Discussion Thread I - 2019-nCov (new coronavirus)

[gsgs]

, I get 13165 for the China A50 index at 03:35 MET = GMT+1
-3.5% less than expected

 

[Shiloh]

Early Transmissibility Assessment of a Novel Coronavirus in Wuhan, China
7 Pages Posted: 24 Jan 2020 Last revised: 26 Jan 2020
Maimuna Majumder
Harvard University - Computational Health Informatics Program
Kenneth D. Mandl
Harvard University - Computational Health Informatics Program
Date Written: January 23, 2020

[h=3]Abstract[/h] Between December 8, 2019 and January 22, 2020, nearly 600 cases of respiratory illness caused by a novel coronavirus originating in Wuhan, China have been reported. In this short analysis, we combine publicly available cumulative case data from the ongoing outbreak with phenomenological modeling methods to conduct an early transmissibility assessment. Our model suggests that the basic reproduction number associated with the outbreak (at time of writing) may range from 2.0 to 3.3. Though these estimates are preliminary and subject to change, they are consistent with previous findings regarding the transmissibility of the related SARS-Coronavirus and indicate the possibility of epidemic potential.

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3524675

 

[hawkeye]

Mongolia going into lockdown:
”On January 24, Friday, the State Emergency Commission decided to close all schools and kindergartens in the country from January 27, 2020 to March 2, 2020.”...

“The cabinet ordered to cancel all kinds of public gatherings, which include activities of training centers, cyber gaming centers, public tour, children playground center and driving schools, etc.

It was also resolved to close border crossings with China for auto vehicles and pedestrian traffic, starting Monday, January 27”

https://montsame.mn/en/read/213972

 

[alert]

Now 2500+ confirmed cases in China with 80 deaths....and 51 discharges. 51. Really? That doesn't even seem possible. How could they have had so few discharges? It becomes even worse when you consider that 28 of the first 41 cases have been discharged, so only 23 other people have recovered from this virus in all of China? I can think of a few possibilities:

1. This virus is much more severe than reported. This seems unlikely, given that Nepal has discharged its case, Japan has discharged at least one, and Thailand has discharged 5 of 8. This wouldn't be happening if this virus really had anywhere near the 60% CFR that is computed using only cases that have resolved.
2. China is keeping most recovered patients in the hospital as a precaution because they're not really sure that they're not carrying the virus.
3. The case definition or the testing regime in China are so fouled up that in order to be confirmed, you have to be so sick that you really have a 60% chance of dying. If this is true, it means that 1500 people are going to die from this virus in the next week. I think this is probably unlikely as well, but possible.
4. China is massaging the numbers to under report the total case count by replacing each discharge with a new case, keeping the total number hospitalized correct, but not having to report the new case. The problem with this explanation is that if there are only 23 of these other recoveries in China, at some point someone would find 24+ survivors of the virus (on Weibo?) and severely damage China's credibility.
5. A slightly more severe version of #4: So many people are ill that authorities cannot keep track of which patients are confirmed and which are not, so they can't accurately report the discharge of confirmed cases.
6. You can't discharge a case if you never hospitalize it. Late in the 2003 SARS outbreak, when the number of actual confirmed ill cases worldwide had dropped to a few dozen, the USA count of ill suspected cases began to exceed the actual number of confirmed cases worldwide. The CDC was reporting about 75 suspected cases with only about 30 discharges. It took a few weeks to determine that the US was only reporting a case as discharged if it had actually been hospitalized. Cases that were so mild that they didn't need to be hospitalized (in this case, because they weren't SARS) had been excluded from the discharge count. The CDC in 2003 made a sudden adjustment once this was detected, and the US discharge count jumped up from 30 to about 70, bringing its numbers in line with the world. Perhaps China's nCoV discharge count will make a similar jump in coming days.

Personally, I'm guessing #2, followed closely behind by #4 or #5. Right now, this anomaly is worsening by the day and prevents any attempt to calculate a CFR for this virus.

 

[Laidback Al]

alert, I hope you are right that the Chinese are taking precautions not to release recovered patients because they are unsure if they are still infectious or not. That may be moot, given how quickly the number of cases in the wild are increasing. The number of hospitalized patients and the number of recovered patients are probably meaningless given the scale of infections already reported.

 

[Emily]

China apparently counts deaths from flu much differently than is done in the U.S. If there is an underlying condition such as a cardiac problem and the flu patient dies from a heart attack, China would count that as a cardiac death but here it would be called a flu death. That why there are sometimes rumors in China of there being a deadly flu epidemic in the U.S. – we appear to have thousands more flu deaths than they have.
Since we are hearing that mostly people with underlying conditions are getting sick from the new coronavirus, it could be that most deaths are reported as the underlying condition. I hope that is not the case.

https://translate.googleusercontent...700271&usg=ALkJrhjUTCUMwJrVy66rX2hJS5Ozf4mHTQ

 

[kiwibird]

https://www.scmp.com/news/hong-kong...na-coronavirus-hong-kong-medical-experts-call

Professor Gabriele Leung of Hong Kong University has estimated that there are already 44,000 cases in Wuhan. Given 5 million people left just before the city was locked down, does this mean the same number again are "at large"???

 

[Tea]

The time to worry is now’: The coronavirus in China could threaten pharma’s ingredient sourcing

As a novel coronavirus spreads through China and rattles the rest of the world, the pharmaceutical industry is on guard over the adequacy of its global supply chain.





https://www.statnews.com/pharmalot/2...l-ingredients/

 

[Pathfinder]

:tiphat:https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200126-sitrep-6-2019--ncov.pdf

Excerpt page 1:

WHO’s assessment of the risk of this event has not changed since the last risk assessment conducted on 22 January: very high in China, high at the regional level and high at the global level.3
...
3Note: Error in situation reports published on 23,24 and 25 January as originally published, which incorrectly summarized the risk for global level to be moderate.

 

[Tea]

Here’s why the stock market may be overreacting to the coronavirus threat

Published Mon, Jan 27 202011:44 AM ESTUpdated Moments Ago

Jesse Pound@jesserpound


Key Points

• Stocks opened lower on Monday, with the Dow Jones Industrial Average down more than 500 points, or 1.8%, after confirmed cases of the coronavirus rose over the weekend.
• Markets also slumped in early 2003 amid an outbreak of severe acute respiratory syndrome, or SARS, but many major indexes finished the year strong.
• “People are under-appreciating how bad this is going to be in China, and over-appreciating how bad it is going to be in the U.S.,” said Chris Meekins, healthcare policy analyst at Raymond James

more at link

https://www.cnbc.com/2020/01/27/here...e=twitter|main

 

[sharon sanders]

HI everyone!

Thank you very much for participating.

One note - Please only post a tiny snip of an article in its original language. We do not want to infringe on anyone's copyright. Also please - a link back to the original source.

Copyright claims are being used to silence the internet. Let's not give anyone a reason to try to shut us down.

Thanks!

 

[Tea]

Scott Gottlieb, MD scolon ttGottliebMD

https://twitter.com/ScottGottliebMD/...91996945235972

My Op-ed: How we need to prepare for a U.S. outbreak of Wuhan coronavirus ⁦ @CNBC
⁩ Op-ed: We need to prepare for US outbreak of Wuhan coronavirus

Published Mon, Jan 27 20207:01 AM ESTUpdated 2 hours ago


Key Points

• The epidemic in China is likely much broader than official statistics currently suggest.
• A lot of mild cases probably remain unrecognized.
• Global spread appears inevitable. So too are the emergence of outbreaks in the U.S

Dr. Scott Gottlieb is a CNBC contributor, a resident fellow at the American Enterprise Institute, Pfizer board member and the former commissioner of the FDA.

Even though there’s a lot that we don’t know about the novel coronavirus that’s burning its ways through China, there are some critical assumptions we should make about its continued spread.
First, the epidemic in China is likely much broader than official statistics currently suggest. A lot of mild cases probably remain unrecognized. Even a lot of severe cases are unreported since diagnostic tests were only recently deployed to the front lines of China’s healthcare system.

Second, global spread appears inevitable. So too are the emergence of outbreaks in the U.S., even if a widespread American epidemic can still be averted. When pockets of the outbreak arrive on our shores, we shouldn’t have undue panic. But we need to be ready.

The most important public health measures to contain new outbreaks are the early identification and isolation of cases to prevent further spread. Key to applying these measures and limiting spread will be easy access to reliable and rapid diagnostic tests to enable widespread screening. These tools will allow us to identify new cases early and isolate sick individuals.

Right now, the Centers for Disease Control and Prevention has a test that works by detecting parts of the virus’ genome in the blood. CDC is working with the Food and Drug Administration to make this type of test more widely available to public health labs throughout the U.S. The agencies are working to advance the test under an authorization for emergency use. This is a regulatory designation that accelerates the normal FDA clearance process during public health emergencies.

The CDC test is fast. It can diagnose a sample in a few hours once a blood specimen reaches a designated lab. The test is likely to be given primarily to state and local public health laboratories. But to adopt more widespread surveillance and diagnosis, we may need a diagnostic that’s more readily accessible to providers on the front line of response. This includes tests that can be used right in the doctor’s office, clinics, and hospitals – or even at ports of entry.


More at:

https://www.cnbc.com/2020/01/26/op-e...ronavirus.html

 

[Tea]

HI everyone!

Thank you very much for participating.

One note - Please only post a tiny snip of an article in its original language. We do not want to infringe on anyone's copyright. Also please - a link back to the original source.

Copyright claims are being used to silence the internet. Let's not give anyone a reason to try to shut us down.

Thanks!

OOh, I wondered about that, I will edit.

 

[hawkeye]

I’m seeing more and more “soft” (via retired..etc. officials) messaging about the virus significantly spreading beyond China’s borders.

Global spread appears inevitable. So too are the emergence of outbreaks in the U.S.... We shouldn’t have undue panic. But we need to be ready." says former US FDA commissioner
@ScottGottliebMD
of the #coronavirus.

https://mobile.twitter.com/DrEricDin...49062850334720

 

[hawkeye]

After seeing what is going on in China - I'm having a tough time reconciling this article:

New coronavirus 'not spreading' in the US, CDC says
https://abcnews.go.com/Health/coronavirus-spreading-us-cdc/story?id=68560892

 

[Laidback Al]

A quick review of the different country threads regarding the 2019-nCoV spread here at FluTrackers seems to indicate that all reported confirmed cases in countries other than China are people who were infected in China before arriving in these other countries. So far, there has been no reported cases of human-to-human transmission outside of China.

 

[hawkeye]

A quick review of the different country threads regarding the 2019-nCoV spread here at FluTrackers seems to indicate that all reported confirmed cases in countries other than China are people who were infected in China before arriving in these other countries. So far, there has been no reported cases of human-to-human transmission outside of China.

So we have a 4th Gen virus that only spreads within the geographic area of China?

 

[JimO]

If the incubation period is a week or more, we probably won't see H2H cases outside China for a few more days, at least. Plus, unless serious symptoms develop quickly, cases might not be diagnosed until patients are seriously ill. Assuming the CDC is going to be transparent and not try to control messaging as this unfolds, my guess is that we will likely see confirmed H2H cases in the US within the next week. However, based on the CDC's responses to the 2009 H1N1 outbreak and the ebola outbreak, I believe the CDC will control the release of test results to "avoid panic" and they can do this for the time being since they are the only testing center in the US.

 

[etudiant]

If the incubation period is a week or more, we probably won't see H2H cases outside China for a few more days, at least. Plus, unless serious symptoms develop quickly, cases might not be diagnosed until patients are seriously ill. Assuming the CDC is going to be transparent and not try to control messaging as this unfolds, my guess is that we will likely see confirmed H2H cases in the US within the next week. However, based on the CDC's responses to the 2009 H1N1 outbreak and the ebola outbreak, I believe the CDC will control the release of test results to "avoid panic" and they can do this for the time being since they are the only testing center in the US.

That is a reasonable assessment. However, the CDC is very much at risk here, at least imho.

The CDC's and the WHO's downplaying the hazards 'to avoid panic' clearly delays the kind of aggressive action that could save the day for the US and others., If largely because of this the epidemic turns out to become as serious here as it already is in China, both these entities will be eviscerated by the politicians and the public.
I do not understand why they are not acting more forcefully, given the unprecedented efforts by the Chinese government.

 

[hawkeye]

That is a reasonable assessment. However, the CDC is very much at risk here, at least imho.

The CDC's and the WHO's downplaying the hazards 'to avoid panic' clearly delays the kind of aggressive action that could save the day for the US and others., If largely because of this the epidemic turns out to become as serious here as it already is in China, both these entities will be eviscerated by the politicians and the public.
I do not understand why they are not acting more forcefully, given the unprecedented efforts by the Chinese government.

While I'm not a fan of an over zealous government - the fact that the CDC is taking this position when so much is unknown is absolutely incredible (and rather frightening). But, I hope the right..and I hope it stops spreading in China. But hope is not a plan.