1503 replies to this topic

[ymc]

Another update for the mortality rate based on deaths and recoveries only:

 

Hubei: 2761/(2761+31187) = 8.133%

mainland China outside Hubei: 109/(109+10441) = 1.036%

Rest of the World: 109/(109+531) =  17.03%

 

Netease is the source for China data. Wiki is the source for RoW data.

 

As we can see, the Chinese data improves while the RoW data worsens significantly.

[xEva]

How did you determine that 5% need intensive care? We get conflicting figures out of iran, around 25% died according to a couple reports then the figures changed. Nothing out of china is reliable. 

 

 

Back to these 5% again. I just happened to see the latest Diamond Princess numbers. Among 705 positive cases, there are 6 deaths and 36 are in intensive care. 36/705 =5%. But assuming that the 6 deaths occurred in ICU, that makes it 6% -- not much of a difference, especially taking into account an older cohort.

 

Re Iran, their data are also in line with the Chinese figures, if we assume that only those with serious symptoms were accounted for (coz they sought medical care). According to the Chinese, that should be 20% of all infected. A quarter of serous cases died (presumably due to inadequate ICU resources in heavily sanctioned Iran). That would be 5% of all.

 

And so (assuming that only 20% with serous symptoms make the Iranian statistics) both Iran and Diamond Princess are in agreement with the Chinese figures.

 

(to remind you again, Chinese say that 80% have mild symptoms, 15% get it bad and 5% require ICU)

 

 

What's worrisome now is the Italians. Out of 1128 cases, they have 29 deaths with 105 currently in ICU. That's almost 12% instead of 5%. From what I've heard about how Italians come up with  their statistics, they start with those who seek med care and then test their contacts (who mostly have mild symptoms and stay at home, with med personnel checking on them daily). Still, the identification of cases starts with people in serous condition, while those with mild symptoms (and their contacts) remain at large, unaccounted. I think this factor may be skewing  the Italian figures.

Edited by xEva, 01 March 2020 - 06:50 AM.

[xEva]

https://www.youtube....h?v=2kj3HNoIuy4

 

gee, if that's what it takes, this is another reason to get it over with sooner rather than later. Then you could skip this sort of preparations. I mean, it's fun to play survivor games, especially after you have spent decades getting ready but -- hey, they talk as if it's 25% death rate or worse, you turn into a bloodthirsty zombie.

 

A 91-y.o. woman I talked to said, "15% death rate? This means 85% recover. If it were the other way around, I would start worrying."

[Mind]

For reference here are a couple past discussions about other viral outbreaks. You will find it uncanny how similar the discussions are. Comparing it to the 1918 flu. Wild speculation. How to protect yourself. Unreliable data. Where will it strike next, etc. 

 

https://www.longecit...bird-flu/page-1 (bird flu)

 

https://www.longecit...ne-flu-anybody/ (swine flu)

[adamh]

These are Chinese figures. 80% have mild symptoms, 15% get pretty sick and 5% require intensive care. 

 

I know people mistrust the Chinese figures, but they are in line with the Diamond Princess case. I'm not gonna look for the exact numbers now, but from what I recall, they had ~4K passengers and crew, of those ~700 tested positive and, despite most passengers being older, there have been around 7 deaths so far. I think the lower number could be attributed to an excellent care they got and that the passengers as a whole were an affluent crowd (i.e. well nourished and in generally good health).

 

re: "Could it be that its better to get it early while treatment is available than to get it later when none is to be had?"

 

Just my thought a few days back! Take the plunge and get it over with, while good care is still available. Otherwise the anxiety is killing me Presumably, after that one is immune and can just skip all the turmoil -- and it will last for over a year (!!)

Yes, everything seems to come back to the chinese figures and the chinese have demonstrated that they will always lie if its in their best interest. China is not an open country its a dictatorship and all news is tightly controlled. They would want to give cheerful figures showing that its not so bad, that its going away or getting better. They want people to go back to work so the economy does not collapse completely.

 

Independent reports out of china all seem to say the authorities are downplaying everything. Another factor is they do not have enough testing kits so when someone dies they are simply taken to the incinerator rather than becoming a confirmed corona victim.

 

"What's worrisome now is the Italians. Out of 1128 cases, they have 29 deaths with 105 currently in ICU. That's almost 12% instead of 5%"

 

Yes and the iranian numbers were a lot worse before they "adjusted" them. Iran too is a dictatorship grimly holding onto power. The diamond princess case is odd, first of all they were quarantined right away since they had come from china. They no doubt had a few cases on board but may have been early cases not showing symptoms. 

 

What we don't know yet for sure, among other things, is how long is the latency period, when are they infectious after getting the virus, and how long until symptoms go away or patient dies? If diamond princess had one or a few new cases and the others contacted it during quarantine, they have not had time to reach end stage. May not have had time to show symptoms, some of them.

 

I also question the assumption that children will not get it. Were all the cases and deaths broken down into age groups? They say primarily the aged and sick but children historically have been among the victims of any plague or disease. Exceptions being cancer and some genetic diseases, things like obesity and diabetis but those are not communicable

 

The italian cases are worrisome because they are an open society and report some 2.6% deaths and 12% in icu. ICU patients will die without medical care and some will die with it so when the hospitals can no longer treat, will the death rate be 12%?

[adamh]

Here is a story claiming that it does strike asians more so than blacks or europeans. Good news if you aren't one of the bad groups. It also says men are more likely to die than women. The reason they give is a certain receptor found mostly among asian populations. They also have some genetic differences which make them more prone. Smoking too seems to be a factor which makes sense since it damages the lungs

 

https://www.eturbone...sians-revealed/

[Mind]

People are wondering about the Italian situation. Early on, all of the fatalities we 80+ years old. Is that still the case. If so, I wonder if the virus struck in a retirement community or nursing home first.

 

I don't trust much info from Iran and China.

 

Focusing exclusively on the U.S. and the data so far, it would seem very likely that it is not as bad as so many people are promoting.

 

2 people have died in the U.S.. Both were either "seriously ill" or had "underlying health issues", depending upon which source you go to.

 

To me it is blindingly obvious that the virus has been spreading around the U.S for weeks now. How else to explain numerous cases popping up "surprisingly" with "no connection to travel." It began in China in December and millions of people traveled freely out of Wuhan. Travel from China to the U.S. was not restrained until the end of January! The west coast of the U.S. has a significant Asian population.

 

Over the past month, the Corona virus has been spreading rapidly across the U.S. People have been chalking it up to the flu. No hysteria - because everyone is familiar with the flu - it has killed thousands already this year in the U.S. - like usual.

 

I might even be a super-spreader of the Corona virus. I traveled in early February, through 2 international airports and I attended a wedding with many people who traveled from Brazil, Turkey, and Vietnam (through international airports). I caught a significant respiratory illness that lasted almost 3 weeks. I only took one day off work. Many of my coworkers caught it (not sure how to prevent that because it is unrealistic to take 3 weeks off from work - just to prevent the spread of of the cold/flu). Some people at a I Church I attended got the same illness (most likely - same symptoms). I thought about getting tested, but you know I think panic is worse than the virus.

 

That is what it looks like to me, just seeing things happening in the U.S. Maybe it will get worse, but right now it just seems like a bit more severe version of the flu.

Edited by Mind, 02 March 2020 - 07:27 PM.

[Blu]

These are Chinese figures. 80% have mild symptoms, 15% get pretty sick and 5% require intensive care.

 

I read a paper of Bonn University hypotizing 60-70% of people being affected during the next 2 years.

If a 5% needs intensive care for 2 weeks, then in my country - with one of the best public healthcare systems in the world - we'll need about a 500% increase in intensive care beds. Which just can't be done. We can provide room and logistic (cleaning, food, etc.). We maybe can provide medicines and technologies. Yet we cannot provide medics and paramedics enough.

That's a huge problem. We can't provide this numbers for intensive care. Of course, some care is better than no care - but the numbers could end being overwhelming.

 

I can't start to imagine what could happen in Africa or South Asia.

[ymc]

People are wondering about the Italian situation. Early on, all of the fatalities we 80+ years old. Is that still the case. If so, I wonder if the virus struck in a retirement community or nursing home first.

 

I don't trust much info from Iran and China.

 

Focusing exclusively on the U.S. and the data so far, it would seem very likely that it is not as bad as so many people are promoting.

 

2 people have died in the U.S.. Both were either "seriously ill" or had "underlying health issues", depending upon which source you go to.

 

 

Six deaths now. If 2% death rate, then at least 200 cases are not reported.

 

Often, deaths are likely to be a more accurate count than cases because doctors are not likely to dismiss infected lungs in CT scans among the dead people as non-cases. 

[ambivalent]

2 people have died in the U.S.. Both were either "seriously ill" or had "underlying health issues", depending upon which source you go to.

 

To me it is blindingly obvious that the virus has been spreading around the U.S for weeks now. How else to explain numerous cases popping up "surprisingly" with "no connection to travel." 

 

 

I wonder though (purely guessing) if the incubation period might be a function of immune function. It would make some evolutionary sense I'd had have thought - this paper refers to that period between infection and immune system detection as the stealth phase - the weaker the immune system the less stealthy the virus would need to be, surely? If true, it would seem reasonable those with weak immune systems would display symptoms before those of the healthier immune systems (say from abroad) that had infected them - it is a long incubation period.

Edited by ambivalent, 02 March 2020 - 11:48 PM.

[xEva]

I read a paper of Bonn University hypotizing 60-70% of people being affected during the next 2 years.

If a 5% needs intensive care for 2 weeks, then in my country - with one of the best public healthcare systems in the world - we'll need about a 500% increase in intensive care beds. Which just can't be done. We can provide room and logistic (cleaning, food, etc.). We maybe can provide medicines and technologies. Yet we cannot provide medics and paramedics enough.

That's a huge problem. We can't provide this numbers for intensive care. Of course, some care is better than no care - but the numbers could end being overwhelming.

 

I can't start to imagine what could happen in Africa or South Asia.

 

well, according to this piece by the Guardian, you are better off in Poland than in England: Coronavirus: England only has 15 beds for worst respiratory cases. NHS says system will struggle if more than 28 patients need artificial lung treatment. Count your blessings

 

Re Africa, this being a 'cold' virus, it should not fare as well in warm weather. The impact in warm climates should be less.

Edited by xEva, 03 March 2020 - 03:02 AM.

[Daniel Cooper]

 

To me it is blindingly obvious that the virus has been spreading around the U.S for weeks now. How else to explain numerous cases popping up "surprisingly" with "no connection to travel." It began in China in December and millions of people traveled freely out of Wuhan. Travel from China to the U.S. was not restrained until the end of January! The west coast of the U.S. has a significant Asian population.

 

 

 

China seems to have become aware of the virus in mid December and reported it to the WHO in late December.  That would mean that the virus was running around no later than mid-October and probably earlier than that.

 

Give that a large number will be asymptomatic or have only mild symptoms, there must have been cases of infected Chinese nationals traveling for a good three months before anyone really knew what was going on.

 

I'll bet there were a few cases in the US before the end of 2019 personally.  Certainly by some time in Jan 2020.  

 

This virus was never containable.  I see a lot of people complaining about the US response and believe me, I'm no fan of the FDA/CDC, but there was literally nothing to be done to stop this.  At best maybe you might slow the progress of the spread so that your health care system isn't completely overwhelmed at one time.  But I'm even doubtful of that.

 

So far no country has been successful containing this. Which is exactly what you'd expect from a highly contagious virus that is transmissible while patients are asymptomatic.  Stopping covid-19 would be like trying to stop this year's cold virus, which is basically what this is, albeit a cold virus that makes maybe 15% of those infected severely ill and kills 2 ~ 3%.

[Mind]

Just to keep the 6 deaths in the U.S in perspective. Sadly, the virus struck a nursing home. All of the victims at the nursing home were old and in ill-health (5 of them). The other man in his 50s was alos seriously ill before contracting the virus.

 

This is why I have been arguing for focusing our time and energy toward protecting/supporting the old and vulnerable - especially since it is essentially impossible to contain it. I think extreme quarantine measures will do more harm than good at this point.

[Mind]

The death toll is up to 9 in the U.S. Now change in the case profile, all but one were from a nursing home for elderly people with health problems. The other fatality was a man in his 50s with "health issues".

 

I can't find the case profiles of Italian fatalities, but the first several were all 80+ years old according to news reports. I wonder if the Italian situation is the same as in the U.S. (so far).

[ymc]

 

 

This virus was never containable.  I see a lot of people complaining about the US response and believe me, I'm no fan of the FDA/CDC, but there was literally nothing to be done to stop this.  At best maybe you might slow the progress of the spread so that your health care system isn't completely overwhelmed at one time.  But I'm even doubtful of that.

 

So far no country has been successful containing this. Which is exactly what you'd expect from a highly contagious virus that is transmissible while patients are asymptomatic.  Stopping covid-19 would be like trying to stop this year's cold virus, which is basically what this is, albeit a cold virus that makes maybe 15% of those infected severely ill and kills 2 ~ 3%.

 

Macau is doing the best job so far in containing the virus. Their case number remains at 10 for one month now. Now their effective case number (ie cases-deaths-recoveries) is exactly one. They allows everyone in except for people from high risk areas, they need to undergo 6-8 hours check-up at the border to prevent missing people who took tylenol to lower body temperature. Economically, they shut down casinos and schools for two weeks. Macau also encourage everyone to wear masks to reduce the chance of transmission from asymptomatic patients. Now casinos and schools are re-opened.

 

Singapore can be counted as the second most successful. Its effective case number remains in the 30s for over a month. Economically, it is business as usual. They ban everyone who was in the high risk areas for the last 14 days from coming in. They discourage people without symptoms to wear masks.

 

Hong Kong can also be counted as a success as its effective case number remains in the 60s for over a month. Economically, work from home is encouraged and large events are suspended. Everyone from the high risk areas for the last 14 days need to be quarantined for 14 days (effectively bans people from high risk areas). Everyone is also encouraged to wear masks.

 

I think US can start with copying the success stories of these regions/countries for cities near international airports. I think the Singapore model is the one that is the easiest for US to copy. However, Singapore is hot literally but US is not. Therefore, I would suggest US to encourage everyone in cities near international airports to wear masks.

 

All three regions are testing people extensively and quarantine patients' close contacts. I think at the beginning of an epidermic, the cost of doing this is acceptable.

[ymc]

Just to keep the 6 deaths in the U.S in perspective. Sadly, the virus struck a nursing home. All of the victims at the nursing home were old and in ill-health (5 of them). The other man in his 50s was alos seriously ill before contracting the virus.

 

This is why I have been arguing for focusing our time and energy toward protecting/supporting the old and vulnerable - especially since it is essentially impossible to contain it. I think extreme quarantine measures will do more harm than good at this point.

 

 

Not sure what you mean by protecting the old and vulnerable. If they are sick, they will be taken care of by the hospitals. Do you mean giving them N95 masks? Not only N95 masks are not enough for that but also the old people are not likely to use them effectively.

 

Containing the outbreak is also a way to protect the old and vulnerable. If the healthcare system is overwhelmed by the sheer number of critical cases, how can we protect the old and vulnerable? An overwhelmed healthcare system can also kill other non-coronavirus patients.

 

By the way, since we now hits 200 deaths outside China, let me update mortality rate:

 

Hubei: 2835/(2835+36206) = 7.26%

mainland China outside Hubei: 110/(110+11247) = 0.969% 

Rest of the world: 220/(220+932) = 19.097%

 

It is interesting that the mortality rate is increasing outside China but decreasing inside China...

[albedo]

March 4 2020 a positive hint for outside mainland China and total recovery increasing:

 

 04 03 2020 0837.PNG   225.55KB   1 downloads

https://gisanddata.m...423467b48e9ecf6

Edited by albedo, 04 March 2020 - 07:16 AM.

[Dorian Grey]

March 4 2020 a positive hint for outside mainland China and total recovery increasing:

 

04 03 2020 0837.PNG

https://gisanddata.m...423467b48e9ecf6

 

Looks like there are two strains now:

 

https://www.dailymai...udy-claims.html

 

Milder version becoming more common?  

[Hip]

Looks like there are two strains now:

 

https://www.dailymai...udy-claims.html

 

Milder version becoming more common?  

 

 

Very interesting. The article says:

 

They claimed that around 70 per cent of patients have caught the L strain, which is more aggressive and faster-spreading than S.

 

But L has become less common as the outbreak has gone on, with it apparently struggling to spread since early January, while S has become more common.

 

S is less aggressive but is thought to be the first strain of the virus which made the jump into humans and is continuing to infect new patients.

 

 

So the milder S strain was the first to appear, but then a more virulent L strain appeared (by natural genetic mutation). Maybe the L strain might explain the much higher death rate in Wuhan.

 

If the S strain continues to spread faster than the L strain, then that is good news, as being infected with this milder S strain will likely result in people developing protective antibodies to both strains. 

 

So if you are hit with the milder S strain first, and survive that, then it will effectively act as a vaccination against the nastier L strain. 

 

Edited by Hip, 04 March 2020 - 03:55 PM.

[ymc]

Looks like there are two strains now:

 

https://www.dailymai...udy-claims.html

 

Milder version becoming more common?  

 

https://www.gisaid.o...-sars-cov2-app/

 

If you define strains simply by mutations at the molecular level, then there are way more than two strains.

This is not surprising due to the instability of RNA virus.

[ymc]

 

 

So if you are hit with the milder S strain first, and survive that, then it will effectively act as a vaccination against the nastier L strain. 

 

 

https://www.sciencem...rge-scale-study

 

I am pessimistic about a working vaccine because RNA virus easily mutates. HIV which is also an RNA virus still has no working vaccine as of now. Our best hope is a cocktail of antiviral drugs that buys time for our immune system to fight it. 

[Hip]

I am pessimistic about a working vaccine because RNA virus easily mutates.

 

 

There are plenty of successful vaccines that work on RNA viruses:

 

mumps, measles, rubella, hepatitis A, hepatitis C, rotavirus, influenzavirus are all RNA viruses of various sorts, but have effective vaccines.

[Dorian Grey]

Previous vaccine attempts with SARS/Corona have not gone so well.  

 

Immunization with SARS Coronavirus Vaccines Leads to Pulmonary Immunopathology on Challenge with the SARS Virus

 

https://www.ncbi.nlm...les/PMC3335060/

 

"Evaluations of an inactivated whole virus vaccine in ferrets and nonhuman primates and a virus-like-particle vaccine in mice induced protection against infection but challenged animals exhibited an immunopathologic-type lung disease."

 

"These SARS-CoV vaccines all induced antibody and protection against infection with SARS-CoV. However, challenge of mice given any of the vaccines led to occurrence of Th2-type immunopathology suggesting hypersensitivity to SARS-CoV components was induced. Caution in proceeding to application of a SARS-CoV vaccine in humans is indicated."

 

-------------------------------------

 

I wouldn't want to be first in line for the new COVID jab!  

[Mind]

Not sure what you mean by protecting the old and vulnerable. If they are sick, they will be taken care of by the hospitals. Do you mean giving them N95 masks? Not only N95 masks are not enough for that but also the old people are not likely to use them effectively.

 

Containing the outbreak is also a way to protect the old and vulnerable. If the healthcare system is overwhelmed by the sheer number of critical cases, how can we protect the old and vulnerable? An overwhelmed healthcare system can also kill other non-coronavirus patients.

 

By the way, since we now hits 200 deaths outside China, let me update mortality rate:

 

Hubei: 2835/(2835+36206) = 7.26%

mainland China outside Hubei: 110/(110+11247) = 0.969% 

Rest of the world: 220/(220+932) = 19.097%

 

It is interesting that the mortality rate is increasing outside China but decreasing inside China...

 

Focus on nursing homes. Medical supplies, medical personnel, extra measures to prevent spreading in nursing homes, sick people staying away from nursing homes, etc...

 

The experience so far in the U.S. is that no one has died except the old and/or infirm.

[Mind]

WHO reports 248 deaths and 12668 cases outside of China. I know it is just bulk numbers, but this puts the preliminary/unadjusted mortality rate at 1.7%

 

In the U.S. there have been 10 deaths. Every death has been among the very old and those with serious underlying health issues.

[Daniel Cooper]

Focus on nursing homes. Medical supplies, medical personnel, extra measures to prevent spreading in nursing homes, sick people staying away from nursing homes, etc...
 
The experience so far in the U.S. is that no one has died except the old and/or infirm.

 
Also focus on anti-virals that may lessen the severity of the disease, particularly those that are currently approved and in production.
 
There are currently approved drugs (many approved as things other than anti-virals) that seem to have a reasonable anti-viral effect against conronavirus.  Most of these were investigated during the SARS and MERS scares but when those were contained the urgency was dropped.  You might be able to bring down the mortality rate with these drugs to something more benign, while you wait on a vaccine which is probably 1 to 2 years out.
 
Existing drugs may offer a first-line treatment for coronavirus outbreak

 

Naturally, the drug currently being most heavily investigated (Remdesivir) is absolutely the most expensive on the list, not currently in large scale production, and not actually approved.  Chloroquine, which is an anti-malaria drug, approved since the 1960s, widely available, and dirt cheap, seems to be about as effective.

 

Several anti-malaria drugs seem to have an activity against coronavirus in general btw.

[Dorian Grey]

Here's an interesting first hand account of what a 25 year old male went through with his COVID adventure. 

 

https://www.dailymai...oronavirus.html

 

Looks like around 7 days of mild symptoms, followed by 10-12 days of hell.  

 

Interesting his healthy/young cat took sick & died.  

[Blu]

1-2 years for a vaccine is optimistic. We still don't have a vaccine for SARS 1 after sixteen years of research.

[Mind]

11 deaths reported in the U.S. The deaths remain among the very old and infirm. No healthy young(er) people he fallen victim to the virus.

 

Any Italian people frequenting this discussion? I have been trying to get local information about the Italian outbreak (because U.S. mainstream media is awful about providing details.)

[ymc]

https://www.sciencem...other-countries

 

Jeremy Konyndyk, a US public health expert, suggests using Singapore and Hong Kong as examples to contain coronavirus.