assisted care. They literally have more of everything.


We're looking at per capita rates though so doesn't matter if they have more of something in absolute terms.


Could. If the agitating factor to severe cases is car exhaust, as an example. There are usually tipping points to that kind of thing.

Look, I agree that I don't know. Just trying to get that uncertainty in the counter claims, as well.


I’m talking about having more number of nursing homes because they have “more of everything”, not making an argument about density and pollution or anything like that.


Ah, yes, I misstook your argument. That said, I do suspect having more nursing homes means they have more people over 60 than most places. Which will skew them to have more deaths, period.

Consider, from all that we have seen, elementary schools could get 100% infection rate on the same population size that NYC nursing homes have and not see the number of deaths they have had. It is not controversial that the IFR is dependent on how many people over 60 you have in your population.

To drive that home some, here in WA, fully 92% of the deaths have been in people over the age of 60. It is quite ridiculous how deadly this is if you are older.


All I am saying people there breath the NYC air every single day. Can't possibly be good for them, especially in the light of some chronic pulmonary inflammation induced deaths.

The point on the lower bound of 0.2% is informative. I did not know that.


That lower-bound argument is overly simplistic.

There are huge error bars on that ratio, because "the population of NYC" is not something easily defined, and the death count (at this time) includes a lot of "excess deaths" that almost certainly have nothing to do with the virus (e.g. untreated cardiac arrest).


That's some major revisionism. No credible source was ever suggesting a 5% IFR. For example the Imperial model was using 0.9% given UK's age distribution. That looks likely to be spot on.

And Ioannidis? He was quite certain that the CFR was going to be a little higher than 0.1%. Yes. CFR, not IFR. So he's off by two orders of magnitude.


At various points in interviews and articles he used Diamond Princess, South Korea, Germany, Iceland as strong evidence of miniscule fatality rates, in every single case selectively ignoring that deaths lag symptoms which was already well known at the time. All of them had their death rates double or more after he used them, and it was easily predictable based on recent exponential growth and death lag.

In his stat article he was saying it is conceivable if we didn't know about it we wouldn't have been able to even detect it in the death numbers after it ran its course (he has since walked that back).

Even the other day after his serology preprint he was saying it doesn't seem to have a higher chance of killing you than seasonal flu for each person infected: https://www.youtube.com/watch?v=cwPqmLoZA4s&t=1h9m50s

And he claims the WHO said 3.4% of people who get infected would die:

https://www.youtube.com/watch?v=cwPqmLoZA4s&t=12m54s

But they actually said that was the case fatality rate at the time. Their actual quote was:

> Globally, about 3.4% of reported COVID-19 cases have died


His data from the Diamond Princess is completely outdated. He cited 7 deaths. We are now up to 13 with 7 more on critical condition. He has been completely wrong in each of his predictions.

I would respect him more if he just argued from am economic perspective that the economic damage is greater but his wild hypotheses about Covid being comparable to the common cold or flu have been completely refuted by all data.


> We are now up to 13 with 7 more on critical condition.

Minor note, but it appears we are up to 14 now - https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_on_D...

> Another Japanese man in his 70s died on 14 April, making him the fourteenth fatality.


3.4% was never stated to be anything but the case fatality rate. The WHO's statement was:

>Globally, about 3.4% of reported COVID-19 cases have died

Ioannidis acknowledged that in his original STAT article:

>Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror — and are meaningless.

Maybe because he had an editor. But I saw him in a recent video claim the WHO said 3.4% of people who get infected would die. A blatant lie:

https://www.youtube.com/watch?v=cwPqmLoZA4s&t=12m54s


0.1% is the flu cfr. 0.6ish% seems to be the corona ifr. these are comparing chalk and cheese. how many people who get the flu never rock up to a doctor? the ifr for flu is closer to 0.01%.

the worst case scenarios are disproven it is true - but so is the idea that it's just a flu.

let us be grateful this trial run of a deadly global pandemic was only moderately bad.


.1% is flu IFR but if I remember right the number doesn't include true asymptomatics which are estimated at up to 75% (which could bring it down to 0.025%). I'm not sure on this, that was on a CDC page I saw.


first you say 0.1% is the CFR for flu then, in the same sentence you claim that it is probably closer to 0.01% because people don't go to doctors with the flu.

Are you arguing that after all this time we still don't know what the actual CFR for flu is? And that the reported CFR is a gross overestimation? - I find that hard to believe.

To me, this feels that once this disease hits the reported flu numbers people start arguing that oh wait, the flu is actually even less dangerous ...


Oh, wait. You don't understand that the CFR and IFR are not the same thing? That explains a lot. I thought you were just being disingenous when comparing the early CFR statistics to the current IFR estimates.

The CFR is, by definition, computed from known cases. It's thus trivial to determine exactly: just divide the confirmed deaths by confirmed cases. So we definitely know the CFR of flu. The problem is, of coures, that it's highly likely to be an over-estimate.

On the other hand, the IFR is hard to determine, since we don't know which cases we missed, nor whether the unresolved cases will end up living or dying. Which is why all we have is estimates.


I'm sorry but 0.1%-0.2% directly contradicts 0.6%-0.9% (or higher because that doesn't account for the lag between infection and death). That's a 3 to 9 times higher death rate.




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