Combustible
Well-Known Member
This is in Chinese but has the official numbers by location
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This is in Chinese but has the official numbers by location
Ax^
Silly Rabbit
Compare to the first global outbreak of the H1N1 virus this is not looking biblical
but fair point it viral pneumonia
elbows
Well-Known Member
I should also mention that unless serological testing has been done, its hard to come up with reasonable figures for things like mortality rate. Because the mild and asymptomatic cases mostly get missed, skewing the picture, and making the mortality rate look worse than it actually is.
elbows
Well-Known Member
The number is all over the place and probably most of the experts involved dont think those numbers mean much at this stage anyway. Or at the very least they pay attention to the numbers but expect them to evolve, possibly to a significant extent.
And sometimes there is detail in the language used that makes a difference. For example a few days ago I think I saw some Hong Kong scientists giving a 14% case-fatality rate, but the crucial detail on that one was that it applied only to those who were hospitalised by the coronavirus. As such its a number that can actually be fully based on the data we actually have, rather than all the unknown, mild, non-hospitalised cases. But even in that more limited domain, its still a little early for such estimates, and the raw numbers are changing so frequently at the moment that I assume most stuff I am reading is out of date by the time they've published.
Yossarian
Get thee behind me, Santa
Wuhan residents say they've been turned away from hospitals despite having symptoms so whatever figures they're giving for the number of cases are probably off by thousands. I'm not sure why they even bothered sealing the city off after 5 million people had already left.
www.scmp.com
5 million left Wuhan before lockdown, 1,000 new virus cases expected
Health commission says battling the epidemic is becoming more complicated as scientists discover virus is infectious even during its incubation period.
www.scmp.com
Yu_Gi_Oh
天天好心情
Yeah. I don't need you to explain China to me, thanks.
cupid_stunt
Merry fecking Christmas.
TBF, whilst they quoted you, I don't think the reply was specifically directed at you, more a general post for everyone reading the thread.
elbows
Well-Known Member
Wuhan residents say they've been turned away from hospitals despite having symptoms so whatever figures they're giving for the number of cases are probably off by thousands. I'm not sure why they even bothered sealing the city off after 5 million people had already left.
5 million left Wuhan before lockdown, 1,000 new virus cases expected
Health commission says battling the epidemic is becoming more complicated as scientists discover virus is infectious even during its incubation period.
Thanks for the article, which includes updates from the last figures we talked about (now 2047 China cases and 56 deaths).
As for the 'why they even bothered sealing off the city' thing, even without the revelation that 5 million people had left, we were talking about the horse already having bolted, and the picture now points even further in that direction.
The article has slightly more words on the stuff that I said might confuse experts. I've not found expert commentary on this stuff yet so I'll have my own stab at it.
Yeah, this is linked to why optimism about containment has probably plummeted in recent days. I wont be surprised if the framing of what we are dealing with changes this week as a result.
My suggestions of confusion in regards 'virus is becoming more transmissible' is probably a language thing. In part its a tense thing, eg I would be more likely to say that if there was a change it already happened a while ago, or that it is our understanding and evidence of how transmissible it is that has changed, not the actual reality of the virus.
I'd put it like that for a few reasons, one of which relates to my next point.
I'm pretty sure that bit will make some experts groan. Because years ago some very real concerns about how things can mutate over time were explained to the media, in connection with H5N1 bird flu, and despite a kernel of truth to this stuff, its sort of taken on an oversimplified media myth life of its own in the years since. I cannot do the subject proper justice now, and there are a bunch of mutation-related things that particular branches of science need to take an interest in. But the main mutations they worry about tend to be the ones that make a virus good at spreading between people in the first place. ie something that clearly already happened with this coronavirus, otherwise we'd only be seeing cases with more direct links to the wild animal market.
Plus in this particular example there is a glaring contradiction. The idea that at the moment the virus is not spreading to certain age groups. That idea is unsafe, because so many of the known cases so far are the serious ones that required hospitalisation, and because they've just been acknowledging the 'hidden carriers', who could be in any age group. They are mostly hidden so the data just isnt there much yet, including their ages. But at least one of the discovered asymptomatic cases reported on so far was in a young child, for example.
Anyway, experts groan because they get bored of answering slightly misconcieved questions from journalists about the mutation threat. Largely because the threat most of the experts are focussed on is the one that already exists, the virus as it is now. Broadly speaking, the mutation stuff is more the sort of thing that is focussed on when trying to get people to take funding seriously, or trying to ensure that vigilance and surveillance levels remain high in situations where people are dealing with a small animal->human outbreaks where human->human spread seems rather limited, and they must guard against people not realising that the picture could evolve into something with wider spread potential. This latter thing might have been a feature at some early stage in Wuhan, or it might just be that by the time any alarming signs were seen at all, the reality had already gone beyond that, and not much could have been done to reduce the lag between the true picture and our understanding of it.
elbows
Well-Known Member
The caveat I should add to my thoughts is that it is always possible that statements made by officials are in part based on information we havent seen yet.
As this applies to transmission worsening, or mutations, I suppose there are a few possibilities. For example an impressive set of genetic info from a whole bunch of early cases has been shared online, and analysis of these has suggeted very little variation between them. If later samples turn out to show more variety, then talk of mutations has some legitimate point. Especially if any of them are in areas where we actually know something about the function or implication of the mutation, eg increased affinity to infect humans.
By the way it. was really interesting what they were able to deduce from the lack of variation in the initial sample set.
www.statnews.com
As this applies to transmission worsening, or mutations, I suppose there are a few possibilities. For example an impressive set of genetic info from a whole bunch of early cases has been shared online, and analysis of these has suggeted very little variation between them. If later samples turn out to show more variety, then talk of mutations has some legitimate point. Especially if any of them are in areas where we actually know something about the function or implication of the mutation, eg increased affinity to infect humans.
By the way it. was really interesting what they were able to deduce from the lack of variation in the initial sample set.
DNA sleuths read the coronavirus genome, tracing its origins and looking for dangerous mutations
As epidemiologists race to contain the outbreak of a novel #coronavirus, they’re getting backup from the explosion in genetic technologies
www.statnews.com
cupid_stunt
Merry fecking Christmas.
Not sure that'll help, the World Health Organization has so far refused to declare the outbreak "a public health emergency of international concern", which is hardly surprising, because it took them 8 months to declare the Ebola outbreak as such, they are not fit for purpose.
The World Health Organization should sound the alarm on Wuhan coronavirus | CNN
As the Wuhan coronavirus continues to spread around the world, the World Health Organization's decision to hold off on declaring the outbreak "a public health emergency of international concern" is baffling.
Supine
Newt Member
There are presumably big implications to labelling it ‘of international concern’. If the cases reported outside China start turning into localised and hard to contain outbreaks I imagine they would escalate their assessment as required. So far I haven’t seen any reports of this multiplying outside of China. Hopefully it won’t.
elbows
Well-Known Member
Some WHO failures are down to the political context. Global health is not a realm free from such concerns, and at the very least the WHO have been naive with the current PHEIC system. Its sensible to have a committee to make the decision, and its completely normal that not everyone on the committee will agree. But because the current system is just binary, the political (including economic) pressures that lurk behind such decisions are magnified. A more nuanced systems would allow for more wiggle room, and we'd have seen the level of alert/emergency raised already, instead of this wait to see when some arbitrary threshold is reached and the binary PHEIC switch is flicked.
If I had my way then the entire world and humanity would be ordered differently, so the political considerations would not be the same at all. But since we have the current shitty order it is no surprise that the WHO inherits various terrible flaws as a result.
I do tend to temper my frustration with entities such as the WHO a bit at times like this though, for several reasons. Firstly some of the criticism is from idiots who expect impossible feats of containment. Or conspiracy idiots. Secondly, in outbreaks such as SARS, health workers are on the front lines of risk, and many victims end up coming from their ranks. Including WHO staff. One of the victims of SARS was Carlo Urbani in 2003, a WHO infectious disease specialist who was in Vietnam. He died, and was one of at least 38 staff who were infected by an early SARS patient who had travelled after been infected in a Hong Kong hotel outbreak that was itself caused by another doctor.
If I had my way then the entire world and humanity would be ordered differently, so the political considerations would not be the same at all. But since we have the current shitty order it is no surprise that the WHO inherits various terrible flaws as a result.
I do tend to temper my frustration with entities such as the WHO a bit at times like this though, for several reasons. Firstly some of the criticism is from idiots who expect impossible feats of containment. Or conspiracy idiots. Secondly, in outbreaks such as SARS, health workers are on the front lines of risk, and many victims end up coming from their ranks. Including WHO staff. One of the victims of SARS was Carlo Urbani in 2003, a WHO infectious disease specialist who was in Vietnam. He died, and was one of at least 38 staff who were infected by an early SARS patient who had travelled after been infected in a Hong Kong hotel outbreak that was itself caused by another doctor.
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Supine
Newt Member
I bet they end up in quarantine
weltweit
Well-Known Member
Yes, that probably would be wise!!
elbows
Well-Known Member
A bit more on Dr Urbani since I had mentioned him without the full context.
www.who.int
WHO remembers Dr Carlo Urbani as a hero who fought SARS
WHO celebrates the 15th death anniversary of Dr Carlo Urbani- who died fighting SARS on 29 March 2003
Part-timah
Well-Known Member
Chinese make an unlikely claim that people can transmit before showing symptoms referenced in this CNN article: China says coronavirus can spread before symptoms show -- calling into question US containment strategy
What I did find surprising is the mentioned incubation period of 2 weeks. If this is true then all these temperature taking efforts on borders is a particularly ineffective containment tactic.
What I did find surprising is the mentioned incubation period of 2 weeks. If this is true then all these temperature taking efforts on borders is a particularly ineffective containment tactic.
elbows
Well-Known Member
Why do you think its an unlikely claim?
Its true that I hadnt seen much in the way of explanation in the media for what details in particular lead to the claim, a claim which has been widely reported today. But there are a bunch of famous diseases that can spread at that stage so its not unthinkable, its just something people were hoping wasnt going to be true of this outbreak because it wasnt really seen with SARS.
Anyway I probably found the detail I was seeking, via someone on twitter linking to an article from the official state news agency. I had to use machine translation but it seemd to do a pretty good job. I'm not quoting the complete story, just the key bit:
Google translated from 专家：新型冠状病毒潜伏期没有任何典型症状的时候或已具备传染性-新华网
Main bit I would think should be changed to make more sense is that 'he did not get the disease after another two days' is most likely to really mean 'he did not show symptoms of the disease for another two days'.
Its true that I hadnt seen much in the way of explanation in the media for what details in particular lead to the claim, a claim which has been widely reported today. But there are a bunch of famous diseases that can spread at that stage so its not unthinkable, its just something people were hoping wasnt going to be true of this outbreak because it wasnt really seen with SARS.
Anyway I probably found the detail I was seeking, via someone on twitter linking to an article from the official state news agency. I had to use machine translation but it seemd to do a pretty good job. I'm not quoting the complete story, just the key bit:
Google translated from 专家：新型冠状病毒潜伏期没有任何典型症状的时候或已具备传染性-新华网
Main bit I would think should be changed to make more sense is that 'he did not get the disease after another two days' is most likely to really mean 'he did not show symptoms of the disease for another two days'.
Part-timah
Well-Known Member
That’s interesting case but there’s a posdibility that person was the vector.
The reason for the doubt is that a lot of symptoms of flu type viral infections are the direct results of the replication of viruses e.g. coughing up gunk made up partly from dead cells used for the growth of infection. Of course this coughing helps spread the microbes.
Other vectors need considering. Sharing resources at conference could be one. We cannot know from that for certain. The next couple of weeks may answer this question. Grim stuff.
The reason for the doubt is that a lot of symptoms of flu type viral infections are the direct results of the replication of viruses e.g. coughing up gunk made up partly from dead cells used for the growth of infection. Of course this coughing helps spread the microbes.
Other vectors need considering. Sharing resources at conference could be one. We cannot know from that for certain. The next couple of weeks may answer this question. Grim stuff.
elbows
Well-Known Member
With some illnesses it seems that the asymptomatic cases, of which will there will be many, are still able to shed the virus, so they can still transmit it to others. Its just that the rate of shedding may be substantially lower than symptomatic cases, for reasons including some of the symptoms helping to spread the disease like you mentioned.
Anyway yes I am expecting our sense of the picture to evolve quite a bit in the next week. And I dont want to get too hung up on the 'how much are asymptomatic cases spreading it' question without remembering that this is part of a larger overarching question about transmissibility in general. Whatever the details of the vectors that are responsible for the spread seen so far actually turn out to be, and however long it takes us to understand them correctly, the magnitude of confirmed cases in different places will tell its own story in the days ahead. One that will invite some assumptions that are probably quite reasonable.
Anyway yes I am expecting our sense of the picture to evolve quite a bit in the next week. And I dont want to get too hung up on the 'how much are asymptomatic cases spreading it' question without remembering that this is part of a larger overarching question about transmissibility in general. Whatever the details of the vectors that are responsible for the spread seen so far actually turn out to be, and however long it takes us to understand them correctly, the magnitude of confirmed cases in different places will tell its own story in the days ahead. One that will invite some assumptions that are probably quite reasonable.
Baronage-Phase
Well-Known Member
If it's the case that people can be infectious without showing signs of the virus, then how can it be contained?
elbows
Well-Known Member
Well thats one of the reasons the mood has sort of changed a bit in recent days. Not the only one though, the evolution of the number of cases and their locations needs to be sufficiently worrying in order for these other alarming possibilities to resonate.
From what I can tell via things like twitter, some people who work in relevant disciples are at a slightly awkward moment where they are now feeling the need to ready themselves for the grim, 'containment isnt going to be possible' scenario, without yet considering it appropriate to completely ditch the previous containment possible scenario.
For example:
SpookyFrank
A cheap source of teeth for aquarium gravel
Well, if the incubation period was very short and human to human transmission remained rare, then it could be theoretically possible to track down and quarrantine all the people who had contact with the original source. Some people would slip the net but most of those would not infect others. If all those infected developed recongisable symptoms, that would also help in their identification and containment.
What we seem to have here is a long incubation period, many asymptomatic or mild cases, and relatively easy transmission. That's a triple whammy of bad news for any containment efforts.
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elbows
Well-Known Member
Due to the passage of time since we last spoke about modelled estimates for total cases, numbers from such models will be considerably higher by now. To the extent that one of the people involved with the report we talked about the other day, was on Sunday giving a figure of 100,000 as his best guess at the present reality.
www.theguardian.com
(the original model I mentioned assumed 4000 as the total number of cases by 18/1/2020, with uncertainty range bounds of 1000-9700, and obviously we are quite a way past the 18th now, plus certain assumptions may have changed).
Coronavirus: 100,000 may already be infected, experts warn
UK government urged to reassure public that NHS is ready for cases within days
(the original model I mentioned assumed 4000 as the total number of cases by 18/1/2020, with uncertainty range bounds of 1000-9700, and obviously we are quite a way past the 18th now, plus certain assumptions may have changed).
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