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Started By
Message
re: Coronavirus Disease 2019 (COVID-19) ***W.H.O. DECLARES A GLOBAL PANDEMIC***
Posted on 1/27/20 at 3:05 pm to wdhalgren
Posted on 1/27/20 at 3:05 pm to wdhalgren
quote:
You also have to consider the ability to test for the diagnosis. When did China first have the ability for widespread reliable tests? Maybe confirmed fatality counts are rising in part due to better diagnosis.
You also have to consider at what point the lack of any medical treatment increases mortality rate. Is the 2-3% expiring based on the other 97% having the capability of riding to the urgent care to get a Zpac and picking up a quart of chicken soup at Rousses? What is the mortality rate if there in no treatment available for anyone, which what will happen if there are suddenly 100s of 1000s sick to millions sick at the same time?
1
Posted on 1/27/20 at 3:07 pm to lsu13lsu
Pic of the thermal scanner in that article is pretty cool.
Posted on 1/27/20 at 3:08 pm to tigerfoot
quote:
But these seems a little meh.
Sure. Because nothing would say meh better that having local authorities pile dirt up on I-10 at the city limits.
Posted on 1/27/20 at 3:08 pm to bamarep
quote:
San Fransisco can't even keep human shite off the streets.
Do we honestly think those idiots could stop a highly contagious virus?
Bitch please.
..and they will blame Trump for it.
Posted on 1/27/20 at 3:11 pm to LSUGrrrl
Posted on 1/27/20 at 3:21 pm to LSUGrrrl
Did she just say that the number of people flying in from Wuhan are declining or inclining? It was hard to understnad
Posted on 1/27/20 at 3:23 pm to NastyNatiNole
quote:
Did she just say that the number of people flying in from Wuhan are declining or inclining? It was hard to understnad
I think she said reclining.
Posted on 1/27/20 at 3:38 pm to LegendInMyMind
From r/c_f:
I made the following notes during the press conference by Professor Gabriel Leung. He is the Dean of Medicine at Hong Kong University and led HK's efforts against H1N1 in 2009.
I was only able to summarize the English portions. Also I apologize if I have misnamed or mistaken any Chinese cities, I did my best to transcribe them correctly.
GL: The report I am about to share with you (PDF) is also being immediately sent to the authorities in Beijing and to the WHO.
GL: The epidemic is growing at an exponential, accelerating rate. The real question is given the lag between infection, incubation, symptom onset, hospital admission, treatment, and then recovering or perishing, given that lag, we used our mathematical model to try and infer how many cases there actually are/were (as of two days ago) in Wuhan and other places in mainland China.
GL: the basic reproductive number we measure as 2.13 - this is the best estimate we have at the moment. A doubling time of six days in the absence of any public health interventions is expected..
I made the following notes during the press conference by Professor Gabriel Leung. He is the Dean of Medicine at Hong Kong University and led HK's efforts against H1N1 in 2009.
I was only able to summarize the English portions. Also I apologize if I have misnamed or mistaken any Chinese cities, I did my best to transcribe them correctly.
GL: The report I am about to share with you (PDF) is also being immediately sent to the authorities in Beijing and to the WHO.
GL: The epidemic is growing at an exponential, accelerating rate. The real question is given the lag between infection, incubation, symptom onset, hospital admission, treatment, and then recovering or perishing, given that lag, we used our mathematical model to try and infer how many cases there actually are/were (as of two days ago) in Wuhan and other places in mainland China.
GL: the basic reproductive number we measure as 2.13 - this is the best estimate we have at the moment. A doubling time of six days in the absence of any public health interventions is expected..
This post was edited on 1/27/20 at 3:42 pm
Posted on 1/27/20 at 3:39 pm to LSUGrrrl
GL: (explaining a graph presentation) The number of clinically apparent cases we model to be 25 to 26 thousand as of Chinese New Year Day. The number of total infections when including presymptomatic cases "approaches 44 thousand."
GL: Wuhan is extensively connected to the North, South, East and West of China. The number of cases exported from Wuhan to the rest of mainland China, in our model as of Jan25, range from 18 in Qingdao to a high of 318 in Chongqing. The numbers will be higher by now. But that's not the most important point. There have been megalopolis quarantines since Jan23. We ran the model with and without the quarantines accounted for, and the forecasts are very similar. The quarantines may not be able to substantially change the course of the epidemic curves in other major Chinese city clusters.
GL: We modeled epidemic curves out to August 2020 for all the major city clusters in China: Chongqing, Shanghai-Guangzhou, Shenzhen and Beijing. Chongqing is predicted to have the largest epidemic due to large population and most intense traffic volume coupled to Wuhan. The timing of the peak is sometime in April to May 2020, one to two weeks in Chonqing before the other major city clusters (except Wuhan which will peak even earlier).
GL: a special note on HK and Macao. They are also linked to G'zhou and Shenzhen by rail which may (be more important than?) the links direct from HK/Macao to Wuhan. (His speech is not clear here).
GL: We are expecting to see Self sustaining epidemic clusters - not just repeated exports from Wuhan but actually a local self sustaining epidemic - within all five?/four? of the major city clusters of China.
GL: Wuhan is extensively connected to the North, South, East and West of China. The number of cases exported from Wuhan to the rest of mainland China, in our model as of Jan25, range from 18 in Qingdao to a high of 318 in Chongqing. The numbers will be higher by now. But that's not the most important point. There have been megalopolis quarantines since Jan23. We ran the model with and without the quarantines accounted for, and the forecasts are very similar. The quarantines may not be able to substantially change the course of the epidemic curves in other major Chinese city clusters.
GL: We modeled epidemic curves out to August 2020 for all the major city clusters in China: Chongqing, Shanghai-Guangzhou, Shenzhen and Beijing. Chongqing is predicted to have the largest epidemic due to large population and most intense traffic volume coupled to Wuhan. The timing of the peak is sometime in April to May 2020, one to two weeks in Chonqing before the other major city clusters (except Wuhan which will peak even earlier).
GL: a special note on HK and Macao. They are also linked to G'zhou and Shenzhen by rail which may (be more important than?) the links direct from HK/Macao to Wuhan. (His speech is not clear here).
GL: We are expecting to see Self sustaining epidemic clusters - not just repeated exports from Wuhan but actually a local self sustaining epidemic - within all five?/four? of the major city clusters of China.
Posted on 1/27/20 at 3:40 pm to LegendInMyMind
I wish someone would take some evacuation footage and set it to Yakety Sax, in the fashion of Benny Hill.
Posted on 1/27/20 at 3:40 pm to LSUGrrrl
GL: The question is now whether those predicted self sustaining epidemics will in turn seed such local epidemics overseas. The four Bj/Sh/Gz/Shz account for 53% of all international travel in the country and 70% of all international air travel out of Asia originating from mainland China. These four are highly likely to seed local epidemics in connected ports overseas.
GL: The conclusion that we draw from this analysis - why it's important to submit it publicly immediately after sending to WHO - The epidemic in Wuhan, as a precautionary principle, we must be prepared for it to become a global epidemic. This is not a certainty but there is a "not weak," "not insubstantial," "not trivial" chance that this will happen.
GL: There is already self sustaining chains of transmission modeled in the major Chinese cities. (Because the four mega city clusters have such high population?), if these cities were in turn to become significant exporters of virus (due to the acceleration of their epidemic curves?), they would have a "NOT TRIVIAL" chance of kickstarting local epidemics in connected overseas cities.
GL: Again let me emphasize, this is not a prediction but these findings make us concerned enough to alert the authorities and the public to keep everyone informed. It is incumbent on us to prepare for this non trivial possibility.
GL: If we want to change the course of these epidemic curves, then we are looking at "SUBSTANTIAL, DRACONION MEASURES LIMITING POPULATION MOBILITY" which should be taken sooner rather than later: school closures, ban mass gatherings, work from home, but also between population clusters, we must reduce population mobility. Should containment fail and local transmission is established, mitigation measures from previous pandemics could "come off the shelf" as templates for action. The major Chinese cities would be "well advised" to review these mitigation plans and prepare to act. (Prof. Leung did not specify in English what those measures would be).
GL: The conclusion that we draw from this analysis - why it's important to submit it publicly immediately after sending to WHO - The epidemic in Wuhan, as a precautionary principle, we must be prepared for it to become a global epidemic. This is not a certainty but there is a "not weak," "not insubstantial," "not trivial" chance that this will happen.
GL: There is already self sustaining chains of transmission modeled in the major Chinese cities. (Because the four mega city clusters have such high population?), if these cities were in turn to become significant exporters of virus (due to the acceleration of their epidemic curves?), they would have a "NOT TRIVIAL" chance of kickstarting local epidemics in connected overseas cities.
GL: Again let me emphasize, this is not a prediction but these findings make us concerned enough to alert the authorities and the public to keep everyone informed. It is incumbent on us to prepare for this non trivial possibility.
GL: If we want to change the course of these epidemic curves, then we are looking at "SUBSTANTIAL, DRACONION MEASURES LIMITING POPULATION MOBILITY" which should be taken sooner rather than later: school closures, ban mass gatherings, work from home, but also between population clusters, we must reduce population mobility. Should containment fail and local transmission is established, mitigation measures from previous pandemics could "come off the shelf" as templates for action. The major Chinese cities would be "well advised" to review these mitigation plans and prepare to act. (Prof. Leung did not specify in English what those measures would be).
Posted on 1/27/20 at 3:44 pm to LSUGrrrl
Q: What is the WHO's understanding of presymptomatic transmission?
GL: We don't know the severity profile. Everyone currently is guessing. We must do extensive testing of the "full unbiased, unselected sample" of cases "sweeping down the clinical severity spectrum." There is a bias towards confirming and testing the patients who are obviously sick. We are not yet testing outpatients and everyone who comes in with mild symptoms. So we don't know the infectivity of presymptomatic patients. Healthcare workers are already at the PEAK of their capacity. Laboratory capacity constraints - surge capacity for testing - and the quality control to prevent false positives/negatives in tests - also restrain us. Whatever we are now seeing is the BEST GUESS from our clinicians who are most experienced and have lived through similar epidemics but that is no guarantee we are correct because even different coronaviruses (SARS/MERS) are very different.
GL: (clarifying) What we are hoping is that "viral shedding" (?) scales, preferably even exponentially, with symptom severity. But we don't know, it is a conclusion we can only hope for.
Q: Does presymptomatic infectivity mean screening is now inefficient?
GL: We don't know the clinical spectrum. For example SARS - you WILL become moderately to severely sick. MERS, it's more like other respiratory viruses, there's a wide range of (clinical isotopes? clinical iceberg? I think he means there's plenty of people who barely get sick). What NCoV turns out to be, we don't know. So far NCoV looks more like MERS than SARS in clinical severity spectrum but that is based on our observations, it is still a best guess.
GL: We don't know the severity profile. Everyone currently is guessing. We must do extensive testing of the "full unbiased, unselected sample" of cases "sweeping down the clinical severity spectrum." There is a bias towards confirming and testing the patients who are obviously sick. We are not yet testing outpatients and everyone who comes in with mild symptoms. So we don't know the infectivity of presymptomatic patients. Healthcare workers are already at the PEAK of their capacity. Laboratory capacity constraints - surge capacity for testing - and the quality control to prevent false positives/negatives in tests - also restrain us. Whatever we are now seeing is the BEST GUESS from our clinicians who are most experienced and have lived through similar epidemics but that is no guarantee we are correct because even different coronaviruses (SARS/MERS) are very different.
GL: (clarifying) What we are hoping is that "viral shedding" (?) scales, preferably even exponentially, with symptom severity. But we don't know, it is a conclusion we can only hope for.
Q: Does presymptomatic infectivity mean screening is now inefficient?
GL: We don't know the clinical spectrum. For example SARS - you WILL become moderately to severely sick. MERS, it's more like other respiratory viruses, there's a wide range of (clinical isotopes? clinical iceberg? I think he means there's plenty of people who barely get sick). What NCoV turns out to be, we don't know. So far NCoV looks more like MERS than SARS in clinical severity spectrum but that is based on our observations, it is still a best guess.
This post was edited on 1/27/20 at 3:45 pm
Posted on 1/27/20 at 3:47 pm to LSUGrrrl
GL: Fatality rate is currently being measured only among people who are admitted and confirmed cases. So our best guess - of the hospitalization(?) fatality ratio is 14%. But let me emphasize that is not the CASE fatality ratio and certainly not the INFECTION fatality ratio... which will be much lower.
Q: Why advise draconian measures if so many factors are unknown? Overseas cases are being managed well currently with low fatality?
GL: Fatality ratio during the beginning of an epidemic is usually low. We learned that from SARS. For the first few weeks of SARS the WHO estimated 3-5% case fatality, it turned out to be 17% in HK. That's because of the timespan from infection to symptoms, to hospitalization, to treatment, to recovering or expiring - a full month. A cross-sectional cut will underestimate the true case fatality due to the characteristics of coronavirus (?). Secondly, overseas cases are self-screening for better prognosis (I am heavily paraphrasing that) because if you are very sick you won't travel and you can't pass the thermal screen. To base our actions on those cases which are caught early by thermal scans in otherwise healthy passengers is optimistic.
Q: Why advise draconian measures if so many factors are unknown? Overseas cases are being managed well currently with low fatality?
GL: Fatality ratio during the beginning of an epidemic is usually low. We learned that from SARS. For the first few weeks of SARS the WHO estimated 3-5% case fatality, it turned out to be 17% in HK. That's because of the timespan from infection to symptoms, to hospitalization, to treatment, to recovering or expiring - a full month. A cross-sectional cut will underestimate the true case fatality due to the characteristics of coronavirus (?). Secondly, overseas cases are self-screening for better prognosis (I am heavily paraphrasing that) because if you are very sick you won't travel and you can't pass the thermal screen. To base our actions on those cases which are caught early by thermal scans in otherwise healthy passengers is optimistic.
This post was edited on 1/27/20 at 3:48 pm
Posted on 1/27/20 at 3:56 pm to Boat Motor Bandit
quote:
Hearing talk at the local noodle shop here in SWLA at lunch. They have family in that province that are in the medical field. They are in contact by phone once a day only, government restriction on communication. No cell phones work at all without wifi and they use whats app when they can find internet turned on by government. They are telling family over here that they are certain the infected number is well over 250,000+ conservative and they know for certain death toll is over 1000 people and would not surprise them if death toll was over 2500. Government is controlling everything at every clinic. Soon as a patient is on the down hill side, they make a round and that patient has been taken from clinic by government and a new one in its place. They have been asked to throw all kinds of different meds at the virus and document any reaction.
if you do the timeline from last Friday where a Wuhan nurse/doctor estimated 90k sick, that is within reason.
If the number of infected is currently at 250k then 1000 dead is actually closer to being in line with the mortality rate for a bad flu season (0.4%).
Posted on 1/27/20 at 4:00 pm to CivilTiger83
quote:
If the number of infected is currently at 250k then 1000 dead is actually closer to being in line with the mortality rate for a bad flu season (0.4%).
It’d be much higher because many of the pt would be in the early stages of the disease. Eventually many more would die. Look at the previous post saying the infection to death time was one month in other coronaviuses.
Posted on 1/27/20 at 4:01 pm to LSUGrrrl
quote:
GL: We modeled epidemic curves out to August 2020 for all the major city clusters in China: Chongqing, Shanghai-Guangzhou, Shenzhen and Beijing...The timing of the peak is sometime in April to May 2020, one to two weeks in Chonqing before the other major city clusters (except Wuhan which will peak even earlier).
Was supposed to move to Shenzhen in May. Think I may put a hold on that for now
Posted on 1/27/20 at 4:05 pm to arkyhawk
Posted on 1/27/20 at 4:08 pm to Poker_hog
quote:
It’d be much higher because many of the pt would be in the early stages of the disease. Eventually many more would die. Look at the previous post saying the infection to death time was one month in other coronaviuses.
Good point.
Posted on 1/27/20 at 4:11 pm to CivilTiger83
quote:
hey are telling family over here that they are certain the infected number is well over 250,000+
I am curious how a doctor or nurse could get to this number. I know the government numbers are not true but for a front line medical provider to get to this number seems a little far fetched. To reach that number I would bet they are relying on a decent amount of second or third-hand information.
This post was edited on 1/27/20 at 4:12 pm
Posted on 1/27/20 at 4:12 pm to CivilTiger83
Too much info since I last checked... was a little jet lagged.
So CDC and others thinking better or worse than previously stated?
So CDC and others thinking better or worse than previously stated?
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