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First Case of New Coronavirus Detected in U.S.

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Re: First Case of New Coronavirus Detected in U.S.

#211
post #146

Earlier quoted context omitted.

From your second citation: "Although N95 respirators appeared to have a protective advantage over surgical masks in laboratory settings, our meta-analysis showed that there were insufficient data to determine definitively whether N95 respirators are superior to surgical masks in protecting health care workers against transmissible acute respiratory infections in clinical settings."

Insufficient data to show that N95 is better than a surgical mask, not insufficient data that N95 works. My guess is that whether the mask fits and makes a good seal, whether the user wears it consistently, and whether the user washes his hands before handling food or touching his mouth or nose all matter a lot more than the type of mask.

Agreed, but many of these studies were done in a medical context, which is close to a best-case scenario in terms of training for the use of an N95.

Re: First Case of New Coronavirus Detected in U.S.

#212
post #134

https://www.mobs-lab.org/2019ncov.html Current modeling estimates put the likely number of infections between 1 and 6.2 thousand, primarily concentrated in China.

This estimate [0] puts it at 4,000 as of Jan 18. It’s weird to not have government numbers that are actionable and we have to use models that range from 1-9.7k. [0] https://www.imperial.ac.uk/mrc-global-infectious-disease-ana...

It's actually not all that weird. The link I posted above is from a group that was funded by the NIH in a program called MIDAS (Modeling Infectious Disease Agent Study). The express goal was to produce modeling platforms usable by the government.

Imperial's MRC group has a very similar mandate, IIRC. Where these numbers are coming from, and the range of uncertainty around them, is very much characteristic of an emerging infectious disease (bad early data, stochasticity, etc.).

Re: First Case of New Coronavirus Detected in U.S.

#213
post #186
post #133

Earlier quoted context omitted.

A couple notes, from an infectious disease epidemiologist: - The CDC Director is, in rare form for this administration, not someone devoted to dismantling the agency he's in charge of. I work with the CDC fairly frequently, and they're in pretty good shape. - This is our third novel coronavirus, and the 2nd out of China. There's been a lot of prep work for this.

But wouldn't prevention require to screen all returning passengers from China and/or other Asian countries after Chinese New Year? I'm not sure how feasible that would be with the number of connecting flights with passengers from China arriving in the US each day. Or is it enough to isolate patients once they are ill enough to seek treatment?

Generally speaking in the U.S., quick isolation and contact tracing once cases do arise works well enough when combined with good infection control at the point of treatment.

Re: First Case of New Coronavirus Detected in U.S.

#214

Earlier quoted context omitted.

> he isn't a traveller, he is a resident in the Seattle area returning from China. A traveller is somebody who travels, e.g., from Seattle to China and back.

The implication seemed to be that it was someone passing through, as opposed to a resident. But yes, my read could have been wrong.

It confused me a bit on initial reading because a non-traveller in Seattle would have to have caught it there.

Re: First Case of New Coronavirus Detected in U.S.

#215
post #81
post #57

Earlier quoted context omitted.

Just according to superficial stats, it looks like the flu kills orders of magnitude more people than SARS and MERS. Is the public health response to these diseases really so effective as to account for most of this difference? I don't pay close attention but also wouldn't off the top of my head be able to describe anything that, say, Washington State does to effectively respond to CoV incidents to keep it from propa…

Yes, seasonal flu in the US alone kills around 30,000 each year, and may have killed as many as 60,000 during the 17-18 flu season alone [1]. MERS and SARS have each killed less than 1,000 worldwide. A few things that may interest you: * The rate of transmission for a disease is estimated by its R0 or basic reproduction number. R0 estimates the number of new cases from the unaffected population that one infection wil…

Change that first sentence to may kill around 30,000. The CDC knowingly cooks the books and lumps in Pneumonia and other illnesses with their numbers on possible deaths from the Flu. From their web site:

Why doesn’t CDC base its seasonal flu mortality estimates only on death certificates that specifically list influenza?

Seasonal influenza may lead to death from other causes, such as pneumonia, congestive heart failure, or chronic obstructive pulmonary disease.

Re: First Case of New Coronavirus Detected in U.S.

#216
post #110
post #78

Earlier quoted context omitted.

> We have much better medicine now, thankfully. Do we? Against a deadly and virulent flu virus causing viral pneumonia? Not really without development of a highly effective vaccine. You have better life support, but that's about it. Something like ECMO is extremely invasive and limited to maybe a few per ICU.

We have anti-virals now, when back then we didn't. Not sure if they'd actually work on these strains, but it's something.

We also have extreme cases like the rabies survivor, using a introduced coma as measurement.

Re: First Case of New Coronavirus Detected in U.S.

#217
post #211

Earlier quoted context omitted.

Insufficient data to show that N95 is better than a surgical mask, not insufficient data that N95 works. My guess is that whether the mask fits and makes a good seal, whether the user wears it consistently, and whether the user washes his hands before handling food or touching his mouth or nose all matter a lot more than the type of mask.

Agreed, but many of these studies were done in a medical context, which is close to a best-case scenario in terms of training for the use of an N95.

Yes, except that studies showed surgical masks are likely as effective, which strongly suggests that precise fit confirmed by a fit-test probably isn't necessary.

Re: First Case of New Coronavirus Detected in U.S.

#218
post #87

Reports are that China has just quarantined Wuhan, a city of 11 million people.

Wuhan is in the middle of China, every transit passes through it. It’s like the Chicago of China. There is no way in hell the government is going to able to lock it down.

and yet they just did

Re: First Case of New Coronavirus Detected in U.S.

#219
post #137

It is not SARS, but it is highly possible that it was caused by people who kill and sell wild animals in the live poultry market. Where these animals like gem-faced civet got virus from bats. It is a long-held tradition for certain regions in China to eat wild animals. We even have a Chengyu called: 山珍海味, meaning precious and tasty animals from mountains and seas. Most wild animals are not evolved to be eaten by huma…

There is also a newly opened medical research facility that investigates pathogens in Wuhan. It's possible the virus escaped.

Re: First Case of New Coronavirus Detected in U.S.

#220
post #136

Earlier quoted context omitted.

First, this isn't a flu. This is a coronavirus, related (but not identical) to both the common cold and (more closely due to subtypes) SARS. That said, while I am not an epidemiologist, this doesn't seem nearly as fatal - about a 2% compared to a 9.5% of SARS and 10-15% of the Spanish Flu. Remember that known cases will usually have more serious reactions than less serious cases - milder cases won't go to doctors. I…

I am an epidemiologist. Right now, the case fatality definition is bonkers . 2.3% is the low estimate, and it goes way up. The high estimate is 91%. That's just a uselessly broad figure because it's still very early days. If I had to guess, I'd guess it's probably around the level of SARS/MERS.

I made the mistake of assuming the official numbers being reported were accurate. If the Weibo rumors are true, this is truly scary and uncontrolled within China.
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