Just curious, anyone have a plan, or preps for global pandemic?

[Sibiriak]

 

10 hours ago, BrianA said:

WHO now estimates average death rate is 3.4%

 

According to the WHO, Coronavirus Is WORSE Than the Spanish Flu

Quote

 

[...]  According to the Director of the US Centers for Disease Control and Prevention, the Director of the National Institute of Allergy and Infectious Diseases and others, Coronavirus can be spread even when people have no symptoms. On the one hand, this is bad news, as it is very hard to screen and locate carriers when they are symptom-free or have only mild, cold or flu-like symptoms.  On the other hand, this means that the real R0 might be much higher than WHO estimates … which would make the mortality rate lower.

If the number of people with Coronavirus is a lot higher than is being reported, that means the mortality is a lot lower … i.e. a smaller percentage of the larger population of people infected have died.  

Indeed, China only tests a portion of those who are really sick, and the United States has tested less than 500 people total for Coronavirus (American doctors have to beg to get their sick patients tested).

So far, WHO has rejected the theory that there are more people who have Coronavirus than reported:

One of the hopes of people watching China’s coronavirus outbreak was that the alarming picture of its lethality is probably exaggerated because a lot of mild cases are likely being missed.

But on [February 25th], a World Health Organization expert suggested that does not appear to be the case. Bruce Aylward, who led an international mission to China to learn about the virus and China’s response, said the specialists did not see evidence that a large number of mild cases of the novel disease called Covid-19 are evading detection.

But one can’t assess whether mild cases are being missed without a widespread testing program.  Especially since many cases are mild, and some cases are wholly asymptomatic.

The bottom line is that we don’t yet have the core data we need to determine how lethal the Coronavirus is.

 

 

[Sibiriak]

 

 

Quote

 

Stephen The Tech Critic

March 4, 2020 at 6:15 am

When it comes to estimating mortality, I think it’s helpful to keep in in mind the concept of multiple tiers and required care at each tier. My numbers here are very roughly derived from case report data from a handful of sources. Uncertainties are large here, and I mostly just want to illustrate the point.

First, we are told that around 80% of cases are “mild”. Mild means that they don’t require hospitalization to recover. That’s “tier zero” as it requires no significant health-care resources.

About 20% of cases, require a hospital bed and supplemental oxygen. About 3 in 4 of these cases (15% of total) recover without additional measures, and these “serious” cases make up “tier one”.

This implies about 5% of cases need mechanical ventilation. About 3 in 4 of these cases (3.75% of total) will recover without additional measures, and these “severe” cases make up “tier two”.

About 1.25% of cases need extreme measures that can only be delivered in highly equipped ICUs. About 3 in 4 of these cases will survive (although they can tie up other hospital resources for many weeks), and these “critical” cases make up “tier three”.

Finally, even with all resources brought to bear, some small fraction of cases (like 0.3%???) still die anyway (“tier 4”).

Like I said, all these numbers are uncertain, but you can see how resource shortages at each tier are likely to impact mortality variance from region-to-region, and how reducing the spread of the disease through containment measures can make a huge impact on the number of lives lost. Of course if the whole point is to keep the hospitals from overflowing, whatever containment measures are necessary are likely to have to remain in place for a long time with such a contagious disease.

 

 

[Sibiriak]

Virus has mutated into two strains

Quote

 

The latest findings of Chinese scientific researchers allegedly show that new coronavirus has recently generated 149 mutation points and has evolved into an L subtype and an S subtype (see map below).

The study found that the two subtypes showed significant differences in geographical distribution and population spread.

The S subtype is a relatively older version, while the L subtype is “more aggressive and more contagious”  [...]

 

[Ron Put]

Here are the fatality rates of coronavirus for every age bracket — and they vary widely

A recent study from the Chinese Center for Disease Control and Prevention (CDC) analyzing 72,314 coronavirus cases in mainland China found that while about 80 percent of cases are mild, the virus poses the greatest threat to elderly people with preexisting health issues. 

The research shows patients older than the age of 80 had a 14.9 percent chance of dying after being infected, while those in their 70s were found to have an 8 percent chance of death. Patients in their 50s were about three times more likely to die than patients in their 40s, at a rate of 1.3 percent. 

Patients ages 10 to 19 were as likely to die as patients in their 30s, at just 0.2 percent. The study did not report any deaths in children younger than 10, who represented less than 1 percent of patients. 


And this is just as a broad reference:

Flu Pandemic Morbidity / Mortality

[mccoy]

There is not agreement between the official data as just broadcasted by Italian media (2710 confirmed cases today) and the data displayed in the worldometer (3089 confirmed cases today). Deaths are very, very few in S. Korea. Iran is going to reach Italy soon and maybe go on top of it on the list. 

 

[Todd Allen]

According to https://corona.help/ the US now has had 154 cases with 11 fatalities putting us at a mortality rate in excess of 7%.  Looks to me like another example of the US being the exceptional nation.  USA!  USA!  USA!

[BrianA]

The fatality rate in US is simply a statistical error due to how few people continue to be tested here compared to some other countries like South Korea.

 

Here's another study on how curcumin can prevent lung damage in severe lung infections in mice. Dose used was 50 mg/kg, not sure how to translate that to humans. The most severe cases of this virus in China are showing lung fibrosis on autopsy: https://www.globaltimes.cn/content/1181121.shtml

 

Curcumin Modulates the Inflammatory Response and Inhibits Subsequent Fibrosis in a Mouse Model of Viral-induced Acute Respiratory Distress Syndrome

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577717/

[BrianA]

Possible evidence emerging from China research that the virus fairly often involves some level of nervous system infection:

 

Chinese doctor discovers novel coronavirus in patient's cerebrospinal fluid

https://www.globaltimes.cn/content/1181630.shtml

"It said that 30 percent of the 214 patients the team studied showed symptoms in their nervous systems and the rate is even higher in critical patients at 45.5 percent."

[Sibiriak]

Quote

 

The US death toll from coronavirus has climbed to 11 as California reported its first fatality and declared a state of emergency over the virus.

The death in California was of an elderly man with underlying health issues, who tested positive for the virus on Tuesday and was probably exposed while traveling on a Princess cruise ship that departed from San Francisco to Mexico in February, public health officials said.

It was the first death from the outbreak in the US outside of Washington state.

The man lived in Placer county, an area north-east of Sacramento, near Tahoe national forest, and was kept in isolation at Kaiser Permanente Roseville. It was the second confirmed case of coronavirus in the county.

California governor Gavin Newsom declared a state of emergency over the virus on Wednesday. In a statement, Newsom said he extended “deepest condolences” to those affected by the death in Placer county and that “California is working around the clock to keep our communities safe, healthy and informed”.

 

 

[Todd Allen]

9 hours ago, BrianA said:

The fatality rate in US is simply a statistical error due to how few people continue to be tested here compared to some other countries like South Korea.

This seems most likely but currently there is no other country with stats as much in error and it begs the question why have we been testing so few people?

[Sibiriak]

Lots of articles on the shortage of testing kits in the U.S.    For example:

The United States badly bungled coronavirus testing—but things may soon improve

Trump attempts to blame Obama for coronavirus test kit shortage

 

 

Edited March 5, 2020 by Sibiriak

[Gordo]

COVID-19 Isn’t As Deadly As We Think

[Sibiriak]

Thanks Gordo.   Good article. 

[Ron Put]

The Slate article Gordo posted makes perfect sense. It's very likely that the infection rate is significantly higher than reported, partially because of limitations in the testing methods and partially because there is political pressure on governments to show action and success, even if their information is inaccurate, and if they are aware of such inaccuracies. While liberal democracies often wash their dirty laundry in public, this is not the case for authoritarian states such as China or some of its neighbors.

Test kits appear to have some significant shortcomings, which means that a significant number of carriers are not detected. CT scans appears to be more accurate, but such equipment is less readily available in poorer countries:

"About 60% tested positive with the RT-PCR, but 88% with chest CT scan. Of this 60%, it is possible to pick up 97% of cases using chest CT alone. Moreover, when the RT-PCR test is negative, the positive chest CT scan made it possible to pick up approximately 300 more patients who were very likely to have the infection, and 33% of these were thought to have COVID-19 infection.

Among the RT-PCR negative patients, 75% showed chest CT findings, which suggested COVID-19 infection. In all, there were about 900 patients with positive chest CT findings, with an average age of 60 years. Just over 300 of them had positive chest CT findings but negative RT-PCR results. Of these patients, 83% showed characteristic lung signs.

About half of these were highly likely cases, and another third probable cases – which means that, in the words of the author, “About 81% of the patients with negative RT-PCR results but positive chest CT scans were re-classified as highly likely or probable cases with COVID-19.”
https://www.news-medical.net/news/20200227/Chest-CT-scan-best-for-coronavirus-diagnosis.aspx

[Gordo]

Looks like big trouble in the UK, look how spread out it is!

 

There is also some emerging evidence that China has been faking their recovery.

 

 

Edited March 5, 2020 by Gordo

[Clinton]

The kill rate is really low so why do healthy people gaf?

Edited March 6, 2020 by Clinton

[BrianA]

According to this note supposedly from a Milan doctor, there roughly 10% of all positive patients are ending up in the ICU. Perhaps due to older typical average age of Italians?

 

https://mailchi.mp/esicm/the-future-of-haemodynamic-monitoring-first-webinar-of-the-year-1009715?e=[UNIQID]

[mccoy]

On 3/4/2020 at 9:52 PM, mccoy said:

There is not agreement between the official data as just broadcasted by Italian media

OK, I realized the cause of such discrepancies. The Italian media (and probably everyone else), of course, broadcast the active cases, whereas the first column in the worldometer reports the total cases since the inception of the epidemics.

[mccoy]

7 hours ago, Clinton said:

The kill rate is really low so why do healthy people gaf?

Mainly communication, which triggers pristine instincts. Unknown virus, the plague. No defense, no vaccine, first time ever the human being has been exposed to it. Survival instinct. 

For example, in Italy, more and more truckers have been reported to refuse to drive into the quarantined areas. 

One more reason: uncertainty. I am so sure I won't be affected by the SARS-COV-2. I laugh at it. But I cannot neglect the lurking thought that I really don't know, my immune system may have a glitch which won't allow those antigens to be readily produced.... Who really knows, until I catch the bug? The first patient confirmed in the quarantined areas in Italy is 38 and was pretty fit, practicing a few sports. Now he's in intensive care.

[mccoy]

3 hours ago, BrianA said:

According to this note supposedly from a Milan doctor, there roughly 10% of all positive patients are ending up in the ICU. Perhaps due to older typical average age of Italians?

Probably so. Also, fatalities are in the range of 5% of confirmed cases, which is a very high percentage, relative to the official death ratio of SARS-COV-2 of about 2.5%.

The fact that the real death ratio is lower than the official numbers was clear from the beginning. But none really knows, nor will ever know probably the real death rate. The Diamond Princess case may give us an estimate which presently might be the most reasonable one, although there may be more variables that govern the spreading.

Confirmed cases now, at least in Italy, must have had some serious symptoms. So the death ratio is the number of deaths relative to the cases which are tested and confirmed according to the official state protocol for testing. 5% would decrease to how much? A reasonable upper bound is half of it, 2.5%. A reasonable lower bound could be one tenth, 0.5%. The real numbers for the general population are probably closer to the lower bound. But as already discussed at length, if we break down the age classes and the healthy and not so healthy individuals, the ratios will diverge so much that maybe young and healthy will plummet to a 0.05 to 0.01 death ratio...

The above figures are of course all wild guesses.

 

But there is an additional factor which may contribute to increase significantly death ratios: overflow of the health system and especially so the IC system.

I don't know if western countries will come to that, but in the affected areas in Italy medical staff is already not enough. No intensive care and serious respiratory insufficiency mean a high probability of death.

 

Edited March 6, 2020 by mccoy

[Sibiriak]

10 hours ago, Clinton said:

The kill rate is really low so why do healthy people gaf? 

Apart from the fact that you might be concerned  about the fate of vulnerable individuals and societies (the head of the UN World Food Program warned of  possible absolute devastation as the outbreak's effects ripple through Africa and the Middle East):

If you become infected (or think you have)

1)  Several weeks of mild-moderate symptoms is not fun.

2) There's still the chance you might end up in a hospital (dangerous place).

3) You will be ethically compelled to self-isolate for 3-4 weeks or more (not easy).

4) You could get caught up in a quarantine or lock down.

 

Even if you don't become infected

1) You will probably want to take steps to avoid infection which may be inconvenient/costly, and your life will be restricted in various ways.

2) Normal  provision of healthcare, policing and other social services etc are  under great stress, affecting everyone.  School closures may soon become widespread. Etc.

2) Governments and international organizations will be spending  colossal sums of money to combat the virus and deal with the social disruption (your tax dollars).

3) The pandemic will put the global economy under enormous pressure, with all kinds of unforeseeable  consequences.

4) The experience of the pandemic will  push societies toward increasingly authoritarian surveillance structures and restrictions on individual freedoms.

Edited March 6, 2020 by Sibiriak

[mccoy]

Sibiriak, the list is pretty exhaustive. All kinds of schools are already closed in Italy. That brings about the problem of young boys and girls at home, if both parents are working, then someone else must be called to look after them.  The government is about to allow one parent to do that, but without a salary, you just save your job. This is just one example of the many possible effects.

In the meanwhile, Iran has gone on top of Italy, as foreseeable,  probably because of a non-optimal healthcare system.

 

[Todd Allen]

13 hours ago, Clinton said:

The kill rate is really low so why do healthy people gaf?

My wife's parents are 91 and 88.  Neither drive and we give them an hour or two of assistance weekly for things they find challenging.  My wife is concerned about her potential exposure as a school teacher to colds and flus and now this virus too and bringing any of them to her parents.  While she sometimes expresses frustration with some of their self inflicted issues such as excessive alcohol consumption, poor exercise habits, poor dietary choices, past history of heavy smoking, etc. she doesn't like the thought of potentially being the vector of their premature demise.

[mccoy]

Another drawback which is occurring in Italy: a few hospitals have been closed because of infected medical staff. Totally closed until all the staff will be tested. In the meanwhile, people are being directed elsewhere, further from their place. It is a time when it's better not to get injured.

[mccoy]

So far, deceased people in Italy have ages from 62 to 95.