CDC Begins Passenger "Funneling" re 2019-nCov
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Ooh. Wrong answer. R0 = 4.1! Which isn’t good.
https://www.peakprosperity.com/new-c...ontagion-risk/
Nought what the doctor ordered. Any crew discounts on Tamiflu going?
Edit: Does Tamiflu even work for this thing?
https://www.peakprosperity.com/new-c...ontagion-risk/
Nought what the doctor ordered. Any crew discounts on Tamiflu going?
Edit: Does Tamiflu even work for this thing?
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That the statistics are only showing what's known is exactly why I focused on Hubei. The rest of the provinces are only recording a handful of outcomes. Chongqing is showing about a 25% CFR (which is still awful) with 3 recoveries and 1 death. They simply haven't been dealing with this long enough to have meaningful data. Hubei still shows a 60% CFR with 249 deaths and 168 recoveries. While there's almost certainly underreporting, I don't think that it's limited to those with limited illness. I doubt the mortality rate for 2019-nCoV will eventually become similar to a typical flu. You simply don't quarantine 60 million people for the seasonal flu.
Here's the link to the transcript of the WHO press conference on the 29th, with the estimates of 20% serious and about 2% fatal: https://www.who.int/docs/default-sou...-29jan2020.pdf
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No, no and no. There is exactly no credible evidence or analysis to support fatality rates anywhere near those percentages. And the gross numbers of cases you cite are ridiculously low. As of two hours ago, the South China Morning Post reported a total of just over 9,000 confirmed cases in Hubei, with about 1,100 becoming seriously ill and around 450 currently critically ill. The China-wide case total is reported as 14,380 and total deaths as 304. All of those numbers will keep changing, rapidly, of course.
I don't think that a 50-60% CFR will prove to be accurate, even with deaths lagging by a few weeks, but I suspect it will be in the double digits (and likely higher than SARS which was around 15%).
The reliability of any of these numbers is low. There is a desperate shortage of beds and the hospitals are hugely overtaxed, with even basics such as testing kits in short supply.
Plus there is an ongoing flu seasonal peak, so there are pressures to post the deaths as flu or organ failure rather than nCoV.
The floor estimate for the case fatality ratio will be from the foreign patients outside of China, who are getting really first rate care. That could change very quickly if the efforts to prevent the spread of the disease fail
So if there are 100 cases in the US in another couple of weeks, which would indicate the virus has escaped confinement, we may find out that the 'natural' CFR is really ugly.
Plus there is an ongoing flu seasonal peak, so there are pressures to post the deaths as flu or organ failure rather than nCoV.
The floor estimate for the case fatality ratio will be from the foreign patients outside of China, who are getting really first rate care. That could change very quickly if the efforts to prevent the spread of the disease fail
So if there are 100 cases in the US in another couple of weeks, which would indicate the virus has escaped confinement, we may find out that the 'natural' CFR is really ugly.
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Hubei is currently reporting 9,074 confirmed cases, 294 deaths, and 215 recovered patients. At the high end that puts the CFR around 58% if you only look at known outcomes, at the low end at 3.2% if you don't with much of that depending on how accurate you think that the reporting on case outcomes is accurate. If you believe that there are a significant amount of infected persons who simply never see serious symptoms and either don't seek medical advice or are turned away then sure 3.2% seems reasonable. I don't believe that the CCP would quarantine so many people so quickly if they were looking at something near the severity of the H1N1 flu. Nor do I believe that there's a mass of people whose symptoms are so minor that they're not being counted.
I don't think that a 50-60% CFR will prove to be accurate, even with deaths lagging by a few weeks, but I suspect it will be in the double digits (and likely higher than SARS which was around 15%).
I don't think that a 50-60% CFR will prove to be accurate, even with deaths lagging by a few weeks, but I suspect it will be in the double digits (and likely higher than SARS which was around 15%).
Note: The WHO report from yesterday indicates that transmission by asymptomatic carriers appears to be "rare." If that turns out to be correct, it's very good news.
US CDC 2019-nCoV Situation Summary
WHO 2019-nCoV Information
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The reliability of any of these numbers is low. There is a desperate shortage of beds and the hospitals are hugely overtaxed, with even basics such as testing kits in short supply.
Plus there is an ongoing flu seasonal peak, so there are pressures to post the deaths as flu or organ failure rather than nCoV.
The floor estimate for the case fatality ratio will be from the foreign patients outside of China, who are getting really first rate care. That could change very quickly if the efforts to prevent the spread of the disease fail
So if there are 100 cases in the US in another couple of weeks, which would indicate the virus has escaped confinement, we may find out that the 'natural' CFR is really ugly.
Plus there is an ongoing flu seasonal peak, so there are pressures to post the deaths as flu or organ failure rather than nCoV.
The floor estimate for the case fatality ratio will be from the foreign patients outside of China, who are getting really first rate care. That could change very quickly if the efforts to prevent the spread of the disease fail
So if there are 100 cases in the US in another couple of weeks, which would indicate the virus has escaped confinement, we may find out that the 'natural' CFR is really ugly.
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Update: A study from Germany that's just making the rounds appears to contradict the WHO observation, from yesterday, that transmission from asymptomatic carriers may be rare.
Letter to the New England Journal:
Letter to the New England Journal:
Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany
CNN story with comments by Anthony Fauci (who is definitely the real deal in epidemiology):'There's no doubt': Top US infectious disease doctor says Wuhan coronavirus can spread even when people have no symptoms
Last edited by OldnGrounded; 2nd Feb 2020 at 22:42.
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Lancet Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study pdf direct
Findings
Findings
In our baseline scenario, we estimated that the basic reproductive number for 2019-nCoV was 2·68 (95% CrI 2·47–2·86) and that 75 815 individuals (95% CrI 37 304–130 330) have been infected in Wuhan as of Jan 25, 2020. The epidemic doubling time was 6·4 days (95% CrI 5·8–7·1). We estimated that in the baseline scenario, Chongqing, Beijing, Shanghai, Guangzhou, and Shenzhen had imported 461 (95% CrI 227–805), 113 (57–193), 98 (49–168), 111 (56–191), and 80 (40–139) infections from Wuhan, respectively. If the transmissibility of 2019-nCoV were similar everywhere domestically and over time, we inferred that epidemics are already growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about 1–2 weeks.
Interpretation
Given that 2019-nCoV is no longer contained within Wuhan, other major Chinese cities are probably sustaining localised outbreaks. Large cities overseas with close transport links to China could also become outbreak epicentres, unless substantial public health interventions at both the population and personal levels are implemented immediately. Independent self-sustaining outbreaks in major cities globally could become inevitable because of substantial exportation of presymptomatic cases and in the absence of large-scale public health interventions. Preparedness plans and mitigation interventions should be readied for quick deployment globally.
Corona Virus has just made another *victim*...Hummmmm.. Dr. Eric Feigl-Ding who's posts about the HIV/ nCoV almost reached fearmongering-doomporn interpretation status, it seems has changed his stance on the matter.
*Dear friends, after learning that the original authors have formally retracted yesterday’s “uncanny” titled pre-print article, I believe it is prudent to delete the earlier posts 16-24 pertaining to it.*
Some science community saying now»»»
"You dont need to be a scientist to feel those reports were junk science upon the first read..."
*Dear friends, after learning that the original authors have formally retracted yesterday’s “uncanny” titled pre-print article, I believe it is prudent to delete the earlier posts 16-24 pertaining to it.*
Some science community saying now»»»
"You dont need to be a scientist to feel those reports were junk science upon the first read..."
Last edited by JanetFlight; 3rd Feb 2020 at 03:42.
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Corona Virus has just made another *victim*...Hummmmm.. Dr. Eric Feigl-Ding who's posts about the HIV/ nCoV almost reached fearmongering-doomporn interpretation status, it seems has changed his stance on the matter.
*Dear friends, after learning that the original authors have formally retracted yesterday’s “uncanny” titled pre-print article, I believe it is prudent to delete the earlier posts 16-24 pertaining to it.*
Twitter.com /DrEricDing/status/1223834719651094528
Some science community saying now»»»
"You dont need to be a scientist to feel those reports were junk science upon the first read..."
*Dear friends, after learning that the original authors have formally retracted yesterday’s “uncanny” titled pre-print article, I believe it is prudent to delete the earlier posts 16-24 pertaining to it.*
Twitter.com /DrEricDing/status/1223834719651094528
Some science community saying now»»»
"You dont need to be a scientist to feel those reports were junk science upon the first read..."
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We have now entered into the phase of whether to believe or not believe. Contradictory disinformation is now flying all over the place. Whether that info or disinfo is benevolent or malevolent matters not. Whether that info or disinfo is intentional or unintentional matters not. Welcome to dither. The only thing that helps is to think / post only facts that are proveble by multiple independent sources. Opinions are not of much help in a scenario such as the present wherein causing dithering can turn out to be fatal. This is why I have such respect for pilots. They can't afford to dither. Opinions don't help when there are problems in flight. And in this 2019-nCoV we are all together on this flight of our one ship in space.
For readers of English, there are a handful of informative and authoritative sites that should be the go-to places for reliable information:
UK Department of Health and Social Care Coronavirus Information
US CDC Novel Coronavirus Information
WHO 2019-nCoV Information
Australian Department of Health Novel Coronavirus Information
For up-to-date raw data and statistics, and the latest serious estimates of things like R0, latency period, etc. the Worldometers site is generally reliable: https://www.worldometers.info/coronavirus/
If it's in The Lancet, or JAMA, or New England Journal of Medicine or similar prestigious publications, you can be pretty sure it's not nonsense, but it may not be unquestionable fact, either. There's going to be a lot of uncertainty, even among real experts, for some time to come.
JHU DATA
As yet, 2 fatalities outside of PRC. first in PHI on Sunday, and this morning in HKG. Both cases appear to have been patients with compromised immune systems.
Question on veracity of the PRC data output, for various non nefarious reasons. Their total cases are likely to be under reported due to logistical demands in dealing with a high rate of transmission. That alone should suggest that the spread rate should be a concern. Fatality rates should be better reported, but that also appears now to be under some stress, and could also be under reported in PRC at present. Hope otherwise.
On linear axis, the data gets untidy fast with a geometric progression, but it shows the overall growth. The PRC case appears to have an inflexion point around the 24th, where the rate changed substantially, but then falls back towards a fairly uniform geometric progression. Possibly the data prior to that point is under reported, and that was corrected around that point. PRC spread remains at same overall rate without much change, which is not what we need. Thats PRC.
Non PRC, the early progression is similar to the PRC case in the early stages. As the virus would have travelled in one of our shiny incubators, with lots of other opportunities to spread, that is still odd, the early rate would have been potentially like letting cats out of a bag, and an earlier development of cases outside of the PRC would have been likely, and did not occur as such. The spread did however go to many different countries in parallel, but not with a large step locally. That is before, now, the current non PRC cases while growing, do not show the same progression that they have done in the PRC. That could be doe to under reporting but the rest of the world is paying attention, even if the WHO had to be dragged into the light. The curve on the foreign cases is what would be seen if a control was effective, or the conditions for maintaining a high R0 was removed.
The non PRC fatality rate is below that which would be expected at this point if CFR's were similar in both populations. It is effectively zero at this time, for cases that were transferred external to the PRC. That doesn't mean that it isn't about to change in the near future, it may well do so, but it is below the progression that is seen on the PRC cases, noting that the PRC cases are probably understated for total cases, and may be close to correct for fatalities. That is also open to error, with cases possibly being attributed to the virus on one hand, and others not having been recorded due to remote communities and the privacy preferences of family.
On a normal/log scale, the difference in the last 5-6 days in the non PRC cases shows up as below. The date series lag is removed in this example, and the curves matched to give a preliminary lag time, which comes out at about 22 days. The non PRC cases show a rate change that has slight confidence that it should be correct, reporting in the countries concerned should be reasonable (Many countries have not reported as yet what is happening, but those that are reporting can be considered to be reasonable).
On the following chart, a straight line would be a geometric progression, so a curve away, a lowering of the cases/# from any line is good. The last chart is the same data on linear axis. Both of these charts show curves for various R0 and days per Cycle with the latter converted to a date.
In the graphs showing fatalities, they curiously happened to shadow the non PRC cases, however they split from the non PRC case in the last week, the fatality rate remaining geometric at present, the non PRC cases reducing the exponent by the looks of it.
Question on veracity of the PRC data output, for various non nefarious reasons. Their total cases are likely to be under reported due to logistical demands in dealing with a high rate of transmission. That alone should suggest that the spread rate should be a concern. Fatality rates should be better reported, but that also appears now to be under some stress, and could also be under reported in PRC at present. Hope otherwise.
On linear axis, the data gets untidy fast with a geometric progression, but it shows the overall growth. The PRC case appears to have an inflexion point around the 24th, where the rate changed substantially, but then falls back towards a fairly uniform geometric progression. Possibly the data prior to that point is under reported, and that was corrected around that point. PRC spread remains at same overall rate without much change, which is not what we need. Thats PRC.
Non PRC, the early progression is similar to the PRC case in the early stages. As the virus would have travelled in one of our shiny incubators, with lots of other opportunities to spread, that is still odd, the early rate would have been potentially like letting cats out of a bag, and an earlier development of cases outside of the PRC would have been likely, and did not occur as such. The spread did however go to many different countries in parallel, but not with a large step locally. That is before, now, the current non PRC cases while growing, do not show the same progression that they have done in the PRC. That could be doe to under reporting but the rest of the world is paying attention, even if the WHO had to be dragged into the light. The curve on the foreign cases is what would be seen if a control was effective, or the conditions for maintaining a high R0 was removed.
The non PRC fatality rate is below that which would be expected at this point if CFR's were similar in both populations. It is effectively zero at this time, for cases that were transferred external to the PRC. That doesn't mean that it isn't about to change in the near future, it may well do so, but it is below the progression that is seen on the PRC cases, noting that the PRC cases are probably understated for total cases, and may be close to correct for fatalities. That is also open to error, with cases possibly being attributed to the virus on one hand, and others not having been recorded due to remote communities and the privacy preferences of family.
On a normal/log scale, the difference in the last 5-6 days in the non PRC cases shows up as below. The date series lag is removed in this example, and the curves matched to give a preliminary lag time, which comes out at about 22 days. The non PRC cases show a rate change that has slight confidence that it should be correct, reporting in the countries concerned should be reasonable (Many countries have not reported as yet what is happening, but those that are reporting can be considered to be reasonable).
On the following chart, a straight line would be a geometric progression, so a curve away, a lowering of the cases/# from any line is good. The last chart is the same data on linear axis. Both of these charts show curves for various R0 and days per Cycle with the latter converted to a date.
In the graphs showing fatalities, they curiously happened to shadow the non PRC cases, however they split from the non PRC case in the last week, the fatality rate remaining geometric at present, the non PRC cases reducing the exponent by the looks of it.
Last edited by fdr; 5th Feb 2020 at 06:07. Reason: updated data
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Good data and analysis.
I've been plotting only since 20 Jan but I show the same curves. What is not readily apparent in your presentation (you can see it but it's not clear) is that there is an inflection point around 28 Jan in the China data to a much lower growth rate. By happenstance I read a Time article today which quotes: (1) Wuhan shutdown started on 23 Jan; (2) average incubation period is thought to be 5 days; (3) it is assumed that it takes five days for symptoms to become severe enough that a patient presents to a hospital and gets tested.
Just to be clear, I identified the inflection point at 28 Jan several days ago, it is only now that I find that there might be a reason for that. It's nice to have a different source provide some confirmation of a possible reason.
This means that, if it appears in the record, there will be inflection points at 28 Jan (ie five days after 23 Jan) and 2 Feb (five days after that). I'm being cautious here, but I think we are just beginning to see a glimmer of a change for the better:
"Cases" are number of cases reported in mainland China (M. China) and rest of the world (ROW), from John Hopkins University.
Y-axis is plotted as a logarithm, so straight lines on graph show the exponential rate.
Coloured lines on chart show examples of specified daily increase in number of cases reported. They are not lines of best fit.
"Daily change" for mainland China (M. China) and rest of the world (ROW), from John Hopkins University.
Coloured lines on chart are linear lines of best fit.
Lines extending beyond data points are extrapolated and therefore not data-based but are speculative.
I've been plotting only since 20 Jan but I show the same curves. What is not readily apparent in your presentation (you can see it but it's not clear) is that there is an inflection point around 28 Jan in the China data to a much lower growth rate. By happenstance I read a Time article today which quotes: (1) Wuhan shutdown started on 23 Jan; (2) average incubation period is thought to be 5 days; (3) it is assumed that it takes five days for symptoms to become severe enough that a patient presents to a hospital and gets tested.
Just to be clear, I identified the inflection point at 28 Jan several days ago, it is only now that I find that there might be a reason for that. It's nice to have a different source provide some confirmation of a possible reason.
This means that, if it appears in the record, there will be inflection points at 28 Jan (ie five days after 23 Jan) and 2 Feb (five days after that). I'm being cautious here, but I think we are just beginning to see a glimmer of a change for the better:
"Cases" are number of cases reported in mainland China (M. China) and rest of the world (ROW), from John Hopkins University.
Y-axis is plotted as a logarithm, so straight lines on graph show the exponential rate.
Coloured lines on chart show examples of specified daily increase in number of cases reported. They are not lines of best fit.
"Daily change" for mainland China (M. China) and rest of the world (ROW), from John Hopkins University.
Coloured lines on chart are linear lines of best fit.
Lines extending beyond data points are extrapolated and therefore not data-based but are speculative.
Last edited by FlareArmed2; 4th Feb 2020 at 16:29. Reason: Graphs updated
