8 ms·

Also 15% of pregnant Moms in NYC had the virus. This could already be much more widely spread that people think. https://www.nbcnewyork.com/news/local/nyc-hosp

• easytiger 6y ago
  Yup. And for far longer.
  • gnulinux 6y ago
    It seems to indicate this disease infected a lot more than what we see, and maybe mortality rate is lower than what we currently assume. Maybe it's around 0.1% to 0.5%. So is it possible this disease appeared in China way before December, maybe a few months back. Then in December it reached a saturation point (i.e. infected hundreds of thousands of people, so deaths started to get noticed by respiratory specialists). Then around January/February this disease spread to the world, but it went unnoticed. Then in March it reached the same saturation point that the deaths became too many not to notice. Is this a realistic scenario?
    • raphlinus 6y ago
      No. We know from genomic analysis [1] that "The common ancestor of circulating viruses appears to have emerged in Wuhan, China, in late Nov or early Dec 2019." It's fun to speculate about other possibilities, but I personally like to stick to what the science tells us. [1]: https://twitter.com/nextstrain/status/1248707010750640128 https://twitter.com/nextstrain/status/1248707010750640128
      • gnulinux 6y ago
        Very interesting, thanks for the link. In that case, how should that change our mental model? It seems like more people in Western countries are infected than visible, doesn't that mean the same would apply to China? How would it spread so fast in December?
        • Retric 6y ago
          US is generally not testing people with mild symptoms to significant symptoms. We are mostly telling people to stay home until you have difficulty breathing. That’s why are deaths to cases ratio is so high before the new infection rate has dropped to near zero for weeks. Adjusting for infection vs death curve in China US deaths from people currently infected are likely to hit in the ballpark of 50k to 100k. Assuming we get new infections under control in the next few days and keep it low for the next month.
      • autokad 6y ago
        well, google coronavirus searches in China, specifically Hubei province, spiked in September of 2019. Science is a term being twisted out of its original context. if people keep doing that, its going to be a pejorative.
        • gnulinux 6y ago
          How is Google searches relevant here? Was the news of possible coronovirus outbreak leaked to the public? Also, do you have a source?
        • IAmEveryone 6y ago
          Even if I were inclined to believe such statements without a link, this doesn’t make any sense. For Google searches to spike, information about the disease would need to be public knowledge. And at that point, you wouldn’t need Google search traffic to prove anything. Also: Google is blocked in China, isn’t it?
        • bb2018 6y ago
          Do you have a link to that? I'd love to know more about why this would be the case.
          • raphlinus 6y ago
            Here's my attempt to validate the claim: https://trends.google.com/trends/explore?date=2019-01-01%202019-12-31&geo=CN&q=%2Fm%2F01cpyy https://trends.google.com/trends/explore?date=2019-01-01%202... I'll leave it for readers to determine whether it holds up.
            • gnulinux 6y ago
              So there was 0 searches, then ~90 searches suddenly? Yeah no sounds like just noise. There will always be some people searching about corona viruses, they always existed and we always knew of them.
        • FrojoS 6y ago
          Source?
      • gowld 6y ago
        That report appears to based on genomic analysis, which obviously only includes cases that were tested, not undocumented transmissions before the discovery. The article you cite says: "The common ancestor of circulating viruses appears to have emerged in Wuhan, China, in late Nov or early Dec 2019. Accordingly, the majority of sampled and inferred ancestral cases were located in Asia during this early period. "
        • raphlinus 6y ago
          It samples cases that are detected after the fact, from which they are able to reconstruct the phylogeny with impressive clarity. If you are not familiar with the work of nextstrain.org, I highly recommend it, they are brilliant.
    • Retric 6y ago
      No for several reasons. The Dimond Princess had over 100 crew of young healthy adults test positive and only 25% where asymptotic long term. Additionally South Korea has a massive effort into contact traction which demonstrated just how rapidly the disease spread. Their mortality numbers looked to be about 0.6% early on, but eventually hit 2% a month after the peak with people spending weeks in critical condition. On top of that it’s spread rapidly across every country outside of China and there uncontrolled growth rate showed a similar doubling every few days.
      • gnulinux 6y ago
        When we say long term here, do we mean within the 14 day incubation period that's been going around? Or does this imply incubation period is likely a lot more than 14 days, maybe in the order of months?
        • Retric 6y ago
          Within 14 days, but most people where evacuated to different countries almost immediately after infection. So, it took longer to gather the data on that population.
      • w0utert 6y ago
        >> Their mortality numbers looked to be about 0.6% early on, but eventually hit 2% a month after the peak with people spending weeks in critical condition. I see this repeated often but this is a misrepresentation of the statistics. Case fatality rate (CFR) is not the same as mortality rate. The CFR is the ratio between deaths and confirmed cases, mortality rate is the ratio between deaths and total number of people infected. The former number is 2% in South Korea now, the latter can not be measured directly without testing 100% of the population continually during the entire timespan of the outbreak, but it is (practically speaking) by definition significantly lower than 2%, unless there is a huge number of unaccounted Covid-19 deaths, which is very unlikely.
        • dh37 6y ago
          Agreed, although a nitpick: I think what you call "mortality rate" is called "infection mortality rate". (Totally agree with your important point that IFR < CFR.)
    • sjg007 6y ago
      No.
    • redis_mlc 6y ago
      Hospital Patient Zero has been traced back to Dec. 1. Given that most ill people don't get lung complications, that likely means Nov. was the real patient zero. This is close to 100% certain. It should be verified by looking at Chinese sites.
  • pm_me_ur_fullz 6y ago
    I really don't understand why people immediately want to discredit the idea that US patient zero was not the first in US. Or that this virus was around earlier and that there are limitations in contact tracing capabilities. This seems to have the toughest aspect of gaining consensus. Need antibody tests now, and ones that work reliably.
    • sjg007 6y ago
      Because it's not true.
      • vmception 6y ago
        okay, now it is true, ready for a discussion? https://www.sfchronicle.com/bayarea/article/Exclusive-Autopsy-report-of-first-known-15226422.php https://www.sfchronicle.com/bayarea/article/Exclusive-Autops... https://www.cnn.com/2020/04/23/us/california-woman-first-coronavirus-death/index.html https://www.cnn.com/2020/04/23/us/california-woman-first-cor... tl;dr first covid death (feb 6) is nearly a month earlier than previously official first US covid death (feb 26), and also from community spread. suggesting it was in the bay area at least half a month earlier than that.
      • pm_me_ur_fullz 6y ago
        Why is that the most preposterous hypothesis that doesn't warrant any review? We have no reliable antibody tests, and then won't give the unreliable ones people because they are so rare. So where does the confidence come from that we can rule out this possibility? What if this is already the "second wave". Something with lower symptoms wouldn't have warranted checking for a new strain, complications and deaths would fit into the normal distribution of last fall's flu season with no outlier spikes. We would then be deep into the second wave and can't even test most for people currently exposed to it, much less having already been exposed. This is enough not to dismiss the hypothesis.
        • MaulingMonkey 6y ago
          > Why is that the most preposterous hypothesis that doesn't warrant any review? It's not. What is preposterous is advancing the hypothesis without any meaningful evidence, to the detrement of more useful topics, or even useful discussion of the same topic. It's one thing to be an epidemiologist saying "hey, let's see how we can double check the exact origins of this", which is a potentially useful line of inquery. It's another to take some hypochondriac's third hand retelling of someone else's flu symptoms back in December and jump to the same untested unproven unscientific fear-driven conclusions they did on little more than their wild speculation. Even if they do somehow end up being right, they'll be right in the "broken clock is right twice a day" sense rather than a bringing anything useful to the table sense. So far, alternative suggestions as to the virus's origins have looked more similar to the latter - with perhaps some undertones of (completely understandable and expected) attempted political diversion (I sure wouldn't want fault for this mess hanging on my neck!) If you have some epidemiologist's proposed study that you're trying to drive funding towards - something that even remotely looks like the former - it'd be a welcome breath of fresh air on the topic, and I'd suggest sharing that as a far more useful and constructive way of advancing the hypothesis.
• drtillberg 6y ago
  The Boston Globe this morning ran an op-ed advocating testing a random sample of residents to get a better sense of community-wide infection rates.[1] It's amazing that this needed to be stated in a major market newspaper four weeks after most business and school was stopped due to the virus. Goverent is doing some interesting things, random sampling apparently isn't one of them, for reasons it's hard to understand. [1]. https://www.bostonglobe.com/2020/04/15/opinion/how-get-better-covid-19-infection-data-without-universal-testing/ https://www.bostonglobe.com/2020/04/15/opinion/how-get-bette...
  • jandrese 6y ago
    Everybody knows this, but the US healthcare system was so unprepared for this that there simply weren't (aren't) enough test kits around to do a proper study. Even people who have the symptoms struggle to find a place that will test them in some cities.
    • arcticfox 6y ago
      I like Step 0 of Paul Romer's proposal: "Stop testing people with symptoms. Presume positive and isolate." https://twitter.com/paulmromer/status/1248712889705410560 https://twitter.com/paulmromer/status/1248712889705410560
  • raincom 6y ago
    In the developing countries without universal health care, there are government health workers, who are into vaccination, prevention, etc. In situations like this, these workers are mobilized for random testing. However, in the states, I don't see such a workforce. It is mostly done by volunteers, such as that Stanford drive in testing.
  • sjg007 6y ago
    It's probably low prevalence in the population based on our understanding of when covid-19 first appeared. The UK has some randomized seriological surveillance and it's about 13% prevalence. That matches with the pregnancy study of 15% prevalence (which may be enriched due to hospital visits).
• esoterica 6y ago
  NYC has something like 15x the death rate per capita of the the US ex-NYC. Even if you think that NYC is approaching herd immunity (debatable), that means the rest of the country is only 5-10% of the way there.
• danielharan 6y ago
  Many of those people testing positive were presymptomatic (some even developed symptoms during the follow-up period). It typically takes several days to develop symptoms. Also worth considering is the period mentioned in the correspondence is one in which there was very fast exponential growth. When more of the positive cases are recent, it's only normal that they don't show symptoms yet. Besides the test used showing a lot of false positives, the population of pregnant women looked at had a much higher rate of symptomatic infections 1 month ago than the entire population does today... we should be very cautious about concluding much from that sample. https://www.nejm.org/doi/full/10.1056/NEJMc2009316 https://www.nejm.org/doi/full/10.1056/NEJMc2009316
• viklove 6y ago
  That's really not that much, I would expect the infection rate in NYC to be anywhere between 10-20%, that makes sense given the numbers we're seeing in hospitals.
• thehappypm 6y ago
  That is mind-boggling. You don't test positive if you've cleared the virus, either, so that 14% is actually a lower limit because some portion of them might have had it long enough ago to clear. I don't know what pregnancy does to the immune system -- but we do know that these women were all young enough to give birth (likely <40 years old).
• m3kw9 6y ago
  At least not more than the people i know.