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[elbows]

Here is a rather specific document that tries to model a few things based on a number of scenarios. It gets rather heavy and dull so instead I am deliberately quoting a couple of bits from it that are not really about its central areas of detail and may be of broader interest.

Reports point to mildly symptomatic but infectious cases of 2019-nCoV, which were not a feature of SARS. Prompt detection and isolation of such cases will be extremely challenging, given the larger number of other diseases (e.g. influenza) which can cause such non-specific respiratory symptoms. While more severe cases will always need to be prioritised, control may depend upon successful detection, testing and isolation of suspect cases with the broadest possible range of symptom severity.

Despite the recent decision of the WHO Emergency Committee to not declare this a Public Health Emergency of International Concern at this time, this epidemic represents a clear and ongoing global health threat. It is uncertain at the current time whether it is possible to contain the continuing epidemic within China. In addition to monitoring how the epidemic evolves, it is critical that the magnitude of the threat is better understood. Currently, we have only a limited understanding of the spectrum of severity of symptoms that infection with this virus causes, and no reliable estimates of the case fatality ratio – the proportion of cases who will die as a result of the disease. Characterising the severity spectrum, and how severity of symptoms relates to infectiousness, will be critical to evaluating the feasibility of control and the likely public health impact of this epidemic.

https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-2019-nCoV-transmissibility.pdf

I dont know how much interesting stuff they will be the source of in future but here is their twitter feed anyway MRC Centre for Global Infectious Disease Analysis (@MRC_Outbreak) on Twitter

 

[weltweit]

From a BBC article:

Elsewhere, a team at Lancaster University have published their estimates of the number of cases suggesting 11,000 have been infected this year. If true, that would be more than Sars

 

[weltweit]

From another BBC article:

The lockdown in Wuhan has caused panic in the city - the World Health Organization (WHO) has said that containing a large city like this is "new to science"

 

[elbows]

Regarding the 11000 estimate and the comparison of size to SARS, I'm having to study the SARS timeline because I dont think I started getting a grip on flu etc knowledge until well after the SARS outbreak ended. And I do want to make comparisons with this new coronavirus outbreak, especially as more data emerges.

I'm not read to do so yet, but I can already tell that it might be a mistake to compare a particular estimate of cases in the current outbreak with the official number of suspected cases in the 2003 SARS. eg the number of SARS cases may have been underreported by an unknown order of magnitude, and perhaps if the same methodology for this latest estimate had been applied to the SARS outbreak, the number would be higher.

All the same, there are some indications that make it tempting to already see this 2019-nCoV outbreak as being a bigger thing in terms of numbers of people affected than SARS was. I should probably resist this temptation for at least a little longer though as we seem to be in the middle of a period of rapidly increasing numbers from lots of parts of China, and scale of further international cases in soming days will also offer clues.

 

[Humberto]

So no one knows at this point? What do we know, if at all? Feel free to disregard if I'm knocking you out of step.

 

[ice-is-forming]

There's a university in Qld who reckon they'll come up with a vaccine In six weeks. There's been about 40 people tested here, who had recently arrived from China, and only four of them have been confirmed as having the virus.

 

[weltweit]

So no one knows at this point? What do we know, if at all? Feel free to disregard if I'm knocking you out of step.

There are a lot of very reasonable articles on the BBC website suggesting that we do actually know quite a lot about what's happening. That's said it is early days in terms of the development of the crisis.

 

[Humberto]

There are a lot of very reasonable articles on the BBC website suggesting that we do actually know quite a lot about what's happening. That's said it is early days in terms of the development of the crisis.

Well i suppose it boils down to virulence, spread and deadliness. BBC news service is broken so I don't bother.

 

[Cid]

Most of my contacts in China are from Guangdong and Chongqing - Chongqing is pretty close to Wuhan (in that Wuhan is the next really major city along the Yangtze, and Hubei borders the wider municipality) and Guangdong is apparently the province with the second most cases. So this seems to be like 80-90% of my Wechat moments recently.

Actually have talked to some of my closer friends now, and sounds a lot worse than I thought. European friends who are a bit more open... Two of them have gone back to Europe, sounds like people who can leave are leaving (though obviously many would be on holiday anyway). Nanjing quiet, no 外卖, many places closed, people stay home. A lot of rumour about things being far worse going around. Also going to have a proper conversation with my closest Chinese friend early next week, see what they’re saying. Friend at 南大says his course will open 3 weeks later than planned. But yeah, sounds bleak.

Though, as elbows says, it doesn’t really tell us much about the actual situation. I think it does indicate that there's further mismanagement, even if just in terms of keeping people informed.

 

[cupid_stunt]

Couple of troubling things being reported this morning.

Yi Guan, a senior Hong Kong-based virologist who helped identify the cause of the Sars virus, said he was much more worried about this disease, and feared the window for controlling its spread might already have closed.

“I’ve never felt scared. This time I’m scared,” Yi, who heads the University of Hong Kong’s state key laboratory of emerging infectious diseases, told China’s influential Caixin magazine.

Coronavirus: from one food market to global panic

China was praised for its early response to the disease

www.theguardian.com

SHANGHAI, Jan 26 (Reuters) - The ability of the coronavirus to spread is getting stronger and infections could continue to rise, China's National Health Commission said on Sunday, with more than 2,000 people globally infected and 56 in China killed by the disease. National Health Commission Minister Ma Xiaowei, speaking at a press briefing, said knowledge of the virus was limited.

Ma said the incubation period for the coronavirus can range from one to 14 days, and that the virus is infectious during incubation, which was not the case with Severe Acute Respiratory Syndrome (SARS), a coronavirus that originated in China and killed nearly 800 people globally in 2002 and 2003.

China virus ability to spread getting stronger

CHINA-HEALTH/ (WRAPUP 4, PIX, TV):WRAPUP 4-China virus ability to spread getting stronger

news.trust.org

The incubation period was being reported as 6 days, that's now 14. The New Scientist reports Chinese authorities have presented evidence of fourth-generation cases in Wuhan, which means one person has infected another, who went on to infect a third, who in turn infected a fourth.

 

[weltweit]

All I have been able to pick up in relation to what's new is that that it is infectious during incubation which means people are passing it on before they realise they have it and that at the moment each infected person is passing it on to three more people.

 

[cupid_stunt]

There's a university in Qld who reckon they'll come up with a vaccine In six weeks.

Looks like they are in a race with Imperial College.

Professor Robin Shattock, from Imperial College London, said his team had “two vaccine candidates” developed from the genetic sequence of coronavirus provided by Chinese scientists, and some British experts are confident that a vaccine could be available within weeks.

Prof Shattock told Radio 4’s Today programme the vaccines would be ready for use in “animal models” by the middle of next month and they were ready to “rapidly move those into human studies” if required.

Sunday Telegraph

Although it sounds promising, it could be months before all human testing is done & manufacturing is up & running.

 

[krtek a houby]

Watching the interviews with Chinese tourists arriving in Japan & they're buying lots of masks as there's (understandably) panic buying of masks back in parts of China.

 

[weltweit]

In terms of capacity, the report said Wuhan had 6.51 hospital beds and 3.08 doctors per 1,000 people - this isn't a straightforward indication of healthcare capacity (more doctors doesn't always mean better healthcare), but it does rank Wuhan among the more developed places in the world. The UK and US have 2.8 and 2.6 doctors per 1,000 heads, respectively

BBC

 

[cupid_stunt]

All I have been able to pick up in relation to what's new is that that it is infectious during incubation which means people are passing it on before they realise they have it and that at the moment each infected person is passing it on to three more people.

The three more people is a chain of infection, I read one report of someone passing it onto 14 people at stage one of that chain, each then can pass it onto a third lot of people, who then pass it on to a fourth lot. There's nothing to suggests it stops at stage 4, its just they only have evidence of that number of stages so far.

For example, if one passes it onto 14, and they go onto infect 14 more each, that's 196 people at stage 3, if those 196 also infect 14 more each, that's 2,744 from the original one person source. That's using the current worst numbers (14 x 4th generation), hopefully it will not be that bad, but it's too early for them to know how it will continue to spread.

Of course, we must remember many millions worldwide get flu every year, and 500,000+ can die from it each year.

 

[andysays]

I read an interesting article on the BBC about how China can build a hospital in 6 days. Partly it's because the hospital will be prefabricated but also it is because of the massive resources they are able to throw at it.

Apparently this won't be the first time, during the last epidemic they built a hospital in 6 days, after the emergency it was discarded.

I wonder to what extent this new building is what we would consider a hospital capable of carrying out a wide range of medical treatments, and to what extent it's more a containment or quarantine centre.

The latter could be built more quickly, and is probably more along the lines of what they'll if this thing really takes hold.

 

[weltweit]

I am beginning to wonder about my obsessive interest in this particular story. I'm not directly affected yet the news stories coming out about this outbreak seem compelling.

 

[Winot]

I have a work trip planned in mid-February to Hong Kong and then onto Guangzhou and Shenzhen. Watching FCO advice carefully. My main concern at the moment is whether there will be travel restrictions.

 

[Supine]

The three more people is a chain of infection, I read one report of someone passing it onto 14 people at stage one of that chain, each then can pass it onto a third lot of people, who then pass it on to a fourth lot. There's nothing to suggests it stops at stage 4, its just they only have evidence of that number of stages so far.

For example, if one passes it onto 14, and they go onto infect 14 more each, that's 196 people at stage 3, if those 196 also infect 14 more each, that's 2,744 from the original one person source. That's using the current worst numbers (14 x 4th generation), hopefully it will not be that bad, but it's too early for them to know how it will continue to spread.

Of course, we must remember many millions worldwide get flu every year, and 500,000+ can die from it each year.

I don't think it works quite that way. There is no magic barrier at three transmitions that stop it. What they are saying is that based on how easy it transmits, how many people are in contact with the carrier, and how potent it is within the host it is averaging three infections per host. This can be reduced by reducing contacts and detecting hosts as soon as possible.

 

[Baronage-Phase]

I find this quite terrifying as someone with a suppressed immune system.

 

[Supine]

I've just read that an asymptomatic child has been found carrying the virus. If it's possible for someone to carry the disease and transmit it, without knowing, it's much harder to contain the virus.

 

[Yossarian]

Roadblocks are apparently going up across China, especially around Hubei province, where Wuhan is the capital - this sign over a road to neighbouring Jiangxi province says "Jiangxi People Welcome You."

 

[Cid]

I don't think it works quite that way. There is no magic barrier at three transmitions that stop it. What they are saying is that based on how easy it transmits, how many people are in contact with the carrier, and how potent it is within the host it is averaging three infections per host. This can be reduced by reducing contacts and detecting hosts as soon as possible.

The new scientist article CS linked to discusses generations specifically.

 

[cupid_stunt]

I don't think it works quite that way.

Sorry, which bit? The 'for example' paragraph was just to illustrate how a chain can work, using the worst figures I've seen so far, not how it will.

There is no magic barrier at three transmitions that stop it.

Indeed, as I said - There's nothing to suggests it stops at stage 4, its just they only have evidence of that number of stages so far.

The World Health Organization reported Thursday that there have been at least four generations of spread of the new virus, provisionally called 2019-nCoV, meaning a person who contracted the virus from a non-human source — presumably an animal — has infected a person, who infected another person, who then infected another person.

It’s not clear from a WHO statement whether transmission petered out after that point, or whether further generations of cases from those chains are still to come.

SOURCE

Present estimates suggest the average infection rate is between is between 1.4 & 2.5 people from one, well below that 14 figure, those could then go to stage 3, etc., but no suggestion it will stop there, especially considering the news today that it's getting stronger.

Of course, infection rates can be reduced by reducing contact & detecting hosts earlier, but with the incubation period now being quoted as up to 14 days, before signs and symptoms show, that's not going to be easy.

 

[Cid]

Information is bloody terrible. Officially 600ish infected in Wuhan but various figures floating about; 1万，9万 (10k, 90k). This rumour mill type stuff probably isn’t helping, China really needs to be looking at getting some independent experts in for verification.

 

[Part-timah]

Yep, the Chinese have a tight propaganda machine run by hard authoritarian governance and it’s good at making disaster response appear superb. It’ll be safe to assume things are worse but by how much?

There’s an unmitigated torrent of noise online and its not easy to sort the wheat from the chaff.

 

[maomao]

The Chinese Internet is full of stories of thousands of old people being sent home to die and not included on the official death figures. Bit of truth and a bit of conspiracy/fearmongering in that one I think.

 

[nyxx]

Does anyone have info on what’s happening in Shanghai with regards to this?

 

[cupid_stunt]

Does anyone have info on what’s happening in Shanghai with regards to this?

New York Times is reporting one case so far, but they are on the highest-level emergency response against the virus, like the rest of China.

Shanghai Launches Level 1 Emergency Response Over Coronavirus

The city is taking maximum emergency measures to prevent the spread of the deadly pneumonia-like virus as epidemic concerns grow.

www.sixthtone.com

 

[nyxx]

Thanks