10 ms·

WHO Director: "Covid-19 does not transmit as efficiently as influenza"

186 points by vanilla-almond 7y ago

username90 7y ago
Then how come we see cases where there were no symptomatic patients nearby? Like this CDC screener, no cases where known in the entire state when the person contracted the disease and it happened weeks ago: https://www.nbcnews.com/health/health-news/medical-screener-lax-airport-tests-positive-coronavirus-n1149986 https://www.nbcnews.com/health/health-news/medical-screener-... And this is not the first such case in USA. So either there are a ton of symptomatic Covid-19 patients in USA right now who are just thought to have the flu, or Covid-19 can spread just fine from asymptomatic people and that was how it spread to the well protected CDC personnel in the airport. And if an expert who follows all hygiene standards and wearing gloves and N95 respirators got it from an asymptomatic person, imagine how many other people at the Airport must have gotten it as well? And how many persons the carrier infected after arriving in USA? I am all but certain that the statement "We can contain it" is a lie at this point, I don't see how anyone can believe that. At least not without aggressively doing complete lockdowns of large communities before we even confirm cases, but I feel it is too late even for that now.
cbsks 7y ago
This paper has more information: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6909e1-H.pdf https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6909e1-H.pdf TLDR: "Since February 28, an increasing number of newly diagnosed confirmed and presumptive COVID-19 cases have been in patients with neither a relevant travel history nor clear epidemiologic links to other confirmed COVID-19 patients. However, despite intensive follow-up, no sustained person-to-person transmission of symptomatic SARS-CoV-2 was observed in the United States among the close contacts of the first 10 persons with diagnosed travel-related COVID-19." They tracked the first 10 people in the US with travel-related confirmed COVID-19, and followed up with 445 people who had close contact with them. Over 14 days, 54 of those 445 people developed new or worsening symptoms and were tested for COVID-19. Of the 54 people, only 2 tested positive for COVID-19. Both were household members of originally infected people. "Both persons with confirmed secondary transmission had close contact with the respective source patient before COVID-19 was confirmed and were isolated from the source patient after the patient’s COVID-19 diagnosis." "No other close contacts who were tested for SARS-CoV-2 had a positive test, including the five household members who were continuously exposed during the period of isolation of their household member with confirmed COVID-19. An additional 146 persons exposed to the two patients with secondary COVID-19 transmission underwent 14 days of active monitoring. Among these, 18 (12%) developed symptoms compatible with COVID-19 and were considered PUIs. All tested negative, and no further symptomatic COVID-19 cases (representing tertiary transmission) have been identified."
- jwlake 7y ago
  "54 of those 445 people developed new or worsening symptoms" So we're basically having people make themselves sick by watching the news, its a brand new pandemic!
- deleted 7y ago
  [deleted]
- AnimalMuppet 7y ago
  So... what? These people are picking up something that looks like COVID-19, but isn't? The COVID-19 tests are missing something like 90% of the people who have it? Or what?
  - cbsks 7y ago
    > These people are picking up something that looks like COVID-19, but isn't > The COVID-19 tests are missing something like 90% of the people who have it As far as I know (I'm not an expert) either of those are possibilities, and it's too early to know for sure. Edit: This comment mentions the possibility of there being 2 types of the virus that spread at different rates: https://news.ycombinator.com/item?id=22489599 https://news.ycombinator.com/item?id=22489599 Maybe the 10 people monitored in the US had the less contagious version? There are a lot of unanswered questions right now.
  - makomk 7y ago
    It's flu season. The symptoms of mild Covid-19 which were sufficient reason for the CDC to test close contacts of infected people are also basically just the symptoms of the flu or a cold or probably any number of other things.
deleted 7y ago
[deleted]
Tilian 7y ago
... "from the data we have so far." There are still a lot of unknowns, as stated in the media briefing.
Congeec 7y ago
The title is just one of those many points made.
- 9nGQluzmnq3M 7y ago
  It's arguably the most interesting/novel of the points, and HN titles have strict length limits.
heyitsguay 7y ago
Interesting... i wonder what the data is to back up that assertion? Another interesting tidbit in there was that very few cases (1%) appear to be totally asymptomatic, and that most infections apparently start showing some symptoms after a couple days. So there are a few assertions in total that seem to depart from what was previously understood, at least through mass and social media.
- ngngngng 7y ago
  I've never had such a steady stream of seemingly conflicting data before.
  - baddox 7y ago
    Are you actually receiving conflicting data, or just conflicting reports about data? It's not clear to me how data itself can "conflict." As a made-up example, if you keep seeing alternating cases where one person had symptoms and another person didn't, that's not "conflicting data." That's just data showing that 50% of people have symptoms.
    - Eliezer 7y ago
      Well said. There can be conflicting reports but never conflicting realities. That said, sometimes our apparent data is being filtered by different factors, or even altered, across different reports.
- knzhou 7y ago
  > i wonder what the data is to back up that assertion? The data is the tens of thousands of cases the WHO has stats on. You can read any of their reports, they've been saying the same thing for months. The main sources contradicting them are random internet commentators.
  - himinlomax 7y ago
    They've not been saying that for months, that's completely absurd. The disease started spreading in November at the earliest. Just a month ago very little was known about its transmission rate and lethality; estimates from reputable sources ranged from 1 to 20%.
knzhou 7y ago
This is important, because lots of internet commentators are just going with the most alarming possible statements: 28 day incubation periods, people can get infected twice, airborne transmission, asymptomatic transmission. These assertions are all based on outlier cases, sometimes even single cases, observed during the fog of war. Even if these accounts are correct, they aren't the typical case, which is what actually matters for policy and prevention. The typical case has been well-known for months: most people get fevers, the incubation period is usually a few days, and most transmission is from symptomatic cases and via droplets. The WHO has collected stats from tens of thousands of cases and they've been straightforwardly pointing in this direction the entire time. There definitely is a serious problem, but misinformation helps nobody, even if its spreaders are well-meaning. For example, I've seen a lot of people take the inflated statements ("28 day incubation period!!") to mean that stopping the spread is completely impossible, while we have seen by example that it isn't.
- mantap 7y ago
  I don't share your optimism. The virus has been able to successfully evade e.g. testing people's temperatures in airports. It doesn't really matter if there are asymtomatic carriers or not, it doesn't matter whether people eventually get a high fever. What matters is whether people with non-specific/mild symptoms (a dry cough) can pass on the infection. And the answer is emphatically yes.
  - tylerhou 7y ago
    Bypassing airport temperature tests is an incredibly low bar because it rarely catches other diseases. Anecdotally, I've travelled multiple times with people who have had fevers and entered countries with routine temperature screening and haven't been stopped. Human body temperature is also so variable that a small fever is masked by the margin of error.
    - fspeech 7y ago
      You don't need to catch everyone. You just need to bring R0 to below 1. If R0 is a little over 2 in the first place you just need to catch a little over 50% of the infected with all your actions (in addition to temperature checking) to eventually control the epidemic. The better you do the sooner you get it under control.
Leary 7y ago
"To summarize, COVID-19 spreads less efficiently than flu, transmission does not appear to be driven by people who are not sick, it causes more severe illness than flu, there are not yet any vaccines or therapeutics, and it can be contained – which is why we must do everything we can to contain it. "
fractal618 7y ago
They're trying to avoid a panic, so I'm just looking at the data from now on.... Numbers from https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/ https://bnonews.com/index.php/2020/02/the-latest-coronavirus... As of March 4th. 6:22 pm eastern standard In China: Deaths: 2,981 recoveries : 49,856 Death/recovery : 5.98% Outside of China... Deaths: 272 Recoveries : 1205 Deaths/recoveries : 22.6%
- perl4ever 7y ago
  Recovery takes more time compared to dying. So areas where it's been present for less time are going to show a different proportion even if it's evolving the same way.
  - Animats 7y ago
    Right. You can see that here: [1] The "Deaths" line and the "Recovered" line add up to maybe 60% of the "Confirmed" line. The difference is the people who are sick, but alive. [1] https://hgis.uw.edu/virus/ https://hgis.uw.edu/virus/
- function_seven 7y ago
  You're missing the # for "Unreported". That may be huge. For example, in China, are there another 100,000 people who contracted it, and recovered, without ever knowing they had it? You're looking at this data through the fog of war (as a sibling comment mentions).
  - flukus 7y ago
    TFA addresses this: > Evidence from China is that only 1% of reported cases do not have symptoms, and most of those cases develop symptoms within 2 days. They came up with this number by testing people who didn't have symptoms but were in some contact with someone who had the virus. The big question is how much the lockdown affected this, but there doesn't appear to be large swaths of asymptomatic people.
    - 7y ago
jcadam 7y ago
"To summarize, COVID-19 spreads less efficiently than flu, transmission does not appear to be driven by people who are not sick, it causes more severe illness than flu, there are not yet any vaccines or therapeutics, and it can be contained – which is why we must do everything we can to contain it. That’s why WHO recommends a comprehensive approach." Ah, so there aren't hordes of asymptomatic carriers out there, which is both good and bad (the death rate really is high)
- roywiggins 7y ago
  The confusing thing is that the Diamond Princess data points in the other direction: more asymptomatic cases, and a significantly lower case fatality rate, than the WHO numbers. https://slate.com/technology/2020/03/coronavirus-mortality-rate-lower-than-we-think.html https://slate.com/technology/2020/03/coronavirus-mortality-r... The WHO says they haven't found many asymptomatic cases (despite looking), but apparently lots of the cruise ship cases were. The WHO estimates a mortality rate over 3%, but much less 3% of the Diamond Princess infected died. I don't know how to reconcile these other than to suppose the virus has mutated (possible) or the asymptomatic cases were false positives (maybe?) or some demographic factor on the cruise ship was different.
  - makomk 7y ago
    The WHO seemed to be relying on Chinese flu surveillance data, which is basically useless - even the figures it produces for flu infections are implausible and probably wrong. Between this and their other comments it might be best to treat anything the WHO says as just Chinese propaganda at this point.
  - servercobra 7y ago
    The Diamond Princess is a pretty small sample size to be extrapolating the mortality rate.
    - roywiggins 7y ago
      Statistics out of South Korea look similar: https://mobile.twitter.com/HelenBranswell/status/1235211584600932352 https://mobile.twitter.com/HelenBranswell/status/12352115846...
MilnerRoute 7y ago
I just want to highlight this quote from the WHO: "With influenza, people who are infected but not yet sick are major drivers of transmission, which does not appear to be the case for COVID-19." "Evidence from China is that only 1% of reported cases do not have symptoms, and most of those cases develop symptoms within 2 days."
- ceejayoz 7y ago
  That's good news. Early-onset symptoms (in particular, a fever) was part of what made tackling SARS possible.
  - MilnerRoute 7y ago
    Another quote from the WHO: "We don’t even talk about containment for seasonal flu – it's just not possible. But it is possible for COVID-19. We don't do contact tracing for seasonal flu – but countries should do it for COVID-19, because it will prevent infections and save lives. Containment is possible."
thorum 7y ago
Keep in mind that almost 20% of the Diamond Princess cruise ship's passengers and crew (700+ of 3711) were infected with the coronavirus. However its infection rate compares with the seasonal flu (which is a much less dangerous illness overall), it clearly has the potential to infect a large number of people in the coming months.
- jcadam 7y ago
  IIRC, the crew was largely responsible for spreading the virus. Not that I'm faulting them. They simply were neither trained nor equipped to do a specialized job that was essentially forced on them - operating a quarantine facility.
- Trasmatta 7y ago
  I feel like the Diamond Princess is an atypical case and it's maybe a mistake to extrapolate too much from it.
- mc32 7y ago
  Isn’t a cruise ship a special case because it’s all self contained and there is almost no way to avoid contact with other infected people? Unless they had access to disposable Kevlar jumpsuits, masks, gloves and disinfectant, they’d be hard pressed to slow its spread in cramped conditions.
  - chaostheory 7y ago
    The way ship HVAC systems are designed, it helps limit costs while simultaneously increasing infections from anything that's airborne. In regard to Diamond Princess though, there were no safety protocols that were followed, so we don't know if it was the ship or the failure to follow pathogen related protocols.
    - cyphar 7y ago
      This virus isn't airborne. It's spread through respiratory droplets.
deleted 7y ago
[deleted]
allovernow 7y ago
Just a reminder that this is coming from an organization that 1. Receives part of it's funding from China 2. Has been using China's clearly manufactured numbers since day 1 3. Has yet to officially call this a pandemic though it has met the criteria for weeks ($425MM in pandemic bonds would default) [0] 4. Is led by a man (the very director being quoted) who was accused by the NYT of covering up no less than 3 cholera epidemics in his home country of Ethiopia. [1] So you're telling me China shut down it's entire economy [2] and put 700MM people under lockdown and/or travel restrictions because of something about as dangerous as the common flu? Note that the Chinese economy is still not back online - don't believe me? Check real time pollution maps for yourself. The air is still cleaner than it has been in decades. The WHO and CDC are lying to you. You can verify all of this for yourself. Hell, 8% of Iranian parliament members are infected. Look at the chaos gripping Iran, Italy, and SK. This is not the flu and I'm astounded that not only are official organizations misleading the public to this degree, but people are buying it en masse. Finally, after a mass petition, a number of journals released all 2019ncov literature from paywall. You can find estimates for mortality and R0 from many sources, and I don't think I've seen a single one below 2. The Spanish Flu of 1918 was at 2. Of course take these with a grain of salt as they may be oversampling severe cases, but they all point to the same grave conclusions, and you can read them yourself. Do not rely on these agencies to digest this information for you when you have unprecedented access to the same information. 0. https://markets.businessinsider.com/news/stocks/pandemic-bond-debate-inside-look-world-bank-coronavirus-relief-investment-2020-2-1028906657?op=1 https://markets.businessinsider.com/news/stocks/pandemic-bon... 1. https://www.nytimes.com/2017/05/13/health/candidate-who-director-general-ethiopia-cholera-outbreaks.html https://www.nytimes.com/2017/05/13/health/candidate-who-dire... 2. https://www.bloomberg.com/news/articles/2020-01-31/at-least-two-thirds-of-china-s-economy-to-stay-closed-next-week https://www.bloomberg.com/news/articles/2020-01-31/at-least-...
- mrow84 7y ago
  I find your point 3 confusingly worded: the trigger conditions for the pandemic bonds are specific and essentially transparent, but have not yet been met. They are independent of any statement the WHO may or may not make about whether a particular outbreak can reasonably be called a "pandemic". This independence should be unsurprising, because investors want some kind of "clarity" about what it is they are investing in. Whether or not the trigger conditions are too stringent for the bonds to be useful in dealing with the targeted crises, and whether or not the additional "clarity" provided by having well-defined trigger conditions is sufficient to manage risk for investors, are both separate concerns.
eruditegamer420 7y ago
The WHO is the fraud organization who cares more about keeping their Chinese masters happy than health and safety, right? Cool.
all_blue_chucks 7y ago
You are all interpreting this wrong. In a population with no preexisting immunity to either virus, flu would spread faster than COVID. But there is widespread immunity to flu (from both vaccines and exposure). There is ZERO immunity to COVID. So IN PRACTICE, this new disease spreads MUCH faster than flu.
ardit33 7y ago
1. I would not trust anything coming out of WHO at this point. Even Germany called it a pandemic, yet they are not willing to call it such (perhaps due to political influence/pressure, or just incompetence). This looks more like a 'panic containment' type of statement than the truth. 2. The R0 of seasonal flu, is about 1.5, Covid-19 has a R0 between 2.6 and 3.5*. (yet to be determined), which is much more contagious than normal flu. This article has no mention of it, hence has no credibility. By any account of any data, Covid-19 looks to be 2x more efficient to spread as the normal flu. 3. The major cases from the Diamond Princess, the cult in South Korea, and the Eldery Care facility in Seatle, are an indication that the virus is very easily spread in close quarters. That's not a normal flu type of virality, it is much worse. 4. We have many cases where people still tested positive even after 14 days of quarantine, hence it is not going to be easy to contain. But we don't know yet if a person is still contagious after testing positive after 14 days. No mention to this as well. TLDR: Don't panic, yet 3.4% of people are going to die, or 10-15% of your parents/grandparents will perish earlier due to this virus. I am sorry, but that's war-zone like statistics.... and this should be treat as such. (it needs a true war like mobilization to be combated, and talks like this to minimize the impact are just irresponsible).
- allovernow 7y ago
  https://markets.businessinsider.com/news/stocks/pandemic-bond-debate-inside-look-world-bank-coronavirus-relief-investment-2020-2-1028906657?op=1 https://markets.businessinsider.com/news/stocks/pandemic-bon... > The [class a] bonds default if pandemic-related deaths reach 2,500 in a single nation with an additional 20 or more deaths confirmed in an overseas country, according to the bank's prospectus. > The [class b] bonds pay 11.5% annually, but reach default after 250 deaths. The bonds' payout rate scales with the number of additional countries that experience than 20 confirmed deaths. Well? Why are they dragging their feet? Even the official numbers have seen more than 2.5k die in China and more than 20 in Iran. The only question now is whether this is incompetence or maliciousness.
  - JumpCrisscross 7y ago
    I don’t see it. Pandemics are objectively defined. The bonds’ principal pays for relief in the event of a pandemic, meaning a venal WHO would lean towards categorising non-pandemics as pandemics.
pezo1919 7y ago
To me it seems WHO was downplaying it the whole time. First lie is China will be able to contain it and now they don't even call it a pandemic. Also R0 is much higher then for flu. I really hope the new idea about transmissability is true but if it is I don't get why China treats it as they do. Wuhan is locked for 40+ days. I can't trust WHO now related to Covid-19, especially after what happened to stock. Of course they have to lie more if that avoids "panic". Truth is underrated in our civilization at the moment.
- blackrock 7y ago
  China’s authorities, nor the WHO, never claimed that China could contain the virus. China’s goal with the Wuhan lockdown, then Hubei, then all of China, was to slow down the spread of the virus. In order to give themselves, and humanity, a chance to fight it. And to understand it, and devise a cure or vaccine for it. The escape of the virus was inevitable. This was a known fact. To believe otherwise is naive. The only thing you can buy with the lockdown, is time. And to make matters worse, the governments of the world, flew all their citizens out of Wuhan and China. Then, they screwed up the decontamination and quarantine process. The incompetence of the American CDC shipped out faulty test kits all over the world. Then they released someone infected into San Antonio, before their quarantine was over, and before the positive test results came back. Then, news came out that the flight attendants and pilots flying the chartered planes, weren’t even properly protected from airborne transmissions of the virus. Then, the Princess cruise ship quarantine was a disaster, which is entirely the fault of the Western governments. So now, the responsibility of the spread of the virus outside of China, lays in the respective governments, and their inability to monitor and contain it. So the blame goes all around. It really is illogical to blame the China government for a virus that arose out of nature.
- eli 7y ago
  Did they really say China would be able to contain it?
  - pezo1919 7y ago
    Could not find the exact reference, but here are some other bullshit from that time: https://www.globaltimes.cn/content/1178015.shtml https://www.globaltimes.cn/content/1178015.shtml That "transparency" and "openness" were quoted a lot but it was not the case at all. Many chinese doctors and journalists were shut down.
victorlin 7y ago
Please don't trust WHO, obviously they got heavily influence from Chinese government. Remember when COVID-19 out-broken in China, the WHO told us "The Committee does not recommend any travel or trade restriction based on the current information available. " https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov) https://www.who.int/news-room/detail/30-01-2020-statement-on... Then we saw China locked down all major city themselves. Now you tell me it's fine not to ban flights from China? And they also keep mentioning it's not a big deal. Obviously they don't want to hurt Chinese economy. I won't trust anything they say, as their interest is China government's interest, not people's health.
- FabHK 7y ago
  Hindsight. At the time, nobody had travel restrictions. Were they all influenced by China? No, with the then current information travel or trade restrictions didn’t make sense. This is the same lazy argument as with the 737 MAX - why wasn’t it immediately grounded? Well, you can’t just shut down the world at any sign of trouble. You have to make an informed judgement call with the information you have at the time. Sometimes, ex post, it will turn out to have been the wrong call. Doesn’t mean you need to revise or impugn the decision procedure.
  - victorlin 7y ago
    Well, allow me to remind you the timeline > On 23 January 2020, the central government of the People's Republic of China imposed a lockdown in Wuhan and other cities in Hubei province in an effort to quarantine the epicentre of an outbreak of coronavirus disease 2019 (COVID-19) https://en.wikipedia.org/wiki/2020_Hubei_lockdowns https://en.wikipedia.org/wiki/2020_Hubei_lockdowns What do you mean nobody had travel restrictions? The report from WHO date was on 30 January 2020, when they saw this and yet suggest not to put any restrictions?
    - lovemenot 7y ago
      Imagine if Israel had taken the opportunity to lock-down West Bank in the name of health, specifically prevention of novel coronavirus. My artificial example is perhaps not accurate on its face, but I hope you can see the principle. WHO was trying to prevent unnecessary border restrictions in the world, until such time as they became justified for health reasons. In China that was already the case.
mrb 7y ago
"First, COVID-19 does not transmit as efficiently as influenza, from the data we have so far." Ok let's look at the data he summarizes in the next sentences: "With influenza, people who are infected but not yet sick are major drivers of transmission, which does not appear to be the case for COVID-19. Evidence from China is that only 1% of reported cases do not have symptoms, and most of those cases develop symptoms within 2 days." That's 1% of reported cases. But evidence shows there are many more unreported cases, and these cases tend to be asymptomatic, or very mild. Peer-reviewed research has estimated there are 11x to 38x more cases than detected: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30260-9/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... https://www.mdpi.com/2077-0383/9/2/419 https://www.mdpi.com/2077-0383/9/2/419 Another study estimates there are 19x to 26x more cases than detected: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-2019-nCoV-severity-10-02-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s... These 3 studies are all the studies I know of that try to estimate the rate of underascertainment. I did not cherry-pick these to make a point. Anyway, this suggests the vast majority of cases might be, in fact, just like influenza: asymptomatic or very mild. And there are no reason to believe they are not major drivers of transmission. "Some countries are looking for cases of COVID-19 using surveillance systems for influenza and other respiratory diseases. Countries such as China, Ghana, Singapore and elsewhere have found very few cases of COVID-19 among such samples – or no cases at all." China: the only reason they find so few new cases in March (only 100-200 new cases per day) is not because COVID-19 is less contagious than the flu, but because they implemented extreme response measures including the complete shutdown and isolation of whole cities, cancellation of public events, closing all schools nationwide, prohibition of attendance at work, etc. So of course COVID-19 is spreading slower than the influenza. If China implemented these measures during influenza season, they would likely drastically reduce the number of influenza cases. Singapore: COVID-19 has, so far, been contained (less than 110 cases country-wide) with strict isolation procedures for patients. I am not sure this is evidence that COVID-19 is less contagious than influenza. Ghana: it is not even a country rated "high risk" by https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30464-5/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... but just "moderate risk". And there are no known cases of COVID-19. So in my opinion, it is insufficient evidence to suggest COVID-19 is less contagious than the flu. "The only way to be sure is by looking for COVID-19 antibodies in large numbers of people, and several countries are now doing those studies. This will give us further insight into the extent of infection in populations over time." That's the only statement from the WHO Director-General that makes sense: we need more evidence to be sure we can correctly quantify COVID-19's contagiousness.
DreamSpinner 7y ago
It's interesting that the notes regarding transmission efficiency are not present in the similar speach given on the 4th of March (as opposed to the article link, which is the 3rd of March). I'm not sure what to make of it. It might be pure paranoia on my part - but it is an interesting change in the welcome statements that are otherwise generally similar. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-mission-briefing-on-covid-19---4-march-2020 https://www.who.int/dg/speeches/detail/who-director-general-...
deveac 7y ago
It feels like all of the reporting I've seen from experts (not just mainstream news outlets which are admittedly terrible)has indicated Covid-19's R0 is worse than influenza. It would have been awfully nice if The WHO tossed us a citation on their claim that this is not the case. It was hard to read the entire piece with that unsupported claim hanging so heavily. And the containment claim...again...would have loved for them to argue the case, because it is exceedingly easy to argue against the case.
- ianburrell 7y ago
  R0 is not the only factor in the spread of the disease. R0 is measure of how contagious a disease is, the average number of infections from each case. But other factors matter for the spread and for possibility of containment. For example, the incubation period matters for how fast it spreads, and asymptomatic transmission matters for can be contained. "With influenza, people who are infected but not yet sick are major drivers of transmission, which does not appear to be the case for COVID-19." It sounds like the big difference is that most of spread from COVID-19 is when people are sick. With lots of testing, can detect who is sick and isolate them. It also sounds like most of the spread is with close contacts and unlike flu, it is possible to map contacts and isolate them.
- knzhou 7y ago
  Unfortunately R0 is a bit of a vague thing. For seasonal flu, you could think of it as being very low, because most people already have immunity. It's already endemic, so there isn't room for exponential growth. For a new flu (like the 2008 swine flu) it is extremely high, which is why people barely did anything to contain it back then -- it was just impossible. What we have right now is in between.
  - usaar333 7y ago
    Isn't R0 by definition for a population that isn't immunitized?
- cm2187 7y ago
  The problem is that “worse” can mean anything. It can be marginally worse without being a serious cause of concern or it can be really really bad. That’s the beauty of journalism: being flexible with the truth. You can print end of the world headlines with the clean conscience that since it is technically worse, you are not pushing fake news. But that may still be a massively over exaggerated and misleading headline. And I think that is what happening. I don’t see many people claiming it is no worse than the flu. I see people claiming it is marginally worse than the flu.
Sevrene 7y ago
I've noticed a trend in the discussion of Covid-19 when talking to people. They tend to either under estimate it; "it's just the flu", or they over estimate it; "This is going to be really bad, time to buy all toilet paper". There's a lot of confusing mixed messages, not even from just random people, but from the WHO and different governments. They say they are fully prepared and it can be contained yet doctors and health advisors are saying that's just not true. I think there's a bit of play here between the negative effects from the virus, versus the perceived negative effects from panic (I suspect the economy plays a role in government's responses far more than people think). So to me it seems there is a bit of a management or reaction to an over reaction. Yet, in face of a pandemic, being worried is probably sensible because it will lead you prepare and be conscious of good hygiene practises. Telling people everything is okay in the face of possible emergency or possible disaster is not good. Are there people out there over reacting and over reaching with their analysis of this? Sure. But that doesn't mean there's nothing worth reacting over. This is a serious health issue, and calling it 'just the flu' could be considered reckless in my opinion.
- singularity2001 7y ago
  Where do you put Paul Grahams simple analysis that at the current rate within one month we have 1 million cases? Over estimation?
  - eveningcoffee 7y ago
    Can you refer to his model? Is it just that the number of cases doubles in 3 days? I think it is an overestimate but not more than by 1 order of magnitude.
  - marvin 7y ago
    Doubling rate in confirmed cases is closer to 4 days than 3 unless you include only the last week or so. A doubling rate of 6 days in the medium term has also been estimated. This will obviously delay the time to reach one million cases. However, confirmed cases are a lower bound for the total number of cases, as cases only get confirmed when evaluated by healthcare personnel. It is not credible that Iran and Italy have 3000 cases each, when lots of tourists returning from there have been diagnosed. Did they just randomly bump into one of the 3000 in a country of millions? Uncertainties aside, the model of exponential growth is sound. Disease spread follows exponential growth until it hits an inflection point, either due to running out of viable hosts or due to quarantines and other countermeasures reducing the transmission rate per infected below 1. China forcibly caused this inflection on February 4th, by essentially stopping their economy through strict quarantines. A doubling rate of 4 days yields 1 million infected globally on the 29th of March, and that's what we'll get unless the transmission rate somehow falls before then. Plenty of assumptions in that statement though.
whotang 7y ago
On January 23rd, 2020. Tedros Adhanom Ghebreyesus declines to declare China virus outbreak as a global health emergency. As we all know, the Coronavirus is not treatable at the moment. The number of infected and deaths has risen more than ten times (infected from 800 - close to 10,000) within only 5 days. Part of it is related to Tedros Adhanom Ghebreyesus under estimated the coronavirus. We strongly think Tedros Adhanom Ghebreyesus is not fit for his role as WHO Director General. We call for the Immediate Resignation of Tedros Adhanom Ghebreyesus. A lot of us are really disappointed, we believe WHO is supposed to be political neutral. Without any investigation, Tedros Adhanom Ghebreyesus solely believes on the death and infected numbers that the Chinese government provided with them. On the other hand, Taiwan should not be excluded from WHO for any political reasons. Their technologies are far more advanced than some of the countries on the “selected WHO list”. https://change.org/p/united-nations-call-for-the-resignation-of-tedros-adhanom-ghebreyesus-who-director-general https://change.org/p/united-nations-call-for-the-resignation...

Then how come we see cases where there were no symptomatic patients nearby? Like this CDC screener, no cases where known in the entire state when the person contracted the disease and it happened weeks ago: https://www.nbcnews.com/health/health-news/medical-screener-lax-airport-tests-positive-coronavirus-n1149986 https://www.nbcnews.com/health/health-news/medical-screener-... And this is not the first such case in USA. So either there are a ton of symptomatic Covid-19 patients in USA right now who are just thought to have the flu, or Covid-19 can spread just fine from asymptomatic people and that was how it spread to the well protected CDC personnel in the airport. And if an expert who follows all hygiene standards and wearing gloves and N95 respirators got it from an asymptomatic person, imagine how many other people at the Airport must have gotten it as well? And how many persons the carrier infected after arriving in USA? I am all but certain that the statement "We can contain it" is a lie at this point, I don't see how anyone can believe that. At least not without aggressively doing complete lockdowns of large communities before we even confirm cases, but I feel it is too late even for that now.

cbsks 7y ago

This paper has more information: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6909e1-H.pdf https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6909e1-H.pdf TLDR: "Since February 28, an increasing number of newly diagnosed confirmed and presumptive COVID-19 cases have been in patients with neither a relevant travel history nor clear epidemiologic links to other confirmed COVID-19 patients. However, despite intensive follow-up, no sustained person-to-person transmission of symptomatic SARS-CoV-2 was observed in the United States among the close contacts of the first 10 persons with diagnosed travel-related COVID-19." They tracked the first 10 people in the US with travel-related confirmed COVID-19, and followed up with 445 people who had close contact with them. Over 14 days, 54 of those 445 people developed new or worsening symptoms and were tested for COVID-19. Of the 54 people, only 2 tested positive for COVID-19. Both were household members of originally infected people. "Both persons with confirmed secondary transmission had close contact with the respective source patient before COVID-19 was confirmed and were isolated from the source patient after the patient’s COVID-19 diagnosis." "No other close contacts who were tested for SARS-CoV-2 had a positive test, including the five household members who were continuously exposed during the period of isolation of their household member with confirmed COVID-19. An additional 146 persons exposed to the two patients with secondary COVID-19 transmission underwent 14 days of active monitoring. Among these, 18 (12%) developed symptoms compatible with COVID-19 and were considered PUIs. All tested negative, and no further symptomatic COVID-19 cases (representing tertiary transmission) have been identified."

jwlake 7y ago
"54 of those 445 people developed new or worsening symptoms" So we're basically having people make themselves sick by watching the news, its a brand new pandemic!
deleted 7y ago
[deleted]
AnimalMuppet 7y ago
So... what? These people are picking up something that looks like COVID-19, but isn't? The COVID-19 tests are missing something like 90% of the people who have it? Or what?
- cbsks 7y ago
  > These people are picking up something that looks like COVID-19, but isn't > The COVID-19 tests are missing something like 90% of the people who have it As far as I know (I'm not an expert) either of those are possibilities, and it's too early to know for sure. Edit: This comment mentions the possibility of there being 2 types of the virus that spread at different rates: https://news.ycombinator.com/item?id=22489599 https://news.ycombinator.com/item?id=22489599 Maybe the 10 people monitored in the US had the less contagious version? There are a lot of unanswered questions right now.
- makomk 7y ago
  It's flu season. The symptoms of mild Covid-19 which were sufficient reason for the CDC to test close contacts of infected people are also basically just the symptoms of the flu or a cold or probably any number of other things.

deleted 7y ago

[deleted]

Tilian 7y ago

... "from the data we have so far." There are still a lot of unknowns, as stated in the media briefing.

Congeec 7y ago

The title is just one of those many points made.

9nGQluzmnq3M 7y ago
It's arguably the most interesting/novel of the points, and HN titles have strict length limits.

heyitsguay 7y ago

Interesting... i wonder what the data is to back up that assertion? Another interesting tidbit in there was that very few cases (1%) appear to be totally asymptomatic, and that most infections apparently start showing some symptoms after a couple days. So there are a few assertions in total that seem to depart from what was previously understood, at least through mass and social media.

ngngngng 7y ago
I've never had such a steady stream of seemingly conflicting data before.
- baddox 7y ago
  Are you actually receiving conflicting data, or just conflicting reports about data? It's not clear to me how data itself can "conflict." As a made-up example, if you keep seeing alternating cases where one person had symptoms and another person didn't, that's not "conflicting data." That's just data showing that 50% of people have symptoms.
  - Eliezer 7y ago
    Well said. There can be conflicting reports but never conflicting realities. That said, sometimes our apparent data is being filtered by different factors, or even altered, across different reports.
knzhou 7y ago
> i wonder what the data is to back up that assertion? The data is the tens of thousands of cases the WHO has stats on. You can read any of their reports, they've been saying the same thing for months. The main sources contradicting them are random internet commentators.
- himinlomax 7y ago
  They've not been saying that for months, that's completely absurd. The disease started spreading in November at the earliest. Just a month ago very little was known about its transmission rate and lethality; estimates from reputable sources ranged from 1 to 20%.

knzhou 7y ago

This is important, because lots of internet commentators are just going with the most alarming possible statements: 28 day incubation periods, people can get infected twice, airborne transmission, asymptomatic transmission. These assertions are all based on outlier cases, sometimes even single cases, observed during the fog of war. Even if these accounts are correct, they aren't the typical case, which is what actually matters for policy and prevention. The typical case has been well-known for months: most people get fevers, the incubation period is usually a few days, and most transmission is from symptomatic cases and via droplets. The WHO has collected stats from tens of thousands of cases and they've been straightforwardly pointing in this direction the entire time. There definitely is a serious problem, but misinformation helps nobody, even if its spreaders are well-meaning. For example, I've seen a lot of people take the inflated statements ("28 day incubation period!!") to mean that stopping the spread is completely impossible, while we have seen by example that it isn't.

mantap 7y ago
I don't share your optimism. The virus has been able to successfully evade e.g. testing people's temperatures in airports. It doesn't really matter if there are asymtomatic carriers or not, it doesn't matter whether people eventually get a high fever. What matters is whether people with non-specific/mild symptoms (a dry cough) can pass on the infection. And the answer is emphatically yes.
- tylerhou 7y ago
  Bypassing airport temperature tests is an incredibly low bar because it rarely catches other diseases. Anecdotally, I've travelled multiple times with people who have had fevers and entered countries with routine temperature screening and haven't been stopped. Human body temperature is also so variable that a small fever is masked by the margin of error.
  - fspeech 7y ago
    You don't need to catch everyone. You just need to bring R0 to below 1. If R0 is a little over 2 in the first place you just need to catch a little over 50% of the infected with all your actions (in addition to temperature checking) to eventually control the epidemic. The better you do the sooner you get it under control.

Leary 7y ago

fractal618 7y ago

They're trying to avoid a panic, so I'm just looking at the data from now on.... Numbers from https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/ https://bnonews.com/index.php/2020/02/the-latest-coronavirus... As of March 4th. 6:22 pm eastern standard In China: Deaths: 2,981 recoveries : 49,856 Death/recovery : 5.98% Outside of China... Deaths: 272 Recoveries : 1205 Deaths/recoveries : 22.6%

perl4ever 7y ago
Recovery takes more time compared to dying. So areas where it's been present for less time are going to show a different proportion even if it's evolving the same way.
- Animats 7y ago
  Right. You can see that here: [1] The "Deaths" line and the "Recovered" line add up to maybe 60% of the "Confirmed" line. The difference is the people who are sick, but alive. [1] https://hgis.uw.edu/virus/ https://hgis.uw.edu/virus/
function_seven 7y ago
You're missing the # for "Unreported". That may be huge. For example, in China, are there another 100,000 people who contracted it, and recovered, without ever knowing they had it? You're looking at this data through the fog of war (as a sibling comment mentions).
- flukus 7y ago
  TFA addresses this: > Evidence from China is that only 1% of reported cases do not have symptoms, and most of those cases develop symptoms within 2 days. They came up with this number by testing people who didn't have symptoms but were in some contact with someone who had the virus. The big question is how much the lockdown affected this, but there doesn't appear to be large swaths of asymptomatic people.
  - 7y ago

jcadam 7y ago

"To summarize, COVID-19 spreads less efficiently than flu, transmission does not appear to be driven by people who are not sick, it causes more severe illness than flu, there are not yet any vaccines or therapeutics, and it can be contained – which is why we must do everything we can to contain it. That’s why WHO recommends a comprehensive approach." Ah, so there aren't hordes of asymptomatic carriers out there, which is both good and bad (the death rate really is high)

roywiggins 7y ago
The confusing thing is that the Diamond Princess data points in the other direction: more asymptomatic cases, and a significantly lower case fatality rate, than the WHO numbers. https://slate.com/technology/2020/03/coronavirus-mortality-rate-lower-than-we-think.html https://slate.com/technology/2020/03/coronavirus-mortality-r... The WHO says they haven't found many asymptomatic cases (despite looking), but apparently lots of the cruise ship cases were. The WHO estimates a mortality rate over 3%, but much less 3% of the Diamond Princess infected died. I don't know how to reconcile these other than to suppose the virus has mutated (possible) or the asymptomatic cases were false positives (maybe?) or some demographic factor on the cruise ship was different.
- makomk 7y ago
  The WHO seemed to be relying on Chinese flu surveillance data, which is basically useless - even the figures it produces for flu infections are implausible and probably wrong. Between this and their other comments it might be best to treat anything the WHO says as just Chinese propaganda at this point.
- servercobra 7y ago
  The Diamond Princess is a pretty small sample size to be extrapolating the mortality rate.
  - roywiggins 7y ago
    Statistics out of South Korea look similar: https://mobile.twitter.com/HelenBranswell/status/1235211584600932352 https://mobile.twitter.com/HelenBranswell/status/12352115846...

MilnerRoute 7y ago

I just want to highlight this quote from the WHO: "With influenza, people who are infected but not yet sick are major drivers of transmission, which does not appear to be the case for COVID-19." "Evidence from China is that only 1% of reported cases do not have symptoms, and most of those cases develop symptoms within 2 days."

ceejayoz 7y ago
That's good news. Early-onset symptoms (in particular, a fever) was part of what made tackling SARS possible.
- MilnerRoute 7y ago
  Another quote from the WHO: "We don’t even talk about containment for seasonal flu – it's just not possible. But it is possible for COVID-19. We don't do contact tracing for seasonal flu – but countries should do it for COVID-19, because it will prevent infections and save lives. Containment is possible."

thorum 7y ago

Keep in mind that almost 20% of the Diamond Princess cruise ship's passengers and crew (700+ of 3711) were infected with the coronavirus. However its infection rate compares with the seasonal flu (which is a much less dangerous illness overall), it clearly has the potential to infect a large number of people in the coming months.

jcadam 7y ago
IIRC, the crew was largely responsible for spreading the virus. Not that I'm faulting them. They simply were neither trained nor equipped to do a specialized job that was essentially forced on them - operating a quarantine facility.
Trasmatta 7y ago
I feel like the Diamond Princess is an atypical case and it's maybe a mistake to extrapolate too much from it.
mc32 7y ago
Isn’t a cruise ship a special case because it’s all self contained and there is almost no way to avoid contact with other infected people? Unless they had access to disposable Kevlar jumpsuits, masks, gloves and disinfectant, they’d be hard pressed to slow its spread in cramped conditions.
- chaostheory 7y ago
  The way ship HVAC systems are designed, it helps limit costs while simultaneously increasing infections from anything that's airborne. In regard to Diamond Princess though, there were no safety protocols that were followed, so we don't know if it was the ship or the failure to follow pathogen related protocols.
  - cyphar 7y ago
    This virus isn't airborne. It's spread through respiratory droplets.

deleted 7y ago

[deleted]

allovernow 7y ago

Just a reminder that this is coming from an organization that 1. Receives part of it's funding from China 2. Has been using China's clearly manufactured numbers since day 1 3. Has yet to officially call this a pandemic though it has met the criteria for weeks ($425MM in pandemic bonds would default) [0] 4. Is led by a man (the very director being quoted) who was accused by the NYT of covering up no less than 3 cholera epidemics in his home country of Ethiopia. [1] So you're telling me China shut down it's entire economy [2] and put 700MM people under lockdown and/or travel restrictions because of something about as dangerous as the common flu? Note that the Chinese economy is still not back online - don't believe me? Check real time pollution maps for yourself. The air is still cleaner than it has been in decades. The WHO and CDC are lying to you. You can verify all of this for yourself. Hell, 8% of Iranian parliament members are infected. Look at the chaos gripping Iran, Italy, and SK. This is not the flu and I'm astounded that not only are official organizations misleading the public to this degree, but people are buying it en masse. Finally, after a mass petition, a number of journals released all 2019ncov literature from paywall. You can find estimates for mortality and R0 from many sources, and I don't think I've seen a single one below 2. The Spanish Flu of 1918 was at 2. Of course take these with a grain of salt as they may be oversampling severe cases, but they all point to the same grave conclusions, and you can read them yourself. Do not rely on these agencies to digest this information for you when you have unprecedented access to the same information. 0. https://markets.businessinsider.com/news/stocks/pandemic-bond-debate-inside-look-world-bank-coronavirus-relief-investment-2020-2-1028906657?op=1 https://markets.businessinsider.com/news/stocks/pandemic-bon... 1. https://www.nytimes.com/2017/05/13/health/candidate-who-director-general-ethiopia-cholera-outbreaks.html https://www.nytimes.com/2017/05/13/health/candidate-who-dire... 2. https://www.bloomberg.com/news/articles/2020-01-31/at-least-two-thirds-of-china-s-economy-to-stay-closed-next-week https://www.bloomberg.com/news/articles/2020-01-31/at-least-...

mrow84 7y ago
I find your point 3 confusingly worded: the trigger conditions for the pandemic bonds are specific and essentially transparent, but have not yet been met. They are independent of any statement the WHO may or may not make about whether a particular outbreak can reasonably be called a "pandemic". This independence should be unsurprising, because investors want some kind of "clarity" about what it is they are investing in. Whether or not the trigger conditions are too stringent for the bonds to be useful in dealing with the targeted crises, and whether or not the additional "clarity" provided by having well-defined trigger conditions is sufficient to manage risk for investors, are both separate concerns.

eruditegamer420 7y ago

The WHO is the fraud organization who cares more about keeping their Chinese masters happy than health and safety, right? Cool.

all_blue_chucks 7y ago

You are all interpreting this wrong. In a population with no preexisting immunity to either virus, flu would spread faster than COVID. But there is widespread immunity to flu (from both vaccines and exposure). There is ZERO immunity to COVID. So IN PRACTICE, this new disease spreads MUCH faster than flu.

ardit33 7y ago

1. I would not trust anything coming out of WHO at this point. Even Germany called it a pandemic, yet they are not willing to call it such (perhaps due to political influence/pressure, or just incompetence). This looks more like a 'panic containment' type of statement than the truth. 2. The R0 of seasonal flu, is about 1.5, Covid-19 has a R0 between 2.6 and 3.5*. (yet to be determined), which is much more contagious than normal flu. This article has no mention of it, hence has no credibility. By any account of any data, Covid-19 looks to be 2x more efficient to spread as the normal flu. 3. The major cases from the Diamond Princess, the cult in South Korea, and the Eldery Care facility in Seatle, are an indication that the virus is very easily spread in close quarters. That's not a normal flu type of virality, it is much worse. 4. We have many cases where people still tested positive even after 14 days of quarantine, hence it is not going to be easy to contain. But we don't know yet if a person is still contagious after testing positive after 14 days. No mention to this as well. TLDR: Don't panic, yet 3.4% of people are going to die, or 10-15% of your parents/grandparents will perish earlier due to this virus. I am sorry, but that's war-zone like statistics.... and this should be treat as such. (it needs a true war like mobilization to be combated, and talks like this to minimize the impact are just irresponsible).

allovernow 7y ago
https://markets.businessinsider.com/news/stocks/pandemic-bond-debate-inside-look-world-bank-coronavirus-relief-investment-2020-2-1028906657?op=1 https://markets.businessinsider.com/news/stocks/pandemic-bon... > The [class a] bonds default if pandemic-related deaths reach 2,500 in a single nation with an additional 20 or more deaths confirmed in an overseas country, according to the bank's prospectus. > The [class b] bonds pay 11.5% annually, but reach default after 250 deaths. The bonds' payout rate scales with the number of additional countries that experience than 20 confirmed deaths. Well? Why are they dragging their feet? Even the official numbers have seen more than 2.5k die in China and more than 20 in Iran. The only question now is whether this is incompetence or maliciousness.
- JumpCrisscross 7y ago
  I don’t see it. Pandemics are objectively defined. The bonds’ principal pays for relief in the event of a pandemic, meaning a venal WHO would lean towards categorising non-pandemics as pandemics.

pezo1919 7y ago

To me it seems WHO was downplaying it the whole time. First lie is China will be able to contain it and now they don't even call it a pandemic. Also R0 is much higher then for flu. I really hope the new idea about transmissability is true but if it is I don't get why China treats it as they do. Wuhan is locked for 40+ days. I can't trust WHO now related to Covid-19, especially after what happened to stock. Of course they have to lie more if that avoids "panic". Truth is underrated in our civilization at the moment.

blackrock 7y ago
China’s authorities, nor the WHO, never claimed that China could contain the virus. China’s goal with the Wuhan lockdown, then Hubei, then all of China, was to slow down the spread of the virus. In order to give themselves, and humanity, a chance to fight it. And to understand it, and devise a cure or vaccine for it. The escape of the virus was inevitable. This was a known fact. To believe otherwise is naive. The only thing you can buy with the lockdown, is time. And to make matters worse, the governments of the world, flew all their citizens out of Wuhan and China. Then, they screwed up the decontamination and quarantine process. The incompetence of the American CDC shipped out faulty test kits all over the world. Then they released someone infected into San Antonio, before their quarantine was over, and before the positive test results came back. Then, news came out that the flight attendants and pilots flying the chartered planes, weren’t even properly protected from airborne transmissions of the virus. Then, the Princess cruise ship quarantine was a disaster, which is entirely the fault of the Western governments. So now, the responsibility of the spread of the virus outside of China, lays in the respective governments, and their inability to monitor and contain it. So the blame goes all around. It really is illogical to blame the China government for a virus that arose out of nature.
eli 7y ago
Did they really say China would be able to contain it?
- pezo1919 7y ago
  Could not find the exact reference, but here are some other bullshit from that time: https://www.globaltimes.cn/content/1178015.shtml https://www.globaltimes.cn/content/1178015.shtml That "transparency" and "openness" were quoted a lot but it was not the case at all. Many chinese doctors and journalists were shut down.

victorlin 7y ago

Please don't trust WHO, obviously they got heavily influence from Chinese government. Remember when COVID-19 out-broken in China, the WHO told us "The Committee does not recommend any travel or trade restriction based on the current information available. " https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov) https://www.who.int/news-room/detail/30-01-2020-statement-on... Then we saw China locked down all major city themselves. Now you tell me it's fine not to ban flights from China? And they also keep mentioning it's not a big deal. Obviously they don't want to hurt Chinese economy. I won't trust anything they say, as their interest is China government's interest, not people's health.

FabHK 7y ago
Hindsight. At the time, nobody had travel restrictions. Were they all influenced by China? No, with the then current information travel or trade restrictions didn’t make sense. This is the same lazy argument as with the 737 MAX - why wasn’t it immediately grounded? Well, you can’t just shut down the world at any sign of trouble. You have to make an informed judgement call with the information you have at the time. Sometimes, ex post, it will turn out to have been the wrong call. Doesn’t mean you need to revise or impugn the decision procedure.
- victorlin 7y ago
  Well, allow me to remind you the timeline > On 23 January 2020, the central government of the People's Republic of China imposed a lockdown in Wuhan and other cities in Hubei province in an effort to quarantine the epicentre of an outbreak of coronavirus disease 2019 (COVID-19) https://en.wikipedia.org/wiki/2020_Hubei_lockdowns https://en.wikipedia.org/wiki/2020_Hubei_lockdowns What do you mean nobody had travel restrictions? The report from WHO date was on 30 January 2020, when they saw this and yet suggest not to put any restrictions?
  - lovemenot 7y ago
    Imagine if Israel had taken the opportunity to lock-down West Bank in the name of health, specifically prevention of novel coronavirus. My artificial example is perhaps not accurate on its face, but I hope you can see the principle. WHO was trying to prevent unnecessary border restrictions in the world, until such time as they became justified for health reasons. In China that was already the case.

mrb 7y ago

"First, COVID-19 does not transmit as efficiently as influenza, from the data we have so far." Ok let's look at the data he summarizes in the next sentences: "With influenza, people who are infected but not yet sick are major drivers of transmission, which does not appear to be the case for COVID-19. Evidence from China is that only 1% of reported cases do not have symptoms, and most of those cases develop symptoms within 2 days." That's 1% of reported cases. But evidence shows there are many more unreported cases, and these cases tend to be asymptomatic, or very mild. Peer-reviewed research has estimated there are 11x to 38x more cases than detected: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30260-9/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... https://www.mdpi.com/2077-0383/9/2/419 https://www.mdpi.com/2077-0383/9/2/419 Another study estimates there are 19x to 26x more cases than detected: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-2019-nCoV-severity-10-02-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s... These 3 studies are all the studies I know of that try to estimate the rate of underascertainment. I did not cherry-pick these to make a point. Anyway, this suggests the vast majority of cases might be, in fact, just like influenza: asymptomatic or very mild. And there are no reason to believe they are not major drivers of transmission. "Some countries are looking for cases of COVID-19 using surveillance systems for influenza and other respiratory diseases. Countries such as China, Ghana, Singapore and elsewhere have found very few cases of COVID-19 among such samples – or no cases at all." China: the only reason they find so few new cases in March (only 100-200 new cases per day) is not because COVID-19 is less contagious than the flu, but because they implemented extreme response measures including the complete shutdown and isolation of whole cities, cancellation of public events, closing all schools nationwide, prohibition of attendance at work, etc. So of course COVID-19 is spreading slower than the influenza. If China implemented these measures during influenza season, they would likely drastically reduce the number of influenza cases. Singapore: COVID-19 has, so far, been contained (less than 110 cases country-wide) with strict isolation procedures for patients. I am not sure this is evidence that COVID-19 is less contagious than influenza. Ghana: it is not even a country rated "high risk" by https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30464-5/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... but just "moderate risk". And there are no known cases of COVID-19. So in my opinion, it is insufficient evidence to suggest COVID-19 is less contagious than the flu. "The only way to be sure is by looking for COVID-19 antibodies in large numbers of people, and several countries are now doing those studies. This will give us further insight into the extent of infection in populations over time." That's the only statement from the WHO Director-General that makes sense: we need more evidence to be sure we can correctly quantify COVID-19's contagiousness.

DreamSpinner 7y ago

It's interesting that the notes regarding transmission efficiency are not present in the similar speach given on the 4th of March (as opposed to the article link, which is the 3rd of March). I'm not sure what to make of it. It might be pure paranoia on my part - but it is an interesting change in the welcome statements that are otherwise generally similar. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-mission-briefing-on-covid-19---4-march-2020 https://www.who.int/dg/speeches/detail/who-director-general-...

deveac 7y ago

It feels like all of the reporting I've seen from experts (not just mainstream news outlets which are admittedly terrible)has indicated Covid-19's R0 is worse than influenza. It would have been awfully nice if The WHO tossed us a citation on their claim that this is not the case. It was hard to read the entire piece with that unsupported claim hanging so heavily. And the containment claim...again...would have loved for them to argue the case, because it is exceedingly easy to argue against the case.

ianburrell 7y ago
R0 is not the only factor in the spread of the disease. R0 is measure of how contagious a disease is, the average number of infections from each case. But other factors matter for the spread and for possibility of containment. For example, the incubation period matters for how fast it spreads, and asymptomatic transmission matters for can be contained. "With influenza, people who are infected but not yet sick are major drivers of transmission, which does not appear to be the case for COVID-19." It sounds like the big difference is that most of spread from COVID-19 is when people are sick. With lots of testing, can detect who is sick and isolate them. It also sounds like most of the spread is with close contacts and unlike flu, it is possible to map contacts and isolate them.
knzhou 7y ago
Unfortunately R0 is a bit of a vague thing. For seasonal flu, you could think of it as being very low, because most people already have immunity. It's already endemic, so there isn't room for exponential growth. For a new flu (like the 2008 swine flu) it is extremely high, which is why people barely did anything to contain it back then -- it was just impossible. What we have right now is in between.
- usaar333 7y ago
  Isn't R0 by definition for a population that isn't immunitized?
cm2187 7y ago
The problem is that “worse” can mean anything. It can be marginally worse without being a serious cause of concern or it can be really really bad. That’s the beauty of journalism: being flexible with the truth. You can print end of the world headlines with the clean conscience that since it is technically worse, you are not pushing fake news. But that may still be a massively over exaggerated and misleading headline. And I think that is what happening. I don’t see many people claiming it is no worse than the flu. I see people claiming it is marginally worse than the flu.

Sevrene 7y ago

I've noticed a trend in the discussion of Covid-19 when talking to people. They tend to either under estimate it; "it's just the flu", or they over estimate it; "This is going to be really bad, time to buy all toilet paper". There's a lot of confusing mixed messages, not even from just random people, but from the WHO and different governments. They say they are fully prepared and it can be contained yet doctors and health advisors are saying that's just not true. I think there's a bit of play here between the negative effects from the virus, versus the perceived negative effects from panic (I suspect the economy plays a role in government's responses far more than people think). So to me it seems there is a bit of a management or reaction to an over reaction. Yet, in face of a pandemic, being worried is probably sensible because it will lead you prepare and be conscious of good hygiene practises. Telling people everything is okay in the face of possible emergency or possible disaster is not good. Are there people out there over reacting and over reaching with their analysis of this? Sure. But that doesn't mean there's nothing worth reacting over. This is a serious health issue, and calling it 'just the flu' could be considered reckless in my opinion.

singularity2001 7y ago
Where do you put Paul Grahams simple analysis that at the current rate within one month we have 1 million cases? Over estimation?
- eveningcoffee 7y ago
  Can you refer to his model? Is it just that the number of cases doubles in 3 days? I think it is an overestimate but not more than by 1 order of magnitude.
- marvin 7y ago
  Doubling rate in confirmed cases is closer to 4 days than 3 unless you include only the last week or so. A doubling rate of 6 days in the medium term has also been estimated. This will obviously delay the time to reach one million cases. However, confirmed cases are a lower bound for the total number of cases, as cases only get confirmed when evaluated by healthcare personnel. It is not credible that Iran and Italy have 3000 cases each, when lots of tourists returning from there have been diagnosed. Did they just randomly bump into one of the 3000 in a country of millions? Uncertainties aside, the model of exponential growth is sound. Disease spread follows exponential growth until it hits an inflection point, either due to running out of viable hosts or due to quarantines and other countermeasures reducing the transmission rate per infected below 1. China forcibly caused this inflection on February 4th, by essentially stopping their economy through strict quarantines. A doubling rate of 4 days yields 1 million infected globally on the 29th of March, and that's what we'll get unless the transmission rate somehow falls before then. Plenty of assumptions in that statement though.

whotang 7y ago

On January 23rd, 2020. Tedros Adhanom Ghebreyesus declines to declare China virus outbreak as a global health emergency. As we all know, the Coronavirus is not treatable at the moment. The number of infected and deaths has risen more than ten times (infected from 800 - close to 10,000) within only 5 days. Part of it is related to Tedros Adhanom Ghebreyesus under estimated the coronavirus. We strongly think Tedros Adhanom Ghebreyesus is not fit for his role as WHO Director General. We call for the Immediate Resignation of Tedros Adhanom Ghebreyesus. A lot of us are really disappointed, we believe WHO is supposed to be political neutral. Without any investigation, Tedros Adhanom Ghebreyesus solely believes on the death and infected numbers that the Chinese government provided with them. On the other hand, Taiwan should not be excluded from WHO for any political reasons. Their technologies are far more advanced than some of the countries on the “selected WHO list”. https://change.org/p/united-nations-call-for-the-resignation-of-tedros-adhanom-ghebreyesus-who-director-general https://change.org/p/united-nations-call-for-the-resignation...