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Discussion - Estimating the CFR for 2019-nCoV

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  • #31
    Originally posted by WildernessRetreat View Post
    On Jan 10, 2020 Confirmed cases was 41... From records of the first 17 deaths, the average days from contraction to death was about 17 days...On Jan. 25, fifteen days after Jan 10 when 41 cases were confirmed, 41 were reported dead from the virus. We know it's not killing 100% of the confirmed cases but this also tells us that a lot more people are sick than are being listed as confirmed carriers. At one time I was under the impression that there were only 15 confirmed in the original cluster. I can't find that story anymore. Most stories say there were 27 cases of pneumonia on Dec. 31 2019 in Wuhan. (i couldn't find out how many of those cases were confirmed Wuhan virus). Either way we're looking at a death rate that is so high that it will drive the world economy to it's knees, somewhere between 12% and 30% could die after contracting this virus. This is a farmers math project, so don't hate me if I'm wrong.
    WR-
    AP is saying 27. You can use Google’s date range filters and search news. For example, the search input I used was:

    wuhan after:2019-12-15 before:2019-12-31

    Comment


    • #32
      Originally posted by WildernessRetreat View Post
      On Jan 10, 2020 Confirmed cases was 41... From records of the first 17 deaths, the average days from contraction to death was about 17 days...On Jan. 25, fifteen days after Jan 10 when 41 cases were confirmed, 41 were reported dead from the virus. We know it's not killing 100% of the confirmed cases but this also tells us that a lot more people are sick than are being listed as confirmed carriers. At one time I was under the impression that there were only 15 confirmed in the original cluster. I can't find that story anymore. Most stories say there were 27 cases of pneumonia on Dec. 31 2019 in Wuhan. (i couldn't find out how many of those cases were confirmed Wuhan virus). Either way we're looking at a death rate that is so high that it will drive the world economy to it's knees, somewhere between 12% and 30% could die after contracting this virus. This is a farmers math project, so don't hate me if I'm wrong.
      I understand your frustration Wilderness Retreat. It is important to remember that on any given day the number of reported deaths has ZERO relationship to the number of newly reported confirmed cases of a disease (unless of course the newly reported case is already a deceased individual). Unfortunately, epidemiologist do a poor job of makings this clear in discussions and graphs. Even now the WHO will include individual who survived with individuals who died within a stack bar graph on a specific date, yet these cases are mutually exclusive; they only share being reported on the same day. Reporting these deaths and survivors in the same graph implies that all these individuals contracted the disease the same number of days before they survived or succumbed to death. It is difficult to interpret such confusing data.
      http://novel-infectious-diseases.blogspot.com/

      Comment


      • #33
        SCMP just reported a case that I linked in the news thread with onset December 1 (one week before the earliest case linked to that market) and no links to the seafood market. That means this virus did not first jump to humans in that market and was instead already circulating. Notably, none of his contacts became ill (at least ill enough to be hospitalized). Perhaps the outbreak at the market was due to an ill human going to work and may have represented a superspreading event.

        The origin of this outbreak is now completely unclear.

        That drastically increases the number of people who have likely been infected by now, and reduces the likely CFR. This looks more like Mexico 2009 than SARS 2003.

        I don't think the CFR is going to get all the way down to that of seasonal flu, but it wouldn't surprise me if it got lower than the 2% that is cited for the 1918 virus.

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        • #34
          That's very interesting, alert.
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          • #35
            would they quarantine >30M with just a few thousand cases ? The damage from the quarantine would be larger.
            So I speculate that there are >100K cases and the CFR is low.

            I'm interested in expert panflu damage estimates
            my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

            Comment


            • #36
              A 1% attack rate in Wuhan itself is 110k cases. One percent attack rate in all of Hubei would be more like 600k. These are very densely populated areas. People have been saying since the start of the outbreak that there is a huge amount of background ILI, some or most of which may be due to this virus.

              The question is how low is low? The 1918 pandemic was about 2-2.5% CFR. I think there's a good chance this virus is less than that. But that's still 20-25x the death rate of seasonal flu.

              Comment


              • #37
                Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
                Prof Chaolin Huang, MD *
                Yeming Wang, MD *
                Prof Xingwang Li, MD *
                Prof Lili Ren, PhD *
                Prof Jianping Zhao, MD *
                Yi Hu, MD *
                et al.
                Show all authors
                Show footnotes
                Published:January 24, 2020DOI:https://doi.org/10.1016/S0140-6736(20)30183-5
                ...
                By Jan 2, 2020, 41 admitted hospital patients were identified as laboratory-confirmed 2019-nCoV infection in Wuhan. 20 [49%]) of the 2019-nCoV-infected patients were aged 25–49 years, and 14 (34%) were aged 50–64 years (figure 1A). The median age of the patients was 49?0 years (IQR 41?0–58?0; table 1). In our cohort of the first 41 patients as of Jan 2, no children or adolescents were infected. Of the 41 patients, 13 (32%) were admitted to the ICU because they required high-flow nasal cannula or higher-level oxygen support measures to correct hypoxaemia. Most of the infected patients were men (30 [73%]); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]).
                ...
                As of Jan 22, 2020, 28 (68%) of 41 patients have been discharged and six (15%) patients have died.
                ...
                Click image for larger version

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                Comment - The above paper pushes the onset of the disease back to Dec 1 with no contact with the market. It also suggests that half of those hospitalized where aged under 50. Given the demographics of the fatal cases this indicates that younger individuals are recovering. But the overall recovery rate of hospitalized cases is still only 68% after a minimum of 3 weeks from onset with 17% of cases still under care. - Ro
                Twitter: @RonanKelly13
                The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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                • #38
                  they (Pybus et.al.) were estimating that the time of common anchester of the viruses was in late December,
                  so one first strain had possibly died out
                  I'm interested in expert panflu damage estimates
                  my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

                  Comment


                  • #39
                    Originally posted by hawkeye View Post

                    Serious question - wouldn’t the CFR increase there are more deaths due to unavailable respirators..etc. when health services are overrun? Seems an increase of infections starts to increase CFR at some point when finite resources are included.
                    5 of the 7 cases, in Shilohs post above, specifically mention oxygen therapy. The lack of equipment can only make the outcomes poorer.
                    "The only security we have is our ability to adapt."

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                    • #40
                      Originally posted by kiwibird View Post

                      5 of the 7 cases, in Shilohs post above, specifically mention oxygen therapy. The lack of equipment can only make the outcomes poorer.
                      Thank you. Then it would seem that the CFR can increase over time as health networks become saturated.

                      Comment


                      • #41
                        Originally posted by hawkeye View Post
                        Then it would seem that the CFR can increase over time as health networks become saturated.
                        If this outbreak becomes a pandemic then relating the number of deaths to the CFR for the coronavirus will be misleading. When hospitals become over crowded, and the entire health system is stretched to the limit, we can expect many deaths that are not directly related to the disease. Even during a pandemic people will experience life threatening diseases and traumatic injuries. If these people fail to get needed treatment, they will die. These deaths will be collateral damage from a pandemic.
                        http://novel-infectious-diseases.blogspot.com/

                        Comment


                        • #42
                          Originally posted by Laidback Al View Post

                          If this outbreak becomes a pandemic then relating the number of deaths to the CFR for the coronavirus will be misleading. When hospitals become over crowded, and the entire health system is stretched to the limit, we can expect many deaths that are not directly related to the disease. Even during a pandemic people will experience life threatening diseases and traumatic injuries. If these people fail to get needed treatment, they will die. These deaths will be collateral damage from a pandemic.
                          I'm wondering if we can assume any stats are accurate at this point. It seems the system has collapsed. I imagine the body count will provide answers but what are the chances we will get the truth. I doubt that swabs or blood were done on untested mortality.

                          Comment


                          • #43
                            Originally posted by AnnaLisa View Post

                            I'm wondering if we can assume any stats are accurate at this point. It seems the system has collapsed. I imagine the body count will provide answers but what are the chances we will get the truth. I doubt that swabs or blood were done on untested mortality.
                            Xinhua reports that 150 medical workers from the Army Medical University are being flown to Wuhan, so obviously the crisis is getting militarized. Given reports of bodies in the streets, that seems unavoidable. However, a detachment of 150 is a pittance given the scale of the problem, with 50MM people in quarantine.
                            Possibly there is no readily deploy-able pool of medical staff that has training for managing highly infectious diseases. Whatever the reason, the modest support measures to date indicate that the quarantined areas are essentially on their own.

                            Comment


                            • #44
                              Originally posted by etudiant View Post

                              Xinhua reports that 150 medical workers from the Army Medical University are being flown to Wuhan, so obviously the crisis is getting militarized. Given reports of bodies in the streets, that seems unavoidable. However, a detachment of 150 is a pittance given the scale of the problem, with 50MM people in quarantine.
                              Possibly there is no readily deploy-able pool of medical staff that has training for managing highly infectious diseases. Whatever the reason, the modest support measures to date indicate that the quarantined areas are essentially on their own.
                              It would necessarily any different in the US if that had occurred here. It was and is an overwhelming event.

                              Comment


                              • #45
                                Originally posted by AnnaLisa View Post

                                It would necessarily any different in the US if that had occurred here. It was and is an overwhelming event.
                                Entirely agree, think it would be worse here given our social tensions. Unfortunately, we may find out, this virus appears able to leap national boundaries with ease.

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