Yeah. No known preexisting conditions is very different from no preexisting conditions. That being said, it's certainly possible that she was just unlucky and the virus hit her harder than normal for people her age, or she caught some other bug at the same time.
Also we need to remember what the relevant pre-existing conditions here are.
I think most people are immediately thinking severe asthma, COPD, recent or current cancer treatment; and while all of those elevate your risk, they aren't the most common comorbidities.
The key co-morbidities are high blood pressure, heart disease and diabetes.
Only heart disease seems obvious - high blood pressure is almost standard, and diabetes is often managed well to the point of invisibility.
The cardiac link appears interesting. Patients who are given ECMO, a complete lung bypass alternative to ventilators, have still died after their lungs recovered.
There are other mutations that appears to combat virus more effectively, but who's to say that there are not mutations that are beneficial for some disease, but catastrophic for others ?
But assuming this person had an unknown pre-existing condition is no comfort at all. It just means that anyone could equally have an unknown pre-existing condition that would similarly render then susceptible.
The thing is how do you know you don't have any commodities. Specially if you're in your 20s lots of congenital defects might have not had the chance to be a problem.
I'd argue that this is a single datapoint out of nearly 20k deaths. Are the odds of dying young with zero pre-existing conditions on the order of 1:20k, or exactly zero? Is death from covid rare or impossible?
Most of what I've seen so far seems to suggest it works more like AIDs, where it weakens something (in this case, epithelial cells in the lungs) which allows other opportunistic issues to arise (bacterial pneumonia for example). So rather than dying "from the virus", you die from another underlying issue. Similar to how AIDs doesn't kill you, it just makes it easier for everything else to kill you
We have a choice here: strongly hold onto generalizations derived from early analysis, or keep an open mind about new developments in the rapidly growing data. By all means folks should scrutinize these developments as they arrived, but we should keep Dunning-Kreuger in mind: there's a whole lot we don't know about this virus.
The body is a large and extremely marvelous yet complex piece of machinery, even with self-repairing mechanisms.
Everyone is at risk even if they're healthy, it's just that the risk rates vary and for some groups are incredibly low based on the data. Knowing your risk rate is nearly impossible, but you can try to estimate based on how it effects larger subgroups of the population. That doesn't mean you're not at risk, it just means you're less likely at risk or were not measuring a risk factor you happen to be highly susceptible to.
Even run of the mill drugs have rare reactions that can lead to death. Across a large enough population and enough time, those rare reactions will occur. New unknown and unpredicted issues may even manifest.
People like to think in absolutes: I will die from this or I'm immune to this. Most of life isnt discrete (at least at our scale) and falls in some continuum between extremes.
Or, what we've all heard is correct, and that's why the first story of this type has only hit the news several months and over a hundred thousand confirmed cases into the pandemic.
Or it's correct and this person was one of the unlucky ones. The more total people are infected, the more statistically improbable deaths we're going to see.
Looking for something else to blame when you agree that it's "highly unlikely but not impossible" simply shows how unintuitive statistics are.
How many people are known to have COVID in the US? 55,000 officially, probably 3-10x that, let's say 100k for a nice round number.
Is 1 out of 100k a "highly unlikely but not impossible" chance? Sure. So you don't need to assume that there must be other causes in the absence of other evidence.
I'm puzzled by the intense focus on whether someone who dies had a pre-existing condition. It's like people want to convict the person for their own death, make it look like they were irresponsible, as a denial mechanism.
By blaming the person for succumbing to the virus they can fall in to the US-centric mindset of blaming people for their own disfortune, poverty, illness, accident, lack of whiteness, etc.
It's really stupid, unless you are a physician treating cases, to focus this way. It keeps us from dealing with the reality of the pandemic.
Edit: for those objecting to my observation, see the responses linked below, which were the only ones present when I replied. I've seen this pattern often enough over the last few days to realize that it's not simply people seeking information about the nature of the disease, it is something else, more reactionary and emotional.
Huh? It's well documented by now that comorbidities increase the risk of death from COVID considerably. Articles like this make the news because they're fighting the myth that the young and healthy cannot die from it.
> Articles like this make the news because they're fighting the myth that the young and healthy cannot die from it.
Yes, but look at the comments from when I made mine: they were all of the nature of "I bet they had some other problem". Once you've seen this reaction enough it begins to look less like information-seeking and more like denial.
What you're calling denial is an important part of information seeking. When you see an anecdote that contradicts something you believe, you say "either this anecdote or my belief is incomplete". So if you're pretty confident in your belief, it's reasonable to probe the anecdote for potential flaws; it's not a matter of denial but of trying to find the truth.
It's not victim blaming. It's trying to ascertain whether or not young people that don't have a health condition are at critical risk of dying if they catch the disease, which until this story, many believed they were not.
If they already have something like a compromised immune system and die from the coronavirus, then it's not really surprising. if they were perfectly healthy, it's a bit more interesting.
I don't think it's about blaming the victim this time. Instead I think it's about being able to say to oneself, "well, unlike them, I'm basically healthy, so I don't have to fear that the same will happen to me."
It's probably not wise, but it's very understandable.
I don't think that's it at all. It's the 'normal' person being concerned whether they are at risk.
While lots of people 'know old people' or with pre-existing conditions, many people have youngish parent with already passed grandparents, who have trouble understanding why this is a fuss for them, since they imagine that it'll just be a cold (for them). Cases like this one are 'scary' because it shows that they might still be at risk. Which, in some sense, is good if it makes 'normal people' scared enough to actually stay home/self-quarantine.
I really don't think this has anything to do with the "US-centric mindset of blaming people for their own [snipped]".
I think they're related; healthy people often (implicitly) assume they are healthy because they have done nothing wrong to deserve being ill. This then causes them to act with unexamined cruelty towards people who are ill.
The implication of "it only affects people with a pre-existing condition, so it's not a big deal" is "it doesn't matter to me if people with pre-existing conditions die."
I'm 25, and at 23 I had my lung collapse (spontaneous pneumothorax) twice, due to nothing but random chance (according to my doctors). Does that mean it doesn't matter if I die from the coronavirus? Should we stop lockdowns and resume economic activity despite the dangers this virus presents to people like me?
The answer being sought is just how deadly is this virus? Knowing that helps everyone plan, and thus far, mortality rates haven't been very high at all except in very vulnerable populations.
However, should the virus mutate, or otherwise start posing a larger problem to the general public, the calculus of just how under-prepared are we radically changes.
It has nothing to do with blame and everything to do with dealing with the reality of the pandemic. Are we facing an extremely contagious flu, or are we facing an extremely contagious 1918 / Spanish flu? There is a pretty serious difference between the two in terms of preparedness needed.
A mortality rate of 2-3% is "very high". And it's not just "very vulnerable populations". I'm 55, in generally good shape, but I have (medically controlled) hypertension. So my odds of dying are like 5%.
My daughter is 26, and winds up in the ER once a year or so for asthma. What are her odds? My mother is 78, has had open heart surgery, and is overweight and gets almost no exercise. I'm more or less assuming I will never see her again.
"Mortality rates haven't been very high at all" is easy to say when you're not in any way vulnerable.
The question wasn't "are vulnerable people vulnerable" it was "why is there a focus on whether a person might have had another condition?". The answer potentially changes the extent to which our hospital systems are inadequate to treat patients.
Keep in mind that 2-5% is likely way overblown given how little testing has been done. Unless I am misinformed, the Diamond Princess cruise that had been infected and quarantined had a fatality rate under 1%, and that presumably had a more vulnerable population. A more realistic mortality rate is well below 1% https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-a...
In either case, I am actually more vulnerable than the standard healthy young adult, and it is very easy to say that mortality rates havent been high, especially in the context of a discussion over whether the virus might be mutating to become even more deadly than it already is.
If you want to play pedantic with the numbers, you need to be a lot more aggressive with the whys. Italy currently has a 7.2% mortality rate, but... they believe they are undercounting fatalities due to the virus, because the medical system is overwhelmed and many are dying without seeing doctors or being tested/treated.
Needless to say, a collapse of the medical system and an inability to treat those who are sick has a severe negative effect on the survival rate. That's what social distancing is about - reducing the rate of infection so we lower the peaks striking the medical system. If you develop pneumonia and go to a hospital and get put on a ventilator, you could well survive. If you can't get a ventilator because we as a civilization are out of them, well... you'll probably die, either directly from the virus or from opportunistic secondary bacterial infection.
So the numbers may be underestimated as well as overestimated. It's very much a circumstantial question, and when we haven't scaled cases into the millions yet, we haven't seen the worst of what can happen.
Reminds me of the questions people make here in mexico when someone gets murdered: was he in drugs? Was he in as bad place? Surely he was onto something? Was he showing off?
Human brains have to justify things to try to disassociate the bad events with their reality. It is difficult to accept that calamity is very close to them.
Also it’s the standard script gossipy low class people resort to right away. I don’t want to absolve too much of humanity’s standard operating procedure.
Usually I'd agree that focusing on pre-existing conditions is victim-blaming, but in this case there's a nasty braid of fear:
* Some young people believe they're immune and don't care if they spread the disease. Spring break in Florida.
* Some old people are envious of this and looking for reasons it isn't true.
* Other old people are scared for their offspring and ready for their fears to be confirmed.
* Health officials are selling the story that young people are in more danger than we thought to try to convince them to stay home. Again, spring break in Florida.
* Media outlets focus on the rare youth deaths because the above factors drive clicks.
The data from China is pretty clear. Young people rarely notice having COVID, and that even among symptomatic cases the level of death is incredibly low. I know we're all skeptical of Chinese government numbers but their total lockdown and testing regime gives them the unequaled opportunity to say "everybody in this town was exposed, absolutely every person, and here's how things came out." They're the only country in a position to definitively comment on asymptomatic cases.
It's hard to see why they'd fake a risk curve that increases very slowly through young years and then swoops upward in middle age. Something about the Chinese respect for elders? I can't see it.
Here in the West, you get a half-dozen articles about one 21-year-old who died and appears to have had no pre-existing conditions, a similar number about some doctor who died or priest who refused a ventilator, and no articles detailing each of the thousands of older people who are dying.
Our culture is trying to believe that young people are vulnerable. We "want" a more even risk curve.
So... is this ok? We have a weird circumstance where the usual bad science is serving a public health purpose by propagating a probable untruth. Meanwhile, the "everything's fine, it's just the flu" side is working as hard as possible to spread a different untruth that is very dangerous to public health.
Is it morally defensible to tell people on the internet that young people are almost all going to be fine? Not immune, but probably fine?
This is where many of you who are convinced that young people are in significantly more danger start speaking up. "Some young people do, this young person did, no pre-existing conditions, this article says half the deaths are under 50..."
If the population in general had the death rate that we've seen among young people this virus wouldn't be a big deal. That's what matters. Some young people will get sick and die but not in sufficient quantities to overwhelm the hospital and mortuary systems. The deaths of the middle-aged and old are what will paralyze our countries.
You probably won't know a young person who dies. You probably will know an old person who does.
We’ve certainly stigmatized the outbreak. Initially it was straight up racism against Asians, but now we’ve shifted to ‘well you must be an asshole’. It’s pretty standard modern day mutation of American ‘exceptionalism’.
Imagine the news was running a sensationalized story about "Man dies after drinking Diet Coke. Diet Coke can kill you!"
Except then the comments all point out that the man had PKU, and that Diet Coke won't will you unless you have PKU. And that virtually everybody who has PKU already knows they have it. That the typical person has nothing to worry about from Diet Coke.
Would you object to the comments pointing this out? Would you say they're blaming the person who died? Or would you just say that they're contextualizing a very important piece of information that the news is overlooking to sensationalize its story.
The pedant in me says technically the name of the virus "SARS-CoV-2" but lots of people are referring to the virus by the disease name of "COVID-19". Maybe that's why?
The pragmatic side of me says "Yeah, what the heck. It's clearly known"
Edit: Rereading it, the quote is directed at people who are skeptical of it's existence. So it makes sense in context.
No kidding? I've been remembering it as COrona Virus Infectious Disease 2019. I haven't seen a source on this though- just made sense since CoV was established early in the timeline as corona virus.
Yes. It took a while for WHO to name it. They didn't want to call it SARS because it was too frightening- SARS caused a lot of devastation in Asia.
From the WHO website Q and A [1]:
Is COVID-19 the same as SARS?
No. The virus that causes COVID-19 and the one that caused the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003 are related to each other genetically, but the diseases they cause are quite different.
SARS was more deadly but much less infectious than COVID-19. There have been no outbreaks of SARS anywhere in the world since 2003.
I went to the WHO website to document my first assertion, that they chose the name to not cause fear and confusion with SARS, but didn't find it. It used to be right on the front page explaining the virus- they also explained the name.
It seems that anecdotal evidence of young people dying of COVID-19 is the trend of the moment. Not sure if it's just cheap clickbait or the goal is to make younger generations to actually care about social distancing.
The deal is that we are dealing with the power of large numbers. You can cherry-pick whatever case you want to fit your narrative. It does not mean its relevant information.
Anecdotally, my parents keep bringing up this narrative every time we talk on the phone. I've reminded them that while me and my fiance dutifully haven't left the house since last Sunday they've happily gone to the grocery store multiple times, attended a funeral, and had wine at their neighbor's house. They also refused to stop babysitting my niece and nephew until I called my brother and convinced him to stop dropping them off. But no, young people are the reckless ones.
As a parent of a young man. I understand why your parents have these fears. They know what they are doing, but they don´t know what you are doing other than what you tell them. Even if they trust you, this is a deeper fear. You could start lecturing your parents about how dangerous this is, so they are convinced that you are taking it seriously.
As the parent of adult children currently living at home... one of ours keeps going out to be with friends. I understand she needs to get out of the house sometimes, but it's unnerving, knowing the points of contact (she often goes to her boyfriend's house, with his five currently-unemployed roommates).
Then again, she works in a children's health clinic. I know what vector is probably going to bring COVID into our house.
I would really hope that someone working in a health clinic would be more careful than that. Going over to other people's houses is exactly what people are not supposed to be doing.
From my observations, the people who are most flippant about this seem to be boomers and young adults 20-25. I still see groups of young adults on the sidewalks, clearly not roommates, even though our state is in lockdown, and we're right next to a state that's starting to overwhelm their hospitals because of this kind of behavior.
She's back at home temporarily (broke up with a boyfriend that left her in a bad financial situation, moved back home to recuperate). She was planning to move out this summer and move in with friends who were buying a house, but buying a house may not be viable for them now due to a job at risk.
Someone once gave me a definition of family... "If you have to go there, they have to let you in".
On the flip side, I think we're all going to get exposed sooner or later, over the course of the next year or so. I'll just get exposed sooner than ideal.
On the plus side, she may be moving entirely to work from home in the near future, as they'll be closing inpatient services at her clinic. On the minus side, her brother just got a job at a grocery store after losing his retail job at the mall (mall closed), so now he's probably an even worse vector than she is.
It'd be interesting to understand what evolutionary pressures the combined behaviors of population have on COVID-19.
Distancing arguably should create evolutionary pressure towards a weaker, asymptomatic, more contagious virus. And reckless behavior in the segments of population unaffected by the virus may put evolutionary pressure to make it a stronger, but not as contagious virus.
(an uninformed opinion of a software engineer / researcher)...
> Distancing arguably should create evolutionary pressure towards a weaker, asymptomatic, more contagious virus
This doesn't make sense to me. Distancing reduces number of cases and chances to spread infections, reducing chances for successful mutations.
It seems that instead of having multiple strains you will end up with most resilient strain in the end. But that's probably better as you have to fight a single strain then.
Lecturing is a good idea, even more so if you rarely lecture your parents back, which I assume a lot of children don't. This is something I did to my parents and it changed the way they are approaching this pandemic. Social distancing is happening here now and they have respected my thoughts and ideas since they're scared and trust the information I'm supplying them is valuable.
I spoke with my mother recently and we were lamenting how people were completely ignoring the "JUST STAY HOME" guidance. As the call was ending she mentioned how she was about to have her sisters and friends over for wine the next day. To which I replied that she was doing exactly what she was lamenting others doing.
I think most people just assume they are the exception and can be trusted to do this correctly, when in fact the guidance is the way it is explicitly because that is not the case.
I've been hearing "I rather die from Coronavirus than live my life in fear of it" from some at risk people who don't wish to isolate. Which I suppose is their decision. They'll unfortunately change their tack pretty fast when it becomes hard to breathe.
Unfortunately once infected, that risk-taker will infect others and accelerate disease growth rate.
Infecting others who have no option to completely isolate or are just plain unlucky. Some of which will have possibly life-long lung damage. And some will die who would have otherwise survived.
Responsible people isolate, because they don't want to harm or worse, kill others.
It's not about living in fear. We're not quarantined because of fear. We're quarantined because of knowledge - we know how contagious this is, we know what the hospitalization rates are, we know our medical resources will be quickly depleted and we know how to slow the spread until we're better able to respond. The question we need to ask ourselves is why weren't we prepared?
The fear is of the unknown chance that it will be serious for you or someone close to you. I think everyone is resigned to the fact that they'll get it eventually.
Personally, I'm more in fear of having some non-coronavirus related emergency and not being to get good healthcare.
We’re also dealing with the fallout of living in a “post-truth” era, where we as a society can no longer agree with basic facts.
Yes, it’s exceedingly rare to see a case like this, but what’s not rare is seeing the examples of people not taking this disease seriously, even some public officials.
Getting people to cooperate with drastic disease mitigation efforts won’t happen if there’s a probability embedded in that headline. People are doing that in their heads already when they think “this can’t happen to me, so let’s all go to the beach today.”
But that mindset is exactly why we're in a post-truth era. If a news outlet's primary goal is convincing people to do the right thing rather than accurately communicating information, why should we trust that the information they communicate is accurate?
They can, or they cannot. The media lying about the effectiveness of masks for several weeks was “right” in that it probably allowed hospitals to refresh their stockpiles before mass panic buying set in. But it was a lie nonetheless. Same with the “coronavirus is a virus, Purell is useless because it is antibacterial” meme. The media is burning its credibility in favor of noble lies — but at the end, will it be worth it?
Yes, of course it's worth it. The media's credibility isn't a finite resource. It ebbs and flows like everything else in this world. Nothing is as binary as you see it.
If what you say is true we should have seen trust in the media go up and down a lot over time. In fact it's really only gone down, with one exception - in the USA after Trump got elected trust in the media went up amongst Democrats only. Presumably because they realised the media was completely partisan and in their "tribe". Trust amongst Republicans, which like Democrats had been falling for a long time, completely collapsed at that point.
In most parts of the world it's just been one downward slide.
In these events I don't think the media deserve the blame though. They're not helping but they're not pushing a pre-determined agenda, I think. The evidence that we're in the grip of mass hysteria and not a deadly pandemic is growing enormously every day, and much of that evidence actually is being surfaced in newspaper reports. It's just not affecting the overall narrative yet.
But again, you must see the problem here. To consider the media's credibility a resource at all is a post-truth concept. It presumes that the media is targeted towards a bunch of rubes, who've gotta be manipulated towards the goals you and I know are best. The natural result is exactly the trend we're seeing; almost everyone who pays attention says "well, I'm not a rube, so I guess I'd better get my real information elsewhere".
Exactly. Many are the same outlets who also are happy to do the bidding of the Chinese government that has a horrible human rights record, be overtly political/partisan, shill for corporate interests over facts and the best interests of the average person and who regularly moralize instead of reporting. Thanks, but no thanks.
Several decades ago, it wasn't nearly this bad or widespread. Sure, there's always been conspiracies and anti-science sentiments, but the mass adoption made all that crap much more easily accessible to the masses, so it spread like a disease. Instead of everyone getting their news from Walter Cronkite, now they get it from Alex Jones.
Whoops, I left out a phrase. This should read:
"...but the mass adoption of the internet made all that crap much more easily accessible to the masses..."
At what previous point in time could a conspiracy theory reach 25% of the world’s population within a day? When was the last time the U.S. president was espousing conspiracy theories to a global audience?
“Americans love conspiracy theories. Conspiratorial rhetoric in presidential campaigns and its distracting impact on the body politic have been a fixture in American elections from the beginning, but conspiracies flourished in the 1820s and 1830s, when modern-day American political parties developed, and the expansion of white male suffrage increased the nation’s voting base. “
Before the internet, when it was easily controlled through the media what everyone had to think. It was a golden age where one entity decided on the truth and pretty much nobody disagreed to any noticeable effect.
Now more and more people get exposed to more than one viewpoint of reality and are beginning to not blindly trust the media. This leads to people actually having to discuss points that previously only had to be stated, for everyone to believe them or at least to not have lots of people disagreeing showing up and having the opportunity to talk with other disagreeing people.
So we get amusing situations like holocaust deniers getting told it's illegal to do so, which of course only strengthens their belief. But rarely is there somebody showing up refuting, since that takes effort.
That leaves us in a post-truth world, where nobody simply can state something and have everyone believe it. Instead everything that gets questioned needs to be discussed, like "Do vaccines cause autism?" or "Are there more than two sexes?". Kind of like the difference between having a King and having democracy.
Personally, I blame the media for being verified liars for the loss of trust in them. Everyone can be wrong on occasion, but it takes a liar to stick to their guns after being proven wrong. I mean, did anyone ever actually believe that a "magic" bullet killed Kennedy?
Do you have any evidence to show it’s worse than it ever was?
I guess you can't measure truth in an absolute sense, but you can measure people's perception of it, and trust in institutions - especially the press - is at all time lows.
I completely agree with us being in a "post-truth" era. And both sides are responsible for this. You have everything from people denying basic biological science to everything else in between. To be fair, some people are aware of the risks are are willing to roll the dice. Keep in mind that some of the elderly who are stubborn grew up before we had many of our modern vaccines such as measles etc.. Some of the really old ones even before antibiotics were around.
I know some who are of the opinion that they could die at any point anyways so they would rather just live life. Some also worry that prolonged quarantines could damage the country and decimate small businesses along with the middle class. For them they would rather take the risk and sacrifice for a better future for their kids. Of course there are others who are self centered jerks, but the point is that there are good arguments on both sides.
Also, with post truth... A lot of people who were, up until this pandemic started, denying basic biological facts. Some of that ideology had even begun to makes its way into the major research and medical schools. That doesn't help with credibility when the same individuals start saying that everyone needs to quarantine.
The same people who were censoring people based on ideology, at times over facts, are now claiming that they are censoring "mis-information". Once again, many people are naturally skeptical. In many ways this is one of the natural result of "post truth" fiction and ideology being favored over facts. We reap what we sew.
I just want to point out that the public health authorities and the news media in the United States have completely lied about the efficacy of face masks.
Their goal was to preserve a dwindling stockpile of N95 masks, and in the process they told the public that face mask of any kind don't help prevent the spread of the disease and this is patently false.
so let's keep this in mind before we get in our high horse about people not listening to the media and the government because of this crap. The R0 of the disease is much lower in countries where everyone is wearing face masks of any kind.
Everyone on reading this should Google the fact that that homemade face mask made out of cloth are actually highly effective in reducing the spread of this illness.
I started wearing a well-fitting home-made face mask that completely covers my nose and mouth after reading papers I found on nih.gov and who.int that talked about their effectiveness.
I meet doubters all the time who tell me that "home made masks make it worse" when the masks (not the n95 respirators) worn by nurses, that are loose fitting but prevent particles of saliva from entering nose or mouth are generally accepted as helpful.
Handfuls of cases are enough to discredit the belief (perhaps not common on HN, but common in many other places) that young people can’t get seriously ill or die from it.
Young people can die in a car crash, too, but that doesn't prevent most people from driving anyway. As long as it's only a small chance, nobody will pay it any mind and keep agreeing, that young people won't die from this.
I mean, there are even cases of young people just randomly dying without any visible cause. Yes, not only the elderly can die just like that. No one really pays this any mind either.
There haven't been any common beliefs or narratives that young people couldn't die from driving or couldn't die without visible causes. On the contrary, the common narrative about driving is that young people are disproporionately dying due to inexperience and reckless behavior, and this narrative is true, more young people die in car crashes than old people. https://www.iihs.org/topics/fatality-statistics/detail/teena...
There have been reports that young people without other complications are not dying from coronavirus. That's why reports of someone young and healthy dying of COVID are getting attention, because it runs contrary to what has been widely reported.
It is relevant information when the previous narrative was that 0 young people had died of COVID, and that the “only” old people who had died had co-morbidity factors.
BTW, this isn’t “anecdotal evidence”. This is an actual, verifiable data point.
Maybe doctor's and research scientists should present this as a data point instead of instead of yorkshirecoastradio relaying some facebook posts.
While this narrative may fit what is perceived as a good cause, do we want it at the expense of truth? Do we want every story to first be questioned, "what are they trying to get us to do by telling us this?"
I’m confused by that, what do you mean? What here is untrue? What is the “truth” that should be reported here? Someone died of COVID, someone who was young and didn’t have other health factors, which is abnormal compared to what we’ve heard about nearly all other cases of COVID death so far.
Nobody claimed this is somehow a huge number of cases, and I think it’s well understood - and not being challenged here — that old people and sick people have much, much higher risk factors for dying of Coronavirus.
But isn’t it worth knowing that the risk distribution does not start at 70 years old, that it starts at 18 and goes up?
Have you put this level of skepticism on the news reports about old people dying?
Those details will be proven true or untrue by more official sources, and probably today. My point was not that I know they're true, it's that they are facts that can be checked. But I have no specific reason to be more skeptical of this report than of any other COVID deaths I've read about, do you?
Yes. Such reports also deserve to be examined skeptically.
The big problem surfacing at the moment is deaths being reported as 'caused by covid' when they're in reality deaths that were about to happen anyway, and the victim happened to be infected e.g. cancer sufferers who were already in terminal decline.
There's increasing evidence that the excess death rate - deaths that truly wouldn't have happened if not for COVID - might be nearly zero.
Anecdotal doesn’t mean a lie. Anecdotal means n=1, or more broadly, trying to extrapolate from a narrow sample to draw a broad conclusion. This meets the exact definition of anecdotal.
You’ve moved the goalposts to say that if it kills even one young person then young people generally are at risk. The claim was never that zero young people have died. Just vanishingly few.
DR. BIRX (March 23, 2020):
"In the mortality data that has been provided to us, there has been no child under 15 that has succumbed to the virus in Europe. There was the one 14-year-old in China. So we still see that there is less severity in children, and so that should be reassuring to the moms and dads out there.
To Generation Z and to my millennial colleagues who have been really at the forefront of many of these responses: Less than 1 percent of all the mortality is less than 50. And so this is, I think, also a very important point.
That doesn’t mean that individuals won’t have severe disease. So still 99 percent of all the mortality coming out of Europe, in general, is over 50, and preexisting conditions. The preexisting condition piece still holds in Italy, with the majority of the mortality having three or more preexisting conditions."
No, that is incorrect. It has nothing to do with the size of the sample.
"Anecdotal evidence is evidence from anecdotes: evidence collected in a casual or informal manner and relying heavily or entirely on personal testimony."
"Anecdotal" also means data that is not verifiable. In this case, the data is verifiable even if the news spread via Facebook.
> trying to extrapolate from a narrow sample to draw a broad conclusion. [...] You've moved the goalposts to say that if it kills even one young person then young people are generally at risk.
I did not draw a broad conclusion, I stated clearly in this thread that this is one sample, and old people are at much higher risk. So did the article. You are constructing a straw man argument that doesn't accurately reflect or counter my point of view.
As long as your view is that young people are at vanishingly low risk of dying from this disease, and that individual reports of young people dying are essentially irrelevant and a play on emotions, than I suppose we vehemently agree on the facts.
Whether zero people worldwide under 15 have died or 10 people worldwide under 15 have died doesn’t meaningfully change the obvious conclusion, when the number of cases is several hundred thousand.
It seemed like you were saying that one child dying from COVID was relevant because someone claimed zero children died. Anyone claiming literally zero children have died from COVID are uninformed. The fact remains that children almost universally do not die from COVID.
People think that a low percentage of an outcome means it won't happen. They are wrong.
And exactly as you say: if there is a large population of infected people, the absolute number of people who fit in these small percentage tragedies is actually large.
It may be inevitable either way. 100 years ago life expectancy was 46 years. Today it is well into the 70's. Before that, for most of human history that rate was much lower. Up until now, for the past 80 years (post antibiotics) the human race has been really lucky, but perhaps nature is deciding something different. I hope not, but I do wonder.
It has been refuted already, that the life expectancy was this low, with the explanation for the error being given as stillbirths affecting the average.
As far as I know, even 500 years ago it wouldn't have been that difficult to reach age 70 once you've survived your childhood.
I'm not sure what that has to do with my observation that "small percentage" events do occur in small percentages, and that they do occur in large absolute numbers when multiplied by sufficiently large numbers. My point is we shouldn't be dismissive about it not going to happen to "us", because it will happen to nonzero amounts of "us", and that's kind of the point of the mathematical reasoning.
But to your point: Someone else is disputing you on this, but I would say even that it's irrelevant what life expectancy was 100 years ago. Today in the present reality we are talking about mostly preventable death. I don't think we should be so arrogant to say that we can prevent misfortune all the time, but we're not talking about inevitability either. We have medical technology and progress for a reason.
In the US, 33,000 people a year die in car accidents. That is an actual large number. But statistically there are other factors that determine the likelihood that you will be in that accident and for most statistically it is a low number, or low enough to be considered an acceptable risk.
Sure an individual story of a horrific crash, the pain and suffering is heart wrenching. News outlets love to play that up. Yes, it could also be you, but when you put it into a larger picture it tells a different story.
Then there are the stories of airplane crashes. They get massive coverage yet, statistically, planes are safer than being in a car.
It sounds like you've understood it correctly. The data strongly suggests that COVID-19 isn't a deadly disease for otherwise healthy people, and any apparently healthy young people who die from it are most likely "errors and odd cases". (Although framing it that way could imply too strong of a conclusion - comorbidities in the study include hypertension and diabetes, which aren't exactly rare.)
The hospitalization rates for younger people in Italy and NYC don’t paint such a rosy picture though. While deaths are rare, it’s still a very nasty disease for many younger people, and we don’t have much data yet on potential long term effects.
No, we don't, but what people are interested in here is the lockdowns and when they can end - totally or partly.
The hospitalisations of young people all so far appear to be exceptional cases. This is also true of the reports of "fully healthy people". So far every case I'm aware of like that has turned out to be a lie. It implies the lockdowns could be restricted to the elderly and the frail.
In one case in the UK a woman under 40 was admitted to ICU with no pre-existing health conditions. Worrying, right? She'd been taking 8 ibuprofen a day. Ibuprofen suppresses the immune system and 8 per day is a staggeringly high overdose. The maximum dose for an adult is 4 per day so she was killing her immune system completely.
In another case there was a death of a young person in Spain, reported as no pre-existing conditions. After the death he was diagnosed with an unrecognised leukemia.
It's very likely given how extreme the statistical evidence is that basically all such cases have some sort of mitigating factor. Young people who are healthy and not doing stupid things don't seem to die or even get critically ill.
"The hospitalisations of young people all so far appear to be exceptional cases."
This is just wrong. The numbers are changing all the time, but as of a few days ago, 38% of hospitalized coronavirus patients in the US were between 20 and 54.
This is insane -- Median age of 60 for diagnosed patients?
What this indicates to me is that Italy was testing only the worst patients. This whole scare to me reeks of sampling bias. We only test the worst patients for covid 19 which ups the mortality rate.
The truth is -- people who are at risk should social distance themselves rather than the general population. We want herd immunity to develop for this disease -- that means having young healthy people be exposed to it.
Is that realistic? Many of the most vulnerable people are in nursing homes with a lot of younger staff, or else they have to go to the doctor/hospital frequently for other reasons. It’s hard to see how it won’t end up infecting a huge number of these people if we let it spread at the max rate.
Absolutely there is huge sampling bias in testing. This is true over the entire world.
No one knows what percent of the broader population in Italy have been infected, asymptomatic or otherwise.
We can hope the number is closer to 1 million or 10 million than it is to 100,000. Because you can’t hide the severe and critical cases, a wider incidence means a lower severity. But we have no scientific data on this absolutely crucial statistic.
The only proxy we have is the positive rate for tests that are performed. Recently it was reported that the positive testing rate in NYC was as a high as 28%. This implies that the general population infection incidence is extremely high, e.g. several million cases in NYC. Ideally you would want to see a positive test rate closer to 1-3%.
It is trying to counter misconceptions that COVID-19 is harmless to young healthy people based on misinterpretations of guidance that elderly and those with preexisting conditions are most at risk. Just because younger people are at less risk doesn't mean they have no risk. While the numbers have been hard to pin down, early data from China showed that more than 10% of people in their 20s-40s with the disease had critical cases. Some other studies outside China have put that number at 15-20%. The number of severe cases is much less, but not 0.
With proper treatment nearly all of those critical cases will survive. But if the health care system becomes overwhelmed that may no longer be true.
It is trying to sink in the idea that young people are not invincible to COVID-19 and that they need to practice social distancing, if not for the benefit of society as a whole, then for their own self benefit.
I think I read that statistic differently - that of the critical cases, 10-14% were between 20 to 40.
Not a per-capita number. Not a percentage of young people - a percentage of sick people. Folks in that wide age bracket are around 30% of the US total population. The old - 15%?
It's easy to find an article like this very frightening, if you're young and healthy and have been thinking there's thus no chance you'll die of COVID-19 if (more likely when, tbh) you get it. I already have it, so I totally understand that.
But this is the first time we know of that anyone young and healthy has died of the disease, and we're over a hundred thousand confirmed cases in. Even assuming the current understanding is accurate, and this person didn't have some undiagnosed comorbidity, that's on the order of a .001% chance of dying.
For a pandemic disease, those are very good odds.
Yes, it's frightening, and in frightening times. But it's important to keep a sense of perspective. After all, stressing out over this can only weaken your defenses.
I'm sure there will be more such cases. As other folks here are pointing out, sometimes that's just how it goes, even for somebody who "should" be in no danger. Sometimes 20-year-olds die of the flu.
But you still don't help yourself by getting into a tailspin over it. If you're sick, that just depletes your energy and makes it harder to take care of yourself so you can get better. If you're not, the same stress weakens your immune system and makes it harder to stay well.
> this is the first time we know of that anyone young and healthy has died of the disease
It may be the first one that’s been in the news here, but what about in China? I’m wondering if there have been any cases there, that haven't been officially reported in the news.
We can wonder all day about any number of things. Does it help, though? Does it make you less likely to contract COVID-19, or more likely
to have a mild case if you do get it?
Your odds of that are pretty good, by the way; based on what apparently reputable information I've found, assuming no risk factors like advanced age or comorbidity, it's about 85% likely you have an uncomplicated disease course, with no serious symptoms and requiring no medical support to resolve.
What beneficial influence on those already good chances do you expect to see by worrying yourself halfway into a panic, about something over which you have no control in any case?
You don't mention anything about potential (permanent) lung or organ damage. That seems to happen though I don't know if there's a clear picture yet of how frequently it occurs.
> What beneficial influence on those already good chances do you expect to see by worrying yourself halfway into a panic, about something over which you have no control in any case?
I am amazed by how often people will accuse others of being panicked or hysterical in relation to covid-19 when they've demonstrated no such traits.
Pretty much everyone who took it seriously earlier on, got told they were panicking or being hysterical, when it was just that they were informed of what was coming and took it seriously. Taking something seriously does not equal being panicked.
Where is the panic in this thread you are referring to?
While we're here because it mentions a younger death, it is way less about your (or my) chances and more about where we will spread it. At this point, I have seen it first hand, a spring breaker coming back, carrying it for a few days, and interacting with many people in office settings.
Just because the virus doesn't kill doesn't mean you aren't being used.
Not exactly, there's factors pushing that way down, and some up.
We shouldn't look at [mortality /infected numbers], but rather at [mortality / resolved cases]. Given the exponential growth, most infected occurred very recently, and their death may still be pending, bound to occur in the coming weeks. For example, suppose an infection takes 1 month to resolve. If in January 100 get infected, in February 1000, and in February all the 100 infected from January have died, the mortality rate isn't 100/1100, it's 100/100.
Instead, looking at just the resolved numbers: either death, or recovery, are more accurate. This is still not fully reliable given the cases resolving in death or recovery may have different timing, but it's better than just looking at gross infected rates. This pushes up the 0.001% figure.
More importantly though, our infected numbers are way, way off. Probably 10 times higher. Most countries only test people who are hospitalised. The rest must stay home. There's no country that I know of that is going to people's homes to test people at scale. And there's only a few countries with a drive-through testing kind of model. Given there is evidence that substantial percentages (perhaps 50%) are asymptomatic, and that weak and mild cases aren't being tested either, the true infected numbers are way worse. (which pushes down your 0.001% figure).
This is not even close to "first time we know of that anyone young and healthy has died of the disease", even though such diagnosed & reported cases are relatively rare.
Even if you like those "very good odds", do you really think it is smart to risk playing Russian Roulette at 1/1000 odds for a pizza party?
More critically, even if you like those odds, all the people you meet when you fail to maintain distance, wear PPE, etc. did NOT knowingly decide that those odds are OK for them.
The hospital resources consumed by you or those you unwittingly expose will also prevent treatment of many completely unrelated accidents & health issues, e.g., we now have examples like neurologists staffing ERs, which means their neuro patients get punted.
The sense of perspective to maintain is not "this isn't a big deal", but that this is an exponentially growing deadly threat to a significant portion of the population, and every person even those at minimal personal risk to themselves need to take on the larger responsibility of helping the society survive.
I'm coming at this with the assumption that the people I'm talking to are already doing the right thing in that regard. People who aren't taking it seriously enough by this point seem pretty unlikely to listen to anything I say.
The survival rate with treatment isn’t the important factor though, it’s survival rate without treatment. If you show up at the hospital with covid and there aren’t any ventilators or beds for you, you’re rolling the dice whether you’re 17 or 70.
Or maybe you’re diligent and you haven’t left the home in weeks and one day you slip and fall in the bathtub and break a bone. How long until an ambulance shows up, if at all? How long until you have surgery, if at all? And then you catch covid anyway.
We have a sort of famous person in the Netherlands of 39y/o, he vlogged from his bed on a breather about his past 8 days of almost dying. That did a lot for awareness in my country I feel.
People haven't been hammered with it because it's background cultural knowledge that's never really questioned. I've never met anyone below the age of 60 who acted even a tiny bit scared of the flu, except for a few people who've personally had a severe case before and parents with very young children.
This type of Virus can cause respiratory failure by infecting the central nervous system even without infecting the lungs significantly. Latest interesting theory I’ve seen is that cases like this young woman (if truly otherwise healthy) could be because of this CNS disruption.
It seems the Spanish flu first targeted old people, and almost disappeared during summer, before returning during fall and targeting young people. I hope it won't be like that this time.
Biased as an immunologist, but this sounds like HLA type differences. The cells chop the virus proteins and stick them out using MHC1 to notify the immune system. This response is partly determined by genetics (HLA TYPE) and if we cluster outcomes vs HLA types we could learn a model to predict who’s gonna have worse outcomes. Could help with triage if it were a decision tree model
I hope these kinds of articles go viral. I know too many people about that age that aren't isolating and distancing. I don't care that it's sensational if it saves some lives
This is a very rare (in terms of percent) outlier for now. But as the first big wave comes and health care systems are overloaded this will become normal. Even as young people's lives are saved by triaging and letting old people die. Hospitalization is required in almost 30% of cases of 20-54 year olds and 5% of that is critical.
If it takes abusing the properties of huge numbers to get younger people to wake up then do it. Because pretty soon this isn't going to be rare.
Bruce Aylward, senior adviser to the WHO's Director General, in [1]:
One of the things that terrifies me now is, as this is spread in the west is, there’s this sense of invulnerability among millennials. And absolutely not. Ten percent of the people who are in [intensive care units] in Italy are in their 20s, 30s or 40s. These are young, healthy people with no co-morbidities, no other diseases.
We don’t understand why some young healthy people progress to severe disease and even die and others don’t. We don’t have clear predictors.
On what planet is someone in their late 30s-40s considered young? 40s is prime midlife crisis age for crying out loud. Lumping them in is a clear attempt to push a narrative.
Without a proper PM it’s hard to know, when a 20 something footballer died in Italy it was initially without pre-existing conditions then some results came back and they found he had a undiagnosed leukemia.
However even without pre-existing conditions there is still a non-zero chance of complications that could result in a fatality regardless of how low the chances are.
This both means that people shouldn’t be careless but it also doesn’t mean that the news should abuse this to spread irrational fear.
Comments like this:
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"Clinicians who care for adults should be aware that COVID-19 can result in severe disease among persons of all ages," said the report, published on 18 March.
Serve little to no clinical value, clinicians understand very well that there is always a chance; however it is quite clear that currently the likelihood of younger patients to die is still extremely slim compared to the current high risk groups which includes pretty much anyone over 60.
The number of deaths in the 18-24 group specifically is still a rounding error.
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