Hackensack patient being evaluated for virus.

Formerlyjerseyjack

Hackensack Med Center.

Meanwhile, hospitals in China are in chaos as 10 cities are now in quarantine. There is now a 24/7 project underway in Wuhan City to build a 1.000 bed hospital in 7 days. Imagine how that will work out.


librarylady

False alarm..but still frightening!


spontaneous

Unless the Chinese government is fudging the numbers, the mortality rate seems to be about 3%.   Not the common cold, but not Ebola either.


BG9

spontaneous said:

Unless the Chinese government is fudging the numbers, the mortality rate seems to be about 3%.   Not the common cold, but not Ebola either.

It may be lower. Its 3% of reported patients. There are cases that may not be severe enough to be reported.

Its always China. The contagious disease transmission from animal meat markets or farms to people.

Their government abounds in technology yet disease epidemics are ignored or hidden, until they can't. They need to focus more on their health systems and less on general surveillance.


dave

spontaneous said:

Unless the Chinese government is fudging the numbers, the mortality rate seems to be about 3%.   Not the common cold, but not Ebola either.

There's not enough data yet to determine what global exposure or mortality rate will be.  The only thing known for certain is that the world is a week behind containing this due to bureaucratic blunders, which means it probably can't be contained, so wash your hands a lot, stay away from crowds, and eat a healthy diet to boost your immune system.

The WHO just updated the global threat level from medium to high (and admitted it had made an error ever saying it was a medium level threat).   Everything in Hong Kong is basically shut down; no school for two weeks at least; no postal service until further notice; work from home for many.  Time to sit back and get a lot of reading and music listening done until further notice for us.


yahooyahoo

By comparison, in the U.S. the flu has a mortality rate of 0.1% but the rate goes up to 1% for those over the age of 65.


dave

bub said:

https://www.psychologytoday.com/us/blog/its-catching/202001/the-chinese-coronavirus-is-not-the-zombie-apocalypse

 Not sure what reality this guy is writing about, but there are more deaths than full recoveries thus far in Hubei (over 100 dead and > 4500 infected, 20% of whom are 'critical').   The data are simply not there to gauge what level of threat this is, but thanks, "Psychology Today".  Maybe when Epidemiology Today has an article we'll have some facts.  Containment will not work until nations and regions begin doing half-hour tests of people. A vaccine will not be available for over a year.   


bub

All the info we have is tentative and short term, especially considering its coming out of China.  But for now the fatality rate is much smaller than SARS, the deaths appear to be mostly among older and/or health-compromised people, which is typical of infectious diseases, and many people are reported to have mild and even non-noticable symptoms.  I didn't see the 20% critical figure you are citing but I'll believe it.


bub

Just saw an article about 4 people infected in Germany.  All 4 are reported to have "very very mild" symptoms.  

I don't know where this is going but it's not Ebola.
 


dave

Yes, milder but spreading more easily due to long incubation period without people presenting symptoms like a fever.  I think faster testing kits are being developed, which should help contain it.


BG9

The spread is similar to the flu, not Ebola. That is, being contagious before symptoms. They also reported that every infected infects  about two others.

Its been reported that the antibodies last about four months. Which means you can be infected and be re-infected half a year later.

Not that the airport checks make much difference if its contagious before or after symptoms show. All the asymptomatic's who slip through will end contagious.

The only thing that could have worked is to isolate those coming from infected areas. But is that too late? How many slipped in already?

Hundreds of British citizens being flown back to the UK from Wuhan on Thursday will be put in quarantine for two weeks.

https://www.bbc.com/news/uk-51292590

ps - We're also isolating:

WASHINGTON — An airplane carrying about 200 American evacuees from Wuhan landed at a California Air Force reserve base Wednesday, according to footage released by Reuters.

Those on board included State Department employees, their families and other U.S. citizens. They will be housed on the March Air Reserve Base in Riverside, Defense Department spokesman Chris Mitchell said. He said they will stay there for three to 14 days.

https://www.washingtonpost.com/world/asia_pacific/coronavirus-china-live-updates/2020/01/29/d49b9194-423b-11ea-b503-2b077c436617_story.html#link-XZ7EH5HS6A7JFBQ7YTEH64U444

The death toll is 132 of the 6078 confirmed cases. A little over 2%. But there may be many more cases that haven't reported. So, the percentage may be lower or it maybe 2% because the unreported may get worse, then be reported and have the same mortality.


spontaneous

This is a picture of my husband in 2014 (not joking, this is actually him).  Turns out that person they transported didn’t have Ebola, but they didn’t know that at that time.  It was scary as f*ck.  My husband has since changed employers, but is still in the same line of work.  If my husband called me today to tell me that he had to treat and transport a coronavirus patient I might stock up hand sanitizer, but that’s about it.



dave

Opinion of  a good friend who teaches epidemiology here at a HK Uni.


HatsOff

Dave, thanks for that needed reality check. I am not an epidemiologist but took a couple classes in it long ago, just enough to be dangerous ... but I keep shaking my head at that statistic and thinking how can they even pretend to know the death rate. The ratio of deaths:recoveries is now 172:124. I truly doubt the death rate will be 58% but I also truly doubt it is 2%. But it is far too soon to say anything other than we really have no idea. This is killing people, and a lot of people are getting sick, and the daily growth in cases is (currently) exponential. That is pretty sobering. Encouraging people to minimize this is irresponsible.

Nonetheless there is a fine line between taking this seriously, vs. panic, especially for those of us in the US where so far there are very few (identified) cases. In Hong Kong I'd probably be panicking because I am wired that way ... but even reasonable people have every right to be concerned.

But the comparison to the flu is relevant in this way. If a person is worried about the Coronavirus but has not got a flu shot I refuse to listen to their worries. As of this moment, in the US, flu is far more likely to kill you. The flu shot gives you other immune system benefits as well. It is an absolute win ... just get the damn flu shot already, everyone!


BG9

"America First" -

Nor will the consequences of an “America First” worldview that treats global health security as unnecessary. In only three years, the Trump administration has eliminated the office of pandemic response, created after the Ebola epidemic of 2014; drastically scaled back the C.D.C.’s overseas outbreak prevention efforts, from 49 countries to just 10; and discontinued a surveillance program meant to detect new viral threats, like the coronavirus, before they make the leap into humans.
https://www.nytimes.com/2020/01/29/opinion/coronavirus-outbreak.html

But do we really need the CDC or NIH?

https://twitter.com/RightWingWatch/status/1220740601781608448?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1220740601781608448&ref_url=https%3A%2F%2Fwww.washingtonpost.com%2Freligion%2F2020%2F01%2F26%2Fpaula-white-miscarry-metaphor%2F


BG9

Dr Li, China's virus whistle blower, succumbed to the virus. He was 34 and apparently not immune compromised.

https://www.nydailynews.com/news/world/ny-coronavirus-chinese-doctor-who-warned-about-illness-dies-20200206-phiq2uqe25hs7eamiemkwqmv54-story.html


spontaneous

I’m still not going to panic.  A former co-worker of mine, young, healthy, and in his 30’s, almost died from the flu two years back.  He spent WEEKS in the ICU in an induced coma.  The overall mortality rate seems to be holding steady at 2%


bub

I don't get the 2% number.  It's clear that the confirmed cases are only being counted from among people with severe enough symptoms to go to the hospital.  People with mild cases are not even being counted.  There could be many more of the latter than the former. The death rate could be a lot lower than 2%.  


BG9

The 2% is based on the 30,000 reported cases in China. 15% of the reported require critical care.

The cruise ship with its 70 cases will tell us of severity and spread. Its a closed system that will tell us how many need hospitalization, how many need critical care and the mortality rate.

Assuming the mortality rate is much lower, lets say .2%. In a way that's bad because that means there are 300,000 active cases in China, too many to effectively stop the spread.


yahooyahoo

Missing from the data coming out of China is exactly who is dying?  Are they old, are they young, do they have other underlying health issues?  Without this information, it's difficult to assess the severity of this particular coronavirus.


bub

Getting the feeling it's going to be a pandemic.  It's a matter of panic control and effective strategy now.  "Pandemic" doesn't mean "killer disease," just that the disease spreads worldwide.   Also agree that the cruise ship population will tell us something but we already have some evidence about the severity of the cases outside China.  There have been 2 deaths among 100s of cases outside of China.  

One thing I haven't seen is commentary on China's horrible air quality as a possible factor in outcomes there.  Wuhan's air quality, like much of China, is at a dangerous level and three times worse than it is around here.   I found some medical studies concluding that some forms of air pollution definitely aggravate pneumonia.  That, combined with China's probably inferior health care even in ideal times, suggests that we will do better.


HatsOff

One thing that has been nagging at me is this. (and it is really just a technical / statistical nag - not a real "worry.")

This virus can spread before people have symptoms.

In some people, it causes minor symptoms.

In the early days, people in either of these two categories may quite easily have come here (or Europe, or wherever). They would not be counted as having the virus because they had minor symptoms and never sought treatment (or they sought treatment, but it was early days of this thing getting attention, were told "it's a cold" and that's that).

Then these "early minor cases" infected other people. 

These others may present to a doctor with a more serious illness, but because they had not been to China or in some cases even knew they had interacted with somebody who had recently returned from China, they won't be tested for this virus.

So cases may be very under-reported worldwide. And I'm not sure how we'd ever get a real handle on this unless every single person with respiratory symptoms gets tested - and that is totally unrealistic. 


BG9

yahooyahoo said:

Missing from the data coming out of China is exactly who is dying?  Are they old, are they young, do they have other underlying health issues?  Without this information, it's difficult to assess the severity of this particular coronavirus.

 


yahooyahoo

The worst pandemic in human history is still ongoing but gets limited news coverage these days:

https://www.unaids.org/en/resources/fact-sheet

https://en.wikipedia.org/wiki/Epidemiology_of_HIV/AIDS

HIV/AIDS is a global pandemic.[1] As of 2018, approximately 37.9 million people are infected with HIV globally.[2] In 2018, approximately 57% are men.[2] There were about 770,000 deaths from AIDS in 2018.[3] The 2015 Global Burden of Disease Study, in a report published in The Lancet, estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year, but remained stable from 2005 to 2015.[4]


bub

Not that it's a competition, and AIDs has become weirdly invisible as a news subject, but the Spanish flu infected about 500 million people (in a much less crowded planet than today) and killed between 20 to 50 million.


BG9

Here's a bleak assessment. It may be as lethal as Spanish flu but possibly a lot more infectious.

Recent coverage has been walking a fine line between simultaneously reporting the facts and seeking to calm the waters. The risk of coronavirus to the U.S. is low. You have a much greater chance of dying from the flu. And so on.
This is true at the moment. But we are clearly in the early stages of a global pandemic, and coronavirus is much nastier than the flu. Exactly how much nastier remains to be seen, but we are at the mercy of forces largely beyond our control now.
The current best estimates place the mortality of coronavirus between 1% and 3% with modern medical care. This only sounds low; in fact, it is a very high number. Seasonal influenza kills about 0.1% of patients with the virus, which translates to roughly 650,000 deaths around the world every year.
Coronavirus is more infectious than the flu, and possibly a lot more infectious. If the current numbers are to be believed, it is at least 10 times as lethal as the flu today, which puts it close to the virulence of the influenza strain that killed 50 million people in 1918. Despite medical advances, the world is far more crowded, and hence more vulnerable, than it was in 1918.

https://www.nydailynews.com/opinion/ny-oped-yes-worry-about-coronavirus-20200206-ane5vluupjblbnr4sbvrquuxqy-story.html#rt=chartbeat-flt


bub

1 to 3% is not anywhere close to the estimated fatality rate of 10 to 20% for Spanish flu. 

Read an article, dated today, reporting 336 cases outside of China and still only 2 deaths.

I'm not downplaying the situation, btw.  I think there's going to be a pandemic and it will be disruptive.  I just don't think it helps to overstate the danger with comparison to things like the Spanish flu, which is estimated to have killed 3 to 6% of the entire global population. 


BG9

bub said:

1 to 3% is not anywhere close to the estimated fatality rate of 10 to 20% for Spanish flu. 

Read an article, dated today, reporting 336 cases outside of China and still only 2 deaths.

I'm not downplaying the situation, btw.  I think there's going to be a pandemic and it will be disruptive.  I just don't think it helps to overstate the danger with comparison to things like the Spanish flu, which is estimated to have killed 3 to 6% of the entire global population. 

You may want to address that with Prof Frank Huyler. Let us know what he says.

https://emed.unm.edu/directory/faculty-bios/frank-huyler.html

They think a bit deeper than simply comparing the disease mortality rate of 100 years ago to now.

A difference is that in 1918 that was no real treatment for the flu. Just bed rest, water and opiates. Now we have all kinds of antibiotics that help with the secondary bacterial infections and a few anti-virals, IV saline solutions, balanced electrolytes, IV feeding, etc.

Its likely that with modern medial care only 1 to 2% would have succumbed to the Spanish flu, the same rate as we see with our new virus. This means this new virus could be equivalently lethal to the Spanish flu.



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