WHO declares coronavirus outbreak a public health emergency • Hacker News Board

Re: WHO declares coronavirus outbreak a public health emergency

#191

Post by cyphar » Thu, Jan 30, 2020, 11:26 PM UTC

akiselev wrote: post #128

wyldfire wrote: post #99

Stupid question: is it possible that hygiene practices contribute to outbreaks like this? I remember reading or hearing that one input to recent wildfires was the fact that decades of controlled burns to limit the spread of wildfires left a lot of available fuel that otherwise would have burned naturally. So in that vein, do we have humans with compromised immunity thriving but susceptible to inter-species mutations…

I think you're remembering the fire bit backwards. A lack of controlled burns due to discontinuation of indigenous practices and budget cuts combined with increased fire fighting (preventing natural burns) caused fuel to build up in forests that would have burned away in smaller fires. Many plants in Australia are actually adapted to frequent fires like the eucalyptus tree whose oils ignite during fires to wipe out a…

In Australia, a larger factor is that cotton farmers have literally been stealing water from the Murray-Darling catchment system, resulting in the entire bush becoming much drier for the past decade.

Re: WHO declares coronavirus outbreak a public health emergency

#192

Post by [deleted] » Thu, Jan 30, 2020, 11:34 PM UTC

svara wrote: post #82

mrb wrote: post #35

It's about time... All early characteristics of the novel coronavirus indicate it's far more dangerous than SARS/MERS/seasonal flu (which kills 30-60k/year in the US) so, unless a cure is found soon, we should expect it to kill more people than these other diseases combined : https://mobile.twitter.com/zorinaq/status/122263149332482867...

I think it would be more helpful to cite actual epidemiology research and public health professionals rather than people who seem to use people's fears to garner attention. Edit: In order to make this a little less dismissive, the actual argument in that Twitter post is that due to lag between first symptoms appearing and death, you can't divide fatalities by total cases to get the mortality rate, and should instead…

[deleted]

Re: WHO declares coronavirus outbreak a public health emergency

#193

Post by mhandley » Thu, Jan 30, 2020, 11:35 PM UTC

svara wrote: post #82

mrb wrote: post #35

It's about time... All early characteristics of the novel coronavirus indicate it's far more dangerous than SARS/MERS/seasonal flu (which kills 30-60k/year in the US) so, unless a cure is found soon, we should expect it to kill more people than these other diseases combined : https://mobile.twitter.com/zorinaq/status/122263149332482867...

I think it would be more helpful to cite actual epidemiology research and public health professionals rather than people who seem to use people's fears to garner attention. Edit: In order to make this a little less dismissive, the actual argument in that Twitter post is that due to lag between first symptoms appearing and death, you can't divide fatalities by total cases to get the mortality rate, and should instead…

The rates for Chinese provinces except for Hubei seem inconsistent with 20-56% mortality too. The ten provinces outside Hubei that have the most confirmed infections are:

* Zhejiang: 428 confirmed; 0 deaths; 4 recovered

* Guangdong: 354 confirmed; 0 deaths; 10 recovered

* Henan: 278 confirmed; 2 deaths; 2 recovered

* Hunan: 277 confirmed; 0 deaths; 2 recovered

* Anhui: 200 confirmed; 0 deaths; 2 recovered

* Chongqing: 182 confirmed; 0 deaths; 1 recovered

* Jiangxi: 162 confirmed; 0 deaths; 5 recovered

* Shandong; 158 confirmed; 0 deaths; 1 recovered

* Sichuan: 142 confirmed; 1 deaths; 1 recovered

* Jiangsu; 129 confirmed; 0 deaths; 1 recovered

Although there's a clearly a lag between confirmed cases and death, there's likely to be less lag in outcomes between patients who recover and patients who die.

On this admittedly small sample, we get 29 recovered and 3 deaths, or about a 10% death rate. That's still pretty high, but it's nowhere near the 20-56% death rate.

If people go from being infected to dying more quickly than they go from being infected to being declared to have recovered, then that would lower the rate. The recovered rate seems to have been increasing faster than the death rate in the last couple of days, which might indicate this is the case. In addition, these cases obviously only include patients who present with symptoms. If some people are asymptomatic, that would also lower the death rate.

Re: WHO declares coronavirus outbreak a public health emergency

#194

Post by hnick » Thu, Jan 30, 2020, 11:37 PM UTC

akiselev wrote: post #128

wyldfire wrote: post #99

Stupid question: is it possible that hygiene practices contribute to outbreaks like this? I remember reading or hearing that one input to recent wildfires was the fact that decades of controlled burns to limit the spread of wildfires left a lot of available fuel that otherwise would have burned naturally. So in that vein, do we have humans with compromised immunity thriving but susceptible to inter-species mutations…

I think you're remembering the fire bit backwards. A lack of controlled burns due to discontinuation of indigenous practices and budget cuts combined with increased fire fighting (preventing natural burns) caused fuel to build up in forests that would have burned away in smaller fires. Many plants in Australia are actually adapted to frequent fires like the eucalyptus tree whose oils ignite during fires to wipe out a…

It's not always a lack of funding or will (though that's not helping). Burns can only be done when it's safe to do so. There are fewer safe days in recent years.

An additional worry is that northern and southern fire seasons will overlap, leading to a global strain on shared resources.

Re: WHO declares coronavirus outbreak a public health emergency

#195

Post by lgl » Thu, Jan 30, 2020, 11:37 PM UTC

dpark wrote: post #90

treis wrote: post #60

Earlier quoted context omitted.

Viruses tend to become less deadly as they spread because dead people don't spread disease. Typically it mutates slightly into a less deadly strain. Then that strain spreads more quickly and gives the population some level of immunity against the more deadly one.

This sounds like extremely wishful thinking. Is there some support for this claim?

Yes, it's called evolution. But since this is hn, here're a few articles/papers on the subject.

https://evolution.berkeley.edu/evolibrary/news/071201_adenov...

https://www.pnas.org/content/pnas/early/2014/11/26/141333911...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639916/pdf/896...

http://hedrick.ucsd.edu/BICD136/PDF-links/Galvani-Epid-evol....

Re: WHO declares coronavirus outbreak a public health emergency

#196

Post by kevinstubbs » Thu, Jan 30, 2020, 11:44 PM UTC

parliament32 wrote: post #186

wolco wrote: post #183

Earlier quoted context omitted.

No information is available real time. There will always be a lag even with stock trading. Determining what is acceptable for real time depends on the context. A few seconds would be unacceptable for stock information but would be more than enough for a 911 real time notification system to first responders. 12 hours for global viral outbreak stats seems acceptable for real time status.

There's a difference between latency and delay. If I "touch a.txt" then run "ls", and see "a.txt", I'd consider my filesystem realtime. There's no point in being pedantic about "but there's a 50ms delay when I hit enter after typing ls so it's not realtime!!!". "Realtime virus outbreak" implies that the site is somehow automatically identifying where the virus is and updating it's stats, rather than waiting for a hum…

Since "implies that the site is somehow automatically identifying where the virus is" is obviously impossible with current tech & infrastructure, the next most "real-time" interpretation is that it has the most up-to-date data as it becomes available... which it basically does AFAIK, assuming it automatically pulls from its data sources, such as the WHO situation report feed.

What would you recommend calling it instead?

Re: WHO declares coronavirus outbreak a public health emergency

#197

Post by Fomite » Thu, Jan 30, 2020, 11:54 PM UTC

mrb wrote: post #152

goblin89 wrote: post #130

Earlier quoted context omitted.

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…

...that's not the assumption epidemiologists make. For the very simple reason that there are many "just so" stories you can tell about those still in the hospital - are they sicker, and thus there longer? Are the secondary cases, which in the case of MERS had a much lower CFR?

This is a very straightforward application of survival analysis, and those still in the hospital are "censored" observations - we know their outcome takes place in the future, but we're not sure when.

There are methods for calculating things like CFR in the presence of censoring, which will change based on what type of model you're using.

Re: WHO declares coronavirus outbreak a public health emergency

#198

Post by fspeech » Thu, Jan 30, 2020, 11:54 PM UTC

2019-nCoV wrote: post #83

hanniabu wrote: post #59

Earlier quoted context omitted.

Any idea what the rates are for the corona virus?

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…

Do a sanity check: does your 20% number make any sense based on what is known about the cases outside of China?

Re: WHO declares coronavirus outbreak a public health emergency

#199

Post by mrb » Thu, Jan 30, 2020, 11:54 PM UTC

svara wrote: post #189

mrb wrote: post #181

Earlier quoted context omitted.

« cases that get reported are biased towards people who get more sick » True, the data is biased. « the 20-56% mortality rate claimed based on guessing N=6 is inconsistent with the mortality rates outside of China, where no one has died so far » It's not statistically inconsistent. When China had 100 cases confirmed, they had reported only 2 deaths. Now there are 100 cases outside China, so statistically we should ex…

> It's not statistically inconsistent. When China had 100 cases confirmed, they had reported only 2 deaths. Now there are 100 cases outside China, so statistically we should expect 2. 0 actual vs 2 expected is statistically insignificant. My point here was that the China data is probably biased because the medical system there is overtaxed, but outside of China it isn't. Therefore, estimating mortality based on non-C…

When the WHO declares something a "global health emergency" we have valid reasons to be alarmist :)

I think that "going back 6 days" is insufficient, so your conclusion of a 6% probability is unsupported. Given the extreme state of paranoia around the world (eg. authorities testing people coming out of airplanes) it is likely that cases outside China are detected very early after the onset of symptoms. As such, death, when it takes place, will probably take more than 6 days after a confirmed case is detected.

In fact, the studies in The Lancet document cases of patients that take much more than 6 days to die.

Re: WHO declares coronavirus outbreak a public health emergency

#200

Post by Zod666 » Thu, Jan 30, 2020, 11:54 PM UTC

btilly wrote: post #171

underwater wrote: post #155

Earlier quoted context omitted.

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

She was both. When she was first identified, she cooked for a number of families. The outbreak that got her put away for life was due to working as a cook at Sloane Hospital for Women. I cannot immediately find record of her being a short order cook specifically. However that is my recollection from https://www.amazon.com/Betrayal-Trust-Collapse-Global-Public...

There's a good docu on her story. It might be on YouTube.