WHO Director: "Covid-19 does not transmit as efficiently as influenza" • Hacker News Board

Re: WHO Director: "Covid-19 does not transmit as efficiently as influenza"

#131

Post by koheripbal » Thu, Mar 05, 2020, 1:36 AM UTC

knzhou wrote: post #6

This is important, because lots of internet commentators are just going with the most alarming possible statements: 28 day incubation periods, people can get infected twice, airborne transmission, asymptomatic transmission. These assertions are all based on outlier cases, sometimes even single cases, observed during the fog of war. Even if these accounts are correct, they aren't the typical case, which is what actual…

> The WHO has collected stats from tens of thousands of cases...

This part is inaccurate. The WHO's best quality data set is South Korea, which is only a few thousand cases (the vast majority of which are still in the early stages of the illness). The data quality in places like Iran, China, and even the USA are TERRIBLE and should not be used to draw any conclusions.

Additionally, the R0 is clearly different in different climates, so places like Singapore, Thailand, Vietnam, Malaysia, should not be used to infer infectivity in colder climates like Korea, Taiwan, Japan, Europe, and America.

A great source for facts is the TWIV podcast - twiv.tv. They are experts in Virology and infectious disease control.

> most people get fevers

This is a bit misleading when the WHO says 3.4% of people die, and 5-10% require intensive case and mechanical ventilation. According to the CDC, the flu kills 0.05% of the 32 million people infected in the US annually. A 100X increase is devastating for healthcare systems. The systemic problems occur when masses of older people require more ICU beds and ventilators than are available, which then drives the mortality even higher.

We should be tremendously thankful that children do not seem to be impacted. If it weren't so, the level of panic and economic damage would be significantly higher. Schools would already be closed and a HUGE portion of the workforce would be unable to work.

> ...stopping the spread is completely impossible, while we have seen by example that it isn't.

Given the global spread and the lack of testing in most non-first-world countries, most experts agree that the disease will not be contained and will become endemic. Think about North Korea, Mongolia, or Nepal - the fact that they are not reporting cases, should not be interpreted as evidence that no cases exist.

The recommended WHO strategy is to SLOW the spread of the virus with a balanced strategy of containment and mitigation. The goal is to buy us enough time to develop and deploy a vaccine.

Re: WHO Director: "Covid-19 does not transmit as efficiently as influenza"

#132

Post by RJIb8RBYxzAMX9u » Thu, Mar 05, 2020, 1:41 AM UTC

knzhou wrote: post #115

pezo1919 wrote: post #63

Earlier quoted context omitted.

Could not find the exact reference, but here are some other bullshit from that time: https://www.globaltimes.cn/content/1178015.shtml That "transparency" and "openness" were quoted a lot but it was not the case at all. Many chinese doctors and journalists were shut down.

A month ago I took a lot of flak for saying that China's numbers were probably faithfully reported, as accurately as their logistics permitted. This was a claim that literally nobody could make anywhere on the Western internet without being downvoted to hell and called a shill. Everybody agreed that all numbers were completely made up, because somebody was able to fit a quadratic curve through 3 of their data points.…

> Anybody who still says it's all fake is just jacking off on nationalism.

I mean, they're hoarding toilet paper for a reason...

Re: WHO Director: "Covid-19 does not transmit as efficiently as influenza"

#133

Post by [deleted] » Thu, Mar 05, 2020, 1:52 AM UTC

omarhaneef wrote: post #130

wahern wrote: post #112

Earlier quoted context omitted.

Pretty sure the fatality rate is based on the number of patients who present themselves to a doctor. I've seen estimates of influenza fatality rate of 0.2%, which corresponds with the ~61000 deaths over ~20700000 medical visits for the 2017-2018 influenza season documented here: https://www.cdc.gov/flu/about/burden/2017-2018.htm The fatality rate would obviously decline with a larger denominator which includes total…

> Pretty sure the fatality rate is based on the number of patients who present themselves to a doctor. I don’t think this is right. I believe it’s based on an estimate. Your own numbers bear me out. The flu death rate is estimated to be around 0.1% and we can come to that number by a division here: “ The overall burden of influenza for the 2017-2018 season was an estimated 45 million influenza illnesses, 21 million i…

[deleted]

Re: WHO Director: "Covid-19 does not transmit as efficiently as influenza"

#134

Post by fspeech » Thu, Mar 05, 2020, 1:55 AM UTC

knzhou wrote: post #115

pezo1919 wrote: post #63

Earlier quoted context omitted.

Could not find the exact reference, but here are some other bullshit from that time: https://www.globaltimes.cn/content/1178015.shtml That "transparency" and "openness" were quoted a lot but it was not the case at all. Many chinese doctors and journalists were shut down.

A month ago I took a lot of flak for saying that China's numbers were probably faithfully reported, as accurately as their logistics permitted. This was a claim that literally nobody could make anywhere on the Western internet without being downvoted to hell and called a shill. Everybody agreed that all numbers were completely made up, because somebody was able to fit a quadratic curve through 3 of their data points.…

There is definitely opaqueness and one needs to know how to read the data. For example China does not report people who test positive but do not develop pneumonia. The criteria for classification is clearly listed in the national guideline but is easy to escape notice because the daily report is terse and does not reference the definitions. It may not be a big deal in terms of assessing mortality (WHO explained the percentage of asympotamaic cases that test positive is small), but it can make a significant difference when assessing risk for a particular region. If a region reports zero case but there is actually a postive test, the risk outlook is quite different even though the report is technically correct.

But it would be unfortunate to then disregard all Chinese data. That would be like throwing out the baby with bath water. If we don't study their experience we will be bound to repeat their mistakes. Fortunately this does not appear to be the case with medical professionals and scientists, judging from the volume of peer reviewed publications coming out of China.

Re: WHO Director: "Covid-19 does not transmit as efficiently as influenza"

#135

Post by eric-hu » Thu, Mar 05, 2020, 2:17 AM UTC

Barrin92 wrote: post #34

thorum wrote: post #22

Keep in mind that almost 20% of the Diamond Princess cruise ship's passengers and crew (700+ of 3711) were infected with the coronavirus. However its infection rate compares with the seasonal flu (which is a much less dangerous illness overall), it clearly has the potential to infect a large number of people in the coming months.

Given that there are probably very few places that are worse for a disease outbreak than a cruise ship where everyone eats and drinks all day and touches everything and uses the same toilets I'll actually take the 20% as an encouraging number.

This isn't an accurate representation of how the number got to 700. The numbers were low when the ship docked. I recall in the single digits. Everyone was put on cabin quarantine, though people could leave their rooms for a window of time each day. It was quarantine and they were testing symptomatic people. I was watching mostly HK and Taiwanese news sources on it multiple times every day.

That makes me very skeptical of the WHO claim that asymptomatic spread isn't a problem.

Re: WHO Director: "Covid-19 does not transmit as efficiently as influenza"

#136

Post by eric-hu » Thu, Mar 05, 2020, 2:32 AM UTC

FabHK wrote: post #76

victorlin wrote: post #59

Please don't trust WHO, obviously they got heavily influence from Chinese government. Remember when COVID-19 out-broken in China, the WHO told us "The Committee does not recommend any travel or trade restriction based on the current information available. " https://www.who.int/news-room/detail/30-01-2020-statement-on... Then we saw China locked down all major city themselves. Now you tell me it's fine not to ban flig…

Hindsight. At the time, nobody had travel restrictions. Were they all influenced by China? No, with the then current information travel or trade restrictions didn’t make sense. This is the same lazy argument as with the 737 MAX - why wasn’t it immediately grounded? Well, you can’t just shut down the world at any sign of trouble. You have to make an informed judgement call with the information you have at the time. So…

The 737 Max is actually a great analogy, but you and I come to different conclusions. The FAA shot themselves in the foot by not grounding the Max after the second crash. They were previously so trusted that their standards were the default for other countries. The widespread trust made it easier and faster for American planes to go to market. That trust took decades to build up and will not be easily restored.

Re: WHO Director: "Covid-19 does not transmit as efficiently as influenza"

#137

Post by victorlin » Thu, Mar 05, 2020, 2:33 AM UTC

lovemenot wrote: post #103

victorlin wrote: post #90

Earlier quoted context omitted.

Well, allow me to remind you the timeline > On 23 January 2020, the central government of the People's Republic of China imposed a lockdown in Wuhan and other cities in Hubei province in an effort to quarantine the epicentre of an outbreak of coronavirus disease 2019 (COVID-19) https://en.wikipedia.org/wiki/2020_Hubei_lockdowns What do you mean nobody had travel restrictions? The report from WHO date was on 30 Januar…

Imagine if Israel had taken the opportunity to lock-down West Bank in the name of health, specifically prevention of novel coronavirus. My artificial example is perhaps not accurate on its face, but I hope you can see the principle. WHO was trying to prevent unnecessary border restrictions in the world, until such time as they became justified for health reasons. In China that was already the case.

If you have no idea how bad it already was when WHO suggest not restrictions needed, than I would suggest you watch this video

https://www.youtube.com/watch?v=5-nv7j9HEgY

Many of the footage are before the Jan 30 WHO announcement, like the many body moving in front of hospital.

WHO probably already know what's really happening there, but still given wrong advice, so that many countries, like Korean, Japan follow the instruction by WHO, not imposing the restriction on China. And now people in these countries are suffering from the misinformation provided by WHO.

Another evidence WHO is controlled by China, that is when Taiwanese people want to join WHO to get latest update about the virus and help from the world, Chinese government doesn't want this to happen.

https://foreignpolicy.com/2020/01/22/china-health-coronaviru...

So basically Taiwan was excluded from the global health system for long time because that.

I am from Taiwan, I don't feel surprise at all that WHO is controlled by China, as they have shown it that way long time ago on the issue of excluding people from Taiwan. So that's obviously political over people's health in the world.

Re: WHO Director: "Covid-19 does not transmit as efficiently as influenza"

#138

Post by jwlake » Thu, Mar 05, 2020, 2:57 AM UTC

cbsks wrote: post #31

This paper has more information: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6909e1-H.pdf TLDR: "Since February 28, an increasing number of newly diagnosed confirmed and presumptive COVID-19 cases have been in patients with neither a relevant travel history nor clear epidemiologic links to other confirmed COVID-19 patients. However, despite intensive follow-up, no sustained person-to-person transmission of symptoma…

"54 of those 445 people developed new or worsening symptoms"

So we're basically having people make themselves sick by watching the news, its a brand new pandemic!

Re: WHO Director: "Covid-19 does not transmit as efficiently as influenza"

#139

Post by alteria » Thu, Mar 05, 2020, 2:59 AM UTC

Sevrene wrote: post #87

I've noticed a trend in the discussion of Covid-19 when talking to people. They tend to either under estimate it; "it's just the flu", or they over estimate it; "This is going to be really bad, time to buy all toilet paper". There's a lot of confusing mixed messages, not even from just random people, but from the WHO and different governments. They say they are fully prepared and it can be contained yet doctors and h…

IMO part of this is that at every step there are a number of scenarios that could occur (from "bad flu" to "1918 all over again"). As we get more information and see this unfold, we can update our scenarios based on new information. However, I haven't seen too much reporting that lays it out in this way.

This leads to some people drawing conclusions like "wow I was lied to, they said it wasn't bad and would be contained to China," which isn't entirely true.

Re: WHO Director: "Covid-19 does not transmit as efficiently as influenza"

#140

Post by alteria » Thu, Mar 05, 2020, 3:01 AM UTC

jsharf wrote: post #100

Barrin92 wrote: post #34

Earlier quoted context omitted.

Given that there are probably very few places that are worse for a disease outbreak than a cruise ship where everyone eats and drinks all day and touches everything and uses the same toilets I'll actually take the 20% as an encouraging number.

Yeah, but as soon as they were aware of a single case on board, everyone single person on the ship was informed, told to stay in their room, and became paranoid about further transmission. I don't know if we'll have similar levels of obedience in the rest of the world.

There were reports that the actual procedures on the ship were extremely poor, and the quarantine was half-baked at best.