The concerning part is that the patient required a significant amount of hospitalization with supplemental oxygen to recover.Quote:
On hospital day 8 (illness day 12), the patient's clinical condition improved. Supplemental oxygen was discontinued, and his oxygen saturation values improved to 94 to 96% while he was breathing ambient air. The previous bilateral lower-lobe rales were no longer present. His appetite improved, and he was asymptomatic aside from intermittent dry cough and rhinorrhea. As of January 30, 2020, the patient remains hospitalized. He is afebrile, and all symptoms have resolved with the exception of his cough, which is decreasing in severity.
Actually right now the death rate is over 50%. Deaths exceed recoveries. I dont think we will know real death rates for a while. Hopefully it ends up back down to the 2 range, but we arent there yet.VaultingChemist said:
Some very useful information from an anonymous poster on reddit who claims to have been working the last two weeks on the spread of the Coronavirus.
Corornavirus FAQQuote:
1) What is the incubation period? Why do I keep hearing 14 days? Is this scary?
The incubation period so far shows a period of 2-7 days with a 95% confidence interval, with median cases at 4.8 days. [url=https://www.biorxiv.org/content/10.1101/2020.01.25.919787v1][1][/url]The 14 day limit is the current maximum theorized incubation period from a Zhejiang case study. The exact maximum is difficult to know because this is based on patient survey and contact reconstruction and prone to error, but 14 days is the "safe" upper bound so far. This figure is similar to the ~5 day incubation for SARS. [url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322923/][2][/url] There is no need to panic about this as it's very normal viral behavior.Quote:
2) But what about asymptomatic transmission? Is this worth worrying over?
So to be clear, so far over 95% of patients in most studies do eventually display symptoms. [url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext][3][/url] However, transmission during the asymptomatic incubation stage above has also been confirmed by local and international studies. I believe the US decision to vastly heighten travel restrictions on China last night was largely due to this German confirmation. Ironically US CDC previously did not believe Chinese warnings this was happening.Quote:
4) What is the R0? Is it 2? 5? 12? What does this mean for the viral evolution?
Since popular media (Contagion, Pandemic) really brought the concept of R0 into public focus, there's a lot of confusion about this simplification of statistical methods. Put simply, R0 is a variable used in theoretical epidemiology analysis, derived from the data through various mathematical methods. It is not an intrinsic property of the virus, nor is it set in stone - R0 will change as properties of the outbreak, and our containment efforts, adjust it. There's a good further discussion of R0 here, but generally, without understanding the underlying methods that led to the calculation of a specific R0, you shouldn't overly focus on this number, nor compare it or make conclusions based purely on it.
As best as our models can tell, the R0 of the virus was well above 2-3 in the beginning, where it was infecting people in Wuhan through the Seafood market and across many vectors before broad awareness. This was from Dec of last year to maybe early January. Since increasing awareness and containment factors, the R(t) has likely declined to below 2, and optimistically will head below 1.Quote:
5) Why is the official case count so low? Why do I keep hearing larger numbers of infected? Is there a government cover-up?
The official "confirmed cases" number is not meant to be a "live" count of the # of infected or even identified infected individuals, and the professional community understands this. This number is exactly what it says on the tin, eg, this is the official number we have been able to test and confirm to our satisfaction. In our current fast-response information-driven society, we are used to having access to immediate, live data, and we expect such. The fact we have any confirmation at all at this point is actually a miracle. Back in the days of SARS, no accurate testing existed for many months after the outbreak, so ALL numbers were estimates!
Now due to Chinese bureaucracy and how the confirmations work in China, lack of supplies and personnel when Wuhan hospitals were overwhelmed last week, and difficulty producing the test kits, there is a lag time of up to 12 days to someone being suspected and able to be tested in Wuhan. I think this week they're working hard on bringing that lag down, and the lag is a lot shorter in other provinces due to still-functioning logistics, but it's still about 5 days at least in almost all of China, due to the multiple bureaucratic checks they force it to go through before it's deemed "confirmed enough". There's a trade-off between accuracy (yes, they wouldn't want to make an embarrassing mistake misdiagnosing or mistaking identity) and speed.
In the rest of the world, the delay can be very fast, ~1 day response to 3 or 4 days as well, depending on the country's infrastructure and availability of test kits/proximity to CDC center that's stocking it.
So really the way to think about the number of confirmed cases in China is, this is the number of cases that we can confirm from about 7-10 days ago. This is how we're roughly working with the data. I think most laypeople are just assuming this is a "live" number which is just not the case, it takes time from patient intake to screening to testing to confirmation to double checking.Quote:
6) What about deaths? Have a lot of people died? Why is the official death rate so low? Is there a cover-up?
It is true that the death rate reported by China is heavily misleading. But this is NOT due to an active cover-up. There are 2 main structural reasons:
[ol]This is primarily due to the structural method of how China records deaths on their certificate. It is established policy/practice in China to record the final cause of death, rather than all existing conditions and overlapping factors. [/ol]For example, if a (say 85 yo) patient in the US with diabetes and an existing heart condition gets nCoV, is admitted in the hospital, is confirmed with nCoV, then dies of heart failure, he is recorded as dying of nCoV AND heart failure with other complications. However if the same patient dies in China, he would only be recorded of dying by heart failure.
This is a well-known issue with China and co-morbid diseases. I don't agree with it, I wouldn't do it, but I don't run China. But this is not a new method they made up to try to hide deaths here, it's just the way it's done. This has led to jokes in the epidemiology community that "it's impossible to die of flu in China", because they basically don't record any deaths where the patient has flu. See here this recent article from the Global Times, which is one of China's state-sponsored newspapers.
This is not something even China is really trying to hide. They just tell us, sorry, our doctors just do things this way, we have no interest in changing it.
2) The other reason is, right now if a patient is awaiting test results (turnaround can be 3-5 days in China still), and passes away in the meantime, they are not recorded as nCoV. I guess this I can understand, I think similar policies in US, we don't like to go back and edit death certificates because it's a huge hassle.
Ok so - definitely, the death count is too low. We all agree there. But before you freak out, there's a bright spot. We CAN also put an upper bound with a fair amount of certainty on the general death rate. How? Because there have been enough cases reported globally already, and enough data from the patients OUTSIDE of China, that we can tell the death rate is NOT anywhere near 10% with a strong degree of certainty (many patients have recovered, and are just awaiting the viral test all-clear before they can be discharged. Most other patients are in stable and recovering condition).
Lol ALL numbers are known for sure to be wildly innacurate.Fenrir said:
He is comparing the death numbers to the "recovered" numbers released by China. Both are likely very inaccurate. The first is under reported and the second only accounts for people released from hospital.
third coast.. said:
The left hasn't cared about the actual definition of racism is years.
Fenrir said:
First US infection was reported 2 weeks ago. According to the hysteria about exponential infection rates earlier in this thread it's clear many were expecting a much larger spread by this point.
T&P to all the fatties in the US. Arkansas and LSU will be down a lot of fans...erudite said:
From one of my sources but might be biased cause confirmation bias.
The age group with the most deaths in China is
male, 38-70, preexisting conditions of the below:
- Cardiovascular disease
- High blood pressure
- High blood cholesterol
Aggierific said:
My run through of plague Inc mimicking these symptoms didn't result in success. Wealthy country hand washing killed the spread. China and land countries surrounding were decimated. Maybe if I had mutated a few new abilities?
If it was a created as a bio-weapon then it's was made perfectly for the US.AgResearch said:T&P to all the fatties in the US. Arkansas and LSU will be down a lot of fans...erudite said:
From one of my sources but might be biased cause confirmation bias.
The age group with the most deaths in China is
male, 38-70, preexisting conditions of the below:
- Cardiovascular disease
- High blood pressure
- High blood cholesterol
Somehow, I missed the really important part. An experimental drug used to fight the Ebola virus, remdesivir, was crucial in helping the patient recover.VaultingChemist said:
Research article on Washington State patient, 35-year-old male that visited family in Wuhan.
First Case of 2019 Novel Coronavirus in the United StatesThe concerning part is that the patient required a significant amount of hospitalization with supplemental oxygen to recover.Quote:
On hospital day 8 (illness day 12), the patient's clinical condition improved. Supplemental oxygen was discontinued, and his oxygen saturation values improved to 94 to 96% while he was breathing ambient air. The previous bilateral lower-lobe rales were no longer present. His appetite improved, and he was asymptomatic aside from intermittent dry cough and rhinorrhea. As of January 30, 2020, the patient remains hospitalized. He is afebrile, and all symptoms have resolved with the exception of his cough, which is decreasing in severity.
From Gilead, the maker of remdesivir:Quote:
Given the radiographic findings, the decision to administer oxygen supplementation, the patient's ongoing fevers, the persistent positive 2019-nCoV RNA at multiple sites, and published reports of the development of severe pneumonia3,4 at a period consistent with the development of radiographic pneumonia in this patient, clinicians pursued compassionate use of an investigational antiviral therapy. Treatment with intravenous remdesivir (a novel nucleotide analogue prodrug in development10,11) was initiated on the evening of day 7, and no adverse events were observed in association with the infusion.
Quote:
"To my knowledge, this is the first reported case in the world where this drug has been used against this virus," Jay Cook, chief medical officer at the center, told reporters on a conference call Friday. "At the time, we felt the benefits of using this drug outweighed whatever potential risk there might be and we obtained his informed consent."
The patient's pneumonia appeared to improve within a day, with no obvious side effects, after the intravenous drug was administered, his doctors reported in the New England Journal of Medicine Friday. The finding should encourage randomized, controlled clinical trials to determine its safety and efficacy for treating 2019-nCoV infections, they said.
The drug was approved for use on compassionate grounds. It's not licensed or approved anywhere in the world, and hasn't been demonstrated to be safe or effective for any use, Foster City, California-based Gilead said in a statement.
I found it weird to see the name of Jesus at the end of the video.cbr said:
In one sentence you say until X happens, the stats aren't known. Then proceed to give stats which are essentially irrelevant.cbr said:
Lol literally every source out there. Its no secret.
People are pulling deaths / infected to get low numbers. Deaths / recovered and released is over 50%.
Its not rocket science. Until a patient dies or is declared recovered, the stats arent known.
Presumably a lot more will be released soon, but until that happens the actual mortality remains +50%.
Further disturbing is the fact that china will underreport deaths and infected, but would certainly try to overreport recoveries. But we are still +50%.
There are more Christians in China than in all of Western Europe.Quote:
I found it weird to see the name of Jesus at the end of the video.
Westerner?
Towns03 said:
That can't be right. 26K a day? I bet it's more like 1,500 per day. (Random guess)
Lol let me state some logic for you clearly.GE said:In one sentence you say until X happens, the stats aren't known. Then proceed to give stats which are essentially irrelevant.cbr said:
Lol literally every source out there. Its no secret.
People are pulling deaths / infected to get low numbers. Deaths / recovered and released is over 50%.
Its not rocket science. Until a patient dies or is declared recovered, the stats arent known.
Presumably a lot more will be released soon, but until that happens the actual mortality remains +50%.
Further disturbing is the fact that china will underreport deaths and infected, but would certainly try to overreport recoveries. But we are still +50%.
cbr said:
I didnt realize that 800k people flew to/from china and the us every month.
Hopefully the numbers stay in control, but that is not an encouraging statistic.
cbr said:Lol let me state some logic for you clearly.GE said:In one sentence you say until X happens, the stats aren't known. Then proceed to give stats which are essentially irrelevant.cbr said:
Lol literally every source out there. Its no secret.
People are pulling deaths / infected to get low numbers. Deaths / recovered and released is over 50%.
Its not rocket science. Until a patient dies or is declared recovered, the stats arent known.
Presumably a lot more will be released soon, but until that happens the actual mortality remains +50%.
Further disturbing is the fact that china will underreport deaths and infected, but would certainly try to overreport recoveries. But we are still +50%.
People are claiming under 10% mortality based upon false stats, but which if taken as true are logically flawed.
They are taking dead people and dividing it among total infected, instead of looking at 'fully resolved' cases. The fully resolved cases reflect over 50% died.
All of these stats are know to be wrong.
However working with the stats that exist, 50% is the actual death rate.
One can hope and probably predict that a lot more cases will resolve without death, ultimately driving the mortality rate way down.
But then again, the actions of the government dont really match any of that hope.
Is that how death rate is widely defined? Why do I see everyone else using total deaths to total cases?cbr said:Lol let me state some logic for you clearly.GE said:In one sentence you say until X happens, the stats aren't known. Then proceed to give stats which are essentially irrelevant.cbr said:
Lol literally every source out there. Its no secret.
People are pulling deaths / infected to get low numbers. Deaths / recovered and released is over 50%.
Its not rocket science. Until a patient dies or is declared recovered, the stats arent known.
Presumably a lot more will be released soon, but until that happens the actual mortality remains +50%.
Further disturbing is the fact that china will underreport deaths and infected, but would certainly try to overreport recoveries. But we are still +50%.
People are claiming under 10% mortality based upon false stats, but which if taken as true are logically flawed.
They are taking dead people and dividing it among total infected, instead of looking at 'fully resolved' cases. The fully resolved cases reflect over 50% died.
All of these stats are know to be wrong.
However working with the stats that exist, 50% is the actual death rate.
One can hope and probably predict that a lot more cases will resolve without death, ultimately driving the mortality rate way down.
But then again, the actions of the government dont really match any of that hope.
Let's pray that this remains the case.JJMt said:
The encouraging news is that the total number of deaths outside of China, for which we have hard numbers, is only 1, I believe. In addition, to date, there has only been minimal person to person transmission outside of China.
