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I started following this outbreak about two weeks ago, when confirmed number of cases was still below 300 and 17 people had died. The confirmed cases were almos

by themgt 7y ago

I started following this outbreak about two weeks ago, when confirmed number of cases was still below 300 and 17 people had died. The confirmed cases were almost wholly contained in China, primarily just Wuhan province. At the time there was a lot of debate about the seriousness of the virus and the risk of a pandemic, and I was mostly sitting on the fence, looking back to SARS/Ebola and figuring a quarantine might be able to burn it out. Today confirmed cases stand at 34,964, with 725 dead, and the virus spread to nearly 30 countries. I'd highly recommend this interview from a couple days ago with Neil Ferguson, director of the Institute for Disease and Emergency Analytics at Imperial College London's School of Public Health[1] Some highlights I'll quote, based on his team's modeling of the true situation vs. the necessarily incomplete confirmed cases: - China: estimated 10% of total cases detected - International: estimated 25% of total cases detected - estimated 50,000 new infections per day in China - Doubling every 5 days - Onset to death can take up to 20 days (in fact I think we've seen deaths up to 30 days post-infection now) The NYT today[2] also quotes leading experts that this virus is almost certain to become a pandemic, and no one can with certainty predict the consequences. All of which is just to say, I think it's time to stop the hot takes about how unseriously you're taking the situation. There seems to now be unanimity among global experts, who are taking it very very seriously indeed. The actions of widespread border closures, travel and economic shutdowns and China forcefully quarantining 500 million citizens also ought to suggest that governments are treating this far differently than the flu or in fact any sort of viral outbreak in perhaps modern history. [1] https://youtu.be/ALQTdCYGISw https://youtu.be/ALQTdCYGISw [2] https://www.nytimes.com/2020/02/02/health/coronavirus-pandemic-china.html https://www.nytimes.com/2020/02/02/health/coronavirus-pandem...

agumonkey 7y ago
Yes it's indeed interesting (and reassuring) how the situation has evolved even after starting with the usual fog management policy.
- kgwgk 7y ago
  What is that you find reassuring? This is from the WHO director’s speech on February 4: “Second, we reiterate our call to all countries not to impose restrictions inconsistent with the International Health Regulations. Such restrictions can have the effect of increasing fear and stigma, with little public health benefit. So far, 22 countries have reported such restrictions to WHO. Where such measures have been implemented, we urge that they are short in duration, proportionate to the public health risks, and are reconsidered regularly as the situation evolves.” https://www.reuters.com/article/us-china-health-who-idUSKBN1ZX1H3 https://www.reuters.com/article/us-china-health-who-idUSKBN1...
JauntTrooper 7y ago
Very good point. When the 2009 H1N1 flu virus hit, it infected 11% to 21% of the world's population. The mortality rate was low, at just 0.02%, but because of the number of people it infected it resulted in 284,000 deaths. When a novel disease hits the population for the first time, it often spreads faster and wider than diseases for which we've developed some immunity. The coronavirus mortality rate so far is alarmingly high. It is highly uncertain and very preliminary, but it could go in either direction. Early estimates of SARS were that it had a fatality rate of <3%. It was eventually revised upward to 9.6%.
- lamontcg 7y ago
  It looks a lot more like viral pneumonia than 2009 H1N1. Healthy younger adults largely don't get infected or don't suffer very severe symptoms. In one study in the lancet no patients under 40 were admitted to the ICU. The MuLBSTA score of a patient for predicting fatality from viral pneumonia (which considers comorbidities like diabetes, heart disease, smoking, etc) is predictive of fatal outcomes with nCoV-2019. Everyone on the internet doing the math on this thing loves to assume it will naturally be as broadly infectious as influenza and will ultimately infect 1/3 of the planet (with the usually quoted 2% fatality rate). More likely the number of infections will be lower than that by an order of magnitude at least (even though it will still be a global pandemic). If you look at the quarantined cruise ship only 63 out of 3700 people have been confirmed as cases. At 1.7% (and of course still growing) that is still very far off from 33%. It is still troubling because if you assume the impact is like viral pneumonia then the impact of effectively doubling the number of cases of that worldwide will stress our health care systems, and it will increase mortality in vulnerable populations (very young and older people with comorbidities). I'm a bit worried about my mom and dad who are pushing 80 now, I'm not much worried about myself (48 with no other issues). Healthy 25 year olds probably won't catch this at all, and if they do they'll just get a bad cold.
  - pbourke 7y ago
    > If you look at the quarantined cruise ship only 63 out of 3700 people have been confirmed as cases. I believe they only tested ~300 people.
tim333 7y ago
I wonder if they may rush vaccine trials given the rate things are going? Imperial College for example have a candidate vaccine that "will go into the first animal experiments on Monday [10th February]" https://www.imperial.ac.uk/news/195055/imperial-researchers-race-develop-coronavirus-vaccine/ https://www.imperial.ac.uk/news/195055/imperial-researchers-... Normally even if it works there'd be months of safety trails but if hundreds are dying daily of the virus it might be worth cutting corners on that perhaps. Especially for high risk groups.

by themgt 7y ago

agumonkey 7y ago

Yes it's indeed interesting (and reassuring) how the situation has evolved even after starting with the usual fog management policy.

kgwgk 7y ago
What is that you find reassuring? This is from the WHO director’s speech on February 4: “Second, we reiterate our call to all countries not to impose restrictions inconsistent with the International Health Regulations. Such restrictions can have the effect of increasing fear and stigma, with little public health benefit. So far, 22 countries have reported such restrictions to WHO. Where such measures have been implemented, we urge that they are short in duration, proportionate to the public health risks, and are reconsidered regularly as the situation evolves.” https://www.reuters.com/article/us-china-health-who-idUSKBN1ZX1H3 https://www.reuters.com/article/us-china-health-who-idUSKBN1...

JauntTrooper 7y ago

Very good point. When the 2009 H1N1 flu virus hit, it infected 11% to 21% of the world's population. The mortality rate was low, at just 0.02%, but because of the number of people it infected it resulted in 284,000 deaths. When a novel disease hits the population for the first time, it often spreads faster and wider than diseases for which we've developed some immunity. The coronavirus mortality rate so far is alarmingly high. It is highly uncertain and very preliminary, but it could go in either direction. Early estimates of SARS were that it had a fatality rate of <3%. It was eventually revised upward to 9.6%.

lamontcg 7y ago
It looks a lot more like viral pneumonia than 2009 H1N1. Healthy younger adults largely don't get infected or don't suffer very severe symptoms. In one study in the lancet no patients under 40 were admitted to the ICU. The MuLBSTA score of a patient for predicting fatality from viral pneumonia (which considers comorbidities like diabetes, heart disease, smoking, etc) is predictive of fatal outcomes with nCoV-2019. Everyone on the internet doing the math on this thing loves to assume it will naturally be as broadly infectious as influenza and will ultimately infect 1/3 of the planet (with the usually quoted 2% fatality rate). More likely the number of infections will be lower than that by an order of magnitude at least (even though it will still be a global pandemic). If you look at the quarantined cruise ship only 63 out of 3700 people have been confirmed as cases. At 1.7% (and of course still growing) that is still very far off from 33%. It is still troubling because if you assume the impact is like viral pneumonia then the impact of effectively doubling the number of cases of that worldwide will stress our health care systems, and it will increase mortality in vulnerable populations (very young and older people with comorbidities). I'm a bit worried about my mom and dad who are pushing 80 now, I'm not much worried about myself (48 with no other issues). Healthy 25 year olds probably won't catch this at all, and if they do they'll just get a bad cold.
- pbourke 7y ago
  > If you look at the quarantined cruise ship only 63 out of 3700 people have been confirmed as cases. I believe they only tested ~300 people.

tim333 7y ago

I wonder if they may rush vaccine trials given the rate things are going? Imperial College for example have a candidate vaccine that "will go into the first animal experiments on Monday [10th February]" https://www.imperial.ac.uk/news/195055/imperial-researchers-race-develop-coronavirus-vaccine/ https://www.imperial.ac.uk/news/195055/imperial-researchers-... Normally even if it works there'd be months of safety trails but if hundreds are dying daily of the virus it might be worth cutting corners on that perhaps. Especially for high risk groups.