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Life and Death in a Wuhan Coronavirus ICU

455 points by therealcamino 7y ago

lefstathiou 7y ago
I've learned more about the virus reading this article than anything else I've read over the past weeks.
- ETHisso2017 7y ago
  This. I've begun to realize that part of the reason you see so much pontification from journalists on the Chinese government's supposed failings is that you don't have to be in danger to write such articles. Real objective reporting like this takes personal courage.
- Alex3917 7y ago
  I submitted this already, but this is worth reading also: https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/conference-call-coronavirus-expert https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/confere...
  - codeulike 7y ago
    Thanks for that, it was interesting and quite anti-panic.
    - pnw_hazor 7y ago
      Now it seems healthcare workers are readily getting infected. "A study has found that 40 health-care workers were infected with the novel coronavirus by patients at a single Wuhan hospital in January, underscoring the risks to those at the frontlines of the growing epidemic." https://www.straitstimes.com/asia/east-asia/coronavirus-chinas-death-toll-hits-717-as-hubei-province-reports-81-new-fatalities https://www.straitstimes.com/asia/east-asia/coronavirus-chin...
      - russli1993 7y ago
        yeah, in the early days, before mid of January, health care workers did not know what it was so a significant number got infected. And in the early days the local hospitals were overwhelmed with patients and the supplies were running short, some got infected. Now there are a lot of medical staff coming from other regions, and staff is pretty well protected. Hopefully we do not hear anymore medical staff infected.
      - tim333 7y ago
        From the main article: >...South Central Hospital. The deputy director went there to help in their ICU. He found that two-thirds of the medical staff in the ICU were already infected. I was thinking maybe they should get low risk health workers (young fit) to deliberately get the virus under holiday conditions and then return to run the hospitals when immune.
    - seibelj 7y ago
      I have been telling everyone to relax, these mass media panics about some virus happen every few years like clockwork. We are primed as a society to fear China right now so a panic like this is right on schedule.
      - WillPostForFood 7y ago
        Do you think it is a mass media panic within China? Because if you look at what is going on, it doesn’t look like the response to a yearly flu. It looks like a gravely serious event.
        russli1993 7y ago
        The big difference between this and flu is that there is no effective drug and vaccine. Some people react mildly to the virus, some people's immune system seems to compromised by the virus quickly. It also seems to have long incubation periods and high infection rate. In a city as dense as China, it would spread quick from person to person. So the only effective way to reduce infection is to quarantine people. Not allow them to gather around. Flu is actually affects a lot of people too. It just not a "massive event" because we dont try to contain it. It would take a similar measure to try to contain flu if there is no flu vaccine
  - UncleOxidant 7y ago
    That was very informative and tempers a lot of the fearmongering out there.
  - eloff 7y ago
    He's the expert, and I'm not. But I can do math. Influenza this year in the US: 19M infected and 10K fatalities. If you posit 1% mortality rate for coronavirus like he argues, that's 20 times more deadly. And it's twice that in China, it's unclear if that's a statistical anomaly or a structural feature of some difference in how things are tested/reported in China. So I'm not going to just shrug and say it's no big deal. It could be. I'm a programmer, I know powers of 2 intimately. We're at 2^15 and doubling every 5 days. If that keeps up for a month we'll be at 1M infected and 16K dead. From there it's another 50 days to 1B infected and 1-2M dead. I'm keeping an eye on that, if it doesn't slow down before 2^20 (1M) then I've already planned to bug out with my loved ones to the mountains of Panama for a couple months until this blows over. I think it won't come to that, but I'm keeping an eye on the progression and doubling rate. The thing with exponential growth is it always ends. The question here is does it end in time?
    - baxtr 7y ago
      You can only do the math right if you get counter and denominator right. The number of unreported cases is probably very high. I found this in the article posted above: ”So the 20,000 cases in China is probably only the severe cases; the folks that actually went to the hospital and got tested. The Chinese healthcare system is very overwhelmed with all the tests going through. So my thinking is this is actually not as severe a disease as is being suggested. The fatality rate is probably only 0.8%-1%. There’s a vast underreporting of cases in China. Compared to Sars and Mers we are talking about a coronavirus that has a mortality rate of 8 to 10 times less deadly to Sars to Mers. So a correct comparison is not Sars or Mers but a severe cold. Basically this is a severe form of the cold.”
      - eloff 7y ago
        I'm using his mortality rate of 1%. That's 20x the mortality rate of influenza in the US. If it's 2% like the media reports then it's 40x. It doesn't really matter to me, either way is too deadly for my liking.
        WrtCdEvrydy 7y ago
  - blackrock 7y ago
    That was a good read. This is what should be shared. The entire world is going into a freaking panic over this. And they’re spewing out nonsense that the China government is lying, and their numbers cannot be trusted. Which doesn’t really help the situation, and it clouds the scientific understanding of this incident. Then the 2 moronic scientific papers that were published whipped everyone up into a frenzy. (1) The German paper said that people can transmit it asymptomatically, which means this is some kind of Frankenstein virus that can transmit over 14 days, and infect others when not showing any symptoms. (2) The Indian paper that suggested that this virus was man-made, and thus fueled the conspiracy theories about it being a bio weapon. And this fed more fuel to the fire for #1. Two scientific papers that were both terribly wrong! And what was the result? It created mass panic. So there you have it. Fake news that created real mass panic in the real world. Some good highlights from this transcription were: * This is like SARS, but less deadly. Yes, it is infectious and contagious, but it is also less deadly than SARS. * The virus will likely burn out in May, because it doesn’t do well in warm and humid weathers. So Australia with its hot wildfires will be spared. Go take a vacation in the hot and dry outback of Australia everyone. You’ll be fine out there. * The 2.2 reproductive R0 number is a perfect theoretical scenario, but it will likely not happen in this case, since China mandated the quarantine. And the entire country is a ghost town, with people wearing face masks in public, and avoiding any outdoor activities. This should help to slow the spread, and kill off the virus, like how SARS mysteriously disappeared. So, governments around the world, need to be vigilant, and do what they can to contain the spread of the virus, but we should be ok. There is no need to panic right now. The fear is worse than the disease. The leaders of the world needs to step forward and make regular public health announcements about this. And to calm the public down, and stick to known scientific facts and evidence. Unfortunately, we have morons as our elected leaders.
- 0xebfc 7y ago
  If you want detailed virological and epidemiological research and discussion, please see: http://virological.org/ http://virological.org/ There are other virology / epidemiology forums which may be of use, but I don't have these links at-hand. For instance, the following link is a highly descriptive, accessible analysis of nCoV-2019: http://virological.org/t/analysis-of-wuhan-coronavirus-deja-vu/357/4 http://virological.org/t/analysis-of-wuhan-coronavirus-deja-... OPs article does have merit, as far as giving a first-person account of treating the virus and quarantine procedures, but you'll learn a lot more about the virus itself if you follow the research.
  - thedudeabides5 7y ago
    Ok and what does this mean? “ nCoV2019 has a furin-sensitive motif at the traditional S1/S2 border fo the spike protein, i.e. RRAR, that was lacking in SARS (which depends on cathepsin cleavage a few amino acids downstream). nCoV2019 lacks the secondary minimal furin cleavage site, i.e. RNTR, that is found in SARS. Therefore, the endoproteolytic cleavage pattern is expected to be different between nCoV2019 and SARS. Prediction of O-glycosylation sites reveals a cluster of Serine residues, just before and after the RRAR cleavage site, with a high propensity to form a “mini-mucin” patch at that site. It is positioned to protect the putative fusion peptide region in the native or pre-fusion Swiss-Model projection of the probable nCoV2019 structure.” Not sure how to ‘follow the research’ when the first page has 12 proper nouns/terms I’ve never encountered...
    - eindiran 7y ago
      Furin --> A protein. https://en.wikipedia.org/wiki/Furin https://en.wikipedia.org/wiki/Furin Spike protein --> the proteins on the surface of a virus used to attach onto or enter a host cell. https://en.wikipedia.org/wiki/Peplomer https://en.wikipedia.org/wiki/Peplomer RRAR --> This is a group of amino acids: Arginine Arginine Alanine Arginine. Here is the list of abbreviations: https://www.ncbi.nlm.nih.gov/Class/MLACourse/Modules/MolBioReview/iupac_aa_abbreviations.html https://www.ncbi.nlm.nih.gov/Class/MLACourse/Modules/MolBioR... For a discussion of cleavage --> https://en.wiktionary.org/wiki/endoproteolytic https://en.wiktionary.org/wiki/endoproteolytic For a discussion of it relevant to another virus --> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC103966/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC103966/ Mucin --> https://en.wikipedia.org/wiki/Mucin https://en.wikipedia.org/wiki/Mucin O-Glycosylation --> https://en.wikipedia.org/wiki/O-linked_glycosylation https://en.wikipedia.org/wiki/O-linked_glycosylation So this is a discussion of the differences in how these viruses uses their respective spike proteins to trigger endoproteolytic cleavage in the host cell. Specifically, what the impact of different positionings of their amino acids is. For example, the idea "Furin-sensitive motif" means that there is a section of the spike protein which contains the amino acids described (RRAR), which is sensitive to the protein Furin in host cells. See here as well: https://www.researchgate.net/publication/6756975_Proteolysis_of_Sars-Associated_Coronavirus_Spike_Glycoprotein https://www.researchgate.net/publication/6756975_Proteolysis...
- nitwit005 7y ago
  I've noticed the English language media has been big on facts and events, but generally provide little context besides the usual unhelpful short quotes.
loceng 7y ago
"The most regretful thing to me was a pregnant woman from Huanggang. She was in very serious condition. Nearly 200,000 yuan (S$39,505) was spent after more than a week in the ICU. She was from the countryside, and the money for hospitalisation was borrowed from her relatives and friends. Her condition was improving after the use of Ecmo, and she was likely to survive. But her husband decided to give up. He cried for his decision. I wept too because I felt there was hope for her to be saved. The woman died after we gave up. And exactly the next day, the government announced a new policy that offers free treatment for all coronavirus-infected patients. I feel so sorry for that pregnant woman." I had the unchecked belief that China claiming to be a communist country would be covering medical costs. Above reminded me of this: "'He cannot speak or look after himself': A 17-year-old with cerebral palsy died after being left alone for 6 days while Chinese authorities quarantined his father over coronavirus fears" - https://www.businessinsider.com/teenager-cerebral-palsy-dies-father-quarantined-suspected-coronavirus-china-2020-2 https://www.businessinsider.com/teenager-cerebral-palsy-dies... Edit: I really can't understand why anyone would downvote this comment - the downvotes are making me laugh.
- msie 7y ago
  "The boy's aunt told Damihexiaomi that she fed Cheng three times and changed his clothes twice during the six days that he was alone. Her own poor health prevented her from doing more. When she stopped by to take care of Cheng on Tuesday, his condition was already on the decline, the Post reported. "
- malandrew 7y ago
  The medical system there is far more similar to the US system than the European system. It fails some of its citizens the same way the US system fails some of its citizens. Yet it is also similar to the US system is that it is fostering more medical innovation than socialized systems as well. Basically it is similar in both good and bad ways. China has made more gains in medical R&D than pretty much any other country besides the US and a lot of that has to do with the fact that it allows firms to profit like the US does. It's the second biggest drug market after the United States and I believe it's also the second biggest market for clinical trials after the US.
saltedonion 7y ago
When the innocent pays for the mistakes of the regime.
2bitencryption 7y ago
I'm curious, for most of the infected, is it obvious from the symptoms whether they have novel coronavirus, or just the regular flu? That is, the tail end is clearly deadly -- but for the average case, are symptoms much worse than the yearly flu, or around the same?
- erredois 7y ago
  Most have problem breathing and require hospitalization. Thats the main problem with this disease, it overwhelms the health system with this cases.
  - empath75 7y ago
    I don’t think it’s correct that most do. I think most people have mild symptoms. I’ve seen statistics that up to half of the people that end up in the hospital die, though.
- istorical 7y ago
  Beyond the actual mortality rate or possible sequelae (which seemed to occur in post-SARS survivors), the real danger lies in what the actual percentage of cases requiring hospitalization due to severity of pneumonia is (serious + critical condition). Some believe it to be a much higher percentage of the total # of cases than something like the flu, meaning if the infection spreads as much as the normal flu, we may see a shortage of ICU beds and respirators.
  - mantap 7y ago
    The corollary of this is that you don't even have to be infected with the coronavirus to die because of it. This coronavirus acts as figurative denial of service attack against hospitals. Anybody with a medical emergency is going to have an incresed risk of mortality if hospitals are swamped with an epidemic.
    - blackrock 7y ago
      This is actually a fitting description. It’s effectively a distributed denial of service attack (DDOS) on the medical system. There are a lot of old people in Wuhan and the province, that those that gets a heart attack or an old age ailment, where they normally would have been saved, will now die. This is a terribly tragic secondary effect.
scubaguy 7y ago
The original article (chinese version) http://china.caixin.com/2020-02-05/101511802.html http://china.caixin.com/2020-02-05/101511802.html
notkaiho 7y ago
Did you see Eric Raymond having a completely normal one about novel Coronavirus? http://esr.ibiblio.org/?p=8587 http://esr.ibiblio.org/?p=8587
- UncleOxidant 7y ago
  He seems nice. (wow, what a huge amount of fear mongering and conspiracy theories there)
- newnewpdro 7y ago
  ESR should stick to writing jargon files.
  - plapetomain 7y ago
    I think he pretty much fucked that up to...
    - ggm 7y ago
      Hear hear! Ego overdrive.
- _jal 7y ago
  An excellent example of how expertise and reasoning ability in one domain does not necessarily transfer to another. That humility is hard for engineers is something I try to remind myself daily.
  - mhh__ 7y ago
    https://xkcd.com/1570/ https://xkcd.com/1570/
- 8bitsrule 7y ago
  Meanwhile ... the news on the Lieber story[0], which first appeared 5 weeks ago, has gone silent. Interesting coincidence. Of course, on Reddit it's been combined with Epstein. BTW, in case you run across it, here's what 'BSL-4' means.[1] [0] https://www.npr.org/2020/01/28/800442646/acclaimed-harvard-scientist-is-arrested-accused-of-lying-about-ties-to-china https://www.npr.org/2020/01/28/800442646/acclaimed-harvard-s... [1] https://consteril.com/biosafety-levels-difference/ https://consteril.com/biosafety-levels-difference/
allovernow 7y ago
Honestly if there is truth to this article it is reassuring. I've been scouring the darker corners of the internet obsessively for every seemingly reputable bit of data under the assumption that virtually anything official out of China could not be trusted. This doctor is working on the absolute worst of cases and even they, it seems, have a high overall probability of survival. Also good to see some figures on the progression of the virus - 5-10 days of incubation, 1 week before symptoms either improve or worsen, then one more week before severe cases recover or die. Regardless, we should all be paying attention to the quarantined cruise ships. In a few weeks or so we'll have much a more accurate mortality rate. I feel for those people but perhaps there is some comfort in knowing that their losses will not be without value.
- DanielleMolloy 7y ago
  Isn’t Caixin Global a Chinese news source, almost certainly filtered? Do you have a reason to believe them more than the dark corners?
  - user5994461 7y ago
    The WHO also announced 5-6 days average incubation with a mortality rate around 3%.
    - allovernow 7y ago
      The WHO has been reporting numbers almost identical to those out of China, which are unquestionably and severely underreported and can only represent a distant lower bound. I don't think anything coming from the WHO can be trusted. I honestly think it hugely irresponsible for the WHO to report these numbers without clear disclaimers. In fact, there are clear politics at play here, as the WHO has only come out with massive praise for China's response, making no mention of the CCP's clear attempt to keep knowledge of the virus from spreading and the silencing of activists and the medical community at large by charging them with spreading false rumors. If China had taken proactive measures months ago instead of initiating a campaign of suppression things would be different now.
eindiran 7y ago
> Doctors there were running "naked" as they knew they were set to be infected given the shortage of protective gear. They still worked there nonetheless. That is so rough, especially since some healthcare workers are now among the dead: specifically, I saw that Li Wenliang had died. https://www.straitstimes.com/asia/east-asia/chinese-doctor-who-tried-to-warn-colleagues-in-wuhan-about-coronavirus-dies https://www.straitstimes.com/asia/east-asia/chinese-doctor-w...
- peteretep 7y ago
  Last thing the CCP needs is martyrs against the state
  - 101404 7y ago
    The CCP media machine will know how to spin it.
  - microcolonel 7y ago
    They briefly pronounced him undead, then dead again, IIRC.
  - Forgivenessizer 7y ago
    Easily solved by turning him into a state hero.
    - sudosysgen 7y ago
      A state hero that the state arrested and silence just weeks earlier? That would be transparent.
- aphextron 7y ago
  > "Doctors there were running "naked" as they knew they were set to be infected given the shortage of protective gear. They still worked there nonetheless." The absolute definition of heroes. It blows my mind to imagine ever having that sort of selfless dedication to helping others. For all the crappy things in the world these days, it's stuff like this that gives me hope for humanity.
mullingitover 7y ago
> That was why ICU medical staff were almost all sickened. This is a brilliant strategy for spreading the virus to any patients who might've come in with regular cold or flu and hadn't been infected with coronavirus yet. This is like a commercial for why we need to build medical telepresence robots.
- cycrutchfield 7y ago
  If they were in the ICU in a severe or critical state, they already had the virus. ICU is not the same as the regular hospital admissions.
tempsy 7y ago
This whole thing has brought out my conspiratorial side...I don’t know what to believe anymore but I feel like we’re in a tip of the iceberg situation here. Hope I’m wrong.
- tim333 7y ago
  The https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/conference-call-coronavirus-expert https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/confere... article linked by someone above is quite a good antidote to the worries
one2know 7y ago
Some say the mortality rate is 10-20% because the 1-2% numbers being passed around are comparing current deaths against current population who have the disease. Current deaths should be compared to the population that had the disease at the time they contracted it which was 1-2 weeks ago. The epidemic began only two weeks ago. https://qz.com/1798887/china-coronavirus-fatality-rate-is-too-early-to-tell/ https://qz.com/1798887/china-coronavirus-fatality-rate-is-to...
- lainga 7y ago
  How useful is comparing deaths to confirmed recoveries?
  - kragen 7y ago
    While the epidemic is still in an exponential growth phase, not very useful, because death and recovery may not take the same average time from initial symptoms. Even a small difference in time will result in a huge bias in the death/recovery ratio, which right now is about 1:3, using the official statistics.
lukaa 7y ago
I think we are dealing with black swan event. It's new disease, higly contagious and with 200 more deathly rate than flu. Since we don't know much about that disease and how much that virus can mutate being extra cautious is best strategy.
- xvector 7y ago
  > with 200 more deathly rate than flu. Source? I've not seen any published number higher than 5%.
- dredmorbius 7y ago
  Case mortality rate for typical flu in the US/EU is about 0.05% - 0.1%. (High-consequence flu strains such as H5N1 can have case fatality rates of as much as 60%. Not all flus are created equal.) Case mortality rate for 2019-nCoV has been reported from 1% to as high as 6%, with lower values more plausible. That's a 10x to 120x greater mortality, and again, lower rates appear more likely. The high end isn't great, but is still below 200x. Key differences are that we have vaccine and curative treatment for influenza. Neither are 100%, but both are effective in many cases.
- bredren 7y ago
  I also suspect this is possible.
srik 7y ago
What can we do right now to increase our bio immunity for this?
- ImaCake 7y ago
  Nothing much. If the infection breaks out near you, avoid crowds, wash your hands frequently, and don't touch your face (especially nose) with said hands. SARS and it's ilk kill the old and sick, not the young, so avoid your grandparents or elderly parents. If there's little or no infection near you, I wouldn't do anything yet.
- dredmorbius 7y ago
  Vector reduction. That's the principle mechanism of public health to epidemiological outbreaks: reduce the likelyhood and rate of transmission between people. This is why the appropriate response is to curtail transport, especially long-distance modes which occur faster than onset of symptoms (e.g., air flights from known epidemic zones). It's why locking down cities within epidemic zones, restricting mobility between cities where outbreaks have occurred, wearing barrier protection to prevent both contracting and transmitting particles, disinfecting infected surfaces, and limiting social and business contact, are all primary responses. Get a flu shot, if you haven't already. Not because it'll keep you from getting 2019-nCoV, but because you don't want to be confusing having the flu with having nCoV, and you don't want to have to be out getting treated for flu whilst nCoV's circulating. And having all others treating you like Typhoid Mary to boot. Wash your hands. Carry (and use) alcohol-based hand sanitiser. (Antibiotic is useless against virus.) Wash the doorknobs, light switches, taps, knobs/pulls, and bannisters in your home, regularly. Keep visitors and guests to a minimum. Don't touch your hands to your face, eyes, nose, or ears. Look for indications of breakout in your area on news or online. Realise that if there's a breakout, the disease has likely already been circulating for several weeks, e.g., the risk is high. Currently, outside of China, there are very few places at risk -- Singapore, Hong Kong, Japan, Korea, Japan, Thailand, and South Korea are the major additional locations. Transmission seems to require several hours of fairly close contact. Stocking up on cleaning supplies generally makes more sense than masks, which are of limited use or efficacy. Some somewhat nonobvious practices (salt-infused masks, apparently, others may exist) seem to reduce transmission or viral capability profoundly. For now, the containment trends are strongly positive, outbreaks outside China are quite limited, and it looks as if measures are effective. It'll be another few weeks before this is certain, things could still go quite badly, but signs are encouraging. Most notably, the new cases and deaths trends are dropping well below their initial exponential trajectory: https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_outbreak#/media/File%3ALog-linear_plot_of_coronovirus_cases_with_linear_regressions.png https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_ou... https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_outbreak#/media/File:Semi-log_plot_daily_incidence_of_nCoV.png https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_ou... Comments I made yesterday on Diaspora regarding this, and pointer to a now 10-day-old post based on the then exponential growth, in which I'd suggested we should see containment working on new cases by early February, and deaths by mid-February (we're actually trending well ahead of that): https://joindiaspora.com/posts/17158824 https://joindiaspora.com/posts/17158824 Disclaimers: lay views, not an expert.
nabla9 7y ago
If they screw up other measures, like hygiene for the sick and food delivery to 50 million people they can multiply the death rate. Modern theory of Spanish flu[1] is that the flu itself was not that deadly. Combination of influenza with bacteria in the lungs caused most of the deaths. It was the World War I with lots of wounded in the same place, bad hygiene conditions, many with scarred lungs from poison gas and civilians suffering from malnutrition. [1]: Bacterial Pneumonia Caused Most Deaths in 1918 Influenza Pandemic - Implications for Future Pandemic Planning https://www.nih.gov/news-events/news-releases/bacterial-pneumonia-caused-most-deaths-1918-influenza-pandemic https://www.nih.gov/news-events/news-releases/bacterial-pneu... > However, it is possible that — as in 1918 — a similar pattern of viral damage followed by bacterial invasion could unfold, say the authors. Preparations for diagnosing, treating and preventing bacterial pneumonia should be among highest priorities in influenza pandemic planning, they write. "We are encouraged by the fact that pandemic planners are already considering and implementing some of these actions," says Dr. Fauci.
- 0x8BADF00D 7y ago
  There are very little details on how the bodies are being disposed of. Does the virus become dormant at a certain temperature ranges? How does it fare with irradiation? These are the kinds of experiments that need to be run.
  - 9nGQluzmnq3M 7y ago
    The bodies are all being incinerated. https://www.news.com.au/lifestyle/health/health-problems/chinese-authorities-ban-burials-and-funerals-in-favour-of-instant-cremation/news-story/b0e7a912de24528b9e8bf5af628aa449 https://www.news.com.au/lifestyle/health/health-problems/chi...
- PeterisP 7y ago
  Spanish flu killed very many people in regions that did not directly participate in WWI, so civilians (as opposed to recruits sent overseas) should not be affected by the war; e.g. India, Indonesia, etc. The half a million people who died of the Spanish flu in USA did not die because lots of wounded in the same place and scarred lungs from poison gas.
burnJS 7y ago
Does that lead image tell you something? They are in full gear treating this guy. Would Doctors be geared up like that treating someone for the flu?
- gwbas1c 7y ago
  Doctors get the flu vaccine.
forgingahead 7y ago
Great article all around, worth reading as it's one of the only I've seen that are actually talking about disease progression and timeline. Some key info from the article: ---- Caixin: Based on your clinical experience, what's the disease progression of the new coronavirus? Peng: Lately I've been spending the daytime seeing patients in the ICU, then doing some research in the evenings. I just wrote a thesis. I drew on data from 138 cases that South Central Hospital had from Jan 7 to Jan 28 and attempted to summarise some patterns of the novel coronavirus. A lot of viruses will die off on their own after a certain amount of time. We call these self-limited diseases. I've observed that the breakout period of the novel coronavirus tends to be three weeks, from the onset of symptoms to developing difficulties breathing. Basically going from mild to severe symptoms takes about a week. There are all sorts of mild symptoms: feebleness, shortness of breath, some people have fevers, some don't. Based on studies of our 138 cases, the most common symptoms in the first stage are fever (98.6 per cent of cases), feebleness (69.6 per cent), cough (59.4 per cent), muscle pains (34.8 per cent), difficulties breathing (31.2%), while less common symptoms include headaches, dizziness, stomach pain, diarrhea, nausea, vomiting. But some patients who enter the second week will suddenly get worse. At this stage, people should go to the hospital. The elderly with underlying conditions may develop complications; some may need machine-assisted respiration. When the body's other organs start to fail, that's when it becomes severe, while those with strong immune systems see their symptoms decrease in severity at this stage and gradually recover. So the second week is what determines whether the illness becomes critical. The third week determines whether critical illness leads to death. Some in critical condition who receive treatment can raise their level of lymphocytes, a type of white blood cell, and see an improvement in their immune systems, and have been brought back, so to speak. But those whose lymphocyte numbers continue to decline, those whose immune systems are destroyed in the end, experience multiple organ failure and die. For most, the illness is over in two weeks, whereas for those for whom the illness becomes severe, if they can survive three weeks, they're good. Those that can't will die in three weeks. ----- Whole thing is worth reading.
- not_a_moth 7y ago
  Should add their discussion of cytokine storms in healthy people, which appears to have a more rapid timeline > Some experts argue that the virus triggers a cytokine storm, which ravages the stronger immune system of young adults > Based on my observations, a third of patients exhibited inflammation in their whole body. It was not necessarily limited to young adults. The mechanism of a cytokine storm is about whole-body inflammation, which leads to a failure of multiple organs and quickly evolves into the terminal stage. In some fast-progressing cases, it took two to three days to progress from whole-body inflammation to the life-threatening stage.
oxymoran 7y ago
Even in Communist China, people are turned away from hospitals due to inability to pay for treatment...that’s the worst irony I have ever heard. This disease is virulent and unpredictable. A 34 year old doctor died. 12 hospitals are being built at breakneck speed. This will become endemic at this rate. Either we create a vaccine or we each roll the dice on acquired immunity and too many people die in the process. It is time to be concerned.
- rajup 7y ago
  > Even in Communist China, people are turned away from hospitals due to inability to pay for treatment...that’s the worst irony I have ever heard. If you had read the whole article you would have learnt that treatment is free for those affected. > It is time to be concerned. Concerned sure, alarmed no, like your post seems to tend towards.
  - t0mas88 7y ago
    It became free the day after the person already died for lack of funds for treatment. Very very sad case.
xbmcuser 7y ago
The number of people dying each day from this corona virus is increasing and these are official numbers so might be under reported. 29-30th Jan around 40 people were dying a day now it has reached 80-90. When you take into account the number of infected is still increasing and no real way to control the spread or treat the virus this is going to be way worse in the next few weeks. https://voice.baidu.com/act/newpneumonia/newpneumonia https://voice.baidu.com/act/newpneumonia/newpneumonia
- microcolonel 7y ago
  As the share of the population that is infected grows, the death rate for complications will increase dramatically. It is already extreme, and it is expected to grow exponentially into April (at least in Hubei). Up to the limits of medical facilities, your odds will be good, but it takes a lot of resources to keep patients alive when they are experiencing complications, and those resources are inherently limited.
torgian 7y ago
My wife is mainland Chinese, and she has been saying that it a worse than what the government is saying. Also, since Li Wenliang died, well, frankly a lot of people are pissed at the CCP. Anyway, I feel like it’ll be an epidemic ( it already is, I believe ) in China, and be much better controlled outside of China. Unfortunately my wife is also stuck in Chongqing; Taiwan is essentially closing up its borders and we don’t know if she’ll be able to move here to Taiwan to live with me. At least not until things blow over ( I assume summer time ). I live in Taiwan and they’ve been very good at containing this, afaik. Just this morning they released a map of Taiwan with nav-points where all the cruise ship people were at in Taiwan before they went on the ship, and released information on what to do if you experience certain symptoms. 13 people have been diagnosed and quarantined.
- ShorsHammer 7y ago
  How would you say it is outside of China, are all those governments lying too? 2 deaths now, one of which is in HK. How terrifying. > Anyway, I feel like it’ll be an epidemic So worse than the flu which kills 650,000 people in a bad season? Worse than traffic accidents which kill 1.2 million each year? You should be utterly terrified of cars considering the fear surrounding this mediahype virus Edit: Ahh yes that regular feeling of commenting about China on Hacker/Dunning Kruger News. Good luck folks, hope you all survive this flavour of the month apocalypse unscathed.
- zozbot234 7y ago
  > Also, since Li Wenliang died, well, frankly a lot of people are pissed at the CCP. This is a pretty irrational reaction if you ask me, the CCP is actually the more open, quasi-democratic side of Chinese government and politics. There are loose 'factions' as part of the CCP that are cautiously pushing for more openness, and the Chinese should be aware of them and be supportive. Frustration and anger are not helpful.
  - yspeak 7y ago
    What ?? CCP is the government. https://en.m.wikipedia.org/wiki/Communist_Party_of_China https://en.m.wikipedia.org/wiki/Communist_Party_of_China
bx32 7y ago
It was worth reading and by any measure the first great writeup on the virus and the bravery to fight it.
bx32 7y ago
The whole thing is worth reading. Hats off to all the bravery around to fight the virus and save lives.
rsecora 7y ago
The sad story of the pregant woman described in the Strait Times article, is described in this link http://www.sixthtone.com/news/1005146/dispatches-from-hubei-two-weeks-between-life-and-death http://www.sixthtone.com/news/1005146/dispatches-from-hubei-...
achow 7y ago
This was the most valuable piece of info for me, which I shared among my social circle: Doctor observed that three weeks seemed to determine the difference between life and death. - Patients with stronger immune systems would start to recover in a couple of weeks - Second week, some cases would take a turn for the worse. - In the third week, keeping some of these acute patients alive might require extraordinary intervention. For this group, the death rate seems to be 4 per cent to 5 per cent.
barkrokli9990 7y ago
ICU Medical’s products are designed to prevent bloodstream infections and protecting healthcare workers from exposure to infectious diseases or hazardous drugs. https://www.adwebstudio.com/seo-dubai https://www.adwebstudio.com/seo-dubai
rixrax 7y ago
If you get sick with 2019-nCoV, and recover, do we know if You have developed immunity against it at that point?
- frank2 7y ago
  I don't know, but if the answer is no, then a vaccine against it is not going to confer immunity either.
- Brave-Steak 7y ago
  I’ve seen studies indicating that reinfection with SARS was possible. It’s not unlikely.
bullen 7y ago
If you look at the graphs here: https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/ And know that in 3 weeks everyone either dies or has recovered. Doesn't that mean we will see a large amount of total deaths in a couple of weeks? Those graphs are both exponential! Remember that cases are subjectively selected, while deaths have a fixed statistical variance!
- hef19898 7y ago
  The WHO is regularly publishing situation reports with all kinds of data in there. Maybe you go and have a look those?
- bredren 7y ago
  Those graphs depict Total Cases and Total Deaths. (This presentation of data is sometimes used by startups trying to show their amazing growth off to potential investors.) If you look at the daily change in amounts of deaths from this data series, it is more of a wobbly straight line: https://i.imgur.com/gQajRT9.png https://i.imgur.com/gQajRT9.png I did a linear projection of this data series to see how long it would take for a 1000 a day to be perishing if this trend and I came up with 8/8. Can anyone else replicate this? I would hope containment would slow these numbers, but it is possible it could go another way. If the data itself is underreported then it could also be worse.
  - bullen 7y ago
    Ah, ok... thx! I guess the number of serious condition jumping from 5000 to 6000 since last I looked yesterday or the day before was what startled me...
ilkan 7y ago
There's an understandably big focus on mortality/non-mortality. It seems that people are classified recovered and sent home after 3 to 14 days of tests are clear (depending on the hospital) but I haven't seen estimates for full recovery from symptoms and fatigue afterwards. Many companies run very lean... Is it likely 2 weeks off work per person after hospital discharge? 4?

455 points by therealcamino 7y ago

lefstathiou 7y ago

I've learned more about the virus reading this article than anything else I've read over the past weeks.

ETHisso2017 7y ago
This. I've begun to realize that part of the reason you see so much pontification from journalists on the Chinese government's supposed failings is that you don't have to be in danger to write such articles. Real objective reporting like this takes personal courage.
Alex3917 7y ago
I submitted this already, but this is worth reading also: https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/conference-call-coronavirus-expert https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/confere...
- codeulike 7y ago
  Thanks for that, it was interesting and quite anti-panic.
  - pnw_hazor 7y ago
    Now it seems healthcare workers are readily getting infected. "A study has found that 40 health-care workers were infected with the novel coronavirus by patients at a single Wuhan hospital in January, underscoring the risks to those at the frontlines of the growing epidemic." https://www.straitstimes.com/asia/east-asia/coronavirus-chinas-death-toll-hits-717-as-hubei-province-reports-81-new-fatalities https://www.straitstimes.com/asia/east-asia/coronavirus-chin...
    - russli1993 7y ago
      yeah, in the early days, before mid of January, health care workers did not know what it was so a significant number got infected. And in the early days the local hospitals were overwhelmed with patients and the supplies were running short, some got infected. Now there are a lot of medical staff coming from other regions, and staff is pretty well protected. Hopefully we do not hear anymore medical staff infected.
    - tim333 7y ago
      From the main article: >...South Central Hospital. The deputy director went there to help in their ICU. He found that two-thirds of the medical staff in the ICU were already infected. I was thinking maybe they should get low risk health workers (young fit) to deliberately get the virus under holiday conditions and then return to run the hospitals when immune.
  - seibelj 7y ago
    I have been telling everyone to relax, these mass media panics about some virus happen every few years like clockwork. We are primed as a society to fear China right now so a panic like this is right on schedule.
    - WillPostForFood 7y ago
      Do you think it is a mass media panic within China? Because if you look at what is going on, it doesn’t look like the response to a yearly flu. It looks like a gravely serious event.
      - russli1993 7y ago
        The big difference between this and flu is that there is no effective drug and vaccine. Some people react mildly to the virus, some people's immune system seems to compromised by the virus quickly. It also seems to have long incubation periods and high infection rate. In a city as dense as China, it would spread quick from person to person. So the only effective way to reduce infection is to quarantine people. Not allow them to gather around. Flu is actually affects a lot of people too. It just not a "massive event" because we dont try to contain it. It would take a similar measure to try to contain flu if there is no flu vaccine
- UncleOxidant 7y ago
  That was very informative and tempers a lot of the fearmongering out there.
- eloff 7y ago
  He's the expert, and I'm not. But I can do math. Influenza this year in the US: 19M infected and 10K fatalities. If you posit 1% mortality rate for coronavirus like he argues, that's 20 times more deadly. And it's twice that in China, it's unclear if that's a statistical anomaly or a structural feature of some difference in how things are tested/reported in China. So I'm not going to just shrug and say it's no big deal. It could be. I'm a programmer, I know powers of 2 intimately. We're at 2^15 and doubling every 5 days. If that keeps up for a month we'll be at 1M infected and 16K dead. From there it's another 50 days to 1B infected and 1-2M dead. I'm keeping an eye on that, if it doesn't slow down before 2^20 (1M) then I've already planned to bug out with my loved ones to the mountains of Panama for a couple months until this blows over. I think it won't come to that, but I'm keeping an eye on the progression and doubling rate. The thing with exponential growth is it always ends. The question here is does it end in time?
  - baxtr 7y ago
    You can only do the math right if you get counter and denominator right. The number of unreported cases is probably very high. I found this in the article posted above: ”So the 20,000 cases in China is probably only the severe cases; the folks that actually went to the hospital and got tested. The Chinese healthcare system is very overwhelmed with all the tests going through. So my thinking is this is actually not as severe a disease as is being suggested. The fatality rate is probably only 0.8%-1%. There’s a vast underreporting of cases in China. Compared to Sars and Mers we are talking about a coronavirus that has a mortality rate of 8 to 10 times less deadly to Sars to Mers. So a correct comparison is not Sars or Mers but a severe cold. Basically this is a severe form of the cold.”
    - eloff 7y ago
      I'm using his mortality rate of 1%. That's 20x the mortality rate of influenza in the US. If it's 2% like the media reports then it's 40x. It doesn't really matter to me, either way is too deadly for my liking.
      - WrtCdEvrydy 7y ago
- blackrock 7y ago
  That was a good read. This is what should be shared. The entire world is going into a freaking panic over this. And they’re spewing out nonsense that the China government is lying, and their numbers cannot be trusted. Which doesn’t really help the situation, and it clouds the scientific understanding of this incident. Then the 2 moronic scientific papers that were published whipped everyone up into a frenzy. (1) The German paper said that people can transmit it asymptomatically, which means this is some kind of Frankenstein virus that can transmit over 14 days, and infect others when not showing any symptoms. (2) The Indian paper that suggested that this virus was man-made, and thus fueled the conspiracy theories about it being a bio weapon. And this fed more fuel to the fire for #1. Two scientific papers that were both terribly wrong! And what was the result? It created mass panic. So there you have it. Fake news that created real mass panic in the real world. Some good highlights from this transcription were: * This is like SARS, but less deadly. Yes, it is infectious and contagious, but it is also less deadly than SARS. * The virus will likely burn out in May, because it doesn’t do well in warm and humid weathers. So Australia with its hot wildfires will be spared. Go take a vacation in the hot and dry outback of Australia everyone. You’ll be fine out there. * The 2.2 reproductive R0 number is a perfect theoretical scenario, but it will likely not happen in this case, since China mandated the quarantine. And the entire country is a ghost town, with people wearing face masks in public, and avoiding any outdoor activities. This should help to slow the spread, and kill off the virus, like how SARS mysteriously disappeared. So, governments around the world, need to be vigilant, and do what they can to contain the spread of the virus, but we should be ok. There is no need to panic right now. The fear is worse than the disease. The leaders of the world needs to step forward and make regular public health announcements about this. And to calm the public down, and stick to known scientific facts and evidence. Unfortunately, we have morons as our elected leaders.
0xebfc 7y ago
If you want detailed virological and epidemiological research and discussion, please see: http://virological.org/ http://virological.org/ There are other virology / epidemiology forums which may be of use, but I don't have these links at-hand. For instance, the following link is a highly descriptive, accessible analysis of nCoV-2019: http://virological.org/t/analysis-of-wuhan-coronavirus-deja-vu/357/4 http://virological.org/t/analysis-of-wuhan-coronavirus-deja-... OPs article does have merit, as far as giving a first-person account of treating the virus and quarantine procedures, but you'll learn a lot more about the virus itself if you follow the research.
- thedudeabides5 7y ago
  Ok and what does this mean? “ nCoV2019 has a furin-sensitive motif at the traditional S1/S2 border fo the spike protein, i.e. RRAR, that was lacking in SARS (which depends on cathepsin cleavage a few amino acids downstream). nCoV2019 lacks the secondary minimal furin cleavage site, i.e. RNTR, that is found in SARS. Therefore, the endoproteolytic cleavage pattern is expected to be different between nCoV2019 and SARS. Prediction of O-glycosylation sites reveals a cluster of Serine residues, just before and after the RRAR cleavage site, with a high propensity to form a “mini-mucin” patch at that site. It is positioned to protect the putative fusion peptide region in the native or pre-fusion Swiss-Model projection of the probable nCoV2019 structure.” Not sure how to ‘follow the research’ when the first page has 12 proper nouns/terms I’ve never encountered...
  - eindiran 7y ago
    Furin --> A protein. https://en.wikipedia.org/wiki/Furin https://en.wikipedia.org/wiki/Furin Spike protein --> the proteins on the surface of a virus used to attach onto or enter a host cell. https://en.wikipedia.org/wiki/Peplomer https://en.wikipedia.org/wiki/Peplomer RRAR --> This is a group of amino acids: Arginine Arginine Alanine Arginine. Here is the list of abbreviations: https://www.ncbi.nlm.nih.gov/Class/MLACourse/Modules/MolBioReview/iupac_aa_abbreviations.html https://www.ncbi.nlm.nih.gov/Class/MLACourse/Modules/MolBioR... For a discussion of cleavage --> https://en.wiktionary.org/wiki/endoproteolytic https://en.wiktionary.org/wiki/endoproteolytic For a discussion of it relevant to another virus --> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC103966/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC103966/ Mucin --> https://en.wikipedia.org/wiki/Mucin https://en.wikipedia.org/wiki/Mucin O-Glycosylation --> https://en.wikipedia.org/wiki/O-linked_glycosylation https://en.wikipedia.org/wiki/O-linked_glycosylation So this is a discussion of the differences in how these viruses uses their respective spike proteins to trigger endoproteolytic cleavage in the host cell. Specifically, what the impact of different positionings of their amino acids is. For example, the idea "Furin-sensitive motif" means that there is a section of the spike protein which contains the amino acids described (RRAR), which is sensitive to the protein Furin in host cells. See here as well: https://www.researchgate.net/publication/6756975_Proteolysis_of_Sars-Associated_Coronavirus_Spike_Glycoprotein https://www.researchgate.net/publication/6756975_Proteolysis...
nitwit005 7y ago
I've noticed the English language media has been big on facts and events, but generally provide little context besides the usual unhelpful short quotes.

loceng 7y ago

"The most regretful thing to me was a pregnant woman from Huanggang. She was in very serious condition. Nearly 200,000 yuan (S$39,505) was spent after more than a week in the ICU. She was from the countryside, and the money for hospitalisation was borrowed from her relatives and friends. Her condition was improving after the use of Ecmo, and she was likely to survive. But her husband decided to give up. He cried for his decision. I wept too because I felt there was hope for her to be saved. The woman died after we gave up. And exactly the next day, the government announced a new policy that offers free treatment for all coronavirus-infected patients. I feel so sorry for that pregnant woman." I had the unchecked belief that China claiming to be a communist country would be covering medical costs. Above reminded me of this: "'He cannot speak or look after himself': A 17-year-old with cerebral palsy died after being left alone for 6 days while Chinese authorities quarantined his father over coronavirus fears" - https://www.businessinsider.com/teenager-cerebral-palsy-dies-father-quarantined-suspected-coronavirus-china-2020-2 https://www.businessinsider.com/teenager-cerebral-palsy-dies... Edit: I really can't understand why anyone would downvote this comment - the downvotes are making me laugh.

msie 7y ago
"The boy's aunt told Damihexiaomi that she fed Cheng three times and changed his clothes twice during the six days that he was alone. Her own poor health prevented her from doing more. When she stopped by to take care of Cheng on Tuesday, his condition was already on the decline, the Post reported. "
malandrew 7y ago
The medical system there is far more similar to the US system than the European system. It fails some of its citizens the same way the US system fails some of its citizens. Yet it is also similar to the US system is that it is fostering more medical innovation than socialized systems as well. Basically it is similar in both good and bad ways. China has made more gains in medical R&D than pretty much any other country besides the US and a lot of that has to do with the fact that it allows firms to profit like the US does. It's the second biggest drug market after the United States and I believe it's also the second biggest market for clinical trials after the US.

saltedonion 7y ago

When the innocent pays for the mistakes of the regime.

2bitencryption 7y ago

I'm curious, for most of the infected, is it obvious from the symptoms whether they have novel coronavirus, or just the regular flu? That is, the tail end is clearly deadly -- but for the average case, are symptoms much worse than the yearly flu, or around the same?

erredois 7y ago
Most have problem breathing and require hospitalization. Thats the main problem with this disease, it overwhelms the health system with this cases.
- empath75 7y ago
  I don’t think it’s correct that most do. I think most people have mild symptoms. I’ve seen statistics that up to half of the people that end up in the hospital die, though.
istorical 7y ago
Beyond the actual mortality rate or possible sequelae (which seemed to occur in post-SARS survivors), the real danger lies in what the actual percentage of cases requiring hospitalization due to severity of pneumonia is (serious + critical condition). Some believe it to be a much higher percentage of the total # of cases than something like the flu, meaning if the infection spreads as much as the normal flu, we may see a shortage of ICU beds and respirators.
- mantap 7y ago
  The corollary of this is that you don't even have to be infected with the coronavirus to die because of it. This coronavirus acts as figurative denial of service attack against hospitals. Anybody with a medical emergency is going to have an incresed risk of mortality if hospitals are swamped with an epidemic.
  - blackrock 7y ago
    This is actually a fitting description. It’s effectively a distributed denial of service attack (DDOS) on the medical system. There are a lot of old people in Wuhan and the province, that those that gets a heart attack or an old age ailment, where they normally would have been saved, will now die. This is a terribly tragic secondary effect.

scubaguy 7y ago

The original article (chinese version) http://china.caixin.com/2020-02-05/101511802.html http://china.caixin.com/2020-02-05/101511802.html

notkaiho 7y ago

Did you see Eric Raymond having a completely normal one about novel Coronavirus? http://esr.ibiblio.org/?p=8587 http://esr.ibiblio.org/?p=8587

UncleOxidant 7y ago
He seems nice. (wow, what a huge amount of fear mongering and conspiracy theories there)
newnewpdro 7y ago
ESR should stick to writing jargon files.
- plapetomain 7y ago
  I think he pretty much fucked that up to...
  - ggm 7y ago
    Hear hear! Ego overdrive.
_jal 7y ago
An excellent example of how expertise and reasoning ability in one domain does not necessarily transfer to another. That humility is hard for engineers is something I try to remind myself daily.
- mhh__ 7y ago
  https://xkcd.com/1570/ https://xkcd.com/1570/
8bitsrule 7y ago
Meanwhile ... the news on the Lieber story[0], which first appeared 5 weeks ago, has gone silent. Interesting coincidence. Of course, on Reddit it's been combined with Epstein. BTW, in case you run across it, here's what 'BSL-4' means.[1] [0] https://www.npr.org/2020/01/28/800442646/acclaimed-harvard-scientist-is-arrested-accused-of-lying-about-ties-to-china https://www.npr.org/2020/01/28/800442646/acclaimed-harvard-s... [1] https://consteril.com/biosafety-levels-difference/ https://consteril.com/biosafety-levels-difference/

allovernow 7y ago

Honestly if there is truth to this article it is reassuring. I've been scouring the darker corners of the internet obsessively for every seemingly reputable bit of data under the assumption that virtually anything official out of China could not be trusted. This doctor is working on the absolute worst of cases and even they, it seems, have a high overall probability of survival. Also good to see some figures on the progression of the virus - 5-10 days of incubation, 1 week before symptoms either improve or worsen, then one more week before severe cases recover or die. Regardless, we should all be paying attention to the quarantined cruise ships. In a few weeks or so we'll have much a more accurate mortality rate. I feel for those people but perhaps there is some comfort in knowing that their losses will not be without value.

DanielleMolloy 7y ago
Isn’t Caixin Global a Chinese news source, almost certainly filtered? Do you have a reason to believe them more than the dark corners?
- user5994461 7y ago
  The WHO also announced 5-6 days average incubation with a mortality rate around 3%.
  - allovernow 7y ago
    The WHO has been reporting numbers almost identical to those out of China, which are unquestionably and severely underreported and can only represent a distant lower bound. I don't think anything coming from the WHO can be trusted. I honestly think it hugely irresponsible for the WHO to report these numbers without clear disclaimers. In fact, there are clear politics at play here, as the WHO has only come out with massive praise for China's response, making no mention of the CCP's clear attempt to keep knowledge of the virus from spreading and the silencing of activists and the medical community at large by charging them with spreading false rumors. If China had taken proactive measures months ago instead of initiating a campaign of suppression things would be different now.

eindiran 7y ago

> Doctors there were running "naked" as they knew they were set to be infected given the shortage of protective gear. They still worked there nonetheless. That is so rough, especially since some healthcare workers are now among the dead: specifically, I saw that Li Wenliang had died. https://www.straitstimes.com/asia/east-asia/chinese-doctor-who-tried-to-warn-colleagues-in-wuhan-about-coronavirus-dies https://www.straitstimes.com/asia/east-asia/chinese-doctor-w...

peteretep 7y ago
Last thing the CCP needs is martyrs against the state
- 101404 7y ago
  The CCP media machine will know how to spin it.
- microcolonel 7y ago
  They briefly pronounced him undead, then dead again, IIRC.
- Forgivenessizer 7y ago
  Easily solved by turning him into a state hero.
  - sudosysgen 7y ago
    A state hero that the state arrested and silence just weeks earlier? That would be transparent.
aphextron 7y ago
> "Doctors there were running "naked" as they knew they were set to be infected given the shortage of protective gear. They still worked there nonetheless." The absolute definition of heroes. It blows my mind to imagine ever having that sort of selfless dedication to helping others. For all the crappy things in the world these days, it's stuff like this that gives me hope for humanity.

mullingitover 7y ago

> That was why ICU medical staff were almost all sickened. This is a brilliant strategy for spreading the virus to any patients who might've come in with regular cold or flu and hadn't been infected with coronavirus yet. This is like a commercial for why we need to build medical telepresence robots.

cycrutchfield 7y ago
If they were in the ICU in a severe or critical state, they already had the virus. ICU is not the same as the regular hospital admissions.

tempsy 7y ago

This whole thing has brought out my conspiratorial side...I don’t know what to believe anymore but I feel like we’re in a tip of the iceberg situation here. Hope I’m wrong.

tim333 7y ago
The https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/conference-call-coronavirus-expert https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/confere... article linked by someone above is quite a good antidote to the worries

one2know 7y ago

Some say the mortality rate is 10-20% because the 1-2% numbers being passed around are comparing current deaths against current population who have the disease. Current deaths should be compared to the population that had the disease at the time they contracted it which was 1-2 weeks ago. The epidemic began only two weeks ago. https://qz.com/1798887/china-coronavirus-fatality-rate-is-too-early-to-tell/ https://qz.com/1798887/china-coronavirus-fatality-rate-is-to...

lainga 7y ago
How useful is comparing deaths to confirmed recoveries?
- kragen 7y ago
  While the epidemic is still in an exponential growth phase, not very useful, because death and recovery may not take the same average time from initial symptoms. Even a small difference in time will result in a huge bias in the death/recovery ratio, which right now is about 1:3, using the official statistics.

lukaa 7y ago

I think we are dealing with black swan event. It's new disease, higly contagious and with 200 more deathly rate than flu. Since we don't know much about that disease and how much that virus can mutate being extra cautious is best strategy.

xvector 7y ago
> with 200 more deathly rate than flu. Source? I've not seen any published number higher than 5%.
dredmorbius 7y ago
Case mortality rate for typical flu in the US/EU is about 0.05% - 0.1%. (High-consequence flu strains such as H5N1 can have case fatality rates of as much as 60%. Not all flus are created equal.) Case mortality rate for 2019-nCoV has been reported from 1% to as high as 6%, with lower values more plausible. That's a 10x to 120x greater mortality, and again, lower rates appear more likely. The high end isn't great, but is still below 200x. Key differences are that we have vaccine and curative treatment for influenza. Neither are 100%, but both are effective in many cases.
bredren 7y ago
I also suspect this is possible.

srik 7y ago

What can we do right now to increase our bio immunity for this?

ImaCake 7y ago
Nothing much. If the infection breaks out near you, avoid crowds, wash your hands frequently, and don't touch your face (especially nose) with said hands. SARS and it's ilk kill the old and sick, not the young, so avoid your grandparents or elderly parents. If there's little or no infection near you, I wouldn't do anything yet.
dredmorbius 7y ago
Vector reduction. That's the principle mechanism of public health to epidemiological outbreaks: reduce the likelyhood and rate of transmission between people. This is why the appropriate response is to curtail transport, especially long-distance modes which occur faster than onset of symptoms (e.g., air flights from known epidemic zones). It's why locking down cities within epidemic zones, restricting mobility between cities where outbreaks have occurred, wearing barrier protection to prevent both contracting and transmitting particles, disinfecting infected surfaces, and limiting social and business contact, are all primary responses. Get a flu shot, if you haven't already. Not because it'll keep you from getting 2019-nCoV, but because you don't want to be confusing having the flu with having nCoV, and you don't want to have to be out getting treated for flu whilst nCoV's circulating. And having all others treating you like Typhoid Mary to boot. Wash your hands. Carry (and use) alcohol-based hand sanitiser. (Antibiotic is useless against virus.) Wash the doorknobs, light switches, taps, knobs/pulls, and bannisters in your home, regularly. Keep visitors and guests to a minimum. Don't touch your hands to your face, eyes, nose, or ears. Look for indications of breakout in your area on news or online. Realise that if there's a breakout, the disease has likely already been circulating for several weeks, e.g., the risk is high. Currently, outside of China, there are very few places at risk -- Singapore, Hong Kong, Japan, Korea, Japan, Thailand, and South Korea are the major additional locations. Transmission seems to require several hours of fairly close contact. Stocking up on cleaning supplies generally makes more sense than masks, which are of limited use or efficacy. Some somewhat nonobvious practices (salt-infused masks, apparently, others may exist) seem to reduce transmission or viral capability profoundly. For now, the containment trends are strongly positive, outbreaks outside China are quite limited, and it looks as if measures are effective. It'll be another few weeks before this is certain, things could still go quite badly, but signs are encouraging. Most notably, the new cases and deaths trends are dropping well below their initial exponential trajectory: https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_outbreak#/media/File%3ALog-linear_plot_of_coronovirus_cases_with_linear_regressions.png https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_ou... https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_outbreak#/media/File:Semi-log_plot_daily_incidence_of_nCoV.png https://en.m.wikipedia.org/wiki/2019–20_Wuhan_coronavirus_ou... Comments I made yesterday on Diaspora regarding this, and pointer to a now 10-day-old post based on the then exponential growth, in which I'd suggested we should see containment working on new cases by early February, and deaths by mid-February (we're actually trending well ahead of that): https://joindiaspora.com/posts/17158824 https://joindiaspora.com/posts/17158824 Disclaimers: lay views, not an expert.

nabla9 7y ago

If they screw up other measures, like hygiene for the sick and food delivery to 50 million people they can multiply the death rate. Modern theory of Spanish flu[1] is that the flu itself was not that deadly. Combination of influenza with bacteria in the lungs caused most of the deaths. It was the World War I with lots of wounded in the same place, bad hygiene conditions, many with scarred lungs from poison gas and civilians suffering from malnutrition. [1]: Bacterial Pneumonia Caused Most Deaths in 1918 Influenza Pandemic - Implications for Future Pandemic Planning https://www.nih.gov/news-events/news-releases/bacterial-pneumonia-caused-most-deaths-1918-influenza-pandemic https://www.nih.gov/news-events/news-releases/bacterial-pneu... > However, it is possible that — as in 1918 — a similar pattern of viral damage followed by bacterial invasion could unfold, say the authors. Preparations for diagnosing, treating and preventing bacterial pneumonia should be among highest priorities in influenza pandemic planning, they write. "We are encouraged by the fact that pandemic planners are already considering and implementing some of these actions," says Dr. Fauci.

0x8BADF00D 7y ago
There are very little details on how the bodies are being disposed of. Does the virus become dormant at a certain temperature ranges? How does it fare with irradiation? These are the kinds of experiments that need to be run.
- 9nGQluzmnq3M 7y ago
  The bodies are all being incinerated. https://www.news.com.au/lifestyle/health/health-problems/chinese-authorities-ban-burials-and-funerals-in-favour-of-instant-cremation/news-story/b0e7a912de24528b9e8bf5af628aa449 https://www.news.com.au/lifestyle/health/health-problems/chi...
PeterisP 7y ago
Spanish flu killed very many people in regions that did not directly participate in WWI, so civilians (as opposed to recruits sent overseas) should not be affected by the war; e.g. India, Indonesia, etc. The half a million people who died of the Spanish flu in USA did not die because lots of wounded in the same place and scarred lungs from poison gas.

burnJS 7y ago

Does that lead image tell you something? They are in full gear treating this guy. Would Doctors be geared up like that treating someone for the flu?

gwbas1c 7y ago
Doctors get the flu vaccine.

forgingahead 7y ago

Great article all around, worth reading as it's one of the only I've seen that are actually talking about disease progression and timeline. Some key info from the article: ---- Caixin: Based on your clinical experience, what's the disease progression of the new coronavirus? Peng: Lately I've been spending the daytime seeing patients in the ICU, then doing some research in the evenings. I just wrote a thesis. I drew on data from 138 cases that South Central Hospital had from Jan 7 to Jan 28 and attempted to summarise some patterns of the novel coronavirus. A lot of viruses will die off on their own after a certain amount of time. We call these self-limited diseases. I've observed that the breakout period of the novel coronavirus tends to be three weeks, from the onset of symptoms to developing difficulties breathing. Basically going from mild to severe symptoms takes about a week. There are all sorts of mild symptoms: feebleness, shortness of breath, some people have fevers, some don't. Based on studies of our 138 cases, the most common symptoms in the first stage are fever (98.6 per cent of cases), feebleness (69.6 per cent), cough (59.4 per cent), muscle pains (34.8 per cent), difficulties breathing (31.2%), while less common symptoms include headaches, dizziness, stomach pain, diarrhea, nausea, vomiting. But some patients who enter the second week will suddenly get worse. At this stage, people should go to the hospital. The elderly with underlying conditions may develop complications; some may need machine-assisted respiration. When the body's other organs start to fail, that's when it becomes severe, while those with strong immune systems see their symptoms decrease in severity at this stage and gradually recover. So the second week is what determines whether the illness becomes critical. The third week determines whether critical illness leads to death. Some in critical condition who receive treatment can raise their level of lymphocytes, a type of white blood cell, and see an improvement in their immune systems, and have been brought back, so to speak. But those whose lymphocyte numbers continue to decline, those whose immune systems are destroyed in the end, experience multiple organ failure and die. For most, the illness is over in two weeks, whereas for those for whom the illness becomes severe, if they can survive three weeks, they're good. Those that can't will die in three weeks. ----- Whole thing is worth reading.

not_a_moth 7y ago
Should add their discussion of cytokine storms in healthy people, which appears to have a more rapid timeline > Some experts argue that the virus triggers a cytokine storm, which ravages the stronger immune system of young adults > Based on my observations, a third of patients exhibited inflammation in their whole body. It was not necessarily limited to young adults. The mechanism of a cytokine storm is about whole-body inflammation, which leads to a failure of multiple organs and quickly evolves into the terminal stage. In some fast-progressing cases, it took two to three days to progress from whole-body inflammation to the life-threatening stage.

oxymoran 7y ago

Even in Communist China, people are turned away from hospitals due to inability to pay for treatment...that’s the worst irony I have ever heard. This disease is virulent and unpredictable. A 34 year old doctor died. 12 hospitals are being built at breakneck speed. This will become endemic at this rate. Either we create a vaccine or we each roll the dice on acquired immunity and too many people die in the process. It is time to be concerned.

rajup 7y ago
> Even in Communist China, people are turned away from hospitals due to inability to pay for treatment...that’s the worst irony I have ever heard. If you had read the whole article you would have learnt that treatment is free for those affected. > It is time to be concerned. Concerned sure, alarmed no, like your post seems to tend towards.
- t0mas88 7y ago
  It became free the day after the person already died for lack of funds for treatment. Very very sad case.

xbmcuser 7y ago

The number of people dying each day from this corona virus is increasing and these are official numbers so might be under reported. 29-30th Jan around 40 people were dying a day now it has reached 80-90. When you take into account the number of infected is still increasing and no real way to control the spread or treat the virus this is going to be way worse in the next few weeks. https://voice.baidu.com/act/newpneumonia/newpneumonia https://voice.baidu.com/act/newpneumonia/newpneumonia

microcolonel 7y ago
As the share of the population that is infected grows, the death rate for complications will increase dramatically. It is already extreme, and it is expected to grow exponentially into April (at least in Hubei). Up to the limits of medical facilities, your odds will be good, but it takes a lot of resources to keep patients alive when they are experiencing complications, and those resources are inherently limited.

torgian 7y ago

My wife is mainland Chinese, and she has been saying that it a worse than what the government is saying. Also, since Li Wenliang died, well, frankly a lot of people are pissed at the CCP. Anyway, I feel like it’ll be an epidemic ( it already is, I believe ) in China, and be much better controlled outside of China. Unfortunately my wife is also stuck in Chongqing; Taiwan is essentially closing up its borders and we don’t know if she’ll be able to move here to Taiwan to live with me. At least not until things blow over ( I assume summer time ). I live in Taiwan and they’ve been very good at containing this, afaik. Just this morning they released a map of Taiwan with nav-points where all the cruise ship people were at in Taiwan before they went on the ship, and released information on what to do if you experience certain symptoms. 13 people have been diagnosed and quarantined.

ShorsHammer 7y ago
How would you say it is outside of China, are all those governments lying too? 2 deaths now, one of which is in HK. How terrifying. > Anyway, I feel like it’ll be an epidemic So worse than the flu which kills 650,000 people in a bad season? Worse than traffic accidents which kill 1.2 million each year? You should be utterly terrified of cars considering the fear surrounding this mediahype virus Edit: Ahh yes that regular feeling of commenting about China on Hacker/Dunning Kruger News. Good luck folks, hope you all survive this flavour of the month apocalypse unscathed.
zozbot234 7y ago
> Also, since Li Wenliang died, well, frankly a lot of people are pissed at the CCP. This is a pretty irrational reaction if you ask me, the CCP is actually the more open, quasi-democratic side of Chinese government and politics. There are loose 'factions' as part of the CCP that are cautiously pushing for more openness, and the Chinese should be aware of them and be supportive. Frustration and anger are not helpful.
- yspeak 7y ago
  What ?? CCP is the government. https://en.m.wikipedia.org/wiki/Communist_Party_of_China https://en.m.wikipedia.org/wiki/Communist_Party_of_China

bx32 7y ago

It was worth reading and by any measure the first great writeup on the virus and the bravery to fight it.

bx32 7y ago

The whole thing is worth reading. Hats off to all the bravery around to fight the virus and save lives.

rsecora 7y ago

The sad story of the pregant woman described in the Strait Times article, is described in this link http://www.sixthtone.com/news/1005146/dispatches-from-hubei-two-weeks-between-life-and-death http://www.sixthtone.com/news/1005146/dispatches-from-hubei-...

achow 7y ago

This was the most valuable piece of info for me, which I shared among my social circle: Doctor observed that three weeks seemed to determine the difference between life and death. - Patients with stronger immune systems would start to recover in a couple of weeks - Second week, some cases would take a turn for the worse. - In the third week, keeping some of these acute patients alive might require extraordinary intervention. For this group, the death rate seems to be 4 per cent to 5 per cent.

barkrokli9990 7y ago

ICU Medical’s products are designed to prevent bloodstream infections and protecting healthcare workers from exposure to infectious diseases or hazardous drugs. https://www.adwebstudio.com/seo-dubai https://www.adwebstudio.com/seo-dubai

rixrax 7y ago

If you get sick with 2019-nCoV, and recover, do we know if You have developed immunity against it at that point?

frank2 7y ago
I don't know, but if the answer is no, then a vaccine against it is not going to confer immunity either.
Brave-Steak 7y ago
I’ve seen studies indicating that reinfection with SARS was possible. It’s not unlikely.

bullen 7y ago

If you look at the graphs here: https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/ And know that in 3 weeks everyone either dies or has recovered. Doesn't that mean we will see a large amount of total deaths in a couple of weeks? Those graphs are both exponential! Remember that cases are subjectively selected, while deaths have a fixed statistical variance!

hef19898 7y ago
The WHO is regularly publishing situation reports with all kinds of data in there. Maybe you go and have a look those?
bredren 7y ago
Those graphs depict Total Cases and Total Deaths. (This presentation of data is sometimes used by startups trying to show their amazing growth off to potential investors.) If you look at the daily change in amounts of deaths from this data series, it is more of a wobbly straight line: https://i.imgur.com/gQajRT9.png https://i.imgur.com/gQajRT9.png I did a linear projection of this data series to see how long it would take for a 1000 a day to be perishing if this trend and I came up with 8/8. Can anyone else replicate this? I would hope containment would slow these numbers, but it is possible it could go another way. If the data itself is underreported then it could also be worse.
- bullen 7y ago
  Ah, ok... thx! I guess the number of serious condition jumping from 5000 to 6000 since last I looked yesterday or the day before was what startled me...

ilkan 7y ago

There's an understandably big focus on mortality/non-mortality. It seems that people are classified recovered and sent home after 3 to 14 days of tests are clear (depending on the hospital) but I haven't seen estimates for full recovery from symptoms and fatigue afterwards. Many companies run very lean... Is it likely 2 weeks off work per person after hospital discharge? 4?