The morbidity rate is around 5%. In locations where they can keep the ICU beds from being overwhelmed, the mortality rate is low. In locations where the ICU beds are overwhelmed, the mortality rate goes up considerably. It all comes down to how well the system can respond to the load of people needing substantial medical care.
The main problem is the number of people with very bad symptoms (for example that need ICU). If there are enough ICU, then the mortality rate is like 0.1%. If there are not enough, the mortality is like 5%. (The numbers are difficult to measure, so they are only estimations.)
Now they have added the ICU overflow, that is very important for the mortality rate.
When you can have an ICU bed your chances are much better. There's a very steep inflection point when the hospitals reach capacity. Right now we're highly provisioned so it makes sense that the numbers show as less deadly.
The main take away is the infection rate is not linearly correlated to the death rate.
On the other hand, that depends on ICUs being able to manage capacity. As the infection rate goes up, the death rate can go up as less of those improved treatments are available. Also, as infection rate goes up, you get side-effect problems where non-urgent but necessary treatments (like cancer surgeries) are deferred.
We have enough data from closed experiments (Diamond Princess) to say that COVID sends 5% or more to the ICU. That’s the number that matters right now, not CFR. Fatality rate itself is much more dependent on whether the ICU beds are full (Italy, Iran) than anything else. Unfortunately, beds are about to be full in several US cities.
The death rate is low because we have managed to keep it somewhat under control. If the ICUs fill up, the death rate for all age groups will greatly increase.
Deaths are partly unavoidable, but they're also partly avoidable because if hospitals have ICU /ventilator and bed capacity the death rate goes down. Once they're overrun then the death rate spikes.
1) 37% of ICU beds for Covid means about a 50% increase in ICU patients.
2) If you go into the ICU for Covid you're probably leaving via the morgue. The survival chance for a Covid patient in the ICU is a lot lower than the typical ICU patient.
Three years ago, 0% of ICU beds were used for COVID patients. Now it is 37%. If ICU admission correlates with risk of death, and those beds would have been empty otherwise, or used for lower risk patients, a 40% increase in deaths seems reasonable. Certainly not a rigorous analysis, but it passes the smell test.
The problem is that the number of people who need intensive care is quite high (10-20%) if good health care can be provided to them the mortality stays low, however, if the hospitals are overrun a lot of people would not get it and could potentially die (yes even younger people). And trust me no health care can survive a 300% spike in people needing ICU. So it is not that harmless.
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