BA cancel all flights to and from China due to Coronavirus
On today’s data we are back to an additional 4000 cases. If yesterday’s spike is factored in, the additional case numbers average out to around 4000/day for the last ten days or so. Which is itself an oversimplification. Why would the case numbers grow linearly?
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On today’s data we are back to an additional 4000 cases. If yesterday’s spike is factored in, the additional case numbers average out to around 4000/day for the last ten days or so. Which is itself an oversimplification. Why would the case numbers grow linearly?
It appears that the big jump in reported cases in China is a result of a change in the diagnostic protocol. As we know, they have been hopelessly backlogged trying to verify diagnoses with RT-PCR tests (the only way to do so accurately and quickly). So, now, they are simply judging (assuming, really) that patients showing signs of pneumonia on chest scans are coronavirus cases. Most probably are (there, at this time) and treatment is the same whatever virus may be causing the illness, so it makes good clinical sense to do this. That said, it makes the diagnoses rather less certain and created this big jump, since all those patients who had been through radiology but not been verified by PCR are suddenly "confirmed" cases.
I get figures from John Hopkins, they in turn get their data from a wide variety of sources not just the Chinese government. They have a blog here for those that wish to deep dive.
At the end of the day I don't really know how accurate anything on the internet is. I can point out that the trajectory of data in mainland China matches the rest of the world. If there is a significant diversion between the two then I think the idea that some numbers don't add up would be a supportable hypothesis; but I don't see that right now. But that's just me, you might have another take on it. I honestly don't know.
At the end of the day I don't really know how accurate anything on the internet is. I can point out that the trajectory of data in mainland China matches the rest of the world. If there is a significant diversion between the two then I think the idea that some numbers don't add up would be a supportable hypothesis; but I don't see that right now. But that's just me, you might have another take on it. I honestly don't know.
The "S" be silent?
There is possibly fair skepticism on the numbers that came out of China, which doesn't mean any intent to be deceptive, it is just as likely to be from the problems of responding to the new virus, establishing exactly what is and what isn't a case, and appropriately categorising the data of non COVID-19 (WuFlu) cases against the background cases of similar conditions, flu, pneumonia etc. For scale, the figures on seasonal flu deaths is bad enough, but the deaths from pneumonia alone are over 50,000 PA in the USA, so sorting out the signal from the noise is always problematic until there are reliable tests in place. The recent Chinese numbers reflecting the change in categorisation doesn't mean the situation is deteriorating, it puts the data in better perspective.
A curiosity with this virus so far is that the outcomes are quite variable. The latest information suggests that many more cases exist, yet the rate overall is not increasing that greatly for the adverse outcomes. That is cold comfort for the recently departed, but it puts in context the significance of the outbreak. The fatality ratio is going to be lower against actual infected cases when this is washed out, and it will quite probably be higher than the seasonal flu, but it is not going to change the world, other than an excessive response that shuts down activity globally which may have a greater adverse effect than WuFlu itself.
The adverse outcomes appear to impact those that are immune compromised already, and if that is really the case, then the most effective response to the virus is to identify those that are at risk, and maintain isolation for them from the potential spread of the disease, as, effectively we are at risk of bombing our own global systems into the stone age to stop something that has already been let out of the bag. If the spread is already outside of the containment lines, it is time to point defend, and that currently is a doable procedure. If a belated half hearted attempt to quarantine the global public remains the focus, then we are unlikely to be successful, and that action will take resources away from those that are in greatest peril from adverse outcomes. That same group at most risk are already under risk of similar outcomes from other causation agents.
WuFlu is like a forest fire that set up lots of undetected hot spots throughout the forest. The resources can be focused on the points of critical effect, the building in the forest, or we can attempt to tamp out each new hotspot, but we are behind the spread, and the spots are not showing up easily. Our current response is to pull out every tree in the forest, not sure that is now the correct response any longer. With infinite resources, sure, fill your boots, but when we have limitations, then the best solution may be to protect those that are readily identifiable as being at risk.
This virus doesn't affect the great majority of the cases at present. A risk of a half hearted response is that the virus doesn't spread rapidly through the available population, and all we do is slow it down, and then we are effectively giving it an opportunity to have more time active in the community overall, and allow it therefore more opportunity to evolve. As it changes slightly at every replication cycle, there is as much likelihood that it becomes more problematic over cycles than becomes benign. Right now, it is relatively benign to the vast majority of cases. I'm not suggesting terminating personal discipline in infection control, I am suggesting that the cat is out of the bag, and the rational defence is to protect those that the virus has greatest impact on. To do so would lessen the economic impact that this outbreak has which has all the hallmarks of a bad day out at present. Those at most risk can be protected without affecting trade and commerce at all, and that would be a rational position to consider. The current global response is heading over a cliff, and adding economic collapse to the equation hardly improves the survival rate of those at risk already.
Essentially, there was a panic overreaction by the HK medical establishment that meant patients were given huge doses of steroids. The HK "experts" are, of course, not proud of this, so it doesn't get talked about now. But it did slip out at the time and was reported in the South China Morning Post on 9 May 2003.
But Singapore and Toronto didn't marinate, and their mortality was much closer to HK than mainland China.
China was very much the statistical outlier in the SARS dataset, not HK.
Its hard to work out what is happening with all the changing data.
With a dramatic increase in the number of cases in Hubei, the Hubei mortality has decreased from to 3% (in Hubei) and 4.5% (Wuhan city) to about 2.5%
Meanwhile, the mortality outside Hubei is slowly drifting up (from 0.16% to o.38% to 0.47% to 0.52%).
Overall, it may be that these figures are going to converge at about 2% mortality (compared to 0.1% for a bad 'flu season, and perhaps 2.5% for the 1918 "Spanish 'flu").
All of the numbers and assumptions that make sense indicate that 2% is about right. But we are still in the early stages, and once health care systems get overwhelmed then the fatality rate should increase.
I expect that this year's death rate from the flu will be much lower than typical because COVID-19 is going to cull the people most at risk from the flu first.
Has anyone heard any results from the trials of remdesivir? (The Gilead anti-viral fast tracked into clinical trials on coronavirus patients)
I expect that this year's death rate from the flu will be much lower than typical because COVID-19 is going to cull the people most at risk from the flu first.
Has anyone heard any results from the trials of remdesivir? (The Gilead anti-viral fast tracked into clinical trials on coronavirus patients)
Singapore is an affluent and society, with a population of 74.3% Chinese, 13.4% Malay, 9% Indian, and 3% other races. 25% of the population is over 55 years old. Underneath the headlines of prosperity, there is a considerable disparity between the affluent and the poor in the country, but healthcare is available as is education. The details on the critical cases in Singapore will be telling if they become available.
Agreed. Singapore has world class healthcare and are very likely to be transparent with the data.
8 critical / 50 cases with “no discernible pattern” who was critical and “some likely not to survive” was very sobering yesterday.
7 critical / 58 cases today.
reading behind the lines, it seems they are expecting some non-survivors even with plenty of ICU capacity.
If the numbers increase significantly and the system gets overwhelmed, then it could be like Wuhan.
I am struck that China is critical of international quarantine measures, while China internally has employed extreme measures not seen for 500 years (and even with Black Plague, the quarantining of cities was obviously on a much smaller scale).
8 critical / 50 cases with “no discernible pattern” who was critical and “some likely not to survive” was very sobering yesterday.
7 critical / 58 cases today.
reading behind the lines, it seems they are expecting some non-survivors even with plenty of ICU capacity.
If the numbers increase significantly and the system gets overwhelmed, then it could be like Wuhan.
I am struck that China is critical of international quarantine measures, while China internally has employed extreme measures not seen for 500 years (and even with Black Plague, the quarantining of cities was obviously on a much smaller scale).
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Singapore is an affluent and society, with a population of 74.3% Chinese, 13.4% Malay, 9% Indian, and 3% other races. 25% of the population is over 55 years old. Underneath the headlines of prosperity, there is a considerable disparity between the affluent and the poor in the country, but healthcare is available as is education. The details on the critical cases in Singapore will be telling if they become available.
That racial mix is of citizens and permanent residents. It doesn't include the so called "non-residents" who currently constitute about 30% of the people actually living there. Those ~1.7M people are of a quite different racial mix: a load (maybe 300K) of Indonesian and Filipino domestic servants for a start, plus a lot of ethnic Europeans, Indian labourers, etc.
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On today’s data we are back to an additional 4000 cases. If yesterday’s spike is factored in, the additional case numbers average out to around 4000/day for the last ten days or so. Which is itself an oversimplification. Why would the case numbers grow linearly?
Ecce Homo! Loquitur...
You can see wh6 they are flying in thousands of army medics. I wonder how mn6 more they have in reserve.
https://www.bbc.co.uk/news/world-asia-china-51501005
Coronavirus: New China figures highlight toll on medical staff
Chinese officials have given figures for health workers infected with coronavirus, amid concerns about shortages of protective equipment. Six health workers have died and 1,716 have been infected since the outbreak, they said.......
Zeng Yixin, vice minister of China's National Health Commission, said 1,102 medical workers had been infected in Wuhan, where the outbreak began, and another 400 in other parts of Hubei province. He said the number of infections among staff was increasing.
“The duties of medical workers at the front are indeed extremely heavy; their working and resting circumstances are limited, the psychological pressures are great, and the risk of infection is high," Mr Zeng said, quoted by Reuters.
Local authorities have struggled to provide protective equipment such as respiratory masks, goggles and protective suits in hospitals in the area.
One doctor told AFP news agency that he and 16 colleagues were showing possible symptoms of the virus. Another medical worker said she and more than 100 other staff at her hospital had been quarantined. A further 30 had been confirmed to have been infected there out of a staff of 500 she told CNN.......
https://www.bbc.co.uk/news/world-asia-china-51501005
Coronavirus: New China figures highlight toll on medical staff
Chinese officials have given figures for health workers infected with coronavirus, amid concerns about shortages of protective equipment. Six health workers have died and 1,716 have been infected since the outbreak, they said.......
Zeng Yixin, vice minister of China's National Health Commission, said 1,102 medical workers had been infected in Wuhan, where the outbreak began, and another 400 in other parts of Hubei province. He said the number of infections among staff was increasing.
“The duties of medical workers at the front are indeed extremely heavy; their working and resting circumstances are limited, the psychological pressures are great, and the risk of infection is high," Mr Zeng said, quoted by Reuters.
Local authorities have struggled to provide protective equipment such as respiratory masks, goggles and protective suits in hospitals in the area.
One doctor told AFP news agency that he and 16 colleagues were showing possible symptoms of the virus. Another medical worker said she and more than 100 other staff at her hospital had been quarantined. A further 30 had been confirmed to have been infected there out of a staff of 500 she told CNN.......
short flights long nights
I don’t normally prescribe to conspiracy stuff.. but I’m starting to wonder if this thing popped out of a lab somewhere.
Sleep
There is an interesting sidebar at this time on immune responses vs sleep, logically presented on youtube, on medcram.com, update 17.
The presentation makes a good case to sleep behaviour that would cause variations in the outcome from an infection. The variables may be applicable to some of the cases that have been seen so far, making a case that a good nights sleep is desirable. Worth a coffee break to watch and draw your own conclusions. The conclusion that could be drawn from the referenced studies is that an outbreak would have a more adverse outcome in a group that work activity results in poor quality of sleep and a level of sleep deprivation. A hard working workforce would be at risk, say countries that have a concentration on time at work, poor rest conditions and limited time in rest. That may sound like every airline pilot in the world, but the studies make cases that suggest the airline FDL's are beneficial.
The presentation makes a good case to sleep behaviour that would cause variations in the outcome from an infection. The variables may be applicable to some of the cases that have been seen so far, making a case that a good nights sleep is desirable. Worth a coffee break to watch and draw your own conclusions. The conclusion that could be drawn from the referenced studies is that an outbreak would have a more adverse outcome in a group that work activity results in poor quality of sleep and a level of sleep deprivation. A hard working workforce would be at risk, say countries that have a concentration on time at work, poor rest conditions and limited time in rest. That may sound like every airline pilot in the world, but the studies make cases that suggest the airline FDL's are beneficial.
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Multiple flights at Heathrow with suspected Coronavirus passenger
Unsurprising really but quite worrying that eight flights in total have been reported https://www.dailymail.co.uk/health/a...wn-runway.html
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"Put on lockdown".... "Quarantined on the runway"...... All very dramatic hot air that the Daily Mail relies on to sell newspapers. Shame that they don't indulge in some quality journalism.
Perhaps they mean "Port Health were advised of illness on board by the arriving crew as they are required to do under UK law".... Nowhere near enough fear/drama in that line.
Perhaps they mean "Port Health were advised of illness on board by the arriving crew as they are required to do under UK law".... Nowhere near enough fear/drama in that line.
On today’s data we are back to an additional 4000 cases. If yesterday’s spike is factored in, the additional case numbers average out to around 4000/day for the last ten days or so. Which is itself an oversimplification. Why would the case numbers grow linearly?
Yet we're surely all familiar with drink driving advice that the rate of elimination of alcohol from the body is roughly constant at about 0.01%BAC per hour, regardless of how drunk you are.
Why might this be? Why would alcohol level fall linearly?
The answer to both your question and mine is of course that the factor being measured has hit some sort of maximum capacity. Ethanol metabolism has a limited capacity regardless of blood alcohol level.
Confirmed diagnosis rates are quite possibly also limited by the capacity to test and diagnose. If you've got more probable cases than you can test, then you're probably getting a very high rate of confirmed cases, with total confirmed numbers more representative of your capacity to test, not the actual rate of infection.
And indeed the recent spike in reported infections was apparently about a broadening of the diagnostic criteria to capture more actual infections at the cost of certainty by RNA testing that none were false positives.
Yes, I understand that. It was more of a rhetorical question, because the Chinese have already stated that they can only perform 8000 tests/day, that results take two days and that there are many false negatives. Even many of the CDC test kits are faulty (as per their report on 13/2. Given those realities China had no option but to rely on clinical signs for a diagnosis and a more accurate data set.
However, given the slow incubation period and the relatively modest 2+% fatality rate, this is in no wise a weaponized virus, rather it may have been a research study item.
Fwiw, the best estimates are that it started with a single infection, whether from an animal or from an accidental release, sometime in late November 2019. Since then, it has been transmitted from person to person.
See: https://nextstrain.org/ncov
The inept response of the political leaders in the affected area allowed the virus to spread.