Coronavirus

[KarenRei]

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.

I'm not sure how critical the vent filtration aspect is; according to WHO, beyond fomites, the virus generally spreads through close interpersonal contact - not airborne drift. Of course, that's "generally", so if you're in a hospital situation, you're going to want stricter standards.

I bet new orders for Sprung structures are going well...

 

[SageBrush]

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

You are extrapolating from diseases that are given free reign to spread and think it applies to Covid-19 which is targeted for containment as soon (or before) a cough and a little fever develops.

 

[KarenRei]

You are extrapolating from diseases that are given free reign to spread and think it applies to Covid-19 which is targeted for containment as soon (or before) a cough and a little fever develops.

Nobody gets targeted until they're identified.

If you think there's not an extensive amount of uncaught cases out there, you're simply wrong, and I'm not even going to sugar coat those words. WHO openly discusses this, the CDC openly discusses this, everyone openly discusses this. Uncaught cases tend to be clustered into specific areas where they spread among the local community. The higher the CFR, the sooner said community spread will be noticed. The lower the CFR, the longer it goes on with people just thinking it's a seasonal flu. And the more new (uncaught) areas will be seeded for community spread from that infected population, and themselves go unnoticed.

And this is textbook viral evolution.

 

[Matias]

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.

NEJM editorial “the case fatality rate may be considerably less than 1%.”

https://www.nejm.org/doi/full/10.1056/NEJMe2002387

 

[bkp_duke]

NEJM editorial “the case fatality rate may be considerably less than 1%.”

https://www.nejm.org/doi/full/10.1056/NEJMe2002387

For those not wanting to read the full article, here is the most important paragraph:

On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%. In another article in the Journal, Guan et al. report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.

 

[EVNow]

Diamond Princess is a good lab case. 700+ infected and 6 deaths - so slightly less than 1% mortality. But the population probably tended to be older.

BTW, one more thing that seems to have not been mentioned here. Some of the "cured" cases are getting the infection/symptoms back. Infact there is atleast one report of fatality.

 

[Snerruc]

I’m not super worried it would kill me off but more concerned about me possibly spreading it to others that are more vulnerable. If I survived mono a few years back I feel I could survive any virus now (that was absolutely terrible). And yes worried about being stuck on the boat quarantined as mentioned by others.

The Caribbean & Florida aren’t exactly hot spots for the virus right now either.

Having just gotten back from a cruise with flu and a strep throat, I can tell you that it’s no fun. Two islands are denying port entrance and at least one cruise has been cut short because of the flu. Cruise lines are working with clients to return money or rebook later. Your decision,

 

[KarenRei]

NEJM editorial “the case fatality rate may be considerably less than 1%.”

https://www.nejm.org/doi/full/10.1056/NEJMe2002387

To me, the question is, when does the messaging change? Organizations like WHO and the CDC have different messaging needs depending on what their goals are. When they're trying to quarantine, it's in their best interest that people stay worried about the disease, so that appropriate attempts at containment (and preparations for a broader outbreak) are made. But if it does go pandemic, their interests change to not wanting to cause panic, which would interfere not just more broadly the global economy, but medical supply chains in specific. Even now there's problems with that, such as individuals buying up supplies of medical masks and the like

Right now, you have WHO trotting out the "early-Wuhan inclusive" 3,4% figure, to make sure that people don't dismiss it as just another flu. I strongly suspect that if it goes pandemic and they switch from a focus on containment to a focus on generally reducing R0, they'll likely start using the CFR for new cases in their press releases.

 

[KarenRei]

BTW, one more thing that seems to have not been mentioned here. Some of the "cured" cases are getting the infection/symptoms back. Infact there is atleast one report of fatality.

Remission is a statistical possibility for the majority of diseases at some fraction of the infected population. However, the level appears to be very low with COVID-19. And regardless, it can be hard to declare whether an identified remission case is legitimate or simply the result of a false negative in testing.

In general, one should be careful not to conflate "things that can happen" with "things that are meaningful drivers of spread or mortality".

 

[dfwatt]

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.

No sorry I didn't misunderstand the author. I've been working as a doctor in the healthcare system for 45 years. And since we're talking about resumes, I've published at least 10 chapters in medical textbooks - not about virology or infectious disease - but I do know my way around biological science. What's your resume in healthcare?

You are wildly overconfident about the ease of containment in relationship to highly transmissible viruses. Getting people to self quarantine outside of totalitarian societies is very difficult to do, and that's assuming we can readily identify who has the virus which outside of widespread testing is impossible. And when people point out the intrinsic difficulty in that and the dangers posed by this pathogen calling that FUD (fear uncertainty and doubt) is just BS. Clean up your act please

 

[KSilver2000]

The statistics could get really bad if the virus starts spreading throughout Africa.

 

[SageBrush]

Nobody gets targeted until they're identified.
If you think there's not an extensive amount of uncaught cases out there

You misunderstand. You simply cannot compare two highly infectious diseases that have markedly different public health measures with any hope of validity.

 

[SageBrush]

What's your resume in healthcare?

Three specializations, practice in Immunology related fields and Internal Medicine.

 

[KarenRei]

You misunderstand. You simply cannot compare two highly infectious diseases that have markedly different public health measures with any hope of validity.

Please clarify as to which of the following you're disagreeing with:

• That there are undetected populations of the disease undergoing community spread
• That you cannot quarantine a population you don't know about
• That quarantine is an adverse selective factor to a disease
• That not being quarantined is a positive selective factor for a disease
• That a community with a disease that kills or sends a high percentage of the people who contract it to the hospital will come to the attention of medical authorities sooner than one that seems to be little more than a seasonal flu.
• That in general "making patients sick enough to stay home" is an adverse selective factor to a disease
• That in general "being mild enough that patients go out in public" is a positive selective factor for a disease
• That there exists peer-reviewed work stating that these selective factors can already be seen in the genetic shift of the virus.

 

[SageBrush]

And when people point out the intrinsic difficulty in that and the dangers posed by this pathogen calling that FUD (fear uncertainty and doubt) is just BS. Clean up your act please

Read what I wrote again, with comprehension.

 

[dfwatt]

Three specializations, practice in Immunology related fields and Internal Medicine.

I apologize for this but I simply don't believe you. You do not talk like someone with a background in Immunology. So you're claiming to be an MD with a practice in ID is that correct?

 

[SageBrush]

Please clarify as to which of the following you're disagreeing with:

This all misses the point.
Covid-19 disease is not isolated/quarantined based on severity
Severe Covid-19 disease is often a week or longer into the infectious phase
Diseases such as Influenza are subject to minimal public health measures
There is NO evidence to date that any point mutation in the virus since the outbreak began in Hubei has changed virulence

You are comparing Apples to Teslas. You should not compare covid-19 to measles because the former has widespread vaccination (excluding hot-pockets of stupidity) and you should not compare covid-19 to Influenza where there are large differences in Public Health measures.

 

[dfwatt]

This all misses the point.
Covid-19 disease is not isolated/quarantined based on severity
Severe Covid-19 disease is often a week or longer into the infectious phase
Diseases such as Influenza are subject to minimal public health measures
There is NO evidence to date that any point mutation in the virus since the outbreak began in Hubei has changed virulence

You are comparing Apples to Teslas. You should not compare covid-19 to measles because the former has widespread vaccination (excluding hot-pockets of stupidity) and you should not compare covid-19 to Influenza where there are large differences in Public Health measures.

I can see that you've dodged the question about whether you are in fact a physician with a background in ID. Therefore I have to assume that what you were saying earlier is a lie. That unfortunately invalidates everything else you've been saying.

 

[KarenRei]

This all misses the point.
Covid-19 disease is not isolated/quarantined based on severity

Which in turn misses the point that no disease is quarantined until its noticed.

Severe Covid-19 disease is often a week or longer into the infectious phase

Why are we talking about "a week"? Places like northern Italy and Daegu went for months without being noticed. It's not about what happens with any single person; it's about what happens collectively in an area over time.

 

[SageBrush]

I apologize for this but I simply don't believe you.

<<shrug>>
I have to apologize in turn. I wondered if you are too far removed from Medicine by time and education to be relevant.