Discussion thread III - Covid-19 (new coronavirus)

[sharon sanders]

Somewhere in New York I think....



Tweets mine, retweets ≠ endorsements.
New York City
cnbc.com/id/100957266
Joined May 2009

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Dominic Chu

@TheDomino
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2h
FTR...that’s not my cart in the pic...I was only there to check out the scene...not crazed, but busier than I would expect on a random Tuesday afternoon... Then again, it is #SuperTuesday
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Dominic Chu
@TheDomino
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Replying to @RiskReversal

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Dominic Chu

@TheDomino
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2h
The run on goods at Costco is real. Here’s my local store today...in the area where you’d normally find toilet paper, paper towels, tissue, etc. $COST #coronavirus #Covid_19

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Dominic Chu

@TheDomino
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4h

[mscox]

The CFR is highly variable and hard to predict. In the initial stages of detection, often the CFR will look artificially high, because you are seeing/detecting only the more critical and severe cases. As you begin more aggressive tracing and testing, you will catch more of the milder cases and begin intervention sooner and hence the CFR comes down. This is where Singapore and South Korea are now. If you DO NOT contain the spread, then the number of sick patients begins to overwhelm your hospital system and the CFR will increase (potentially dramatically). This is a significant risk for every country whose response is delayed or insufficient.

[Emily]

mscox, do you think there is any hope for getting better biosecurity defenses in place in nursing homes, etc? A lot of the fatals are coming out of one such facility near Seattle and I could see your worst case scenario as an endgame if another one gets infected soon.

[Emily]

I think Costco shoppers have a hoarder mentality to some extent. (Used to be one myself.) The regular grocery stores have plenty of food and toilet paper, (Puget Sound area). A clerk at a regular grocery store told my husband that there is no panic buying there but he heard the local Costco's are out of toilet paper. My husband did notice that the organic soup section was picked over at the regular supermarket. Maybe organic buyers are more fearful by nature. (And I am an organic buyer so no offense meant.)

[Shiloh]

https://www.cnbc.com/2020/03/03/who-says-coronavirus-death-rate-is-3point4percent-globally-higher-than-previously-thought.html

...World health officials said Tuesday the case fatality rate for COVID-19 is 3.4% globally, higher than previous estimates of about 2%.

“Globally, about 3.4% of reported COVID-19 cases have died,” WHO Director-General Tedros Adhanom Ghebreyesus said during a press briefing at the agency’s headquarters in Geneva. In comparison, seasonal flu generally kills far fewer than 1% of those infected, he said....

[Ronan Kelly]

USA - We have a problem. There is a press briefing on coronavirus going on in the White House right now that the media is not allowed to broadcast. No recording is allowed. Only still photos are allowed. This is truly odd.

https://twitter.com/Acosta/status/1234976814516170753?fbclid=IwAR0WaJSSyU0Cf0eV3YiJLfE3n8ErpE_7KoqN4glb_tgPhYDuqfus_ft4SRM

[mscox]

The only hope is to detect effectively, trace efficiently,enforce social distancing and mandatory quarantine/isolation. This helps to reduce the peak infections and smooth out the infected curve, which reduces the pressure on the health system and lessens the CFR. Basically what China and South Korea are doing.

[Ronan Kelly]

Tweets from the briefing from https://twitter.com/katierogers

WH correspondent NY Times

New coronavirus #'s per
@VP
: 77 domestic cases of coronavirus. 3 additional deaths today, 9 domestic deaths total. Now 13 states plus NYC -- 14 total jurisdictions -- where coronavirus cases have been reported.
https://twitter.com/katierogers/stat...77861498335233

.
@VP
says OMB will be issuing new guidance directing all federal government agencies to review internal travel policies and to adhere to State Department advisories. Says task force will meet with CEOs of major airlines tomorrow "to talk about greater cooperation."

Great question. WH says no audio or video. I asked why and I was told it is because they said no audio.

.
@VP
: "The American people do not have to buy masks."

In briefing, Fauci says that health care officials are prioritizing safety in developing a vaccine for COVID-19. "Even though we're going at rocket speed, it's not going to be at least a year to a year and a half where we say 'we have a product, let's rev it up and give it.'"

Asked by Jim Acosta why this briefing was not on camera or audio for Americans,
@VP
says "I expect we'll be back on camera tomorrow."

CDC's Redfield: "We've got to stay grounded in data. We can't see the future. We really don't know this virus very well. What we do know for sure that in the right settings it does have the potential to move quickly." Fauci says an unknown is potential for asymptomatic infection

[Missouriwatcher]

The CFR figure (.46%) is from a number that CATO Institute article ( https://www.cato.org/blog/misleading...19-death-rates) figured, considering that we may never know the true denominator (or number of cases). If one were to use the CFR of 3.4% (from WHO), would it have the same death projections? Not sure how to figure.

Nonetheless, potentially a lot of deaths.

See also: Estimating the CFR 2019-nCoV

https://flutrackers.com/forum/forum/the-pandemic-discussion-forum/824075-discussion-estimating-the-cfr-for-2019-ncov

[sharon sanders]

https://www.cnbc.com/2020/03/03/who-...y-thought.html

...World health officials said Tuesday the case fatality rate for COVID-19 is 3.4% globally, higher than previous estimates of about 2%.

“Globally, about 3.4% of reported COVID-19 cases have died,” WHO Director-General Tedros Adhanom Ghebreyesus said during a press briefing at the agency’s headquarters in Geneva. In comparison, seasonal flu generally kills far fewer than 1% of those infected, he said....

"Globally, about 3.4% of reported COVID-19 cases have died. By comparison, seasonal flu generally kills far fewer than 1% of those infected."

https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---3-march-2020

[gsgs]

that 3.4% is highly dominated by Wuhan. Without Hubei it's 1.3% . Some cases may still die,
so when you take deaths/recovered then it's 6.3% worldwide and 2.7% ex Hubei.
South Korea tests lots of mild cases, they have ~0.9% when we count severe cases as 1/3 dead.
But this is with still working healthcare..
And it depends a lot on age >60 , much more than flu
For <40 or such it may currently well be almost like flu (my feeling, I didn't calculate it)

[Ronan Kelly]

I think the Cato institute number is low, the Korean numbers are probably the best out there giving a figure around 1% which would be a significant public health threat with high mortality. Their %positive is currently around 4%.

[gsgs]

yes, but what when/if they can no longer hospitalise severe cases

[mscox]

Exactly gsgs, the 1% number seems to look right when you manage the number of infected through aggressive social distancing, tracing and containment AND you have a functioning public health care system. If you have a dysfunctional health care system and/or an overloaded one, then expect the fatality rates to climb (a lot).

[JJackson]

I know a lot of effort has gone into CFR calculations but I am not sure I see the point. The CFR is a moving target and is going to vary greatly over time and in different locations. It is calculated for a given population in a given area over a set time period. The real CFR for an epidemic will be calculated after it is all over based on every case's outcome. The CFR for early Wuhan cases will be a reflection of the fact they had no idea what they were dealing with or how to treat it, nor could they even tell who had it until it was isolated, sequenced and PCR protocols established. They would not have known transmission characteristics or what PPE they should use. Later cases from the same population fared much better. Things that will effect the CFR will include overall health, age distribution, proportion with co-morbidities, how quickly they present for treatment (and get it), what treatment is available to them, how knowledgeable their HCWs are, how much load the system is under, what pharmaceuticals there are (and availability), how effective these are etc. You will get a range of wildly different CFRs depending on where and when you look. As mscox points out a major spike will occur anywhere the health system is overwhelmed and life saving treatments stop being available. Key bits of kit will be PPE, Lab capacity, ICU and CC beds, ventilators/ECMO, CT scanners (X-rays can help but are not as useful) & oxygen plus any of the drugs, currently in trials, that turn out to be useful. Ventilators will probably the first thing to max out. China was very good about shipping capacity into Wuhan (people and kit) which saved many at the peak of the wave which was also considerable smaller, than it would have been, due to their containment measures. They barely coped despite both massive interventions. How good other peoples are going to be about shipping their PPE, ventilators and best HCWs to cities on the other side of the country remains to be seen but it could be a major factor in preserving surge capacity and holding down that country's CFR.
Just what I could think of I am sure I missed lots of other important variables.

[Shiloh]

Great assessment.

[Emily]

"I know a lot of effort has gone into CFR calculations but I am not sure I see the point."
I agree. It seems a number that is spun one way or another to support a narrative.

[Emily]

I think the Cato institute number is low, the Korean numbers are probably the best out there giving a figure around 1% which would be a significant public health threat with high mortality. Their %positive is currently around 4%.

I've got this cued about 30 secs before Dr. Matt McCarthy, an infectious disease physician and "Superbugs" author talks about CFR of .2 to .4 based on Korea data. I think that could be as good an estimate as it gets. But he still predicts that there will be big problems. Worth listening to him if you can. So far I see Seattle repeating early Wuhan situation at hospitals. Maybe worse. UW docs, including Harborview have NO N95 masks. They are being told to use surgical masks.

https://www.youtube.com/watch?v=0Wg_OTTzUv8&feature=youtu.be&t=240