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WHO declares coronavirus outbreak a public health emergency

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Re: WHO declares coronavirus outbreak a public health emergency

#151

Post by alamortsubite »

alamortsubite wrote: post #88
arkadiyt wrote: post #47

Earlier quoted context omitted.

Here are some graphs showing exactly that: https://ncov.r6.no/ It's also worth noting that the ~8k confirmed cases are bottlenecked by how fast China can perform tests. Here's an article guesstimating that there were up to 100k infections a few days ago: https://www.theguardian.com/science/2020/jan/26/coronavirus-...

> It's also worth noting that the ~8k confirmed cases are bottlenecked by how fast China can perform tests. Do you have more info on this? I thought the test was a simple swab deal that a country like China could crank through like nobody's business. Like, at least for a few more orders of magnitude.

Replying to myself, this article linked in a sibling comment discusses the issue: https://edition.cnn.com/2020/01/30/asia/chinese-health-care-...

Re: WHO declares coronavirus outbreak a public health emergency

#152

Post by mrb »

goblin89 wrote: post #130
mrb wrote: post #118

Earlier quoted context omitted.

Ignore the people telling you it's 2-3%. The case fatality ratio is between 9 and 56% according to proper epidemiological methods, such as using the formula "deaths / (deaths + recoveries)": https://mobile.twitter.com/zorinaq/status/122242770872387993... Disclosure: no I'm not an epidemiologist. But for a reference to a paper by actual epidemiologists see https://pdfs.semanticscholar.org/ebf2/48c9fc0a1a23d1778b9408..…

If hospitals err on safe side and do not report recoveries promptly (they probably have other business to deal with), applying this method at such early stage would not result in correct numbers, even supposing the virus is well-studied enough to tell when a patient has recovered.

Agreed, when using the "deaths / (deaths + recoveries)" formula, recoveries being under-reported is possible and would skew the CFR upward. But also, if deaths are under-reported in the same proportion as recoveries, then it would not affect the CFR.

I suppose one way to reduce uncertainty is to examine a cohort of patients and follow it meticulously. To do that, we can look at the 99-patient case study published in The Lancet yesterday: https://www.thelancet.com/journals/lancet/article/PIIS0140-6... 11 died, 31 were discharged, and 57 remain in the hospital. This suggests a CFR of 11/(11+31) = 26% The assumption epidemiologists make when they use this formula is that the 57 still in the hospital have the same chance of dying as those who already died in the hospital.

Re: WHO declares coronavirus outbreak a public health emergency

#153

Post by Accujack »

reaperducer wrote: post #41
splittingTimes wrote: post #13

How is this worse than your normal influenza cycle with 3-5Mio infections and 290k-650k death to warrant such an emergency?

People keeps saying things like, "Yeah, well last year way more people died of the flu!" Yeah, well that was an entire year . This is a few weeks. The goal is to get ahead of things, not to wait until it's too late.

More importantly, the flu has a vaccine. New versions of it are released each year according to what health organizations think will be the dominant variants.

The new virus has no vaccine.

Re: WHO declares coronavirus outbreak a public health emergency

#154

Post by staticautomatic »

throwanem wrote: post #149
staticautomatic wrote: post #136

Earlier quoted context omitted.

That may well be the case. I don't have any firsthand knowledge of the process. Do you?

Do you have a strong prior for large bureaucracies, especially at their interfaces with one another, not being sluggish? If so, how do you come by it? If not, whence comes the doubt whose benefit you seem so anxious to give?

My comment is rooted in a general reluctance to make assumptions about things that have empirical or theoretically provable answers, particularly ones that could be obtained without much effort. Some people call it "science."

Re: WHO declares coronavirus outbreak a public health emergency

#155

Post by underwater »

btilly wrote: post #138
jcfrei wrote: post #127

Earlier quoted context omitted.

There have been quite a few cases covered in the press about patients which carried the virus but didn't show any symptoms. Most recently: https://asia.nikkei.com/Spotlight/Coronavirus-outbreak/Three...

Thanks. If they in fact can't transmit, then this is OK. If they can or, even worse, have a long latency period and will show symptoms in 2 weeks, that is very, very scary. Our best tool for diseases like this is contact tracing. And asymptomatic carriers make that very hard. (Useless trivia, the first documented asymptomatic carrier who was infectious was a short order cook named Mary Mallon. She is better known as…

She wasn't a short order cook, she cooked for a number of families.

Re: WHO declares coronavirus outbreak a public health emergency

#156

Post by Accujack »

splittingTimes wrote: post #13

How is this worse than your normal influenza cycle with 3-5Mio infections and 290k-650k death to warrant such an emergency?

Because:

* Coronavirus has no vaccine

* Coronavirus infected can be contagious for longer than flu patients

* The longer incubation period means more chances for people to get sick, especially since the disease comes on gradually. People will think they have an ordinary cold, go to work, and infect people.

* We understand the progression of the flu in most variants. We don't know all the effects of the Coronavirus, we just have descriptions of the symptoms.

* Flu is basically everywhere already, Coronavirus is not. It's not a choice between one or the other, it's a choice between one or both. If we could declare an emergency and have some chance of stopping flu from getting to some part of the population, we would.

* People with compromised immune systems like the elderly, or babies, or people with existing illnesses or lung problems know to avoid people infected with influenza. Since it's possible for people capable of infecting others with Coronavirus to not even know they carry it, it's harder to avoid for those vulnerable to it.

It's much cheaper to respond to a virus like this in early stages than it is to wait until we see "how serious" it is. All in all, getting things moving now is a good idea.

Re: WHO declares coronavirus outbreak a public health emergency

#157

Post by ufov2 »

chupa-chups wrote: post #69
renton wrote: post #51

Earlier quoted context omitted.

I'm still not sure I understand this. If US alone has ~60k deaths from the flu a year, that still works out to be much more (1153 deaths per week).

https://en.m.wikipedia.org/wiki/Exponential_function

The reported confirmed counts have grown by a factor of ~1.5 every day, fitting reasonably well with exponential growth. If this rate continued, in 35 days it would reach the world population. Obviously, in the real world the growth flattens out way earlier, from natural causes, and especially because of the attempts to confine it.

Comparing the total number of cases or deaths to flu outbreaks from previous years does not make much sense at this point, when the numbers are growing rapidly, but in a month they probably are easier to compare. Neither does comparing average counts per week, because the growth is not linear. The data for the progression of flu (or any other disease) outbreaks exists, and comparing to their growth rate would put it better in perspective. Regardless of armchair analysis, the WHO declaration means it's something requiring unusual action, which flu is not.

Re: WHO declares coronavirus outbreak a public health emergency

#158

Post by starpilot »

mrtksn wrote: post #109
michalu wrote: post #79

Also good real-time chart: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h... tracks confirmed cases and recoveries too.

>Last Update: Jan 30, 2020 11 am EST. It is not a real-time map, I find it bizarre that people believe that we can track the population's wellbeing in real-time. Are you ready to be hooked up to such a system?

Nothing is real time due to the finite speed of light.

Re: WHO declares coronavirus outbreak a public health emergency

#159

Post by mrb »

baq wrote: post #125
mrb wrote: post #118

Earlier quoted context omitted.

Ignore the people telling you it's 2-3%. The case fatality ratio is between 9 and 56% according to proper epidemiological methods, such as using the formula "deaths / (deaths + recoveries)": https://mobile.twitter.com/zorinaq/status/122242770872387993... Disclosure: no I'm not an epidemiologist. But for a reference to a paper by actual epidemiologists see https://pdfs.semanticscholar.org/ebf2/48c9fc0a1a23d1778b9408..…

couldn't believe these numbers, read the link. correctness is obvious in retrospect, numbers are trivial to calculate by hand by just looking at daily data. still can't believe them.

"Just looking at daily data" is your mistake. Essentially, it takes N days for the virus to kill, so deaths will lag confirmed cases by N days, and thus the calculated case fatality rate using this method is incorrect. This is why epidemiologists call it a "naïve esimator" (see section 3.1 in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4540071/).

Re: WHO declares coronavirus outbreak a public health emergency

#160

Post by 2019-nCoV »

jcfrei wrote: post #101
2019-nCoV wrote: post #83

Earlier quoted context omitted.

It's currently 171 deaths, 8,288 confirmed infected, which is 2% dead. However, what needs to be taken into consideration is that infected individuals don't die the day they are confirmed infected, there is a lag of several days. Assuming the average time from symptom onset and diagnosis to death is 7 days, we're looking at at 20% death rate (830 confirmed infected 1 week ago). Even a 5 day lag between symptom onset…

I'm not an expert on viruses by any means but that seems unnecessarily pessimistic. The number of infections is likely much much higher than the confirmed cases (laboratories have only so many test kits available per day) but most people stay asymptomatic. This would reduce the actual mortality rate, not increase it.

If indeed most people stay asymptomatic (but contagious), you're right that the actual mortality rate is lower. But this same outlook would translate to an increase in total fatalities as it greatly complicates containment.
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