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It doesn't make sense from a medical point of view. China, and specifically Hubei Province and its capital Wuhan, suffer an epidemic that they are trying to co

It doesn't make sense from a medical point of view. China, and specifically Hubei Province and its capital Wuhan, suffer an epidemic that they are trying to control with titanic efforts. 99% of cases of coronavirus (COVID-19) infection, today more than 40,000 with a thousand deaths, have been registered in China. Of them, almost 70% in Hubei. Only 1% of cases have been registered outside China, in 24 countries (including Spain), with transmission chains (secondary cases from a first imported case) very short so far. To put things in perspective, although perhaps inaccurate, the number of cases of COVID-19 infection in China is less than 3 cases / 100,000 inhabitants. The flu, in Catalonia, this week has reached figures of 360 cases / 100,000 inhabitants: more than 120 times higher than the incidence of COVID-19 infection in China.[1] Our Health Alerts and Emergencies system works, works as a team and the protocols established in the EU apply: detect the case, isolate it, treat it and follow all possible contacts. In this way, the transmission chain can likely be properly controlled. There are many things we do not know for sure about this disease, but most cases (80%) are mild. Serious cases and mortality (2%) will be adjusted downwards safely in the coming weeks, as the detection of mild cases increases. There is WHO data that indicate that control measures are slowing the epidemic in Hubei and better controlling the situation in the rest of China. [1]: http://canalsalut.gencat.cat/web/.content/_Professionals/Vigilancia_epidemiologica/documents/arxius/spfi.pdf http://canalsalut.gencat.cat/web/.content/_Professionals/Vig...

inglor 7y ago
Was waiting for this. The flu kills 10000 people a year in the US and pneumonia kills 45000. Suicide kills 47000 a year which makes you wonder why we aren't spending more effort on mental health given it's a bigger cause of death. CDC ref: https://www.cdc.gov/nchs/fastats/deaths.htm https://www.cdc.gov/nchs/fastats/deaths.htm
- temporama1 7y ago
  If this virus infects 60% of the world's population, and has a death rate of 1%, that's 50 million deaths.
- downerending 7y ago
  They're worth effort, but the answer is that the parameters area reasonably well known. Suicide isn't increasing exponentially, for example.
  - lawlorino 7y ago
    Exactly this. The expected annual deaths from suicide are normally distributed whereas a highly contagious disease is long-tailed, i.e. a non-negligible probability of a huge number of fatalities.
- throwaway55554 7y ago
  Terrorism kills 2 people per year in the U.S. and we spend 100s of billions. The difference is large companies make more money building weapons than large companies make treating the flue (or mental health). Edit: The point is, it's all about money. There's no rational reason to spend so much on terrorism and so little on mental health, yet we do.
  - downerending 7y ago
    Not going to claim that that money is all well-spent, but terrorism (and security in general) is a rather different problem. A single failure can cost thousands of lives, and huge knock-on effects, as we've sadly seen.
  - lawlorino 7y ago
    I disagree, as I posted elsewhere in this thread these annual death rates are drawn from different distributions. The annual suicide rate is normally distributed, in other words the expected number of deaths will be around the same number each year. Terrorism and pandemics are long-tailed meaning a non-negligible probability that the rate shoots up to something much higher than your quoted two per year.
- jbay808 7y ago
  Suicide is a big problem, buy it's scary in a different way. I'm not personally worried about a suicide epidemic, or catching suicide from someone.
  - CydeWeys 7y ago
    And yet there are actually suicide clusters, with people essentially "catching it" from their friends or loved ones who've committed suicide.
    - keanzu 7y ago
      A copycat suicide is defined as an emulation of another suicide that the person attempting suicide knows about either from local knowledge or due to accounts or depictions of the original suicide on television and in other media. A spike of emulation suicides after a widely publicized suicide is known as the Werther effect. https://en.wikipedia.org/wiki/Copycat_suicide https://en.wikipedia.org/wiki/Copycat_suicide Unbelievably you are correct. You can "catch it". Amazing.
    - baddox 7y ago
      This seems like equivocation on the meaning of "catching it." Isolating yourself so that you either have no close relationships or somehow never hear about any suicides among your close relationships is a fairly nonsensical proposal, and probably wouldn't in fact decrease your chances of committing suicide.
      - catalogia 7y ago
        The realization that suicide has contagious properties does have practical ethical ramifications for journalism. It's not some impractical theoretical matter that can't be acted on.
        totalZero 7y ago
        I went to a talk on this very matter. Kurt Cobain's suicide is an interesting case study on how journalism affects the development (or attenuation) of suicide clusters. https://www.ncbi.nlm.nih.gov/pubmed/8897665 https://www.ncbi.nlm.nih.gov/pubmed/8897665
- ericb 7y ago
  Why not? Because math. This is a contagion. Read about the Spanish Flu. This looks to be both more contagious, and more deadly in most of the published studies. We hope they are biased and overly pessimistic, but whataboutism isn't helpful here. Your argument is like if the rug in your living room is on fire, and you say "why worry about that rug--we should really invest in fixing that roof leak." I agree roof leaks are also bad.
  - Godel_unicode 7y ago
    Here are the CDC burden (upper bound) estimates for the 2019-2020 flu season: 30 million infections, 30k deaths. In other words, 0.1% of infections are predicted to be fatal, which is substantially lower than the current estimates for 2019-nCoV. https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm https://www.cdc.gov/flu/about/burden/preliminary-in-season-e...
- endorphone 7y ago
  These sorts of comparisons are, I would respectfully argue, not very helpful because the various causes of mortality are additive, not competing to kill the same victims (generally). We don't need a perpetual cycle of coronavirus in addition to the perpetual cycle of the flu that we already have, in addition to suicide and every other cause of death. The world's health organizations are trying desperately to curtail it before it becomes a norm. Which is why saying "Oh, why cancel this it's no biggie" is just so misled. If the world was in a situation where we could seriously contain and eliminate the flu, we would surely take every possible measure to do so.
- anonuser123456 7y ago
  The flu infects 30,000,000/year and kills 10,000. Given r0, the Covid-2019 would infect 60,000,000 and kill 1,000,000 if unchecked in the US.
downerending 7y ago
I think people are worried about the unknown unknowns. IIUC, it's infectious for a considerable period of time (one or two weeks) before the infected person becomes systematic. Plus, it's possible that some infectious persons never develop symptoms. Also, the case count is still in exponential growth mode. Plus, information coming out of China might be incomplete. No idea whether the conference should be cancelled, but it's not an irrational idea. There could be a large number of silent cases outside of China already.
- merqurio 7y ago
  The MWC was going to be attended by 100,000 people, 75% of them from Europe and the US, 10% from Asia-Pacific (excluding China) and 9% from the rest of the world. Only 6% of visitors were going to be from China, and less were expected much less due to the COVD-19. Can any of them come infected by the COVD-19? The probability is very low. Almost all of the participants will come from areas where the presence of the COVD-19 is nil or extremely low. By comparison, a number of passengers equivalent to three times the MWC go through the airports of Atlanta or Los Angeles, two times pass through the airports of London, Paris or Amsterdam each day, and 1.5 times through Madrid and Barcelona each day. And none of them closed so far. The basic hygiene measures (handwashing, not sneezing or coughing to the open) and common sense are more solid and effective. If we follow the same line of thinking (we shouldn't), we would have to close all the airports tomorrow. edit: typo
  - electriclove 7y ago
    What is the harm caused by MWC being cancelled?
    - ghaff 7y ago
      A lot of money is wasted. Presumably sales at a lot of companies take some incremental hit. Some startup that planned this as their launch event is screwed. A lot of people in Barcelona don't make money they were expecting to make. (Other Barcelona residents breathe a sigh of relief.) So, yes, there's harm even if the decision was probably the rational one.
ghaff 7y ago
MWC got caught in a tough spot. Lots of companies were pulling out. Companies don't like sending employees to events when, rationally or not, a lot of families are going to be uncomfortable about a family member traveling to a big show with a large number of Chinese attendees. And, of course, a lot of employees also believe, rightly or wrongly, that they can't just say "nope" without consequence. Many years ago, I remember my company canceling some sales event because of, I think, Gulf War I because they didn't want to tell European employees in particular to travel to the US often on American carriers.
baq 7y ago
There’s just the little problem of trustworthiness of Chinese numbers. On one hand you have this reassuring data that dynamic of the virus is slowing down, on the other there are serious people with good credentials going on record saying this might get a lot worse before it gets better. 2% CFR on 60% of world’s population is not a negligible number.
Zenst 7y ago
Liability insurance and details like that would of played a bigger part. After all, panic spreads far quicker with better logistics and vectors than any virus ever will.
- keanzu 7y ago
  > panic spreads far quicker with better logistics and vectors than any virus Literally laughed out loud. Take an upvote!
Darmody 7y ago
From what some people tell me, there's also a political reason as there's a lot happening there. The same companies that rejected to go to Barcelona are attenting ISE in Amsterdam. That makes me thing they junt needed a reason to pull out of Barcelona.
- ghaff 7y ago
  MWC is a lot higher profile. And, once Ericsson pulled out, a number of other companies felt that they wanted to be seen (both internally and externally) as doing the "responsible" thing. And that really opened to floodgates to the point where holding the show without a bunch of major companies and pared-back attendance just didn't make sense.
abc-xyz 7y ago
China only had 144 flu-caused deaths in an entire year (https://www.globaltimes.cn/content/1177725.shtml https://www.globaltimes.cn/content/1177725.shtml), meaning the Wuhan virus has already killed 7.8 times as many people as the flu kills in an entire year throughout China.
- fspeech 7y ago
  It's mostly a classification thing. Most who die from diseases associated with the flu, like pneumonia, are not recorded to have died from the flu.
- greenshackle2 7y ago
  Hilarious, your source is an article that's criticizing China's statistical methods on flu deaths reporting. From your own source: "The statistical methods used by the Chinese CDC should be revised, as deaths from pneumonia caused by the flu, for example, are not counted, the observer said." If you ignore death by pneumonia, the deaths for coronavirus are very low too. "An analysis led by Chinese scientists published in The Lancet Public Health in September 2019 found that there were 84,200 to 92,000 flu-related deaths in China each year, accounting for 8.2 percent of all deaths from respiratory diseases." Oops.
  - deleted 7y ago
    [deleted]
  - Alex3917 7y ago
    > Hilarious, your source is an article that's criticizing China's statistical methods on flu deaths reporting. That's literally the point. If the U.S. has 330M people and 30k flu deaths per year, then all else being equal one would expect that what China reports as 144 deaths is really 120,000. Which means that if Corona virus has already killed 7.8 times as many people who have died of the flu (per China's reporting), one would expect that it's really killed 936,000. Obviously that's very simplistic, but that's basically why people are worried -- no one knows what the real numbers out of China are, so that kind of back-of-the-napkin math is about the best we can do right now.
wolco 7y ago
The death rate has been climbing, today it's 2.5%. Which is a sign that either the reported cases is much lower than the official count or the virus is getting deadlier. From the data we have from other countries it looks like the death rate is stable/low which points to a huge amount of unreported cases. What is the death rate for the 360 person flu group?
erentz 7y ago
> The flu, in Catalonia, this week has reached figures of 360 cases / 100,000 inhabitants: more than 120 times higher than the incidence of COVID-19 infection in China.[1] We need to stop comparing this to the flu. The flu is an established widespread virus with a very low mortality rate. This is a new, so far still spreading, virus with what appears to be a high mortality rate. If you had to choose between being infected with the flu or COVID19 you’d chose the flu because you’re about 20 times more likely to die from COVID19 based on the data available at the moment. If COVID19 has spread globally and becomes established then it will be similar in terms of deaths to the Spanish Flu. Nobody wants that and it is perfectly reasonable for people to be concerned about wanting to prevent that from happening. If this does spread into a pandemic then you will be able to rightly come back in 24 months and compare the annual total deaths from COVID19 to the seasonal flu. Until then it’s an entirely incorrect comparison.
- merqurio 7y ago
  It makes sense total sense to compare, it's another respiratory virus, from a family of viruses already known. We must not reinvent the wheel when we know the dynamics of these viruses and the countermeasures to take. The key metric that determines whether COVID-19 can establish and generate a sustained outbreak is it's ability to reproduce, "R", which represents the average number of individuals to which each transmitter transmits the virus. - If "R" is greater than 1, the transmission may become sustained; - If “R” is less than 1, then the transmission will simply dissipate. In the current outbreak, it represents an R of 2.2 [1], meaning that on average each patient has been spreading infection to 2.2 other people. Only a little bit more than half of the infections should be avoided so that R falls below 1. Preventive isolation and the measures established by the protocols should be sufficient. Besides, there is little evidence to suggest the presymptomatic transmission of COVID-19 [1]: https://www.nejm.org/doi/10.1056/NEJMoa2001316 https://www.nejm.org/doi/10.1056/NEJMoa2001316
  - jpdus 7y ago
    This is outdated information. Most newer studies put R0 >3 (e.g. [1]) and there are many well documentated cases outside of China now which confirm at least partial presymptomatic transmission (German cluster, Signapore Conference, British prisoners). [1] https://www.medrxiv.org/content/10.1101/2020.02.10.20021675v1 https://www.medrxiv.org/content/10.1101/2020.02.10.20021675v...
tmpz22 7y ago
How much can we trust the numbers coming out of China who have retaliated heavily against whistle blowers including one of the original doctors to highlight this crisis, who is now dead? [1]: https://www.npr.org/sections/goatsandsoda/2020/02/07/803680463/china-to-investigate-after-whistleblower-doctor-dies-from-coronavirus https://www.npr.org/sections/goatsandsoda/2020/02/07/8036804...
kalipsosu 7y ago
For flu, each sick person infects 1 person. So Ro is 1. This means no quarantine needed. But for covid-19 estimated Ro is around 2.5. So containing this virus requires quarantine. Also this is a novel virus which means this strain is new and may be unpredictable. Mutations may occur. We even not sure about source of the virus. If it spreads all over the world it could logarithmicly grow in number. Especially for undeveloped counties with weak healthcare infrastructure pose a real threat.
- baddox 7y ago
  I'm not a doctor or a public health expert, but it seems to be that unqualified uncertainty should not be used as justification for any action other than pursuing more information to qualify that uncertainty. Otherwise we would maximally quarantine any illness for which we are at all uncertain of an upper bound on its basic reproduction number or mortality.
  - kalipsosu 7y ago
    I am. The most important factor here is Ro not uncertainty. Maybe I should emphasize it more.
    - baddox 7y ago
      I was replying specifically to when you said "Also this is a novel virus which means this strain is new and may be unpredictable. Mutations may occur." I interpreted that as meaning that because of our lack of knowledge about this strain and the fact that it may mutate, some unspecified amount of additional concern is warranted.
  - retsibsi 7y ago
    There are degrees of uncertainty, and ranges of plausible severity, even when we haven't actually nailed these down quantitatively. We already have enough information about COVID-19 to raise it far above the threat level of a random virus. And given how quickly and stealthily it seems to be capable of spreading, to take no action beyond 'pursuing more information' would be almost the same as assuming the best possible resolution of our uncertainty. That's no more rational than the other extreme of assuming the very worst.
mattrp 7y ago
MWC is a 100,000 person French ski chalet... it makes total sense to cancel it. “Show flu” is a thing... so if just the booth workers come back through customs with even so much as an elevated temperature, it will unnecessarily crowd the quarantine facilities for weeks. You may have math on your side but you’re not winning this one.
jon-wood 7y ago
I think this is less about MWC or Barcelona having health fears and more the domino effect of big exhibitors pulling out. It seems a lot of those pulled out because their Chinese companies, and presumably impacted by travel restrictions meaning they couldn’t get key people prepared in advance and then out to the event. Once the big exhibitors pull out you then see attendees doing likewise as meetings they were travelling for get cancelled, and finally smaller exhibitors deciding it’s not worth the effort.
retsibsi 7y ago
> Serious cases and mortality (2%) will be adjusted downwards safely in the coming weeks, as the detection of mild cases increases. There are factors that could move that number in both directions. Yes, presumably there are many mild cases that haven't been counted. But unfortunately coronavirus deaths are probably also undercounted -- for example, https://www.washingtonpost.com/world/as-families-tell-of-pneumonia-like-deaths-in-wuhan-some-wonder-if-china-virus-count-is-too-low/2020/01/22/0f50b1e6-3d07-11ea-971f-4ce4f94494b4_story.html https://www.washingtonpost.com/world/as-families-tell-of-pne... This point I'm not sure about, because it seems bizarre that everyone would make such an obvious mistake, but: as far as I can tell, the death rate is simply calculated as [current total of recorded deaths] / [current total of recorded cases]. But when the fatal cases take quite a long time to kill (from what I've read, it tends to take a week or so from the onset of symptoms for them to become severe, and up to another two weeks for death to occur -- see https://www.straitstimes.com/asia/east-asia/reporters-notebook-life-and-death-in-a-wuhan-coronavirus-icu https://www.straitstimes.com/asia/east-asia/reporters-notebo...) and the total number of cases is rising dramatically, surely that skews the figure toward a significant underestimate?
- gamblor956 7y ago
  For example, using the simple methodology, SARS' death rate was only about 3%, and that was the number most media used during the outbreak. But years after the epidemic ended, once researchers had greater access to medical records, the death was determined to be 10-15%, or roughly 3-5x higher than originally reported. In the cases of NCV, there is already significant evidence of under reporting of fatalities by Chinese authorities in Wuhan (some sources suggest that up to 90% of NCV deaths in China may be unreported). And as the cruise ship stuck outside of Japan demonstrates, the virus may be far more virulent (i.e., contagious) than previously thought.
  - gamblor956 7y ago
    Followup: https://www.nytimes.com/2020/02/12/world/asia/china-coronavirus-cases.html https://www.nytimes.com/2020/02/12/world/asia/china-coronavi... China just changed how it classifies NCV cases to reduce the number of cases by eliminating those who are infected but not symptomatic meaning the numbers are even less reliable than they were before. The problem with this is that a number of the superspreaders, like the British fellow that infected 11 other people, and the passenger that infected the cruise ship quarantined in Japan, were not symptomatic when they were infecting others.
bugzz 7y ago
> Only 1% of cases have been registered outside China, in 24 countries (including Spain), with transmission chains (secondary cases from a first imported case) very short so far. It seems completely unsurprising to me that we aren't seeing more cases in other countries so far - almost every country with the exception of Singapore are only testing people who have been in Hubei (or China, if symptoms are serious). Meanwhile Singapore, which actually has been testing more people, has been finding more and more locally transmitted cases, despite huge efforts tracking down and isolating contacts of previous cases. >Serious cases and mortality (2%) will be adjusted downwards safely in the coming weeks, as the detection of mild cases increases. Or it could adjust upward, as it seems to often take 3+ weeks to kill. In Singapore 8/50 cases are in critical condition in the ICU (And Singapore has detected many mild cases, even asymptomatic ones). For the flu in the U.S. it seems about 0.1% of cases end up in the ICU, so that's some compelling evidence that this is 10-100x as dangerous as the flu. And what happens to the fatality rate when we run out of ICU beds, as already happens during particularly bad flu seasons? I'm not saying this will be globally devastating, but I think the chance is high enough that I'm disappointed more extreme actions aren't being taken worldwide. edit: I also assume the case numbers in China outside of Hubei have been looking better recently because they also can no longer rely on the fact that a sick person has recently been to Hubei to know who to test.
akiselev 7y ago
From what I understand, the medical community is treating this outbreak with such extreme measures because this virus is a perfect storm of factors that could lead to a new annual disease emerging, just like the flu and cold. It's deadly enough to become a major global concern and transmissible enough that it can continue spreading via asymptomatic hosts and other viral reservoirs between outbreaks. The jury is still out on the virus's rate of mutation but other coronaviruses, like the ones that cause a tenth of common colds, are known to mutate rapidly. If we fail to stop the spread of the virus now, it may become a fact of life with an even higher annual death rate than the flu. We've already got plenty of infectious diseases and based on the data so far, it's worth extreme measures trying to stop it.
- wsinks 7y ago
  I hadn't even thought of the possibility that there could be a new cyclical virus that emerges! Thank you smart people in the WHO and global health community.
  - koheripbal 7y ago
    This is what virologists are expecting since it's clear containment has already failed.
- thaumaturgy 7y ago
  For anyone that wants to read more about this or any other aspect of 2019-nCoV, there's a very good /r/askscience thread: https://www.reddit.com/r/askscience/comments/ewwmem/have_a_question_about_the_2019_novel_coronavirus/ https://www.reddit.com/r/askscience/comments/ewwmem/have_a_q...
  - dredmorbius 7y ago
    https://old.reddit.com/r/askscience/comments/ewwmem/have_a_question_about_the_2019_novel_coronavirus/ https://old.reddit.com/r/askscience/comments/ewwmem/have_a_q...
NicoJuicy 7y ago
And still, there was one super spreader that was linked to 11 cases: https://www.independent.co.uk/news/uk/home-news/coronavirus-super-spreader-news-steve-walsh-brighton-uk-france-singapore-a9328776.html https://www.independent.co.uk/news/uk/home-news/coronavirus-...
doublekill 7y ago
The newspapers of the time also dubbed the Spanish flu: just a familiar grip we've seen time and time again. China desperately wants to save face, at the cost of lives. They rejected help from the U.S. CDC as to not appear weak. They already thought they had it under control, before locking down over 50 million people and damaging their economy. People at risk for the flu can get a flu shot. This disease kills the healthy and average aged. And we all have family members at increased risk. Even a 2% mortality rate is absolutely horrific. Would you play Russian roulette with those chances? If 60% percent of the world gets infected we are talking many many millions of dead. How are you going to track contacts, when someone working in a brothel gets it, or someone preparing food in a McDonald's? What if someone takes the virus back to India or Africa? With 20% needing intensive care, even modern European countries will suffer badly. There simply are not enough beds available, even in the bigger cities. Mortality is a red herring when you do not count the people still hospitalized after months! Look at the tiny amount of recovered people. Despite their titanic and gruesome methods to contain it, China has failed. Imagine such an effort in Europe, where people gladly will walk away from quarantine and can not be cowered into compliance or snitching on their coughing neighbors. We simply do not know enough about morbesity and mortality to say we overreact. Better safe than sorry when uncertainty abound.
jsz0 7y ago
> follow all possible contacts. Not a practical strategy for thousands of conference attendees packed closely together for a short period of time before flying back home. This virus is too infectious and has too long of an incubation period. That's why so many public events are being canceled. This exact scenario is playing out right now aboard the cruise ship docked in Japan.
hanoz 7y ago
I read your post, looked at your profile, and now I'm suffering from a severe case of cognitive dissonance. > To put things in perspective, although perhaps inaccurate, the number of cases of COVID-19 infection in China is less than 3 cases / 100,000 inhabitants. What kind of perspective are we getting by adding the entirety of China to a locked down Wuhan when considering the infection rate? And then to go on to compare that to flu rates in Catalonia. Really, what point is that supposed to make? > Our Health Alerts and Emergencies system works, works as a team and the protocols established in the EU apply: detect the case, isolate it, treat it and follow all possible contacts. In this way, the transmission chain can likely be properly controlled. How can this possibly work if carriers are infectious for lord knows how many days before symptoms appear? It's laughable. How does this crack team of contact follow uppers deal with the case of a single infected metropolitan commuter?
ineedasername 7y ago
It does not logically follow from the low infection rates outside of China that these extreme measures are not warranted, quite possibly it's the opposite: low infections follow from strong containment measures. As for comparisons to the Flu, I see this so often and it always misses the point: it's not one or the other, so why would the medical establishment not fight in the extreme to stop many thousands of deaths that would result if another flu-like disease came along? Second, there is an entire industrial complex complete with seasonal ramp up in staffing to deal with Flu season, and we still see non-negligible fatality rates. Without that support network, which again we don't have for COVID-19, how much worse would things be with the flu? So we should all stop using the flu as some type of benchmark for what a reasonable COVID-19 response looks like.
tim333 7y ago
The scenes from Wuhan are pretty grim - people turned away from hospitals, crematoria running 24/7. I think it's understandable that other countries don't want to repeat that hence caution may be advisable. You don't see anything like that with normal flu.
WillPostForFood 7y ago
99% of cases of coronavirus (COVID-19) infection, today more than 40,000 with a thousand deaths, have been registered in China. Another perspective is that there were only 41 reported cases in China six weeks ago, and now there are 60,000. So while there are only 500 cases outside China so far, we might want to wait six more weeks before declaring victory.

inglor 7y ago

Was waiting for this. The flu kills 10000 people a year in the US and pneumonia kills 45000. Suicide kills 47000 a year which makes you wonder why we aren't spending more effort on mental health given it's a bigger cause of death. CDC ref: https://www.cdc.gov/nchs/fastats/deaths.htm https://www.cdc.gov/nchs/fastats/deaths.htm

temporama1 7y ago
If this virus infects 60% of the world's population, and has a death rate of 1%, that's 50 million deaths.
downerending 7y ago
They're worth effort, but the answer is that the parameters area reasonably well known. Suicide isn't increasing exponentially, for example.
- lawlorino 7y ago
  Exactly this. The expected annual deaths from suicide are normally distributed whereas a highly contagious disease is long-tailed, i.e. a non-negligible probability of a huge number of fatalities.
throwaway55554 7y ago
Terrorism kills 2 people per year in the U.S. and we spend 100s of billions. The difference is large companies make more money building weapons than large companies make treating the flue (or mental health). Edit: The point is, it's all about money. There's no rational reason to spend so much on terrorism and so little on mental health, yet we do.
- downerending 7y ago
  Not going to claim that that money is all well-spent, but terrorism (and security in general) is a rather different problem. A single failure can cost thousands of lives, and huge knock-on effects, as we've sadly seen.
- lawlorino 7y ago
  I disagree, as I posted elsewhere in this thread these annual death rates are drawn from different distributions. The annual suicide rate is normally distributed, in other words the expected number of deaths will be around the same number each year. Terrorism and pandemics are long-tailed meaning a non-negligible probability that the rate shoots up to something much higher than your quoted two per year.
jbay808 7y ago
Suicide is a big problem, buy it's scary in a different way. I'm not personally worried about a suicide epidemic, or catching suicide from someone.
- CydeWeys 7y ago
  And yet there are actually suicide clusters, with people essentially "catching it" from their friends or loved ones who've committed suicide.
  - keanzu 7y ago
    A copycat suicide is defined as an emulation of another suicide that the person attempting suicide knows about either from local knowledge or due to accounts or depictions of the original suicide on television and in other media. A spike of emulation suicides after a widely publicized suicide is known as the Werther effect. https://en.wikipedia.org/wiki/Copycat_suicide https://en.wikipedia.org/wiki/Copycat_suicide Unbelievably you are correct. You can "catch it". Amazing.
  - baddox 7y ago
    This seems like equivocation on the meaning of "catching it." Isolating yourself so that you either have no close relationships or somehow never hear about any suicides among your close relationships is a fairly nonsensical proposal, and probably wouldn't in fact decrease your chances of committing suicide.
    - catalogia 7y ago
      The realization that suicide has contagious properties does have practical ethical ramifications for journalism. It's not some impractical theoretical matter that can't be acted on.
      - totalZero 7y ago
        I went to a talk on this very matter. Kurt Cobain's suicide is an interesting case study on how journalism affects the development (or attenuation) of suicide clusters. https://www.ncbi.nlm.nih.gov/pubmed/8897665 https://www.ncbi.nlm.nih.gov/pubmed/8897665
ericb 7y ago
Why not? Because math. This is a contagion. Read about the Spanish Flu. This looks to be both more contagious, and more deadly in most of the published studies. We hope they are biased and overly pessimistic, but whataboutism isn't helpful here. Your argument is like if the rug in your living room is on fire, and you say "why worry about that rug--we should really invest in fixing that roof leak." I agree roof leaks are also bad.
- Godel_unicode 7y ago
  Here are the CDC burden (upper bound) estimates for the 2019-2020 flu season: 30 million infections, 30k deaths. In other words, 0.1% of infections are predicted to be fatal, which is substantially lower than the current estimates for 2019-nCoV. https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm https://www.cdc.gov/flu/about/burden/preliminary-in-season-e...
endorphone 7y ago
These sorts of comparisons are, I would respectfully argue, not very helpful because the various causes of mortality are additive, not competing to kill the same victims (generally). We don't need a perpetual cycle of coronavirus in addition to the perpetual cycle of the flu that we already have, in addition to suicide and every other cause of death. The world's health organizations are trying desperately to curtail it before it becomes a norm. Which is why saying "Oh, why cancel this it's no biggie" is just so misled. If the world was in a situation where we could seriously contain and eliminate the flu, we would surely take every possible measure to do so.
anonuser123456 7y ago
The flu infects 30,000,000/year and kills 10,000. Given r0, the Covid-2019 would infect 60,000,000 and kill 1,000,000 if unchecked in the US.

downerending 7y ago

I think people are worried about the unknown unknowns. IIUC, it's infectious for a considerable period of time (one or two weeks) before the infected person becomes systematic. Plus, it's possible that some infectious persons never develop symptoms. Also, the case count is still in exponential growth mode. Plus, information coming out of China might be incomplete. No idea whether the conference should be cancelled, but it's not an irrational idea. There could be a large number of silent cases outside of China already.

merqurio 7y ago
The MWC was going to be attended by 100,000 people, 75% of them from Europe and the US, 10% from Asia-Pacific (excluding China) and 9% from the rest of the world. Only 6% of visitors were going to be from China, and less were expected much less due to the COVD-19. Can any of them come infected by the COVD-19? The probability is very low. Almost all of the participants will come from areas where the presence of the COVD-19 is nil or extremely low. By comparison, a number of passengers equivalent to three times the MWC go through the airports of Atlanta or Los Angeles, two times pass through the airports of London, Paris or Amsterdam each day, and 1.5 times through Madrid and Barcelona each day. And none of them closed so far. The basic hygiene measures (handwashing, not sneezing or coughing to the open) and common sense are more solid and effective. If we follow the same line of thinking (we shouldn't), we would have to close all the airports tomorrow. edit: typo
- electriclove 7y ago
  What is the harm caused by MWC being cancelled?
  - ghaff 7y ago
    A lot of money is wasted. Presumably sales at a lot of companies take some incremental hit. Some startup that planned this as their launch event is screwed. A lot of people in Barcelona don't make money they were expecting to make. (Other Barcelona residents breathe a sigh of relief.) So, yes, there's harm even if the decision was probably the rational one.

ghaff 7y ago

MWC got caught in a tough spot. Lots of companies were pulling out. Companies don't like sending employees to events when, rationally or not, a lot of families are going to be uncomfortable about a family member traveling to a big show with a large number of Chinese attendees. And, of course, a lot of employees also believe, rightly or wrongly, that they can't just say "nope" without consequence. Many years ago, I remember my company canceling some sales event because of, I think, Gulf War I because they didn't want to tell European employees in particular to travel to the US often on American carriers.

baq 7y ago

There’s just the little problem of trustworthiness of Chinese numbers. On one hand you have this reassuring data that dynamic of the virus is slowing down, on the other there are serious people with good credentials going on record saying this might get a lot worse before it gets better. 2% CFR on 60% of world’s population is not a negligible number.

Zenst 7y ago

Liability insurance and details like that would of played a bigger part. After all, panic spreads far quicker with better logistics and vectors than any virus ever will.

keanzu 7y ago
> panic spreads far quicker with better logistics and vectors than any virus Literally laughed out loud. Take an upvote!

Darmody 7y ago

From what some people tell me, there's also a political reason as there's a lot happening there. The same companies that rejected to go to Barcelona are attenting ISE in Amsterdam. That makes me thing they junt needed a reason to pull out of Barcelona.

ghaff 7y ago
MWC is a lot higher profile. And, once Ericsson pulled out, a number of other companies felt that they wanted to be seen (both internally and externally) as doing the "responsible" thing. And that really opened to floodgates to the point where holding the show without a bunch of major companies and pared-back attendance just didn't make sense.

abc-xyz 7y ago

China only had 144 flu-caused deaths in an entire year (https://www.globaltimes.cn/content/1177725.shtml https://www.globaltimes.cn/content/1177725.shtml), meaning the Wuhan virus has already killed 7.8 times as many people as the flu kills in an entire year throughout China.

fspeech 7y ago
It's mostly a classification thing. Most who die from diseases associated with the flu, like pneumonia, are not recorded to have died from the flu.
greenshackle2 7y ago
Hilarious, your source is an article that's criticizing China's statistical methods on flu deaths reporting. From your own source: "The statistical methods used by the Chinese CDC should be revised, as deaths from pneumonia caused by the flu, for example, are not counted, the observer said." If you ignore death by pneumonia, the deaths for coronavirus are very low too. "An analysis led by Chinese scientists published in The Lancet Public Health in September 2019 found that there were 84,200 to 92,000 flu-related deaths in China each year, accounting for 8.2 percent of all deaths from respiratory diseases." Oops.
- deleted 7y ago
  [deleted]
- Alex3917 7y ago
  > Hilarious, your source is an article that's criticizing China's statistical methods on flu deaths reporting. That's literally the point. If the U.S. has 330M people and 30k flu deaths per year, then all else being equal one would expect that what China reports as 144 deaths is really 120,000. Which means that if Corona virus has already killed 7.8 times as many people who have died of the flu (per China's reporting), one would expect that it's really killed 936,000. Obviously that's very simplistic, but that's basically why people are worried -- no one knows what the real numbers out of China are, so that kind of back-of-the-napkin math is about the best we can do right now.

wolco 7y ago

The death rate has been climbing, today it's 2.5%. Which is a sign that either the reported cases is much lower than the official count or the virus is getting deadlier. From the data we have from other countries it looks like the death rate is stable/low which points to a huge amount of unreported cases. What is the death rate for the 360 person flu group?

erentz 7y ago

> The flu, in Catalonia, this week has reached figures of 360 cases / 100,000 inhabitants: more than 120 times higher than the incidence of COVID-19 infection in China.[1] We need to stop comparing this to the flu. The flu is an established widespread virus with a very low mortality rate. This is a new, so far still spreading, virus with what appears to be a high mortality rate. If you had to choose between being infected with the flu or COVID19 you’d chose the flu because you’re about 20 times more likely to die from COVID19 based on the data available at the moment. If COVID19 has spread globally and becomes established then it will be similar in terms of deaths to the Spanish Flu. Nobody wants that and it is perfectly reasonable for people to be concerned about wanting to prevent that from happening. If this does spread into a pandemic then you will be able to rightly come back in 24 months and compare the annual total deaths from COVID19 to the seasonal flu. Until then it’s an entirely incorrect comparison.

merqurio 7y ago
It makes sense total sense to compare, it's another respiratory virus, from a family of viruses already known. We must not reinvent the wheel when we know the dynamics of these viruses and the countermeasures to take. The key metric that determines whether COVID-19 can establish and generate a sustained outbreak is it's ability to reproduce, "R", which represents the average number of individuals to which each transmitter transmits the virus. - If "R" is greater than 1, the transmission may become sustained; - If “R” is less than 1, then the transmission will simply dissipate. In the current outbreak, it represents an R of 2.2 [1], meaning that on average each patient has been spreading infection to 2.2 other people. Only a little bit more than half of the infections should be avoided so that R falls below 1. Preventive isolation and the measures established by the protocols should be sufficient. Besides, there is little evidence to suggest the presymptomatic transmission of COVID-19 [1]: https://www.nejm.org/doi/10.1056/NEJMoa2001316 https://www.nejm.org/doi/10.1056/NEJMoa2001316
- jpdus 7y ago
  This is outdated information. Most newer studies put R0 >3 (e.g. [1]) and there are many well documentated cases outside of China now which confirm at least partial presymptomatic transmission (German cluster, Signapore Conference, British prisoners). [1] https://www.medrxiv.org/content/10.1101/2020.02.10.20021675v1 https://www.medrxiv.org/content/10.1101/2020.02.10.20021675v...

tmpz22 7y ago

How much can we trust the numbers coming out of China who have retaliated heavily against whistle blowers including one of the original doctors to highlight this crisis, who is now dead? [1]: https://www.npr.org/sections/goatsandsoda/2020/02/07/803680463/china-to-investigate-after-whistleblower-doctor-dies-from-coronavirus https://www.npr.org/sections/goatsandsoda/2020/02/07/8036804...

kalipsosu 7y ago

For flu, each sick person infects 1 person. So Ro is 1. This means no quarantine needed. But for covid-19 estimated Ro is around 2.5. So containing this virus requires quarantine. Also this is a novel virus which means this strain is new and may be unpredictable. Mutations may occur. We even not sure about source of the virus. If it spreads all over the world it could logarithmicly grow in number. Especially for undeveloped counties with weak healthcare infrastructure pose a real threat.

baddox 7y ago
I'm not a doctor or a public health expert, but it seems to be that unqualified uncertainty should not be used as justification for any action other than pursuing more information to qualify that uncertainty. Otherwise we would maximally quarantine any illness for which we are at all uncertain of an upper bound on its basic reproduction number or mortality.
- kalipsosu 7y ago
  I am. The most important factor here is Ro not uncertainty. Maybe I should emphasize it more.
  - baddox 7y ago
    I was replying specifically to when you said "Also this is a novel virus which means this strain is new and may be unpredictable. Mutations may occur." I interpreted that as meaning that because of our lack of knowledge about this strain and the fact that it may mutate, some unspecified amount of additional concern is warranted.
- retsibsi 7y ago
  There are degrees of uncertainty, and ranges of plausible severity, even when we haven't actually nailed these down quantitatively. We already have enough information about COVID-19 to raise it far above the threat level of a random virus. And given how quickly and stealthily it seems to be capable of spreading, to take no action beyond 'pursuing more information' would be almost the same as assuming the best possible resolution of our uncertainty. That's no more rational than the other extreme of assuming the very worst.

mattrp 7y ago

MWC is a 100,000 person French ski chalet... it makes total sense to cancel it. “Show flu” is a thing... so if just the booth workers come back through customs with even so much as an elevated temperature, it will unnecessarily crowd the quarantine facilities for weeks. You may have math on your side but you’re not winning this one.

jon-wood 7y ago

I think this is less about MWC or Barcelona having health fears and more the domino effect of big exhibitors pulling out. It seems a lot of those pulled out because their Chinese companies, and presumably impacted by travel restrictions meaning they couldn’t get key people prepared in advance and then out to the event. Once the big exhibitors pull out you then see attendees doing likewise as meetings they were travelling for get cancelled, and finally smaller exhibitors deciding it’s not worth the effort.

retsibsi 7y ago

> Serious cases and mortality (2%) will be adjusted downwards safely in the coming weeks, as the detection of mild cases increases. There are factors that could move that number in both directions. Yes, presumably there are many mild cases that haven't been counted. But unfortunately coronavirus deaths are probably also undercounted -- for example, https://www.washingtonpost.com/world/as-families-tell-of-pneumonia-like-deaths-in-wuhan-some-wonder-if-china-virus-count-is-too-low/2020/01/22/0f50b1e6-3d07-11ea-971f-4ce4f94494b4_story.html https://www.washingtonpost.com/world/as-families-tell-of-pne... This point I'm not sure about, because it seems bizarre that everyone would make such an obvious mistake, but: as far as I can tell, the death rate is simply calculated as [current total of recorded deaths] / [current total of recorded cases]. But when the fatal cases take quite a long time to kill (from what I've read, it tends to take a week or so from the onset of symptoms for them to become severe, and up to another two weeks for death to occur -- see https://www.straitstimes.com/asia/east-asia/reporters-notebook-life-and-death-in-a-wuhan-coronavirus-icu https://www.straitstimes.com/asia/east-asia/reporters-notebo...) and the total number of cases is rising dramatically, surely that skews the figure toward a significant underestimate?

gamblor956 7y ago
For example, using the simple methodology, SARS' death rate was only about 3%, and that was the number most media used during the outbreak. But years after the epidemic ended, once researchers had greater access to medical records, the death was determined to be 10-15%, or roughly 3-5x higher than originally reported. In the cases of NCV, there is already significant evidence of under reporting of fatalities by Chinese authorities in Wuhan (some sources suggest that up to 90% of NCV deaths in China may be unreported). And as the cruise ship stuck outside of Japan demonstrates, the virus may be far more virulent (i.e., contagious) than previously thought.
- gamblor956 7y ago
  Followup: https://www.nytimes.com/2020/02/12/world/asia/china-coronavirus-cases.html https://www.nytimes.com/2020/02/12/world/asia/china-coronavi... China just changed how it classifies NCV cases to reduce the number of cases by eliminating those who are infected but not symptomatic meaning the numbers are even less reliable than they were before. The problem with this is that a number of the superspreaders, like the British fellow that infected 11 other people, and the passenger that infected the cruise ship quarantined in Japan, were not symptomatic when they were infecting others.

bugzz 7y ago

> Only 1% of cases have been registered outside China, in 24 countries (including Spain), with transmission chains (secondary cases from a first imported case) very short so far. It seems completely unsurprising to me that we aren't seeing more cases in other countries so far - almost every country with the exception of Singapore are only testing people who have been in Hubei (or China, if symptoms are serious). Meanwhile Singapore, which actually has been testing more people, has been finding more and more locally transmitted cases, despite huge efforts tracking down and isolating contacts of previous cases. >Serious cases and mortality (2%) will be adjusted downwards safely in the coming weeks, as the detection of mild cases increases. Or it could adjust upward, as it seems to often take 3+ weeks to kill. In Singapore 8/50 cases are in critical condition in the ICU (And Singapore has detected many mild cases, even asymptomatic ones). For the flu in the U.S. it seems about 0.1% of cases end up in the ICU, so that's some compelling evidence that this is 10-100x as dangerous as the flu. And what happens to the fatality rate when we run out of ICU beds, as already happens during particularly bad flu seasons? I'm not saying this will be globally devastating, but I think the chance is high enough that I'm disappointed more extreme actions aren't being taken worldwide. edit: I also assume the case numbers in China outside of Hubei have been looking better recently because they also can no longer rely on the fact that a sick person has recently been to Hubei to know who to test.

akiselev 7y ago

From what I understand, the medical community is treating this outbreak with such extreme measures because this virus is a perfect storm of factors that could lead to a new annual disease emerging, just like the flu and cold. It's deadly enough to become a major global concern and transmissible enough that it can continue spreading via asymptomatic hosts and other viral reservoirs between outbreaks. The jury is still out on the virus's rate of mutation but other coronaviruses, like the ones that cause a tenth of common colds, are known to mutate rapidly. If we fail to stop the spread of the virus now, it may become a fact of life with an even higher annual death rate than the flu. We've already got plenty of infectious diseases and based on the data so far, it's worth extreme measures trying to stop it.

wsinks 7y ago
I hadn't even thought of the possibility that there could be a new cyclical virus that emerges! Thank you smart people in the WHO and global health community.
- koheripbal 7y ago
  This is what virologists are expecting since it's clear containment has already failed.
thaumaturgy 7y ago
For anyone that wants to read more about this or any other aspect of 2019-nCoV, there's a very good /r/askscience thread: https://www.reddit.com/r/askscience/comments/ewwmem/have_a_question_about_the_2019_novel_coronavirus/ https://www.reddit.com/r/askscience/comments/ewwmem/have_a_q...
- dredmorbius 7y ago
  https://old.reddit.com/r/askscience/comments/ewwmem/have_a_question_about_the_2019_novel_coronavirus/ https://old.reddit.com/r/askscience/comments/ewwmem/have_a_q...

NicoJuicy 7y ago

And still, there was one super spreader that was linked to 11 cases: https://www.independent.co.uk/news/uk/home-news/coronavirus-super-spreader-news-steve-walsh-brighton-uk-france-singapore-a9328776.html https://www.independent.co.uk/news/uk/home-news/coronavirus-...

doublekill 7y ago

The newspapers of the time also dubbed the Spanish flu: just a familiar grip we've seen time and time again. China desperately wants to save face, at the cost of lives. They rejected help from the U.S. CDC as to not appear weak. They already thought they had it under control, before locking down over 50 million people and damaging their economy. People at risk for the flu can get a flu shot. This disease kills the healthy and average aged. And we all have family members at increased risk. Even a 2% mortality rate is absolutely horrific. Would you play Russian roulette with those chances? If 60% percent of the world gets infected we are talking many many millions of dead. How are you going to track contacts, when someone working in a brothel gets it, or someone preparing food in a McDonald's? What if someone takes the virus back to India or Africa? With 20% needing intensive care, even modern European countries will suffer badly. There simply are not enough beds available, even in the bigger cities. Mortality is a red herring when you do not count the people still hospitalized after months! Look at the tiny amount of recovered people. Despite their titanic and gruesome methods to contain it, China has failed. Imagine such an effort in Europe, where people gladly will walk away from quarantine and can not be cowered into compliance or snitching on their coughing neighbors. We simply do not know enough about morbesity and mortality to say we overreact. Better safe than sorry when uncertainty abound.

jsz0 7y ago

> follow all possible contacts. Not a practical strategy for thousands of conference attendees packed closely together for a short period of time before flying back home. This virus is too infectious and has too long of an incubation period. That's why so many public events are being canceled. This exact scenario is playing out right now aboard the cruise ship docked in Japan.

hanoz 7y ago

I read your post, looked at your profile, and now I'm suffering from a severe case of cognitive dissonance. > To put things in perspective, although perhaps inaccurate, the number of cases of COVID-19 infection in China is less than 3 cases / 100,000 inhabitants. What kind of perspective are we getting by adding the entirety of China to a locked down Wuhan when considering the infection rate? And then to go on to compare that to flu rates in Catalonia. Really, what point is that supposed to make? > Our Health Alerts and Emergencies system works, works as a team and the protocols established in the EU apply: detect the case, isolate it, treat it and follow all possible contacts. In this way, the transmission chain can likely be properly controlled. How can this possibly work if carriers are infectious for lord knows how many days before symptoms appear? It's laughable. How does this crack team of contact follow uppers deal with the case of a single infected metropolitan commuter?

ineedasername 7y ago

It does not logically follow from the low infection rates outside of China that these extreme measures are not warranted, quite possibly it's the opposite: low infections follow from strong containment measures. As for comparisons to the Flu, I see this so often and it always misses the point: it's not one or the other, so why would the medical establishment not fight in the extreme to stop many thousands of deaths that would result if another flu-like disease came along? Second, there is an entire industrial complex complete with seasonal ramp up in staffing to deal with Flu season, and we still see non-negligible fatality rates. Without that support network, which again we don't have for COVID-19, how much worse would things be with the flu? So we should all stop using the flu as some type of benchmark for what a reasonable COVID-19 response looks like.

tim333 7y ago

The scenes from Wuhan are pretty grim - people turned away from hospitals, crematoria running 24/7. I think it's understandable that other countries don't want to repeat that hence caution may be advisable. You don't see anything like that with normal flu.

WillPostForFood 7y ago

99% of cases of coronavirus (COVID-19) infection, today more than 40,000 with a thousand deaths, have been registered in China. Another perspective is that there were only 41 reported cases in China six weeks ago, and now there are 60,000. So while there are only 500 cases outside China so far, we might want to wait six more weeks before declaring victory.