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Clinical characteristics of 50k patients with 2019-nCoV infection
- CHsurfer 7y agoWhat's a morality rate? Is it a typo or an actual indicator? I found this: https://www.hsph.harvard.edu/population-development/tag/morality-rate/ https://www.hsph.harvard.edu/population-development/tag/mora... but it seems to be a typo.
- fortani 7y agoYeah, that's a typo, it should be mortality rate.
- allovernow 7y agoOk, is now a good time to start taking this seriously? Spanish Flu had an R0 of about 2[1]. Current published estimates for 2019-ncov are 2.3-3.8 for this paper [1] and there's another floating around which gets as high as 6-8. 1. https://www.ncbi.nlm.nih.gov/pubmed/19545404/ https://www.ncbi.nlm.nih.gov/pubmed/19545404/ 2. https://www.sciencedirect.com/science/article/pii/S120197122 https://www.sciencedirect.com/science/article/pii/S120197122
- hef19898 7y agoWhat makes you think it isn't taken seriously?
- allovernow 7y agoHow about the fact that it wasn't priced into the markets until today. This information has been around for weeks.
- hef19898 7y agoSO stock markets are the measure if a pandemic is taken seriously or not. I wuld rther say that the measrues being taken are good enough for the mrkets to not worry. Or that markets simply don't care. But than again, WiseTech Global, a logistics software company, lost quite some value over this. Kind of rediculous but still.
- 2a0c40 7y agoThere are almost no travel restrictions in place
- _-___________-_ 7y agoIf you can show a model for a travel restriction that would actually help to prevent the spread, I'd love to see it. The travel restrictions are in place for political reasons, not well-evidenced public health reasons.
- hef19898 7y agoWell, Italy just closed of roughly 50k people. And didn't airlines limit flights to China? What do you expect, a complete, worldwide shutdown of travel? Even between, say, Canada and Greenland?
- _-___________-_ 7y agoAnd there are others that are much lower. It's also worth remembering that given many cases are asymptomatic, or are so mild that people may not see a doctor, the number of cases does not accurately reflect the number of infected people. So these mortality rates should not be read as an indicator of your chance of dying if you are infected with the virus. One reason that many people don't seem to be "taking this seriously" is because the narrative of people who keep fearmongering about COVID-19 just doesn't make sense. There are still direct flights from China to many countries, and they're not empty. Screening is mostly based on taking people's temperature with handheld devices that have twice registered my temperature as 32C (no, I wasn't rushed to a hospital). Where more reliable screening has been implemented, there have been many documented failures. Many quarantine protocols are voluntary / honour-based. People from cruise ships where they were exposed to others who were infected have dispersed worldwide with varying levels of monitoring (in some cases none). If this thing was half as deadly and easily-spread as continues to be claimed on the Internet, 200 new cases in Italy wouldn't be international news at this point.
- allovernow 7y agoAre they consistent with China's unprecedented response?
- _-___________-_ 7y agoI assume you're being facetious, but regardless of early failings and a lack of transparency, it's hard to imagine any other country imposing a quarantine on a city the size of Wuhan in the manner they have, or building hospitals at the rate they have.
- ethbro 7y agoI thought this article was interesting: https://www.theatlantic.com/technology/archive/2020/02/coronavirus-and-blindness-authoritarianism/606922/ https://www.theatlantic.com/technology/archive/2020/02/coron... Particularly the point about "Why build hospitals?" Because in strongly centralized, command political systems, grand projects are one of the few things done well. And so crisis management becomes "What can we build, to show we're taking it seriously?"
- toptal 7y ago“The mortality rate of patients with 2019-nCoV infection was lower than that of Severe Acute Respiratory Syndrome (SRAS) and Middle East Respiratory Syndrome (MERS).” Is this a typo or are they politicizing SARS here so people think it’s something else?
- Spare_account 7y agoI can't see any typos in your quoted text. Am I missing something obvious?
- creato 7y agoSRAS vs. SARS
- KuiN 7y ago> (SRAS)
- jobigoud 7y agoSRAS instead of SARS, Maybe?
- Spare_account 7y agoWow, how did I miss that. Sorry everyone
- sambe 7y agoPoliticizing how?
- jsjddbbwj 7y agoHow is making the typo SARS vs SRAS politicising anything?
- toptal 7y agoThere was a mention last week that WHO would not reference SARS anymore, out of fear of widespread panic. Hence my question.
- ArmandGrillet 7y agoPlease update the title to remove the typo (s/morality/mortality), from the abstract: "the mortality rate of patients with 2019-nCoV infection was 4.8%".
- fortani 7y agoCan't edit the title anymore. Could an admin eg: @dang edit it, thank you.
- thepangolino 7y agoI still would like to see the age repartition and most importantly a study on unreported cases. From what I’ve heard, CIVID-19 has symptoms very similar to the flu.
- chrisco255 7y agoThe flu only has a 0.1-0.05% mortality rate. The early symptoms of of it are flu-like but the severe respiratory symptoms that set in and make it difficult to breath are not like your typical flu, to my knowledge.
- rndgermandude 7y agoThey give a "cough" incidence of 70.8% and a acute respiratory distress syndrome incidence of 14.8% in their paper. Meaning even a lot of people diagnosed with the infection show no respiratory symptoms, let alone severe ones. I therefore wouldn't dismiss the possibility of a high number of unreported cases, where people didn't develop any major symptoms and thought it was a cold or flu if they noticed symptoms at all.
- rpeden 7y agoSince the common cold is caused by coronaviruses a decent chunk of the time, I'm not sure it's even inaccurate for someone with a non-severe case of covid-19 to conclude that they have a cold. Maybe that's the tricky part that helps it spread. Having a cold isn't enough to stop most people from going out in public. In my experience among people I know in the US and Canada, having a mild cold isn't enough for people to stay home from work. But while a covid-19 infection might really be just a cold to a large chunk of people who get it, it's unusually deadly to a non-trivial percentage of people as well.
- snemvalts 7y agothe mortality rate of this is highly skewed because of shortage of test kits
- billars 7y ago
- gerardnll 7y agoIs this 4.8% mortality number from cured/dead patients or also counting ongoing cases?
- jonathanstrange 7y agoI'm confused, I thought that what the paper defines as Mortality Rate is called Case Fatality Rate. Could someone explain to me what the difference is?
- AstralStorm 7y agoMortality Rate is number of deaths divided by total infected count estimate. E.g. it includes self reported cases and estimated using infection rates. (R0 mostly.) It does not exist when mode of infection is not entirely clear it when number of cases are low. Case Fatality Rate is number of deaths divided by number of confirmed cases, which are usually hospitalizations. Mortality Rate is usually much lower than Case Fatality Rate.
- jonathanstrange 7y agoThanks a lot! So if the paper is correct and the mortality is 4.8%, then the CFR would actually expected to be higher. I'm kind of disturbed by this because I've seen numbers for CFRs between 2%-3%, which is already quite high. These should be higher then, right?
- gwd 7y agoIf you look at the breakdown of infections vs deaths in China[1], you'll see that the death rate outside of Hubei is far lower than the death rate inside. As of yesterday, Guangdong, for instance, has had 1345 confirmed cases, but only 6 deaths -- in spite of the fact that at least 800 of those had been exposed more than 2 weeks ago[2]. The most likely explanation to me is that the hospitals in Hubei have been overwhelmed. Obviously that means we should be vigilant about limiting the spread of the disease, so that hospitals elsewhere aren't overwhelmed. But catching it isn't the immediate death sentence headlines like this indicate. [1] https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200224-sitrep-35-covid-19.pdf?sfvrsn=1ac4218d_2 https://www.who.int/docs/default-source/coronaviruse/situati... [2] https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200204-sitrep-15-ncov.pdf?sfvrsn=88fe8ad6_4 https://www.who.int/docs/default-source/coronaviruse/situati...
- fortani 7y agoThe scary thing about this virus, isn't the mortality rate, but the high R0 value and the potentially high proportion of infected people who are classified as severe cases. Assuming that 20% of the US population (330 million) gets it, we're looking at about 13.2 million (20%x20%x330 million) patients who require admission to an ICU ward. Needless to say, that is enough to overwhelm the healthcare system and hospitals, and increase the overall mortality rate, when people who requires ICU are turned away due to lack of beds or equipment. As it is, the best option would be to delay the spread as much as possible, so that the number would be spread across a time-span for as long as possible.
- sschueller 7y agoI don't think that number is accurate because so many people are not tested. Only people with severe infections are tested or those who have been in contact with known infected people. With the deaths in Italy it is now also unclear if one person actually died from COVID-19 or if it was the late stage cancer they had.
- pjc50 7y agoNever mind that, far before you get to 20% the billing issues will destroy the system: https://www.miamiherald.com/news/health-care/article240476806.html https://www.miamiherald.com/news/health-care/article24047680... If you charge $1,400 to each suspected person then either the testing will bankrupt the population or people are going to hide from testing. If coronavirus arrives in bulk in the US, then it's either going to be "Medicare for coughs for everyone" or a pandemic.
- BillyTheKing 7y ago4.8% is pretty alarming..! wouldn't there be an inherent bias, though, towards patients that display such severe symptoms that they would require medical care? Currently, to me at least, these cases in Italy seem to indicate that plenty of cases go unnoticed because many of those infected show few to no symptoms (which makes this virus all the harder to isolate)
- snemvalts 7y agothere aren't enough test kits, and for some people the serious/critical period in ICU can be a month, which means the CFR will always be skewed more or less.
- loyukfai 7y ago*mortality
- deleted 7y ago[deleted]
- 01acheru 7y agoWell... I'm in my hometown in Italy right now, people are advised to work remotely or avoid mass transit, everything closes after 6PM, museums/theaters/schools are closed, a small percentage of the population is going a little crazy so please everyone we must start asking ourselves some questions about those wild numbers that come out and people reporting them must be a little bit more responsible. We had 7 fatalities here in Italy in an really big area, all of those people were old (some very old) and with other aggressive diseases or health problems going on, but we keep saying we have 200something people positive to COVID-19 making the mortality rate 3.5% BUT those 7 people are absolutely not representative of the 3.5% of total population so we must be missing people that are positive to the virus but don't get tested and never will. We don't have enough test kits, we don't have enough personnel, we cannot overwhelm every lab in northern Italy just to start testing everyone for COVID-19 so many people without symptoms or with light symptoms are going on with their lives without ever being reported as positive... you get tested if: - you met with someone that died - you have severe symptoms - you have light symptoms and you are old or have some other disease - you live in one of the (really small) isolated areas - you escape from the areas that are isolated - you are close to someone that have escaped If you are young and have a cold, even if you want to get tested, no one will come. I know from first hand some 4 people that are sick right now (symptoms like normal cold or a mild influenza) and one person that had I bad influenza finishing last week... are they positive? We will never know, now scale that up to the millions of people living in northern Italy
- jamesrcole 7y ago> a small percentage of the population is going a little crazy What are they doing?
- 01acheru 7y agoJust a small list: - emptying supermarkets and fighting for products that finish instead of waiting for the shelves to be refurbished (with police interventions, etc.). I've seen people buy 20kg of pasta or 100 water bottles on Sunday - buying cleaning products and useless face masks for 10+ times the price - firmly believing that COVID-19 is a military plan or a disease made to kill old and sick people to lower costs - avoiding all Chinese people, Chinese food or Chinese shops (some people are afraid of goods made in China) - faking some other illness to avoid going to work And we could go on with a lot of other senseless things people are doing... Edit: formatting