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Clinical features of patients infected with 2019 novel coronavirus

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Re: Clinical features of patients infected with 2019 novel coronavirus

#41

Post by ealexhudson »

danieltillett wrote: post #35
azalemeth wrote: post #28

> "Suspected patients were isolated using airborne precautions in the designated hospital, Jin Yin-tan Hospital (Wuhan, China), and fit-tested N95 masks and airborne precautions for aerosol-generating procedures were taken. > This study was approved by the National Health Commission of China and Ethics Commission of Jin Yin-tan Hospital (KY-2020-01.01). > Written informed consent was waived by the Ethics Commission o…

Serious this sort of thinking is what will kill hundreds of millions of people. We are not dealing with a couple of stubbed toes or hurt feelings here, but a novel deadly virus that is out of control. This is a war situation.

"A war situation" is precisely when you need this sort of thinking: the modern ethical framework for medical research with interventions is heavily influenced by "The Nuremberg Code". I don't think we need to describe in detail why people thought that code was necessary.

In most of these cases, it is highly unlikely that any significant number of the patients will withhold their consent: so to not ask it is basically saying "we can't be bothered", there's no obvious scientific basis for such a waiver. When patients are incapacitated there are equivalent frameworks which take their personal circumstances into consideration.

Re: Clinical features of patients infected with 2019 novel coronavirus

#42

Post by dragonwriter »

tedk-42 wrote: post #38
azalemeth wrote: post #37

Earlier quoted context omitted.

Isolation measures and obtaining information are clearly important; so too is acting ethically, and I would argue that it is _precisely_ these sort of circumstances that should prompt us to consider this. And, owing to selection bias in the cases presented, the death rate of this coronavirus is likely far lower than hyped.

Wow this is the first I've heard of the infection and death rate being 'lower than hyped'. I do believe it's troubling times for everyone near this virus and we need as much information of the virus as possible. This is going past a regular 'patient confidentiality' line and into a 'prevent a possible disaster from occurring by getting on top of it soon'.

> Wow this is the first I've heard of the infection and death rate being 'lower than hyped'.

GP only said the death rate was lower (which necessarily means the infection rate is higher, not lower, assuming all the deaths used in the reported rate are real deaths associated with the disease of concern.)

Re: Clinical features of patients infected with 2019 novel coronavirus

#43

Post by koalala »

nnq wrote: post #9

It would be interesting to see less accurate statistics on the total CURRENT number of cases rather than this OLD NEWS. Cool for whoever published that, but we need more focus on speed of information dissemination, even prioritising it over accurracy, we're moving at pre-Internet pace here or someone is actively hindering the flow of info...

BNO News is tracking the numbers and updating every 30 mins or faster it seems. https://bnonews.com/index.php/2020/01/the-latest-coronavirus...

Re: Clinical features of patients infected with 2019 novel coronavirus

#44

Post by raxxorrax »

danieltillett wrote: post #35
azalemeth wrote: post #28

> "Suspected patients were isolated using airborne precautions in the designated hospital, Jin Yin-tan Hospital (Wuhan, China), and fit-tested N95 masks and airborne precautions for aerosol-generating procedures were taken. > This study was approved by the National Health Commission of China and Ethics Commission of Jin Yin-tan Hospital (KY-2020-01.01). > Written informed consent was waived by the Ethics Commission o…

Serious this sort of thinking is what will kill hundreds of millions of people. We are not dealing with a couple of stubbed toes or hurt feelings here, but a novel deadly virus that is out of control. This is a war situation.

Nothing about this is a war situation. This just reads like reactionary fear mongering.

Re: Clinical features of patients infected with 2019 novel coronavirus

#45

Post by danieltillett »

ealexhudson wrote: post #41
danieltillett wrote: post #35

Earlier quoted context omitted.

Serious this sort of thinking is what will kill hundreds of millions of people. We are not dealing with a couple of stubbed toes or hurt feelings here, but a novel deadly virus that is out of control. This is a war situation.

"A war situation" is precisely when you need this sort of thinking: the modern ethical framework for medical research with interventions is heavily influenced by "The Nuremberg Code". I don't think we need to describe in detail why people thought that code was necessary. In most of these cases, it is highly unlikely that any significant number of the patients will withhold their consent: so to not ask it is basically…

There is nothing to suggest that any patient has withheld consent, just that the requirement to get consent in written form was waived. Given how sick these patients were this is reasonable.

Time is of the essence here. If I was put in the situation these researcher are in I would act first and take the risk of being put on trial later. Real ethics means sometimes you have to do more than just follow rules.

Re: Clinical features of patients infected with 2019 novel coronavirus

#46

Post by danieltillett »

raxxorrax wrote: post #44
danieltillett wrote: post #35

Earlier quoted context omitted.

Serious this sort of thinking is what will kill hundreds of millions of people. We are not dealing with a couple of stubbed toes or hurt feelings here, but a novel deadly virus that is out of control. This is a war situation.

Nothing about this is a war situation. This just reads like reactionary fear mongering.

...and exactly how do you know this?

Re: Clinical features of patients infected with 2019 novel coronavirus

#47

Post by spats1990 »

simongray wrote: post #34
ronnie_fr3 wrote: post #31

Earlier quoted context omitted.

and that's why the West is decaying. Who cares about your morals when there's an epidemic ?

> and that's why the West is decaying. Who cares about your morals when there's an epidemic ? This kind of bait is not needed on Hacker News. Keep that on reddit or facebook or whatever.

In fairness, the GP is bait too. It's just more thoughtful bait with paragraph breaks. It's basically elegant finger wagging.

Decay of the west bit aside, the parent has a point. Do you freak patients out by getting them to sign things when they are already in quarantine and fearing for their lives? Or do you prioritise research and response?

related: "Conducting Research in Disease Outbreaks" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669128/

Re: Clinical features of patients infected with 2019 novel coronavirus

#48

Post by jiofih »

azalemeth wrote: post #28

> "Suspected patients were isolated using airborne precautions in the designated hospital, Jin Yin-tan Hospital (Wuhan, China), and fit-tested N95 masks and airborne precautions for aerosol-generating procedures were taken. > This study was approved by the National Health Commission of China and Ethics Commission of Jin Yin-tan Hospital (KY-2020-01.01). > Written informed consent was waived by the Ethics Commission o…

What is terrifying is the thought of treatment of those very patients, and prevention/cure for the rest of the world being held back by selfish concerns like yours. Can’t wait for the new pleghma privacy law!

Re: Clinical features of patients infected with 2019 novel coronavirus

#49

Post by jiofih »

raxxorrax wrote: post #44
danieltillett wrote: post #35

Earlier quoted context omitted.

Serious this sort of thinking is what will kill hundreds of millions of people. We are not dealing with a couple of stubbed toes or hurt feelings here, but a novel deadly virus that is out of control. This is a war situation.

Nothing about this is a war situation. This just reads like reactionary fear mongering.

Nothing indeed; besides China having put 20m+ people on lockdown, 5m having fled the cities possibly carrying the virus, it having already reached Europe, the US and Australia, doctors on the ground reporting over 100k infected, and the fatality count racing past the hundreds. Enjoy your breakfast.

Re: Clinical features of patients infected with 2019 novel coronavirus

#50

Post by DanBC »

jiofih wrote: post #48
azalemeth wrote: post #28

> "Suspected patients were isolated using airborne precautions in the designated hospital, Jin Yin-tan Hospital (Wuhan, China), and fit-tested N95 masks and airborne precautions for aerosol-generating procedures were taken. > This study was approved by the National Health Commission of China and Ethics Commission of Jin Yin-tan Hospital (KY-2020-01.01). > Written informed consent was waived by the Ethics Commission o…

What is terrifying is the thought of treatment of those very patients, and prevention/cure for the rest of the world being held back by selfish concerns like yours. Can’t wait for the new pleghma privacy law!

The concern is not about privacy, but about forced treatment against your will.

That's a big deal, and most countries have strict law in place to stop it happening in most situations. There are some exceptions for people who are unable to make that choice, but this is limited to people who are not conscious, or who have severe learning disability, or who are currently severely mentally ill.

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