Coronavirus

[bkp_duke]

People should read what the CDC is saying and skip all the other stuff. Those are the only people with world-class expertise who have vetted every single statement that is published. I am concerned that our sociopathic Administration in Washington is going to suppress what the CDC would otherwise say and water it down significantly. But that has not happened yet at least not on the website.

Pretty sure that's what Juliana Grant said in the second line of that web post.

 

[KarenRei]

Right now. But the fatality rate from the flu is probably somewhere between a 20th to a 30th of the fatality rate of covid 19.

A typical seasonal flu has a CFR of around 0,1%. COVID-19 overall has one in the 3,4-3,8% range, but part of that is because the majority of the cases were early on in Wuhan, where there was a CFR of nearly 6%. CFR today appears to be under 1%, with a lot of reports pinning it at about 0,7%, and in some localities as low as 0,4%. Even Wuhan today is said to be 0,7%.

And the covid-19 R value appears higher.

According to WHO, COVID-19 spreads less efficiently than influenza.

 

[dfwatt]

Pretty sure that's what Juliana Grant said in the second line of that web post.

Like I said I appreciated everything on that post except the early "best-case scenario" scenario. We've already passed that possibility. I do think talking about that as a best case scenario when it's plainly evident that this is much more serious than the average seasonal flu contributes to denial and minimization. That in turn contributes to the potential Community spread of this because people don't see how serious it potentially is. This is not advocating for panic or fear-mongering. It is advocating for what we know about this pathogen.

 

[avoigt]

I view the California (and Washington) emergency declarations as positive signs that the governments of these states are taking it seriously. Hopefully we'll see more proactive steps taken in these states and others to complement the inadequate response by the US federal government.

Fully agree and thats what I meant with WHO measures and recommendations to be implemented.

The places where I am concerned about are places where for whatever reasons they do not take it seriously or politicians who don't want to concern the population. China and Iran has been one of that places IMO. The US is vulnerable in that respect too and the bad track record of the Trump administration to tell the truth in the past does not help to strengthen confidence. Thats firing back to them now.

 

[Cherry Wine]

People should read what the CDC is saying and skip all the other stuff. Those are the only people with world-class expertise who have vetted every single statement that is published. I am concerned that our sociopathic Administration in Washington is going to suppress what the CDC would otherwise say and water it down significantly. But that has not happened yet at least not on the website.

To your point:

Trump denies official coronavirus death rate as he has ‘hunch’ it is lower

The US Government continues to disappoint. Apparently he also encouraged people to go to work while sick. WTF.

 

[shootformoon]

I noticed the critical cases% has a large variance among countries. If we look at developed countries(data more reliable?) , Italy, Japan, France are on the high end with %>5%. Germany, S. Korea are on the very low end(<1%). Does this due to some under reporting, different position in the trend, different types of Cov19, different distribution of age/risk groups, or some other reasons?

As predicted days ago the amount of active cases did decrease over time and its now 3 days in a row below 40k. Thats very much a positive and promising as it if sustainable gives confirmation that the exponential growth expected by many did not happen but it needs of course to be taken into account that many undetected cases are out there. However take in consideration thats not new.

Those undetected cases are an unknown but I reiterate what I said before that despite some countries not having enough kids to test and many may be infected but don't know, in a situation where this remains like we have it you would have by definition more severe cases getting into hospitals who are detected as infected. Obviously we do have more serious cases and deaths but not as many as you would expect to call it exponential.

Total critical cases are shrinking since Feb 18th. Thats another really positive signal.

Since I watch the numbers developing every day I am pleased to see that South Korea seems to have peaked and now went slightly down. China is low compared to its part (below 200) as well and that in a sustainable manner. Lets all hope SK can establish a china like shrinking as well. Experts call numbers credible so the uncertainty many had should be gone now.

The remaining country with high new infected rates of today almost 600 is Iran a country I expressed my concern about before. However assuming that those numbers are correct which I am not very confident about the cases did not exponentially increase too and that could be a sign for improvement.

A underestimated factor that I tried to explain is that the lessons learned from countries like china are of course used in other countries since a while and improving which should make clear that the likelihood to get the virus under control is increasing not decreasing.

An unknown factor is how the virus developed e.g. getting more or less deadly over time.

A fear scientists said the a TV show lately that us humans have two brains one for rational and one for fear but the fear brain does not know how to do statistics. Thats I believe a very true statement and the fear increases if your country is a hot spot and infections are near. Here in Germany we have cases too even in the town I am living in and I believe you can overcome that fear by keeping a cool had and analyzing the data profoundly.

In terms of the US there are elements that point to a high risk that the virus will spread fast but if we look in the current data of the last days that did not happen and I like to underline the stamens above that even if you have many undetected and more deaths than other countries compared to the detected its not growing exponentially. It would be best though for everybody in the US to get prepared that many more cases will be found over time like with every other flue as well as more deaths.

The worst case scenario did not happen yet and if nothing unexpected appears its hard to imagine a scenario where the current trend is reversed. This is not to call it over at all but to put things into perspective.

For the stock market and the economies the shut down in China will have a negative effect on the economies globally without a doubt but that was short term and even if many let their people work from home now and conferences and events are cancelled this is not a reason to expect a dramatic GDP drop. The fear people have though may lead to a more negative impact for economies.

In Germany we have right now more cases detected than the US (but that may change quickly with a growing case count in the US and larger population) but not a single death ( 2 critical) and the only explanation I have is the healthcare system. No deaths and many cases is a reality in many countries. As the severe cases are more with the older generation in contrast to a normal flue the impact on the economy may be even lower.

The current emergency declaration for CA may sound alarming for many but the US is at the moment with below 200 cases and certainly many more not detected not in the top list like China, South Korea, Italy or Iran at all. Cases will grow without a doubt but if the US follow the WHO recommendations I won't see a reason why they won't be able to get it under control too.

Coronavirus Update (Live): 96,739 Cases and 3,308 Deaths from COVID-19 Wuhan China Virus Outbreak - Worldometer

 

[bkp_duke]

I noticed the critical cases% have a large variance among countries. If we look at developed countries(data more reliable?) Italy, Japan, France are on the high end. Germany, S. Korea are on the very low end. Does this due to some under reporting, different position in the trend, different types of Cov19, different distribution of age/risk groups, or some other reasons?

It's most likely a combination of factors. Best educated guess:
1) under reporting in many countries due to lower testing (US is a prime example here) or political motivations
2) mortality variation by age - what is being reported is just total mortality, and in most cases not by age group by country. Japan, for example, is a nation of very old people, on average
3) COVID-19 variants - was reported in this thread of 2 possible variants (but I haven't seen that confirmed by WHO or CDC). They could have different severity

 

[Dr. J]

The problem with that post is that it suggests that "best case scenario this will be just like a flu season with.05% mortality". We already know that's absolutely not true so the best case scenario is worse than a bad flu season. The worst case scenario might be worse then the Spanish influenza. While they make some valid points they also appear to not buy what we already know about this disease. It's a bit surprising to see an MD with a master's in public health saying that best case scenario this is just the flu. The post also contains a lot of good information towards the end but I'm troubled by the beginning.

What troubled me more was this: "the best source of information about COVID is the official CDC page. You should trust the CDC more than us (or anyone else)." It's hard to believe any mildly observant person, much less an MD/MPH, can believe that after the events of the past week.

 

[Dr. J]

I am concerned that our sociopathic Administration in Washington is going to suppress what the CDC would otherwise say and water it down significantly. But that has not happened yet at least not on the website.

That's already happened. Democratic lawmaker calls out CDC for removing data on number of Americans tested for coronavirus

 

[heltok]

A typical seasonal flu has a CFR of around 0,1%. COVID-19 overall has one in the 3,4-3,8% range, but part of that is because the majority of the cases were early on in Wuhan, where there was a CFR of nearly 6%. CFR today appears to be under 1%, with a lot of reports pinning it at about 0,7%, and in some localities as low as 0,4%. Even Wuhan today is said to be 0,7%.



According to WHO, COVID-19 spreads less efficiently than influenza.

Wuhan also had more of the more aggressive L-type of the virus. We should be very grateful that the Chinese managed to slow down the spread of the L-type. By not being as strict as the Chinese we risk the L-type overtaking the S-type again. (Start at ~6min)

I would also be careful to trust the Chinese number of deaths(likely low) or the number of confirmed cases(likely also low).

R0 is different in different regions at different times and with different counter measurements. R0 was likely very high(>4) in Wuhan initially but is likely <1 with current quarantine. In Europe and America R0 is likely >>1 right now and in rest of Asia and Africa also likely >>1.

 

[dfwatt]

I noticed the critical cases% has a large variance among countries. If we look at developed countries(data more reliable?) , Italy, Japan, France are on the high end with %>5%. Germany, S. Korea are on the very low end(<1%). Does this due to some under reporting, different position in the trend, different types of Cov19, different distribution of age/risk groups, or some other reasons?

Those kinds of variances are pretty much intrinsic to smaller sampling sizes, but also due to the fact that we don't know how many cases are pre-symptomatic or early symptomatic or mild that are not getting added to the totals. And all statistics coming from totalitarian regimes are potentially doctored numbers. This means that you always have a range of statistical parameters appearing and never a single Universal number in relationship to virtually any variable including fatality, r value, Etc. As for different types of covid 19, see prior post on variants. These pathogens are by definition moving targets because they do mutate and evolve like everything else. And since they have no intrinsic or built in RNA repair mechanisms, they are intrinsically more vulnerable to mutation.

 

[shootformoon]

I still trust some scientists in CDC are competent. But due to political reasons, CDC messages might be already somehow censored.

What troubled me more was this: "the best source of information about COVID is the official CDC page. You should trust the CDC more than us (or anyone else)." It's hard to believe any mildly observant person, much less an MD/MPH, can believe that after the events of the past week.

 

[KarenRei]

Wuhan also had more of the more aggressive L-variant of the virus. We should be very grateful that the Chinese managed to slow down the spread of the L-variant. By not being as strict as the Chinese we risk the L-variant overtaking the S-variant again. (Start at ~6min)

I would also be careful to trust the Chinese number of deaths(likely low) or the number of confirmed cases(likely also low).

R0 is different in different regions at different times and with different counter measurements. R0 was likely very high(>4) in Wuhan initially but is likely <1 with current quarantine. In Europe and America R0 is likely >>1 right now and in rest of Asia and Africa also likely >>1.

While it was interesting, I wouldn't read too much into the specifics of that single L-strain / S-strain differentiation paper on its own. But indeed, the general premise is what's to be expected: that fact that severe cases are easier to notice (and thus prevent people from transmitting) than mild strains is a strong selective factor in viral evolution.

 

[SageBrush]

The problem with that post is that it suggests that "best case scenario this will be just like a flu season with.05% mortality". We already know that's absolutely not true so the best case scenario is worse than a bad flu season.

You misunderstand the author. There is an underlying presumption that the covid-19 spread will be markedly less than a typical Influenza season. As people change their public health behaviors, that will be true.

Folks, this is not rocket science, and you will not be saved by pie in the sky vaccines or medicines: practice good personal hygeine; and if you live in a community with Covid-19 then wear a good mask out of the home when social distances of 2 meters cannot be maintained.

FUD helps no one. Just learn to act smart.

 

[avoigt]

I noticed the critical cases% has a large variance among countries. If we look at developed countries(data more reliable?) , Italy, Japan, France are on the high end with %>5%. Germany, S. Korea are on the very low end(<1%). Does this due to some under reporting, different position in the trend, different types of Cov19, different distribution of age/risk groups, or some other reasons?

Unlikely, I can't speak for South Korea but Germany does not underreport or not test enough.

Also many other countries have low or 0 death toll. The US is in comparison to the known cases a negative outlier but there will be reasons for that.

 

[Causalien]

Thanks for the great analysis! I feel sorry for the people suffered this disease in South Korea and Italy. but as a tesla investor, ultimately, it is the cases in U.S that matter the most. what's your prediction/analysis of the virus outbreak in U.S? Is it going to be something like Japan/Singapore with limited outbreak, or exponential growth as seen in Korea/Italy?

It'll be exponential when it hits the homeless area. Then when people start taking precautions because fear sets in, then it will taper off. Watch south korea on what happens next. Their cult exponential growth will be = homeless exponential growth.

Here in Canukstan, I noticed that most of the homeless have been walking around with a cough now. Of course, we are not testing them because they don't go to the hospital because they don't want to get narcaned.

 

[SageBrush]

But indeed, the general premise is what's to be expected: that fact that severe cases are easier to notice (and thus prevent people from transmitting) than mild strains is a strong selective factor in viral evolution.

People do not go from healthy to ARDS in a day, and to date all of the difference in disease severity is explained by the host.

The apparent differences in case mortality between countries is not well explained, but it is NOT what you guess.

SK is interesting since Nursing homes appear to be infected at higher rates than average. My WAG is that health care workers are vectors between hospitals and the homes, and then the home acts as an amplifier. One way or another it is going to be itinerant workers with multiple workplaces who are the vectors. These workers should be targeted for serial testing and heightened personal protection behavior.

 

[Causalien]

Some hospitals in Switzerland showed on TV their newly installed receiving units and explained the "triage" utilised. I do not know whether all larger medical facilities are already equipped accordingly, but efforts are clearly being made.

Ya, those metal and concrete construction are nice. I've seen some, but high quality means low production.

In the more rural areas and in a pinch, a tent with a vent that sucks air into a filter is enough. The air pressure is the important part. This setup should help in Italy and Iran right now.

 

[KarenRei]

People do not go from healthy to ARDS in a day

A disease does not spread unnoticed for months in northern Italy while everyone is on the look for an outbreak if it kills nearly 6% of the people who get it and sends a large portion of the rest to the hospital.

It's not about individual people. It's about spreading unnoticed.

The fact that the CFR was so high in Wuhan is the very reason it came to the attention of researchers in the first place (even despite government efforts to hide it). You cannot have a contagion like this spread with such a high CFR without being noticed.

and to date all of the difference in disease severity is explained by the host.

Not according to the aforementioned peer-reviewed research. Or the current understanding of viral evolution.

 

[cucubits]

The US Government continues to disappoint. Apparently he also encouraged people to go to work while sick. WTF.

Imagine a world with only young politicians left... if we're looking for maybe the single upside to this mess.