8 ms·

WHO Director-General: “We may only be seeing the tip of the iceberg”

97 points by electriclove 7y ago

wyxuan 7y ago
Indeed, I'm most worried about other asian and african countries where they can't muster the money, manpower or the coordination that the chinese gov't has done in order to contain the spread.
- mikechen233 7y ago
  If this virus is like sars, it doesn't seem to transmit well in hot environments (which is why sars just went away during summer) at least it will not transmit as well in Africa.
  - ryanwaggoner 7y ago
    Haven’t there been multiple local transmissions in Singapore, which is pretty warm right now?
    - fab1an 7y ago
      Yes, but one would assume there is a lot of AC in Singapore.
      - viraptor 7y ago
        Likely blasting full power in every large building. (It's really pretty much the case in every hotel / conference room) Which helps the air to mix where people meet.
dvh 7y ago
The sars outbreak of 2002 is also linked to bats. I wonder if when this outbreak is over if they go back to eating bats because "our traditions and culture". It's not a staple food like chicken or pigs.
- n0rbwah 7y ago
  As was the case with SARS, it's believed that the virus made the jump from bats to humans through another animal intermediary. It was determined to be civets for SARS and I heard it was believed it might be pangolins for the new virus (but don't quote me on this). AFAIK, it shouldn't be possible for the bats viruses we know to make the jump directly to humans. So eating bats wasn't the cause of the outbreak in SARS and isn't the cause either for the new virus.
  - bori5 7y ago
    Pretty sure there was a story from a few years ago of a person dying from a then unknown virus after contact with a fruit bat in Queensland. Edit. Here’s a link but not sure if this was the one https://www.abc.net.au/news/2013-02-22/queensland-boy-dies-of-lyssavirus/4535496 https://www.abc.net.au/news/2013-02-22/queensland-boy-dies-o...
    - n0rbwah 7y ago
      Oh, that's entirely possible. I just heard that for this particular virus (the bat virus believed to be the ancestor of 2019-nCov), transmission to human without an intermediary was very unlikely since the bat version used a receptor that doesn't have an equivalent in human to infect cells. Any animal, wild or domestic, can theoretically transmit diseases to humans if the conditions are right.
      - 1_over_n 7y ago
        Ironically researchers from the Wuhan Institute of Virology demonstrated in 2013 "intermediate hosts may not be necessary for direct human infection by some bat like corona viruses" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389864/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389864/ Also, the lancet publication found that the first diagnoses on December 1st had no link to the seafood market https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... Furthermore, university of Toronto just published a model showing likely start of the outbreak was November, which aligns with first reported diagnoses in December. https://www.utoronto.ca/news/model-built-u-t-researchers-suggests-coronavirus-outbreak-began-november-has-yet-be-controlled https://www.utoronto.ca/news/model-built-u-t-researchers-sug... On that basis we should at the very least be cautious of the bat soup intermediary theory, and the media should stop reporting it as a fact that it was the source of the outbreak.
killjoywashere 7y ago
So, I just copied the data from WHO sitreps and the total-cases diff of diffs has been increasingly negative for three of the last four days. So it's still getting worse, but the second derivative might be negative. And those are WHO numbers, so he surely knew that when he put the tweet out (it's enough that you can just see it in the scatterplot). So I wonder if he's saying that to stay out ahead. What he would really want now is for people to not let up. Keep people on alert, and clamp down on the respiratory human-to-human transmission. Keep that second derivative negative!
- vosper 7y ago
  > So, I just copied the data from WHO sitreps and the total-cases diff of diffs has been increasingly negative for three of the last four days. So it's still getting worse, but the second derivative might be negative. Could you explain what this means in layman's terms?
  - adrianN 7y ago
    The rate at which new people get infected is going down.
    - PeterisP 7y ago
      Only if we assume that the published rates of new infection reflect reality. The statistics refer to diagnosis of 2019-nCov based on conclusive test results. They do not include diagnosis solely made on symptoms - if somebody in China had flu-like symptoms and died from pneumonia, that's not considered a diagnosis of 2019-nCov infection and thus it's not an 2019-nCov death unless proper tests were performed. Even if we assume that all the test results are reported, we know that large quantities of suspected cases in Wuhan are not tested - hospitals report there's an insufficient quantity of RNA test kits available, there are some reports that outpatients aren't tested, and bed capacity is limited, so anybody who does not have space in the hospital system is not tested. And if they die, they're excluded from statistics of 2019-nCov patients because they were not tested. So if you have a system that's capable to test X people per day, even if you report all the test results perfectly honestly, you're not going to see more than X new infections per day... no matter how many new infections you actually have. If it's nontrivial for Japan to test 3600 people quarantined on a ship, how would it be possible to test everyone who's sneezing from 11 million people quarantined in a city?
FooHentai 7y ago
Dr. Tedros has faced a lot of criticism for strongly praising China's handling of the epidemic over the past few months. There is now growing belief that China is under-reporting. Primary evidence for this is that the stats fit too neatly to a curve extrapolated from previous releases. Would actual deaths occur so tidily? Secondary evidence is that China's response seems significantly larger than expected based on the statistics they are releasing. Judge by actions not words, and all that jazz. This doesn't conclusively prove tampering, but at minimum suggests there is some rate-limiting factor influencing the figures. Shortage of test kits or test lab throughput, perhaps. Either way, if China is under-reporting it puts the rest of the world at a disadvantage information-wise, and that leads to inadequate preparation and response. Assuming this is true, Dr. Tedros is in a political pickle. True transmission and mortality rates will become apparent once the virus spreads in countries that can't or won't falsify figures. On the basis of all of the above, which I admit is by no means conclusively proven, this Tweet makes a lot of sense. It provides a stepping-stone in messaging from fawning over the CCP to providing more aligned-with-reality messaging on the developing pandemic. When the dust settles, I wouldn't be surprised if any stats differences between China and what we see in the rest of the world is pinned on 'mutation'. A more generous take is that Dr. Tedros had to gush about China to avoid non-cooperation, but is now trying to move past that and back into a messaging space where the WHO can best prepare the rest of the world to respond appropriately. Disclaimer: I'm not an expert and I spend far too much time in the sewers of the Internet to have an objective opinion. This is just a summary of the more plausible speculation I'm seeing.
- baq 7y ago
  there's no other way he could get china to cooperate. it was the correct play.
  - vanderZwan 7y ago
    Yes, and on top of that there's not cooperating and there's not cooperating. He still has to walk that tightrope even if he knows China will never fully cooperate.
  - tomohawk 7y ago
kgwgk 7y ago
“So what looks like a horrific disease may be the horrific tip of a very large iceberg” https://www.sciencemag.org/news/2020/02/beast-moving-very-fast-will-new-coronavirus-be-contained-or-go-pandemic https://www.sciencemag.org/news/2020/02/beast-moving-very-fa...
deleted 7y ago
[deleted]
mikechen233 7y ago
A Chinese team of doctors working with the Chinese CDC released this paper on the characteristics of patients. https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1.full.pdf+html https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v... (By the way I wish the mainstream media can report on more papers like this. I heard there are a number of papers released on the scientific information about the virus and patients)

97 points by electriclove 7y ago

Indeed, I'm most worried about other asian and african countries where they can't muster the money, manpower or the coordination that the chinese gov't has done in order to contain the spread.

mikechen233 7y ago
If this virus is like sars, it doesn't seem to transmit well in hot environments (which is why sars just went away during summer) at least it will not transmit as well in Africa.
- ryanwaggoner 7y ago
  Haven’t there been multiple local transmissions in Singapore, which is pretty warm right now?
  - fab1an 7y ago
    Yes, but one would assume there is a lot of AC in Singapore.
    - viraptor 7y ago
      Likely blasting full power in every large building. (It's really pretty much the case in every hotel / conference room) Which helps the air to mix where people meet.

dvh 7y ago

The sars outbreak of 2002 is also linked to bats. I wonder if when this outbreak is over if they go back to eating bats because "our traditions and culture". It's not a staple food like chicken or pigs.

n0rbwah 7y ago
As was the case with SARS, it's believed that the virus made the jump from bats to humans through another animal intermediary. It was determined to be civets for SARS and I heard it was believed it might be pangolins for the new virus (but don't quote me on this). AFAIK, it shouldn't be possible for the bats viruses we know to make the jump directly to humans. So eating bats wasn't the cause of the outbreak in SARS and isn't the cause either for the new virus.
- bori5 7y ago
  Pretty sure there was a story from a few years ago of a person dying from a then unknown virus after contact with a fruit bat in Queensland. Edit. Here’s a link but not sure if this was the one https://www.abc.net.au/news/2013-02-22/queensland-boy-dies-of-lyssavirus/4535496 https://www.abc.net.au/news/2013-02-22/queensland-boy-dies-o...
  - n0rbwah 7y ago
    Oh, that's entirely possible. I just heard that for this particular virus (the bat virus believed to be the ancestor of 2019-nCov), transmission to human without an intermediary was very unlikely since the bat version used a receptor that doesn't have an equivalent in human to infect cells. Any animal, wild or domestic, can theoretically transmit diseases to humans if the conditions are right.
    - 1_over_n 7y ago
      Ironically researchers from the Wuhan Institute of Virology demonstrated in 2013 "intermediate hosts may not be necessary for direct human infection by some bat like corona viruses" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389864/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389864/ Also, the lancet publication found that the first diagnoses on December 1st had no link to the seafood market https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... Furthermore, university of Toronto just published a model showing likely start of the outbreak was November, which aligns with first reported diagnoses in December. https://www.utoronto.ca/news/model-built-u-t-researchers-suggests-coronavirus-outbreak-began-november-has-yet-be-controlled https://www.utoronto.ca/news/model-built-u-t-researchers-sug... On that basis we should at the very least be cautious of the bat soup intermediary theory, and the media should stop reporting it as a fact that it was the source of the outbreak.

killjoywashere 7y ago

So, I just copied the data from WHO sitreps and the total-cases diff of diffs has been increasingly negative for three of the last four days. So it's still getting worse, but the second derivative might be negative. And those are WHO numbers, so he surely knew that when he put the tweet out (it's enough that you can just see it in the scatterplot). So I wonder if he's saying that to stay out ahead. What he would really want now is for people to not let up. Keep people on alert, and clamp down on the respiratory human-to-human transmission. Keep that second derivative negative!

vosper 7y ago
> So, I just copied the data from WHO sitreps and the total-cases diff of diffs has been increasingly negative for three of the last four days. So it's still getting worse, but the second derivative might be negative. Could you explain what this means in layman's terms?
- adrianN 7y ago
  The rate at which new people get infected is going down.
  - PeterisP 7y ago
    Only if we assume that the published rates of new infection reflect reality. The statistics refer to diagnosis of 2019-nCov based on conclusive test results. They do not include diagnosis solely made on symptoms - if somebody in China had flu-like symptoms and died from pneumonia, that's not considered a diagnosis of 2019-nCov infection and thus it's not an 2019-nCov death unless proper tests were performed. Even if we assume that all the test results are reported, we know that large quantities of suspected cases in Wuhan are not tested - hospitals report there's an insufficient quantity of RNA test kits available, there are some reports that outpatients aren't tested, and bed capacity is limited, so anybody who does not have space in the hospital system is not tested. And if they die, they're excluded from statistics of 2019-nCov patients because they were not tested. So if you have a system that's capable to test X people per day, even if you report all the test results perfectly honestly, you're not going to see more than X new infections per day... no matter how many new infections you actually have. If it's nontrivial for Japan to test 3600 people quarantined on a ship, how would it be possible to test everyone who's sneezing from 11 million people quarantined in a city?

FooHentai 7y ago

Dr. Tedros has faced a lot of criticism for strongly praising China's handling of the epidemic over the past few months. There is now growing belief that China is under-reporting. Primary evidence for this is that the stats fit too neatly to a curve extrapolated from previous releases. Would actual deaths occur so tidily? Secondary evidence is that China's response seems significantly larger than expected based on the statistics they are releasing. Judge by actions not words, and all that jazz. This doesn't conclusively prove tampering, but at minimum suggests there is some rate-limiting factor influencing the figures. Shortage of test kits or test lab throughput, perhaps. Either way, if China is under-reporting it puts the rest of the world at a disadvantage information-wise, and that leads to inadequate preparation and response. Assuming this is true, Dr. Tedros is in a political pickle. True transmission and mortality rates will become apparent once the virus spreads in countries that can't or won't falsify figures. On the basis of all of the above, which I admit is by no means conclusively proven, this Tweet makes a lot of sense. It provides a stepping-stone in messaging from fawning over the CCP to providing more aligned-with-reality messaging on the developing pandemic. When the dust settles, I wouldn't be surprised if any stats differences between China and what we see in the rest of the world is pinned on 'mutation'. A more generous take is that Dr. Tedros had to gush about China to avoid non-cooperation, but is now trying to move past that and back into a messaging space where the WHO can best prepare the rest of the world to respond appropriately. Disclaimer: I'm not an expert and I spend far too much time in the sewers of the Internet to have an objective opinion. This is just a summary of the more plausible speculation I'm seeing.

baq 7y ago
there's no other way he could get china to cooperate. it was the correct play.
- vanderZwan 7y ago
  Yes, and on top of that there's not cooperating and there's not cooperating. He still has to walk that tightrope even if he knows China will never fully cooperate.
- tomohawk 7y ago

kgwgk 7y ago

“So what looks like a horrific disease may be the horrific tip of a very large iceberg” https://www.sciencemag.org/news/2020/02/beast-moving-very-fast-will-new-coronavirus-be-contained-or-go-pandemic https://www.sciencemag.org/news/2020/02/beast-moving-very-fa...

deleted 7y ago

[deleted]

mikechen233 7y ago

A Chinese team of doctors working with the Chinese CDC released this paper on the characteristics of patients. https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1.full.pdf+html https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v... (By the way I wish the mainstream media can report on more papers like this. I heard there are a number of papers released on the scientific information about the virus and patients)