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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, I personally agree with this decision. Those passengers were minutes from being returned home after enduring a long period of confusion and containment. The other people on those buses were already exposed. They also weren’t “being ordered to self quarantine”. They were all returned to mandatory quarantine on bases in the US.
This was a judgement call. I personally think it was the right thing to do for humanitarian reasons. Unusual in these times.
NY Post is a perfectly fine cite to prove that healthcare workers occasionally die of influenza, just like any other human being. In fact, I found that same article when I Googled “nurse dies of flu.” However, I’d be astonished to learn that a city the size of New York had anything like 10 deaths per year. Perhaps DSeid has some data on this.
In any case, as someone mentioned earlier in this thread, the Diamond Princess should illustrate the mortality rate of this virus in the adult population quite well, although it is a fairly small sample size. There are about 700 confirmed infections out of the 3700 people on the ship. I assume the demographics on the ship tend towards the geriatric, but relatively healthy; these aren’t nursing home residents or the terminally ill. So far there are 3 deaths, all in patients aged >80. My understanding is that there are a few dozen patients in critical condition.
Now, I may be reading this data wrong, but according to the CDC mortality rates for patients aged >65 with the flu in 2017-18 was about 100 out of 11000, or 1%. If only a handful more passengers die, this would mean a Covid-19 infection is about as bad as the flu. If a few dozen or more die, especially if they are among the younger passengers or crew, that would imply that this virus is significantly worse.
One major, major difference is that we don’t quarantine for influenza. That’s where the biggest economic damage will be with covid - the quarantine, the loss of time at work, the lost wages.
Although I don’t think it will result in “breakdown of American society”. It will cause massive disruption if this gets lose like the flu and governments attempt to lock up everybody who might have been exposed.
Further info on age range in this article, 44 more on Diamond Princess cruise ship test positive for COVID-19 - The Japan Times
80% of passengers are over 60 yrs old it says. But around 1100 of the 3700 are crew (per std sources about the ship not that article) with age distribution presumably closer to the general population, perhaps younger than Japan’s general distribution of ages. Overall still older though and ‘elderly people made up the large majority of those newly infected with the virus’ it says, speaking of the few dozen cases just added when the article was written.
I believe that’s what it does say, recent flue had a death rate of around 0.14% for all ages but more like 1% for people over 65, though as you suggest, including already seriously ill people over 65 who probably don’t go on cruises, and also seems a majority of the passengers are Japanese, where life expectancy/health of people of a given older age tends to be better than in most other countries.
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). And the rate I agree will have to be judged against typical flue for the age distribution of people aboard which would be higher than overall normal flue death rate.
There are two death rates (and several intermediate positions):
People untreated for the disease
People treated in advanced Western hospitals
Almost everyone in the Japanese cruise ship who needs it is treated in the advanced Western hospitals. The problem is that these advanced Western hospitals have relatively little excess capacity and will shortly get overwhelmed with cases (just like Wuhan). When this happens the death rates will start massively increasing.
Talk about fear mongering. How about a cite for anything at all about “people untreated for the disease”.
Or a death rate for same. Or Western hospitals having little excess capacity. Or really anything that backs up anything in your post.
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 -
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 …
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).