28 ms·

Coronavirus – The Outlook Has Worsened

49 points by joshuafkon 7y ago

seren 7y ago
I enjoyed the clear and fact based presentation, with different scenarios. I am bit shocked to learn that that the R0 of the Spanish flu was only around 2 though. Regarding the number of case outside of China, raising exponentially, at least half of them, 454 as of today are onboard of the Diamond Princess. I am not sure if this is good or bad but surely a cruise ship is a bit peculiar situation, and maybe you cannot extrapolate too much based on that . On the other hand, it also means that if a "dense" community is hit where people are living closely, it can have a bad outcome as well.
9nGQluzmnq3M 7y ago
This article is junk, and I don't understand why we're accepting medical analysis from a random trader. A few of the more obvious flaws: * At this point in the epidemic you can't compute fatality rates simply by deaths/recoveries, because recoveries lag deaths by several weeks (once you're dead you're dead, but if you survive it takes a few weeks to recover and start testing negative). * It is well known that China is undercounting cases, not because of some deep CCP conspiracy, but because Wuhan/Hubei's health system is so overloaded that only the sickest cases are hospitalized, much less tested. * This also skews death rates very high, because mild cases are not detected and counted at all. This is also clear from the divergence in death rates in Hubei (2.x%) and outside Hubei (under 0.5%, and there's undercounting happening here too). * The virus has been in the wild in a number of countries outside China (Singapore, Japan, Thailand, etc), yet to date local transmission has petered out and there's no sign of massive outbreaks happening. This argues for a much lower R0, and/or that there's something specific to Wuhan that favors the virus, with cold, dry winter air and heavy air pollution (and the accompanying chronic lung damage) cited as possible factors.
- b0sk 7y ago
  I have seen a lot of FUD, bordering on cheerleading, from especially crypto guys. My cynical mind says that anything that weakens the present investment options is an opportunity for crypto to enter the fray (and the guys to make as much money in the interim)
- prepend 7y ago
  > You can't compute fatality rates simply by deaths/recoveries, because recoveries lag deaths by several weeks (once you're dead you're dead, but if you survive it takes a few weeks to recover and start testing negative). There are limitations with this method, but I think it’s the best possible at the time. What method do you think is better?
  - joosters 7y ago
    You could count the number of deaths by date 'n', compared to the number of recoveries by date 'n+14', say, picking a date related to the average recovery time?
    - prepend 7y ago
      The recovery date isn’t fixed so there’s not a single “+14” that is as useful as picking the dead / known outcome. I think this is because it’s hard to know date of infection, but it’s definite to know whether the case resulted in death or has been determined “recovered.”
  - 9nGQluzmnq3M 7y ago
    Count deaths & recoveries a few weeks in for cohorts that showed first symptoms on the same days. But data collection for this is hard and it takes a while too.
    - prepend 7y ago
      This is mentioned in the article and is more accurate, but isn’t possible throughout an outbreak for the reason you state.
    - deleted 7y ago
      [deleted]
- deleted 7y ago
  [deleted]
- ethbro 7y ago
  https://www.cassandracapital.net/blog https://www.cassandracapital.net/blog Oh, but the author's other content inspires so much faith!
- jacknews 7y ago
  i agree, complete garbage. what is worrying is that the percentage of 'serious/critical' cases seems to be stable at 20%. Regardless of fatality rate, if this holds, and the virus becomes pandemic it will impose a significant burden on health systems.
  - lbeltrame 7y ago
    IIRC, the vast majority of earlier cases were people with a previous health condition. Does anyone know if there are data sources where one could look at these figures?
- ljw1001 7y ago
  > The virus has been in the wild in a number of countries outside China (Singapore, Japan, Thailand, etc), yet to date local transmission has petered out and there's no sign of massive outbreaks happening. This argues for a much lower R0... While I agree with your other points, the idea that transmission in Japan is petering out is wildly optimistic and not what epidemiologists in Japan are saying. Unfortunately, you can couple that with the possibility of transmission in states where the medical infrastructure is especially weak (in Africa, for example, where millions of Chinese people work).
  - lbeltrame 7y ago
    > While I agree with your other points, the idea that transmission in Japan is petering out is wildly optimistic Does that take the Diamond Princess cases into account, or just the others (66 last time I checked, and IMO the most important ones are the cases reported outside the group of people who were repatriated and quarantined)? IMO it is clear that keeping all those people in close quarters in the cruise ship wasn't the best idea after all (because interactions keep on occurring, and thus infections keep on spreading). I also don't find the story of the health officer infected for "10 minutes contact" (or so the NHK says) very credible, or at best, it is a stochastic event. A real problem is instead that, for outside infections, people kept on working and having contact with others despite being sick. I don't want to downplay the issue at all, but as far as I can see the Japanese press (I can't say much about the actual people living there) going absolutely hysterical over this (but it was the same with H1N1 back in the days). The government then follows suit.
- mrpopo 7y ago
  > I don't understand why we're accepting medical analysis from a random trader. This CoVid19 outbreak in the age of social media has caused too many wanna-be epidemiologists to post their unfiltered, unscientific opinions and present them as facts. How can we ever get reliable information from that?
- deleted 7y ago
  [deleted]
- makomk 7y ago
  None of those objections seem right at all. The coronavirus deaths so far have been long, drawn-out affairs compared to the recoveries, so there's no particular reason to expact recoveries to lag deaths. We know China has been undercounting deaths as well as cases, and in any case thse estimates in this are based on non-Chinese numbers. Also, transmission outside of China hasn't just "petered" out - it was aggressively stamped out via contact tracing, which is why the non-Chinese numbers are likely to be a fairly accurate total count of infections. It's obviously pretty infectious judging from the clusters we've seen when someone from China who's infected does make it outside, and that level of contact tracing probably isn't going to be viable forever or in less developed countries.
  - 9nGQluzmnq3M 7y ago
    > The coronavirus deaths so far have been long, drawn-out affairs compared to the recoveries No, it took until several weeks into the epidemic until the number of recoveries exceeded the number of deaths. > We know China has been undercounting deaths as well as cases All deaths are counted, people don't just leave corpses lying around, although it is true that many coronavirus deaths were likely misclassified. By comparison, if someone gets a mild case (80%+ probability) and recovers at home, they'll never get recorded in any stats. > it was aggressively stamped out via contact tracing In some countries like Singapore, yes. But in countries like Thailand and Mexico, contact tracing was haphazard to nonexistent, and epidemics still failed to materialize.
    - Brave-Steak 7y ago
      > although it is true that many coronavirus deaths were likely misclassified So we don't have accurate numbers in either direction, and anybody pretending that all the mild cases not being recorded is enough to decide this virus isn't serious and doesn't warrant being careful about, is being an asshole. SARS/MERS show that coronaviruses can be dangerous, and it's too early to decide "well, show's over, nbd".
    - GolDDranks 7y ago
      It still makes a difference whether a death is counted as "death from COVID-19" or "death from pneumonia suspected to be COVID-19 (unverified via tests)" or "death from pneumonia (undiagnosed)" or "death from unknown cause". They changed the counting method once before, counting now more.
mnw21cam 7y ago
Why does the article finish in the middle of a sentence?
- ethbro 7y ago
  Because the generating model ran out of memory.
joosters 7y ago
I'm curious about a rather immaterial point in the corona virus reporting: Why does everyone discuss 'mainland China'? What are they trying to clarify by putting that 'mainland' word in? It surely can't be Taiwan, since these are Western articles, whose audience probably won't confuse the two. So is it about Hong Kong? That doesn't make much sense either, since most of Hong Kong is on the mainland. And yet, while these reports all talk about mainland China, they still include Hainan (a large island off the south coast of China). In fact this article has it highlighted in its map as being an area under lockdown. And yet Hainan is quite obviously not a part of the mainland. So why do writers keep referring to 'mainland' China?
- ohmaigad 7y ago
  Mainland China is PRC.
  - joosters 7y ago
    So is Hainan!
    - ohmaigad 7y ago
      Then why are you wondering why it is included? Mainland in this case is a geopolitical term.
      - joosters 7y ago
        Because it makes no sense? For all the uses of 'mainland China', it would be simpler to just say 'China', with no loss of clarity. Adding pointless words just for the sake of it, especially when it seems that the author(s) don't mean what the word says, is bad writing.
        robjan 7y ago
        Hong Kong is inside China but not governed directly by PRC. Most non-Chinese citizens need a visa to enter "Mainland China" but not Hong Kong. Most Chinese people need a permit to enter Hong Kong. So, yes, the distinction is useful.

49 points by joshuafkon 7y ago

I enjoyed the clear and fact based presentation, with different scenarios. I am bit shocked to learn that that the R0 of the Spanish flu was only around 2 though. Regarding the number of case outside of China, raising exponentially, at least half of them, 454 as of today are onboard of the Diamond Princess. I am not sure if this is good or bad but surely a cruise ship is a bit peculiar situation, and maybe you cannot extrapolate too much based on that . On the other hand, it also means that if a "dense" community is hit where people are living closely, it can have a bad outcome as well.

9nGQluzmnq3M 7y ago

This article is junk, and I don't understand why we're accepting medical analysis from a random trader. A few of the more obvious flaws: * At this point in the epidemic you can't compute fatality rates simply by deaths/recoveries, because recoveries lag deaths by several weeks (once you're dead you're dead, but if you survive it takes a few weeks to recover and start testing negative). * It is well known that China is undercounting cases, not because of some deep CCP conspiracy, but because Wuhan/Hubei's health system is so overloaded that only the sickest cases are hospitalized, much less tested. * This also skews death rates very high, because mild cases are not detected and counted at all. This is also clear from the divergence in death rates in Hubei (2.x%) and outside Hubei (under 0.5%, and there's undercounting happening here too). * The virus has been in the wild in a number of countries outside China (Singapore, Japan, Thailand, etc), yet to date local transmission has petered out and there's no sign of massive outbreaks happening. This argues for a much lower R0, and/or that there's something specific to Wuhan that favors the virus, with cold, dry winter air and heavy air pollution (and the accompanying chronic lung damage) cited as possible factors.

b0sk 7y ago
I have seen a lot of FUD, bordering on cheerleading, from especially crypto guys. My cynical mind says that anything that weakens the present investment options is an opportunity for crypto to enter the fray (and the guys to make as much money in the interim)
prepend 7y ago
> You can't compute fatality rates simply by deaths/recoveries, because recoveries lag deaths by several weeks (once you're dead you're dead, but if you survive it takes a few weeks to recover and start testing negative). There are limitations with this method, but I think it’s the best possible at the time. What method do you think is better?
- joosters 7y ago
  You could count the number of deaths by date 'n', compared to the number of recoveries by date 'n+14', say, picking a date related to the average recovery time?
  - prepend 7y ago
    The recovery date isn’t fixed so there’s not a single “+14” that is as useful as picking the dead / known outcome. I think this is because it’s hard to know date of infection, but it’s definite to know whether the case resulted in death or has been determined “recovered.”
- 9nGQluzmnq3M 7y ago
  Count deaths & recoveries a few weeks in for cohorts that showed first symptoms on the same days. But data collection for this is hard and it takes a while too.
  - prepend 7y ago
    This is mentioned in the article and is more accurate, but isn’t possible throughout an outbreak for the reason you state.
  - deleted 7y ago
    [deleted]
deleted 7y ago
[deleted]
ethbro 7y ago
https://www.cassandracapital.net/blog https://www.cassandracapital.net/blog Oh, but the author's other content inspires so much faith!
jacknews 7y ago
i agree, complete garbage. what is worrying is that the percentage of 'serious/critical' cases seems to be stable at 20%. Regardless of fatality rate, if this holds, and the virus becomes pandemic it will impose a significant burden on health systems.
- lbeltrame 7y ago
  IIRC, the vast majority of earlier cases were people with a previous health condition. Does anyone know if there are data sources where one could look at these figures?
ljw1001 7y ago
> The virus has been in the wild in a number of countries outside China (Singapore, Japan, Thailand, etc), yet to date local transmission has petered out and there's no sign of massive outbreaks happening. This argues for a much lower R0... While I agree with your other points, the idea that transmission in Japan is petering out is wildly optimistic and not what epidemiologists in Japan are saying. Unfortunately, you can couple that with the possibility of transmission in states where the medical infrastructure is especially weak (in Africa, for example, where millions of Chinese people work).
- lbeltrame 7y ago
  > While I agree with your other points, the idea that transmission in Japan is petering out is wildly optimistic Does that take the Diamond Princess cases into account, or just the others (66 last time I checked, and IMO the most important ones are the cases reported outside the group of people who were repatriated and quarantined)? IMO it is clear that keeping all those people in close quarters in the cruise ship wasn't the best idea after all (because interactions keep on occurring, and thus infections keep on spreading). I also don't find the story of the health officer infected for "10 minutes contact" (or so the NHK says) very credible, or at best, it is a stochastic event. A real problem is instead that, for outside infections, people kept on working and having contact with others despite being sick. I don't want to downplay the issue at all, but as far as I can see the Japanese press (I can't say much about the actual people living there) going absolutely hysterical over this (but it was the same with H1N1 back in the days). The government then follows suit.
mrpopo 7y ago
> I don't understand why we're accepting medical analysis from a random trader. This CoVid19 outbreak in the age of social media has caused too many wanna-be epidemiologists to post their unfiltered, unscientific opinions and present them as facts. How can we ever get reliable information from that?
deleted 7y ago
[deleted]
makomk 7y ago
None of those objections seem right at all. The coronavirus deaths so far have been long, drawn-out affairs compared to the recoveries, so there's no particular reason to expact recoveries to lag deaths. We know China has been undercounting deaths as well as cases, and in any case thse estimates in this are based on non-Chinese numbers. Also, transmission outside of China hasn't just "petered" out - it was aggressively stamped out via contact tracing, which is why the non-Chinese numbers are likely to be a fairly accurate total count of infections. It's obviously pretty infectious judging from the clusters we've seen when someone from China who's infected does make it outside, and that level of contact tracing probably isn't going to be viable forever or in less developed countries.
- 9nGQluzmnq3M 7y ago
  > The coronavirus deaths so far have been long, drawn-out affairs compared to the recoveries No, it took until several weeks into the epidemic until the number of recoveries exceeded the number of deaths. > We know China has been undercounting deaths as well as cases All deaths are counted, people don't just leave corpses lying around, although it is true that many coronavirus deaths were likely misclassified. By comparison, if someone gets a mild case (80%+ probability) and recovers at home, they'll never get recorded in any stats. > it was aggressively stamped out via contact tracing In some countries like Singapore, yes. But in countries like Thailand and Mexico, contact tracing was haphazard to nonexistent, and epidemics still failed to materialize.
  - Brave-Steak 7y ago
    > although it is true that many coronavirus deaths were likely misclassified So we don't have accurate numbers in either direction, and anybody pretending that all the mild cases not being recorded is enough to decide this virus isn't serious and doesn't warrant being careful about, is being an asshole. SARS/MERS show that coronaviruses can be dangerous, and it's too early to decide "well, show's over, nbd".
  - GolDDranks 7y ago
    It still makes a difference whether a death is counted as "death from COVID-19" or "death from pneumonia suspected to be COVID-19 (unverified via tests)" or "death from pneumonia (undiagnosed)" or "death from unknown cause". They changed the counting method once before, counting now more.

mnw21cam 7y ago

Why does the article finish in the middle of a sentence?

ethbro 7y ago
Because the generating model ran out of memory.

joosters 7y ago

I'm curious about a rather immaterial point in the corona virus reporting: Why does everyone discuss 'mainland China'? What are they trying to clarify by putting that 'mainland' word in? It surely can't be Taiwan, since these are Western articles, whose audience probably won't confuse the two. So is it about Hong Kong? That doesn't make much sense either, since most of Hong Kong is on the mainland. And yet, while these reports all talk about mainland China, they still include Hainan (a large island off the south coast of China). In fact this article has it highlighted in its map as being an area under lockdown. And yet Hainan is quite obviously not a part of the mainland. So why do writers keep referring to 'mainland' China?

ohmaigad 7y ago
Mainland China is PRC.
- joosters 7y ago
  So is Hainan!
  - ohmaigad 7y ago
    Then why are you wondering why it is included? Mainland in this case is a geopolitical term.
    - joosters 7y ago
      Because it makes no sense? For all the uses of 'mainland China', it would be simpler to just say 'China', with no loss of clarity. Adding pointless words just for the sake of it, especially when it seems that the author(s) don't mean what the word says, is bad writing.
      - robjan 7y ago
        Hong Kong is inside China but not governed directly by PRC. Most non-Chinese citizens need a visa to enter "Mainland China" but not Hong Kong. Most Chinese people need a permit to enter Hong Kong. So, yes, the distinction is useful.