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  #201  
Old 02-23-2020, 05:51 PM
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Originally Posted by KarlGauss View Post
I've never seen or heard of a healthcare worker in my province getting critically ill or dying from influenza. Maybe it happens but it must be rare and not even close to the rate of death/critical illness reported for medical personnel exposed to, and infected by, the new coronavirus (or SARS).

ETA: The New York Post is not the best source for a cite.
As Shmendrik points out - yeah it is a perfectly valid way to give a vignette that HCWs die of influenza just as dead as other people do. They may be more likely to immunized than the general population, true, (although often disappointingly not always), and maybe a bit less likely to be in a higher risk for serious morbidity and mortality cohort, but they are also exposed more and more closely. OF COURSE healthcare workers with influenza die of the disease just as others of similar age and health status do. It just isn't often news that a 65 year old nurse or aid with diabetes and hypertension caught influenza, developed a pneumonia, and died. Any more than that someone got into a car accident. It is just a "boring expected" death.
Most recent numbers for HCW risk I can find -
Quote:
The impact of COVID-19 on healthcare workers became a little clearer today, with a Chinese health official reporting 1,716 cases, 6 of them fatal ... 87% of the infected medical staff are from Hubei province, the outbreak's epicenter. ... Mike Ryan, MD, who directs the WHO's health emergencies program, said for now it appears that the percentage of healthcare worker infections for COVID-19 is lower than for other coronaviruses.
The confirmed case fatality rate there comes to 0.3%. Unsure if that relatively low rate reflects better case finding (testing any possibly minimally clinically suspicious individual) or reflects that the disease will kill more of those infected before they recover - no recovery rate reported.

Still based on those numbers COVID-19 is not SARS. It isn't 229E, NL63, OC43, or HKU1 (the established human coronavirues that cause maybe 20% of all common colds) either.

A case fatality of 0.35% for HCWs, even double that, is much more like influenza than either of those two extremes.

The confounder is that we don't know the denominator. How many frontline HCWs are there in Hubei? If over 40K then we are looking at an attack rate among frontline healthcare workers of between 4 to 5%, pretty similar to influenza. If greater then the attack rate is lower. The region has 60 million residents. I'd WAG they have more than 40K frontline HCWs ...
  #202  
Old 02-23-2020, 05:54 PM
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Originally Posted by Corry El View Post
All in all I agree once the cruise ship case plays out (too many people from the ship seriously ill to draw a conclusion now) it will be a relatively clear data point, at least compared to speculating that the death rate must be much lower than it seems to be in the original area because of a large number of unreported cases (which of course doesn't cut in a strictly optimistic direction, since that could also be a reason it appears less and less likely this epidemic will be contained).
I don't think that's speculation, the only question is what percentage of cases are asymptomatic or mild enough to be unreported. I've seen reports that half of those who tested positive on the ship were asymptomatic, but I don't know if that's reliable, or if those people remained asymptomatic. That number would probably also be much higher if the population didn't skew so old, and certainly if it included a representative number of children and adolescents.

Last edited by Shmendrik; 02-23-2020 at 05:55 PM.
  #203  
Old 02-23-2020, 11:29 PM
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...


That's not what happened. The infected passengers were identified after being loaded onto buses for the flight home. They were flying with other cruise ship passengers, some of whom would test positive on their arrival. Not "healthy people". The planes had containment areas for infected patients...
A lot of those people likely were healthy and not-yet-exposed. Cruise ships are very large, not all people interact with each other, and they'd been mostly locked in their cabins for a while.

I am not an epidemiologist, but it seems like a bad idea to load a bunch of infectious people on a plane with a bunch of people who might not have been exposed.
  #204  
Old 02-24-2020, 08:57 AM
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The DJIA plunged nearly 1,000 points this morning... now down just 780 as I type this... on Coronavirus fears. According to CNBC, that is:

https://www.cnbc.com/2020/02/24/us-f...-outbreak.html
  #205  
Old 02-24-2020, 11:01 AM
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... Still based on those numbers COVID-19 is not SARS. It isn't 229E, NL63, OC43, or HKU1 (the established human coronavirues that cause maybe 20% of all common colds) either.

A case fatality of 0.35% for HCWs, even double that, is much more like influenza than either of those two extremes.

The confounder is that we don't know the denominator. How many frontline HCWs are there in Hubei? If over 40K then we are looking at an attack rate among frontline healthcare workers of between 4 to 5%, pretty similar to influenza. If greater then the attack rate is lower. The region has 60 million residents. I'd WAG they have more than 40K frontline HCWs ...
Just did my best good faith effort to deduce the denominator of HCWs in Hubei. Likely about 380K HCW.

Based on a Hubei population of about 60M and from here a figure of the 1.4B population China as a whole having 8.9M HCWs.

If the 1751 cases of HCWs with infections is accurate then that is an attack rate of under 0.5%. That's absurdly low given that the estimate for the general public there is likely, as above, 1.3% or higher. But if it is falsely low, with mild or asymptomatic case not identified, then the true infection fatality rate is that much even lower than the lower than otherwise reported 0.3%.

Maybe the reported numbers are false (and feel free to check my math!) but there is at least nothing in these numbers that bespeaks for a virus that would as a pandemic lead to societal meltdown or even (if on top of a regular strength influenza season) put HCWs at any more of a risk than they were during a worse than typical influenza season.

Again SARS this is not.
  #206  
Old 02-24-2020, 11:42 AM
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Just did my best good faith effort to deduce the denominator of HCWs in Hubei. Likely about 380K HCW.

Based on a Hubei population of about 60M and from here a figure of the 1.4B population China as a whole having 8.9M HCWs.

If the 1751 cases of HCWs with infections is accurate then that is an attack rate of under 0.5%. That's absurdly low given that the estimate for the general public there is likely, as above, 1.3% or higher. But if it is falsely low, with mild or asymptomatic case not identified, then the true infection fatality rate is that much even lower than the lower than otherwise reported 0.3%.

Maybe the reported numbers are false (and feel free to check my math!) but there is at least nothing in these numbers that bespeaks for a virus that would as a pandemic lead to societal meltdown or even (if on top of a regular strength influenza season) put HCWs at any more of a risk than they were during a worse than typical influenza season.

Again SARS this is not.
GIGO analysis. How many people worldwide do you expect will be reported by the CDC to have died from COVID-19 by the end of the year?
  #207  
Old 02-24-2020, 03:06 PM
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I don't think that's speculation, the only question is what percentage of cases are asymptomatic or mild enough to be unreported. I've seen reports that half of those who tested positive on the ship were asymptomatic, but I don't know if that's reliable, or if those people remained asymptomatic. That number would probably also be much higher if the population didn't skew so old, and certainly if it included a representative number of children and adolescents.
Yeah lots of significant unknowns, those and others, so the 'real' death rate isn't known. Or IOW it's speculative to say it's much lower than the raw deaths/cases in the original area. Unless to you 'speculate' is somehow some loaded term implying some nefarious thing. To me it's just a word, and saying the ultimate death rate will be orders less than a couple of % is speculative.

As another post just said, though with unfortunate coda of pseudo-certainty about death rate 'increasing massively' (also speculative), it also depends how widely the disease spreads and where, how many people are affected v how much high quality medical care is available in that place. Unless I'm missing something, I don't think we're just trying to predict the death rate for a minor number of cases 'leaking' into a rich country. The disease breaking out widely in countries with weaker public health systems than China's now seems very possible (lots of people from China are working on various construction, etc. projects in the poorer parts of the world). And the number of intensive care beds is very limited even in rich countries. It might overwhelm hospitals in rich countries compared to typical flue, and the death rate come out higher in those places than under the assumption everyone seriously affects gets advanced care: there might just not be enough to go around.

All within context of a seeming maximum death rate of a few %, so it's not a question of it 'killing off humanity' or coming remotely close (save for a 100% speculative mutation). But it's a good deal less than 100% speculative to say it could be much worse than a typical annual flue. And the suddenly rising number of cases in various countries some far from China is bad news not available for this discussion say a week ago.

Last edited by Corry El; 02-24-2020 at 03:09 PM.
  #208  
Old 02-24-2020, 03:19 PM
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What part of the “in” do you consider garbage? The figure for the population of China? The number of HCWs there? The population of Hubei? The number of HCWs in Hubei labeled as having COVID-19? How many have died?


I’ll take my stab at a WAG to your question. Actual deaths from it globally IF it becomes a pandemic with no fast drop in virulence might reach the equal of a mild influenza season, 250 to 300K. (Bad influenza season is over 650K global deaths.) In the US alone maybe 10 to 15K. Identified as such during the season much less though. It will need post hoc analysis. I hope for much less as the family of virus evolves fast and less virulent versions will outcompete more virulent ones.
  #209  
Old 02-24-2020, 03:31 PM
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...


That's not what happened. The infected passengers were identified after being loaded onto buses for the flight home. They were flying with other cruise ship passengers, some of whom would test positive on their arrival. Not "healthy people". The planes had containment areas for infected patients.

While ideally, all of the patients from that ship would have been placed in land based quarantine in Japan,
. . . They were all returned to mandatory quarantine on bases in the US.

. . .
NPR story on the process.
Thank you. That is comforting. Although I do argue that they were in fact placed on a plane with healthy people, even if they were people from the same ship.

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A lot of those people likely were healthy and not-yet-exposed. Cruise ships are very large, not all people interact with each other, and they'd been mostly locked in their cabins for a while.

I am not an epidemiologist, but it seems like a bad idea to load a bunch of infectious people on a plane with a bunch of people who might not have been exposed.
I agree. But Steatopygia's scenario is still miles better than what I had been led to believe. I may have conflated two different stories, but I was led to believe that the mandatory quarantine had been refused by a judge and they would all continue on to their homes under voluntary quarantine.

Last edited by TruCelt; 02-24-2020 at 03:32 PM.
  #210  
Old 02-24-2020, 05:40 PM
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My main worry over this coronavirus isn't the illness itself - I have no fears that I'll get it (and even if I did contract it, I'm quite sure I'd recover.) My worry is that it could lead to an economic downturn, and also jeopardize the summer Olympics.
  #211  
Old 02-25-2020, 06:37 AM
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This is a very infectious virus which kills 2 out of every hundred people it infects. The mortality rate dwarfs that of flu or other common respiratory illness by an order an magnitude. This number could be falsely high or low, but we might as well stay with it as an estimate. While older people are more at risk, it has killed plenty of younger people as well. It makes 1 out of 5 patients seriously ill for a prolonged period. It has a long incubation period, can be transmitted by asymptomatic carriers and cases have occurred in dozens of countries, so its hard to see how it won't start spreading in North America or wherever you live. China may or not have slowed or stopped its spread only by using quarantine measures which are insanely disruptive and draconian by Western standards.

And you're not worried about it because people die in car accidents all the time?
I am not worried about it because Coronavirus is just another disease for which a cure will soon be found.
I meant that we should worry about health generally, not about death from one virus.
So, of course, it is terrible that people are dying, and it is as bad as deaths in car accidents. I just don't understand all the hype about the virus. Hope I made it clear.
  #212  
Old 02-25-2020, 08:40 AM
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What's really cool about our health care system is that, in a pandemic, one would want people who are sick to go to the doctor for treatment, but with the vast numbers of uninsured and the even larger number of people with insurance who still can't afford treatment, instead of going home, all these infected people... out of economic necessity... will opt themselves out of the treatment and prevention options, further spreading the contagion.

USA! USA! USA!

Last edited by JohnT; 02-25-2020 at 08:40 AM.
  #213  
Old 02-25-2020, 08:57 AM
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What's really cool about our health care system is that, in a pandemic, one would want people who are sick to go to the doctor for treatment, but with the vast numbers of uninsured and the even larger number of people with insurance who still can't afford treatment, instead of going home, all these infected people... out of economic necessity... will opt themselves out of the treatment and prevention options, further spreading the contagion.

USA! USA! USA!
Not really. You'd want the large majority of people who are sick to stay home.

Last edited by Shmendrik; 02-25-2020 at 08:57 AM.
  #214  
Old 02-25-2020, 09:07 AM
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Ha! Joke's on you! You think they get sick pay? lol.

Naw, they're going to get sick and they're going to go to work. They can't take the day off (can't afford it) and can't go to the hospital (can't afford that, either).

USA! USA! USA!

Last edited by JohnT; 02-25-2020 at 09:08 AM.
  #215  
Old 02-25-2020, 09:32 AM
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Remember that scene in The Stand (book) where the President is giving a speech about Captain Trips, but it's obvious something is wrong and the man was interrupted by his own coughing?

Shot: https://twitter.com/ksadjadpour/stat...235501056?s=20

"In a press conference yesterday an Iranian government spokesman confidently asserts they have "no problem" containing coronavirus. Alongside him, the country's deputy health minister appears symptomatic, but takes no precautions to cover/isolate himself"

Chaser: https://twitter.com/ksadjadpour/stat...389053440?s=20

"Today the deputy health minister--who'd "been briefing briefing officials & journalists", presumably without a mask--casually announces he's tested positive."

Bolding mine.

Last edited by JohnT; 02-25-2020 at 09:35 AM.
  #216  
Old 02-25-2020, 09:37 AM
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I am not worried about it because Coronavirus is just another disease for which a cure will soon be found.
I agree that maybe super worrying is not warranted, but not because 'a cure will soon be found.'

There are plenty of diseases for which a cure has NOT been found. And those that have been developed usually take a long time.
  #217  
Old 02-25-2020, 09:38 AM
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Not really. You'd want the large majority of people who are sick to stay home.
Nevermind the vast numbers of people who, in addition to having either crap or no insurance, also have no paid sick time or risk being fired for not coming to work who therefore have a definite economic incentive (read "arm-twisting") to go to work even when they are sick.

Can't stay home when, due to lack of income, you no longer have a home to go to.
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Old 02-25-2020, 09:40 AM
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Well, we just canceled our plans to go to Taiwan and Japan, so I guess there is enough uncertainty and instilled fear and speculation in the media that caused us to do this. I'm pretty bummed about it, but Taiwan and Japan will be there for many years to come.
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Old 02-25-2020, 10:52 AM
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What's really cool about our health care system is that, in a pandemic, one would want people who are sick to go to the doctor for treatment, but with the vast numbers of uninsured and the even larger number of people with insurance who still can't afford treatment, instead of going home, all these infected people... out of economic necessity... will opt themselves out of the treatment and prevention options, further spreading the contagion.
In the United States, what happens if you walk into a clinic and need service for something severe enough to warrant getting antibiotics or a plaster cast, and you tell them you can't afford the medical service or have no insurance, are they going to refuse you treatment or are they obligated to help you, and bill you later (or scrap the bill entirely)? In Canada, even if you don't have medical coverage, you can still walk into a clinic or the hospital and be treated for your issue. It's not "free" medical - it's paid by all of us and goes into a big pool, so there's lots of money available for treatment, however (in)significant it is.
  #220  
Old 02-25-2020, 11:23 AM
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I was extremely worried about SARS, and I still have part of the case of face masks I bought in case it came to my city.

I'm only slightly worried about this one. I still have the face masks, after all.

Mostly I'm less worried because the China and the international medical community seem to have successfully contained SARS and MERS. I'm shocked that they did that, but the evidence is pretty compelling. But I'm still a little worried. Something as communicable as the common cold that kills a large fraction of its victims seems like it could cause a massive pandemic, and even if I were to survive that, it would be pretty damn problematic to my life.
Whelp, looks like it won't be contained. On the good side, it seems to have a relatively low mortality rate, especially among the young. This is likely to kill a lot of people (possibly including me) but it's not going to end civilization or anything.
  #221  
Old 02-25-2020, 11:27 AM
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Ha! Joke's on you! You think they get sick pay? lol.

Naw, they're going to get sick and they're going to go to work. They can't take the day off (can't afford it) and can't go to the hospital (can't afford that, either).

USA! USA! USA!
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Nevermind the vast numbers of people who, in addition to having either crap or no insurance, also have no paid sick time or risk being fired for not coming to work who therefore have a definite economic incentive (read "arm-twisting") to go to work even when they are sick.

Can't stay home when, due to lack of income, you no longer have a home to go to.
This is where I'm happy that I and all my co-workers can work from home. Last time my analyst had flu (he actually tested positive for flu) I told him I would consider it a personal favor of he stayed home until he was well, and suggested some useful work he could probably do while he was still under the weather, if he didn't want to burn his sick time.
  #222  
Old 02-25-2020, 11:27 AM
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In the United States, what happens if you walk into a clinic and need service for something severe enough to warrant getting antibiotics or a plaster cast, and you tell them you can't afford the medical service or have no insurance, are they going to refuse you treatment or are they obligated to help you, and bill you later (or scrap the bill entirely)?
No medical provider is required to treat you.... except the emergency room, which MUST treat you if your life is in immediate danger. Otherwise - no, you can be completely and totally denied any treatment whatsoever.

In reality, though many clinics/hospitals/doctors will try to do something - you can attempt to negotiate a payment plan. After the fact they can try to bill you, even send you to collections (although if you really have no money or assets they still won't get anything). If it's something easily treatable by common antibiotics or the like the clinic might write off your appointment and send you to a local pharmacy that provides several very common medications for free. If you need something more than that, though, you're screwed.

But yeah - you can be completely turned away if you have no insurance and/or cannot pay. (On this forum there are some threads from back in, oh, it must have been 2008 when, because I had no insurance I was refused treatment even though I had the money in hand to pay for it) I did, eventually, get a doctor's appointment but access here is so tied to private insurance than even WITH money you can have problems if you don't have health insurance. Crazy, huh?
  #223  
Old 02-25-2020, 11:28 AM
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From 2018:

Trump official overseeing pandemic readiness exits.

Quote:
A top official who would lead the U.S. response if a deadly pandemic broke out has left the administration amid a broad reorganization of the national security team, The Washington Post reported Thursday.

Rear Adm. Timothy Ziemer left the National Security Council (NSC) this week, and national security adviser John Bolton dissolved the global health security team that Ziemer oversaw.

The Post reported that Ziemer will not be replaced, and that his departure means that there is no single official at the highest levels of the administration who focuses only on global health security.
So, there's no 'pandemic response team'. Trump killed it. Technically, John Bolton killed it, but he served Trump.
  #224  
Old 02-25-2020, 11:43 AM
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This is where I'm happy that I and all my co-workers can work from home.
You are fortunate.

There is nothing about my current job that can be done from home. Ditto for my coworkers.

The only advantage I have over many of my peers is that I have about 6 months worth of living expenses in savings. If I had to stay home for a week, or 14 days, or a month, it would not break me financially. The same can not be true of the majority of the Americans in my socio-economic group.
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Old 02-25-2020, 12:16 PM
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I'm worried about the response to this more than I am the disease itself. The CDC is telling people today that Americans should start preparing for daily life to be disrupted. Quarantines, food shortages, school closures (and disruption to my kids' education), my 401K....all of these things seem scarier than actually getting the virus.

And my wildest imagination runs to how this could affect the upcoming election and how the Trump administration will act if they feel like this is a threat to them winning or if they can somehow get an advantage using this.
  #226  
Old 02-25-2020, 12:21 PM
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It's a perfectly American pandemic. We elected a moron who ignores the threat as to not spook markets, while at the same time sick people must avoid going to hospital for the coronavirus test because they can't afford the fees, but they still have to go to work because there's no income safety net in this country.

We dumbassed ourselves.

Last edited by JohnT; 02-25-2020 at 12:22 PM.
  #227  
Old 02-25-2020, 02:00 PM
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I’ll take my stab at a WAG to your question. Actual deaths from it globally IF it becomes a pandemic with no fast drop in virulence might reach the equal of a mild influenza season, 250 to 300K. (Bad influenza season is over 650K global deaths.) In the US alone maybe 10 to 15K. Identified as such during the season much less though. It will need post hoc analysis. I hope for much less as the family of virus evolves fast and less virulent versions will outcompete more virulent ones.
Harvard's Marc Lipsitch expects that 40-70% of the world's population will become infected this year, which is actually somewhat conservative because it now appears that the reproductive number R0 is somewhere between 2 and 3 (80-90% infection rate). COVID-19 likely has a higher R0 than the 1918 Spanish Flu that killed 50-100 million people.

For the US, 40-70% translates to 130-230 million Americans contracting COVID-19. Even if the CFR of the virus was only 1% this would cause 1-2 million US deaths and 30-50 million deaths worldwide.
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Old 02-25-2020, 03:51 PM
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Harvard's Marc Lipsitch expects that 40-70% of the world's population will become infected this year, which is actually somewhat conservative because it now appears that the reproductive number R0 is somewhere between 2 and 3 (80-90% infection rate). COVID-19 likely has a higher R0 than the 1918 Spanish Flu that killed 50-100 million people.

For the US, 40-70% translates to 130-230 million Americans contracting COVID-19. Even if the CFR of the virus was only 1% this would cause 1-2 million US deaths and 30-50 million deaths worldwide.
CDC's Director of National Center for Immunization and Respiratory Diseases, Dr. Nancy Messonnier, said the virus, called COVID-19, is "rapidly evolving and spreading" and that "successful containment at U.S. borders is becoming problematic." The bug will soon be here, IOW.

Total deaths in the US in 2018 from everything was about 8.6 per 1000, or 2,839,205. Not age-adjusted, which accounts for the difference between that number and the 7.3 ish number for 2016 and 2017. This disease, by itself, even assuming the CFR in the quoted post, will be adding anywhere from another 50 to 100 percent more deaths to the total the US public health system has to deal with.

(I've seen 2.5 ish as a guideline CFR. Granted those are using Chinese numbers, as they are the vast majority of the known cases so far. A non-Chinese, non-Iranian CFR I calculate as about 1.2, from here. Thank God it didn't turn out to be the 13-14 an early pre-print epidemiology paper predicted that I mentioned here about a month ago.)

Your guess is as good as mine where the necessary ventilators, PPE (a large amount of the materials are made in China), ICU/CCU space, and additional skilled practitioners are going to come from.
  #229  
Old 02-25-2020, 07:04 PM
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Surreal and Grey Ghost - you are both confusing "confirmed case fatality rate" with "infection mortality rate". The two are very very very very different things.

"Confirmed case fatality" is a subset of those who are notably sick - those who are sick enough to have gotten tested with the very limited resource of testing kits. Those who are notably sick are a subset of those who infected.

As the cited Marc Lipsitch, who expects large numbers of infected individuals, explains:
Quote:
... He has estimated that 40 to 70 percent of the adult global population will eventually become infected.

That said, “Infected is different from sick,” he is careful to point out. “Only some of those people who become infected will become sick.” As noted above, only about 1 percent to 2 percent of those who have become sick thus far have died, he says. But the number of people who are infected may be far greater than the number of those who are sick. “In a way,” he says, “that’s really good news. Because if every person who had the disease was also sick, then that would imply gigantic numbers” of deaths from the disease.
His estimate of the potential number infected is based on his past modeling with swine flu in Mexico in which
Quote:
the estimated number of cases in Mexican residents likely exceeded the number of confirmed cases by two to three orders of magnitude.
Note that the upper limit of that range would exceed for COVID-19 would exceed the population of all of Hubei.

It may be that 40 to 70% of Hubei has been infected, with orders of magnitude more infected but not sick than sick, as Lipsitch posits. But we still have out of the 60,000,000 who have been living there under 2600 deaths to date. That's an excess mortality rate of 4 per 100,000 within Hubei. Significantly less than the "average annual mortality excess rate per 100,000 ranged from 11.6 to 41.2 with most of the influenza-associated deaths"


Let me be very clear - I would be very surprised if this does not spread worldwide. I expect I will be having many many children with it but minimally ill, no different in appearance than many other viral illnesses, coughing in my face.

And even as an over 60 year old man I am not any more worried than I am about influenza every year, and more worried about drivers while I am on my bike.
  #230  
Old 02-25-2020, 07:57 PM
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Dseid would you as an over 60 year old man worry overmuch about traveling to non-Chinese Asia in the near future? I'm supposed to be in Japan and SE Asia soonish and am considering otherwise.
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Old 02-25-2020, 08:32 PM
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I personally would not worry overmuch about such travel.
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Old 02-25-2020, 08:40 PM
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My main worry over this coronavirus isn't the illness itself - I have no fears that I'll get it (and even if I did contract it, I'm quite sure I'd recover.) My worry is that it could lead to an economic downturn, and also jeopardize the summer Olympics.
Some people thought the Zika virus would lead to the cancellation of the Rio Olympics in 2016. That didn't happen either.

Am I concerned? Yes, for people who live in China and their contacts. Do I think this is a real-life Captain Trips? NO.

Yesterday, I stopped by a hospital in town to get a blood draw I need for an appointment I have scheduled next week. There were the usual flu warning signs, and also signs stating, "If you have been in China in the past 14 days, inform a staff member immediately." I feel that's as appropriate as the other signs they've had up for the past 5 years that say, "If you have traveled outside the U.S. in the past 30 days and have the following symptoms...(fever, headache, vomiting, diarrhea, etc.)....tell a staff member immediately."
  #233  
Old 02-25-2020, 08:46 PM
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I also heard earlier today that a number of people are currently housed in the Biocontainment Unit at the University of Nebraska, the same one where 3 Ebola patients were treated in 2014 (and they sent two of them home ). Two are being treated in isolation and the others are in quarantine, and they've used it for other quarantines in the meantime.

Here's a 25-minute video they made when it opened. It's worth a view, and there's an underlying theme that they were hoping they would never need to use it.

https://www.youtube.com/watch?v=a68NdXDk9Tk&t=284s

More than once, administration wanted this unit to open up because the ICU was full, and they refused because they said that's all they wanted to use it for, and even transferred patients rather than house them there. That's dedication.
  #234  
Old 02-26-2020, 03:16 AM
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My husband is in the import-export business, and travels globally often. He no longer travels to certain countries or has contact with those who do. Still, I worry about him.
  #235  
Old 02-26-2020, 05:25 AM
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Ok. So, the CDC person said people need to "be prepared". What does that mean? Like, if the reasonable worse case happens, what will I wish I had done? I am imagining a full-blown outbreak here. I think they'd close the schools, so we'd be home. Medical infrastructure would be overwhelmed. If we had CORVID-19 in our house, all of us sick at the same time, is there anything I'd really really wish I'd've stockpiled? It sounds like most of the time, you just are sick and then get better. Sometime it's so bad you need oxygen or a ventilator, which I can't get. Is there anything in the middle? Anything you'd want to have for a person who was very sick, if hospitals were too overwhelmed to help? I am sincerely curious.

The other issue, of course, is if we are all sort of shut-ins for a while, what do I need to have on hand? Food for several weeks? Is there anything else?
  #236  
Old 02-26-2020, 05:50 AM
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Yeah, I got really annoyed with the CDC saying "be prepared" but giving no details.

I'm going to assume they'd keep utilities running based on historical examples of cities under quarantine.

So.... my guess would be

- food and toiletries/supplies for 2 weeks or more (including daily medication and OTC meds for cold/flu type illness for symptom relief)

- plenty of fluid/sick person food: soups, juices, sodas, in addition to the water you presumably get out of the tap. Bottled water if that's what you drink.

- cleaning supplies

- something for entertainment so you don't go stir-crazy

But, goddamn CDC, you need to be more specific than "be prepared".
  #237  
Old 02-26-2020, 07:06 AM
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I would read that as being "mentally prepared".

Don't expect that it is possible to dodge the virus, don't think it is possible for the authorities to keep this bug out completely.

In addition, know the symptoms and what to do if you get them. Here in the Netherlands for instance, they are fairly clear about not going to hospital or a doctor...they will come to you if there is a chance you have it.

Thusfar no cases here, but they just found the virus in a guy in Germany, 20 km from the border. And in Innsbruck of course, where a good chunk of the country is for their skiing holiday. It is highly unlikely that there won't be a case here...

Verstuurd vanaf mijn moto g(6) met Tapatalk
  #238  
Old 02-26-2020, 08:30 AM
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If it ever become apparent that containment is not realistic it seems that it might be better just to stop all efforts at containment and leave it to the individual to take whatever precautions he can. I still have not seen any numbers on death rates of those exposed and the risk factors based on age and underlying health issues. Panic may actually cause more damage than the illness. Allowing it to run its course might shorten the length of time this virus affects world activities.
  #239  
Old 02-26-2020, 08:32 AM
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Other articles I've read have mentioned stuff like, try to figure out a childcare plan if schools are closed and you're still at work, businesses should plan for employees working from home, schools should plan for remote learning...that sort of thing.

Personally, I've lived in hurricane-prone areas most of my life and we camp a lot, so we normally stay supplied for an emergency lasting about a week; we will likely expand our supplies to last us for a month. Broomstick's list is good. Make sure you think about pet supplies if you need them.
  #240  
Old 02-26-2020, 09:27 AM
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I still have not seen any numbers on death rates of those exposed and the risk factors based on age and underlying health issues.
Some of those numbers are found here (a Washington Post article that is likely behind a paywall). Here is a non-paywalled link to the key data from the article.

The death rates listed are:
age 50 - 59: 1 to 2%
age 60 - 69: 4%
age 70 - 79: 8%
age over 80: 15%

So, young people will (generally) be okay. OTOH, unless I've misjudged the SDMB demographics, I'd say we are likely to lose a few Dopers.
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  #241  
Old 02-26-2020, 09:37 AM
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Some of those numbers are found here (a Washington Post article that is likely behind a paywall). Here is a non-paywalled link to the key data from the article.



The death rates listed are:

age 50 - 59: 1 to 2%

age 60 - 69: 4%

age 70 - 79: 8%

age over 80: 15%



So, young people will (generally) be okay. OTOH, unless I've misjudged the SDMB demographics, I'd say we are likely to lose a few Dopers.
As has been stated above, most notably by DSeid, those are not "death rates of those exposed", or even of infected. They are death rates of those sick enough to seek medical help (or perhaps sick enough to not avoid medical help, in China). The difference between those two numbers appears to be the burning question at this point.

Last edited by Shmendrik; 02-26-2020 at 09:38 AM.
  #242  
Old 02-26-2020, 09:49 AM
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Is there anything a person can have on hand to help a person who has labored breathing? That seems to be the thing that kills people, and if hospitals are overwhelmed, is there literally anything that can be done at home other than rest?
  #243  
Old 02-26-2020, 10:28 AM
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. . . those are not "death rates of those exposed", or even of infected. They are death rates of those sick enough to seek medical help (or perhaps sick enough to not avoid medical help, in China).
All true. But it works both ways - the numbers don't include those who died from it but had no access to care; or who died before they accessed it; and especially those with comorbidities who died because their undiagnosed coronavirus infection precipitated another fatal illness (e.g. heart failure, renal failure, etc.)

In my opinion, it requires no great leap of faith to imagine that the death rate for those over age 60 will be several percent. Not only may millions die worldwide, but the health care systems they (try to) access will be inundated and their budgets exhausted, leading to collateral damage to the care of everyone else regardless of what ails them.
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Last edited by KarlGauss; 02-26-2020 at 10:28 AM.
  #244  
Old 02-26-2020, 10:41 AM
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All true. But it works both ways - the numbers don't include those who died from it but had no access to care; or who died before they accessed it; and especially those with comorbidities who died because their undiagnosed coronavirus infection precipitated another fatal illness (e.g. heart failure, renal failure, etc.)

In my opinion, it requires no great leap of faith to imagine that the death rate for those over age 60 will be several percent. Not only may millions die worldwide, but the health care systems they (try to) access will be inundated and their budgets exhausted, leading to collateral damage to the care of everyone else regardless of what ails them.
Maybe. On the other hand, this is the way the news is reporting the first French COVID19 fatality:

Quote:
French authorities are urgently trying to trace the source of the coronavirus infection that claimed the life of a 60-year-old citizen who died over night in the Pitié-Salpêtrière hospital, in Paris, as five new infections were reported in the country.

...

The French fatality was identified as a teacher from L’Oise region, in northern France, who suffered a massive pulmonary embolism as a result of the virus. The teacher is the second infection identified in the L’Oise region.

So COVID-19 causes massive PE's as an early symptom now? Or a patient came in with cough and respiratory distress due to his massive PE, and was incidentally found to be positive for COVID-19?

Last edited by Shmendrik; 02-26-2020 at 10:43 AM.
  #245  
Old 02-26-2020, 01:16 PM
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... it requires no great leap of faith to imagine that the death rate for those over age 60 will be several percent. Not only may millions die worldwide, but the health care systems they (try to) access will be inundated and their budgets exhausted, leading to collateral damage to the care of everyone else regardless of what ails them.
In my opinion a huge leap of imagination is required to think that.

It requires either imagining huge HUGE numbers of Chinese dead from COVID-19 that are not being reported or having some other explanation for how such a scenario is consistent with an excess mortality rate for COVID-19 in Hubei lower than the low end for seasonal influenza (with new reported cases dropping off) and relatively insignificant numbers of deaths for population size in the rest of China. No not the “lock down”.

I make the same point I have made before: imagining that novel to human coronaviruses just suddenly started happening two decades ago is unrealistic. We just haven’t been aware of them before, lost in the statistical noise of flu season severity variability.

There is little doubt in my mind that post hoc analysis w
will show a large portion of children in Hubei having had infections with the virus this year.
  #246  
Old 02-26-2020, 03:43 PM
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I also wouldn't be so quick to predict US healthcare being overwhelmed. It is very quick to adapt to things like this.

In 2009, during the H1N1 pandemic, the ER I was working at was able to set up a "flu clinic" in a separate lobby. No muss, no fuss. We were able to see an additional 50-60 people a day and somewhat isolate them from our normal population. With the low level of lethality so far demonstrated by this virus, we will be OK. Scheduled surgeries will be postponed and people may not receive that wonderfully average care they have come to expect, but I don't think things will break down.

Manda Jo, based on the news reports out of Asia, the only thing you will need is toilet paper.
  #247  
Old 02-26-2020, 03:51 PM
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I borrowed a phone that had an automatic newsfeed from Google UK.

On one day an article matter-of-factly stated "The fatality rate for COVID-19 is unknown, but is likely to be similar to the influenza pandemic of 1918"
The very next day the article was about preparing for coronavirus; a list of all the things you should panic buy to be able to live for months without access to shops.

No wonder so many of my British friends are absolutely freaking out.

Quote:
Originally Posted by squeegee View Post
Dseid would you as an over 60 year old man worry overmuch about traveling to non-Chinese Asia in the near future? I'm supposed to be in Japan and SE Asia soonish and am considering otherwise.
You will likely find that your chance of catching, and even dying, of the flu, wherever you are now, is likely to be at least an order of magnitude higher than of catching or dying respectively of COVID19 anywhere except Hubei proper.

That said, I would be concerned about being stuck in quarantine, especially a fuckup like the princess diamond. There's no way of eliminating that possibility, so it comes down to whether you think that risk is acceptable. But note, that particular risk is no longer limited to just SE Asia; you might end up in a quarantine while travelling within Europe or the middle east.
I myself will be flying within China tomorrow, so I have every crossable bodypart crossed.

Last edited by Mijin; 02-26-2020 at 03:56 PM.
  #248  
Old 02-26-2020, 04:13 PM
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Good luck Mijin, let us know how it goes.

Regarding traveling in SE Asia right now. I would also be worried about things being closed, particularly tourist things.
  #249  
Old 02-26-2020, 04:21 PM
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Guys, you will be thrilled to learn that the HHS director, Alex Azar, is making sure that the drug companies make a profit from the Covid-19 vaccine and, therefore, can not guarantee that it will be affordable.

"We would want to ensure that we work to make it affordable, but we can't control that price, because we need the private sector to invest.. Price controls won't get us there."

https://twitter.com/mmcauliff/status...490799104?s=20

Last edited by JohnT; 02-26-2020 at 04:21 PM.
  #250  
Old 02-26-2020, 05:36 PM
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In my opinion a huge leap of imagination is required to think that.

It requires either imagining huge HUGE numbers of Chinese dead from COVID-19 that are not being reported or having some other explanation for how such a scenario is consistent with an excess mortality rate for COVID-19 in Hubei lower than the low end for seasonal influenza (with new reported cases dropping off) and relatively insignificant numbers of deaths for population size in the rest of China. No not the “lock down”.
I am assuming it will spread more widely, much more widely than has happened in China. Not all countries will have the inclination or the means to lock down their populations.
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