OT: Corona virus (Full Version)

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Canoerebel -> OT: Corona virus (2/26/2020 1:47:56 PM)

The Forum is a repository of smart, well-reasoned folks, and some of them might offer informed opinions about the Corona virus outbreak and how it might play out. Chickenboy comes to mind, given his background, and there may be others. I hope you'll chime in, as your thoughts should be very interested to those of us who are laymen and have no clue what's going on.




RangerJoe -> RE: OT: Corona virus (2/26/2020 1:56:48 PM)

Here is a link to the thread on the General forum:

https://www.matrixgames.com/forums/tm.asp?m=4757221&mpage=3�




jeffk3510 -> RE: OT: Corona virus (2/26/2020 2:01:19 PM)

I sure has taken a toll on the grain markets the last few days in my line of work.

However, I remember the 09 Swine Flu pandemic... it did the same thing, but didn't seem to destroy the world like they think this one is going to... which this one won't either.

I am also a very pessimistic guy, so keep that in mind, but it generally turns out to be correct.

I have a hard time figuring out what flu is what to be honest.

As kids we called it the flu - puking, stomach ache, the ****s.. etc.. The FLU is upper respiratory, so it wasn't that as a kid but we called it that.

We have A, B, and numerous others.

I know right now everyone we do business with the offices are a ghost town - everyone is sick. I don't know that I've seen that many sick before. My kids have all had it (flu or not, they've been sick), and one is home as we speak getting over it. Our office has around 25 people in two buildings, about 8 were here yesterday..

In my opinion (I am by no means an expert), this is just another flu that will come and go. The people dying (unfortunately) usually have some other underlying condition before hand..

If ya'll are anything like us, the cure is Chicken Noodle Soup...[8|]




RangerJoe -> RE: OT: Corona virus (2/26/2020 2:09:52 PM)


quote:

ORIGINAL: jeffk3510

I sure has taken a toll on the grain markets the last few days in my line of work.

However, I remember the 09 Swine Flu pandemic... it did the same thing, but didn't seem to destroy the world like they think this one is going to... which this one won't either.

I am also a very pessimistic guy, so keep that in mind, but it generally turns out to be correct.

I have a hard time figuring out what flu is what to be honest.

As kids we called it the flu - puking, stomach ache, the ****s.. etc.. The FLU is upper respiratory, so it wasn't that as a kid but we called it that.

We have A, B, and numerous others.

I know right now everyone we do business with the offices are a ghost town - everyone is sick. I don't know that I've seen that many sick before. My kids have all had it, and one is home as we speak getting over it. Our office has around 25 people in two buildings, about 8 were here yesterday..

In my opinion (I am by no means an expert), this is just another flu that will come and go. The people dying (unfortunately) usually have some other underlying condition before hand..

If ya'll are anything like us, the cure is Chicken Noodle Soup...[8|]


That stomach flu is probably what they now call Norovirus.




jeffk3510 -> RE: OT: Corona virus (2/26/2020 2:19:23 PM)


quote:

ORIGINAL: RangerJoe


quote:

ORIGINAL: jeffk3510

I sure has taken a toll on the grain markets the last few days in my line of work.

However, I remember the 09 Swine Flu pandemic... it did the same thing, but didn't seem to destroy the world like they think this one is going to... which this one won't either.

I am also a very pessimistic guy, so keep that in mind, but it generally turns out to be correct.

I have a hard time figuring out what flu is what to be honest.

As kids we called it the flu - puking, stomach ache, the ****s.. etc.. The FLU is upper respiratory, so it wasn't that as a kid but we called it that.

We have A, B, and numerous others.

I know right now everyone we do business with the offices are a ghost town - everyone is sick. I don't know that I've seen that many sick before. My kids have all had it, and one is home as we speak getting over it. Our office has around 25 people in two buildings, about 8 were here yesterday..

In my opinion (I am by no means an expert), this is just another flu that will come and go. The people dying (unfortunately) usually have some other underlying condition before hand..

If ya'll are anything like us, the cure is Chicken Noodle Soup...[8|]


That stomach flu is probably what they now call Norovirus.


Yes - the stomach bug




Canoerebel -> RE: OT: Corona virus (2/26/2020 2:24:27 PM)

Thanks for the link, Ranger. That made interesting reading, and Chickenboy indeed weighed in.

That thread is interesting, because it began 1/30 and continued to about 2/1...and then no posts until yesterday, I think. Suddenly a new flurry.

A question: does a flu like this one have a season (ending with winter), or does it span the calendar?




jeffk3510 -> RE: OT: Corona virus (2/26/2020 2:26:56 PM)

This Norovirus kills a couple hundred thousand people a year.. the Coronavirus is at what, 2,700 and change....?? [8|]




Kull -> RE: OT: Corona virus (2/26/2020 2:29:48 PM)

Assuming they can't put this genie back in the bottle, it's particularly worrying for this forum. Anecdotally, most of our membership appears to be in the riskier age category.

Edit: Get your daily updates here.




Canoerebel -> RE: OT: Corona virus (2/26/2020 2:37:13 PM)

Regarding the Spanish flu epidemic, I interviewed Dr. Leila Denmark about 15 years ago. She was in college in a small town in Georgia at the time of the pandemic. She was the third woman to graduate from medical school in Georgia. She was co-credited with developing the whooping cough vaccine. She practiced medicine until she was 103 years old. She died at 114, in 2011. She was a remarkable woman.

With respect to the Spanish flu, she said it disproportionally struck people in the prime of life. They learned why. People would have it for a few days. Then they'd begin to feel better. Then they'd go outside and milk the cows or work the land or whatever. Pneumonia would set in and they'd relapse and die. So the implemented a strong rest regimen and kept people out of the wet weather. From that point forward it wasn't a major problem.

But I don't know if the Corona flu is anything similar to Spanish flu, where common sense precautions would be mostly sufficient to deal with it. I have no idea.

Edited to correct a few minor things about Dr. Denmark's bio.




jeffk3510 -> RE: OT: Corona virus (2/26/2020 2:40:42 PM)


quote:

ORIGINAL: Canoerebel

Regarding the Spanish flu epidemic, I interviewed Dr. Leila Denmark about 15 years ago. She was in college in a small town in Georgia at the time of the pandemic. She was the second woman in Georgia to graduate from medical school. She was credited (co-credited might be better) with developing the whooping cough vaccine. She practiced medicine until she was 102 years old. She died at 111. She was a remarkable woman.

With respect to the Spanish flu, she said it disproportionally struck people in the prime of life. They learned why. People would have it for a few days. Then they'd begin to feel better. Then they'd go outside and milk the cows or work the land or whatever. Pneumonia would set in and they'd relapse and die. So the implemented a strong rest regimen and kept people out of the wet weather. From that point forward it wasn't a major problem.

But I don't know if the Corona flu is anything similar to Spanish flu, where common sense precautions would be mostly sufficient to deal with it. I have no idea.


Appreciate that little piece of history - thanks Dan




RangerJoe -> RE: OT: Corona virus (2/26/2020 2:48:41 PM)


quote:

ORIGINAL: jeffk3510


quote:

ORIGINAL: Canoerebel

Regarding the Spanish flu epidemic, I interviewed Dr. Leila Denmark about 15 years ago. She was in college in a small town in Georgia at the time of the pandemic. She was the second woman in Georgia to graduate from medical school. She was credited (co-credited might be better) with developing the whooping cough vaccine. She practiced medicine until she was 102 years old. She died at 111. She was a remarkable woman.

With respect to the Spanish flu, she said it disproportionally struck people in the prime of life. They learned why. People would have it for a few days. Then they'd begin to feel better. Then they'd go outside and milk the cows or work the land or whatever. Pneumonia would set in and they'd relapse and die. So the implemented a strong rest regimen and kept people out of the wet weather. From that point forward it wasn't a major problem.

But I don't know if the Corona flu is anything similar to Spanish flu, where common sense precautions would be mostly sufficient to deal with it. I have no idea.


Appreciate that little piece of history - thanks Dan



Yes, thank you Dan. It also tells you that when you are feeling better to still take it easy for awhile especially since your body has been weakened and may not be able to fight something else off. So people who work and have sick time should STAY HOME until they are definitely better and not tough it out and go to work, maybe even sharing their illness with others.

Joe.




JohnDillworth -> RE: OT: Corona virus (2/26/2020 2:51:56 PM)

Well, the Chinese Army bio-weapons research lab is in Wuhan so I’m going to put on my tin foil hat and say this got loose from the lab. Yes , it is a virus but it seems to behave in a strange way. Unlike the vast majority of viruses this on remains contagious on hard surfaces for over a week. Maybe longer. That is odd. The common cold virus lives for a few hours and the flu up to 48 hours. So over a week is odd and seems to be what is causing the high transmission levels and the ability to travel long distance. Some people can carry the virus for a week, remain contagious, and show no symptoms. So the delivery mechanism for the virus is capable. The payload, on the other hand, is dangerous, but is only 2 % fatal. A more lethal payload would be cause for even greater alarm. I’ll tread lightly here but China, as a nation, is better equipped to deal with something like this. They can, and did, lock down entire cities and arrest anyone that broke quarantine. If we tried to do that here here the first stop would be the court system for injunction and injunction. Do we still have the ability and the intestinal fortitude to dispense with bureaucracy and build massive hospitals in 10 days? I hope we don’t have to find out. I suspect this gets worse before it gets better. Good time to live in the country Dan. Us Cities might have much cause for concern




MakeeLearn -> RE: OT: Corona virus (2/26/2020 2:55:43 PM)

VIRUS LIVES MATTER!


Fruit Bat Soup: The Traditional Palau Delicacy


Ingredients

1 Large fruit bat
2 Medium donni sali (hot peppers)
1 Chopped white onion
5 tbsp Light soy sauce
2 tsp Lemon juice
1 pinch Salt
2 cans Coconut milk unsweetened



Instructions
For the hot sauce

1- In a sauce bowl, mix 2 tsp lemon juice and 5 tbsp. soy sauce with chopped onion.

2- Then, add chopped Donni Sali (hot pepper) to your tastes.

For the bat soup

1- In a large pot, boil the whole fruit bat in water for around 120 minutes, until the skin of the fruit bat is tender enough to tear through.

2- Remove water. Add coconut milk to the fruit bat with a pinch of salt to taste.

3- Cook for a further 10 minutes. Serve with hot sauce (covered above) and cooked rice.

4- Voilà! Your fruit bat soup is ready to serve.

[image]local://upfiles/55056/F30E2113509D479A9D4214DD86E33D9D.jpg[/image]




MakeeLearn -> RE: OT: Corona virus (2/26/2020 2:56:40 PM)

Coronavirus Disease 2019 (COVID-19) Situation Summary

https://www.cdc.gov/coronavirus/2019-nCoV/summary.html



"Coronaviruses are a large family of viruses that are common in many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2).

The SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV. All three of these viruses have their origins in bats. The sequences from U.S. patients are similar to the one that China initially posted, suggesting a likely single, recent emergence of this virus from an animal reservoir."




MakeeLearn -> RE: OT: Corona virus (2/26/2020 3:01:32 PM)

COVID-19: Confirmed Cases in the United States*†
https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

Travel-related 12

Person-to-person spread 2

Total confirmed cases 14

Total tested 426




MakeeLearn -> RE: OT: Corona virus (2/26/2020 3:04:45 PM)

Locations with Confirmed COVID-19 Cases
Global Map
https://www.cdc.gov/coronavirus/2019-ncov/locations-confirmed-cases.html
As of 11:00 a.m. ET February 26, 2020


[image]local://upfiles/55056/C67591E82B1C4F23B7200D68FC9A377F.jpg[/image]




MakeeLearn -> RE: OT: Corona virus (2/26/2020 3:12:58 PM)

quote:


Canoerebel

...People would have it for a few days. Then they'd begin to feel better. Then they'd go outside and milk the cows or work the land or whatever. Pneumonia would set in and they'd relapse and die. So the implemented a strong rest regimen and kept people out of the wet weather. From that point forward it wasn't a major problem...



Similar to why European diseases killed so many natives. They often OD on their medicines while trying to get better. Or they would wash in the water, on cold days, to purify their bodies of the Small Pox.




jeffk3510 -> RE: OT: Corona virus (2/26/2020 3:14:05 PM)


quote:

ORIGINAL: MakeeLearn

Locations with Confirmed COVID-19 Cases
Global Map
https://www.cdc.gov/coronavirus/2019-ncov/locations-confirmed-cases.html
As of 11:00 a.m. ET February 26, 2020


[image]local://upfiles/55056/C67591E82B1C4F23B7200D68FC9A377F.jpg[/image]


You could show a map of the Norovirus, and color in every single country... the media is going nuts with the Coronavirus




JohnDillworth -> RE: OT: Corona virus (2/26/2020 3:51:53 PM)

On the more optimistic front the virus is not particularly contagious. Viruses have a “basic reproductive number” in susceptible populations. That number, called R0, is an indication of how many people an infected person will spread the infection to. So the R0 for measles is 18. Meaning each person that has it will likely spread it to 18 more people. Fortunately, most of us have been vaccinated or have had measles so while we might get exposed we won’t catch measles , again. The current COVID virus has a R0 of 2.3. So each person that has it will likely spread it to 2.3 people. Things like basic hand washing and isolation go a long way to keeping the numbers down and in more sparsely populated areas the suspect able population, and the contacts within that population are lower so the virus has more trouble taking hold. So the real worries is in cities and with large gatherings for events.




geofflambert -> RE: OT: Corona virus (2/26/2020 3:52:27 PM)

quote:

ORIGINAL: Canoerebel



But I don't know if the Corona flu is anything similar to Spanish flu, where common sense precautions would be mostly sufficient to deal with it. I have no idea.



There seems to be a misunderstanding here that won't go away. The coronavirus is not, repeat not, influenza. I'm not being political when I say Trump is an imbecile. The season has no more to do with it than it does with HIV, rabies, measles or smallpox/chickenpox.




JohnDillworth -> RE: OT: Corona virus (2/26/2020 4:07:58 PM)

I think the dangerous assumption many parties are making is that this will "go away" when the weather gets warmer like the flu does. That may, or may not, be true, but I have not seen any evidence of why people seem so sure of this assumption. I hope so. I think it would be prudent to hope that it does, but prepare like it won't.




Anachro -> RE: OT: Corona virus (2/26/2020 4:13:36 PM)

The economic effects are greater than the health risks...for younger people that is. The death rate seems to go up a lot among the elderly and those with exposed immune systems. 700 million people are under some form of quarantine in China, even in Beijing the restrictions have been more strict in the past week than the week previous. This already has an impact on global economic activity; now if the virus spreads to Japan, Korea, Italy, etc. with restrictions in place than that is more economic activity that is slowed or halted, etc. etc.




Chickenboy -> RE: OT: Corona virus (2/26/2020 4:18:09 PM)

I believe that this virus and disease will have a similar trajectory to that of MERS/SARS some 17 years ago. Coronaviruses are not Orthomyxoviruses (influenza) and act differently in transmissiblity and mutation rates, so again the MERS/SARS analog is probably more useful than H1N1 (1918; 2009) or other seasonal influenzas.

In the case of MERS/SARS, the virus circulated amongst mainland China for some time before diagnosed, a bit longer before there was recognition of it by central authorities and then longer yet before there was even a haphazard and incomplete response. International spread was a feature of the disease. Here's a very interesting and concise timeline from the CDC's website:

https://www.cdc.gov/about/history/sars/timeline.htm

To whit: The disease ran rampant in China for a while. Then it spread internationally. Cases that were not laboratory-confirmed were later re-stated (see entry for July 2003) and halved. In between, the overreaction to cases was addressed (de-stigmatization of SARS) and travel advisories lifted after a few months.

A curious thing about the SARS virus was how it disappeared after a year or so. No isolates were recovered post-2004. Poof. Gone. NIH states that the disappearance was due to quarantine and isolation of affected cases and-of course-due to the research money poured into NIH on interventional strategies.

https://www.niaid.nih.gov/diseases-conditions/coronaviruses

COVID-19 does behave somewhat differently in the human host (replicates higher in the respiratory tract versus deeper in the lungs like SARS) and therefore may spread more readily. By nature of its replication patterns, it will also probably have a lower case fatality rate. That's exempting the exacerbatory effects of other co-pathogens (COVID-19 PLUS influenza, streptococcal pneumonia, TB, asthma, emphysema, other respiratory disease in the same patient) of course. I have not seen *any* efforts to parse the effects of COVID-19 from other co-pathogen effects in infected, but this is likely one of the rationale for making sure to get one's annual flu vaccine ASAP if you haven't already done so.

Viruses spread more readily when they make one sick, but aren't fatal. Paradoxically, the sicker people are with a particular virus, the easier it is to diagnose and ultimately contain. The Los Angeles Times had a nice article on this a couple weeks ago.

https://www.latimes.com/california/story/2020-02-18/sars-coronavirus-china-epidemic

What do I think will happen? Something more akin to SARS, albeit with a more significant global spread in the interim. I expect the peak of this will probably not be too far off and that, with the onset of warmer weather in most of the Northern Hemisphere it will abate. I would be surprised if we heard much about this 12 months from now, excepting in cooler climates (you listening, Oz land?) as they slip into their annual influenza cycle.

The economic and social impacts on our increasingly globally connected supply chains are a totally 'nuther question. I'm limiting my observations to the disease cycle and virus longevity in our public per se.









Chickenboy -> RE: OT: Corona virus (2/26/2020 4:21:14 PM)


quote:

ORIGINAL: geofflambert
I'm not being political when I say Trump is an imbecile.


Yeah, actually, you are. And you should stop. Take your political screed elsewhere.




Chickenboy -> RE: OT: Corona virus (2/26/2020 4:29:41 PM)


quote:

ORIGINAL: JohnDillworth

I think the dangerous assumption many parties are making is that this will "go away" when the weather gets warmer like the flu does. That may, or may not, be true, but I have not seen any evidence of why people seem so sure of this assumption. I hope so. I think it would be prudent to hope that it does, but prepare like it won't.


Heat and sunlight are amongst the best disinfectants for labile viruses like coronaviruses or orthomyxoviruses (influenza). In general, people tend to spend more time outdoors with nicer weather and less time in cramped indoor quarters where respiratory diseases can be more readily spread. Survivors of a novel viral pathogen will tend to mount an immune response to that identical pathogen with future exposure, which further reduces its RO. Add in the fact that SARS (a similar virus to COVID-19) just kind of petered out within a year and I think the grounds to suggest that the same outcome for COVID-19 are reasonable conjecture.

But you're right about prudence and preparedness. For this (or any other novel viral agent), being able to work from home and have basic sanitation away from infectious hosts or carriers for a time is helpful. Anyone that doesn't have a 72-hour bug-out bag / kit for the family ought to update their disaster preparedness planning in general.




USSAmerica -> RE: OT: Corona virus (2/26/2020 4:39:16 PM)

quote:

ORIGINAL: Chickenboy

I believe that this virus and disease will have a similar trajectory to that of MERS/SARS some 17 years ago. Coronaviruses are not Orthomyxoviruses (influenza) and act differently in transmissiblity and mutation rates, so again the MERS/SARS analog is probably more useful than H1N1 (1918; 2009) or other seasonal influenzas.

In the case of MERS/SARS, the virus circulated amongst mainland China for some time before diagnosed, a bit longer before there was recognition of it by central authorities and then longer yet before there was even a haphazard and incomplete response. International spread was a feature of the disease. Here's a very interesting and concise timeline from the CDC's website:

https://www.cdc.gov/about/history/sars/timeline.htm

To whit: The disease ran rampant in China for a while. Then it spread internationally. Cases that were not laboratory-confirmed were later re-stated (see entry for July 2003) and halved. In between, the overreaction to cases was addressed (de-stigmatization of SARS) and travel advisories lifted after a few months.

A curious thing about the SARS virus was how it disappeared after a year or so. No isolates were recovered post-2004. Poof. Gone. NIH states that the disappearance was due to quarantine and isolation of affected cases and-of course-due to the research money poured into NIH on interventional strategies.

https://www.niaid.nih.gov/diseases-conditions/coronaviruses

COVID-19 does behave somewhat differently in the human host (replicates higher in the respiratory tract versus deeper in the lungs like SARS) and therefore may spread more readily. By nature of its replication patterns, it will also probably have a lower case fatality rate. That's exempting the exacerbatory effects of other co-pathogens (COVID-19 PLUS influenza, streptococcal pneumonia, TB, asthma, emphysema, other respiratory disease in the same patient) of course. I have not seen *any* efforts to parse the effects of COVID-19 from other co-pathogen effects in infected, but this is likely one of the rationale for making sure to get one's annual flu vaccine ASAP if you haven't already done so.

Viruses spread more readily when they make one sick, but aren't fatal. Paradoxically, the sicker people are with a particular virus, the easier it is to diagnose and ultimately contain. The Los Angeles Times had a nice article on this a couple weeks ago.

https://www.latimes.com/california/story/2020-02-18/sars-coronavirus-china-epidemic

What do I think will happen? Something more akin to SARS, albeit with a more significant global spread in the interim. I expect the peak of this will probably not be too far off and that, with the onset of warmer weather in most of the Northern Hemisphere it will abate. I would be surprised if we heard much about this 12 months from now, excepting in cooler climates (you listening, Oz land?) as they slip into their annual influenza cycle.

The economic and social impacts on our increasingly globally connected supply chains are a totally 'nuther question. I'm limiting my observations to the disease cycle and virus longevity in our public per se.




Good stuff, CB. Curious what your thoughts might be on the "mortality rate" aspect of COVID-19.

I read somewhere yesterday that the mortality rate in Wuhan was around 2.4% and everywhere else in China and the rest of the world it was around .7%. I can't site the reference for those numbers, so let's just use them as an exercise. Is it a safe assumption that it's calculated from all the reported deaths and all the total reported infection cases? In other words, isn't it very reasonable that there are many cases that were never officially reported, at least in China/Wuhan, as the individual didn't go to the doctor or a hospital? It seems to me those unreported cases would really cut the official, reported mortality rate. My guess would be cutting the reported rate in half.

Too many assumptions on my part? Am I just way out in left field?




HansBolter -> RE: OT: Corona virus (2/26/2020 5:26:45 PM)

My favorite comment in the linked thread is 'why did they name it after a beer'.....




JohnDillworth -> RE: OT: Corona virus (2/26/2020 5:30:39 PM)


quote:

ORIGINAL: HansBolter

My favorite comment in the linked thread is 'why did they name it after a beer'.....

You know what goes with Carona virus? Lyme disease




Chickenboy -> RE: OT: Corona virus (2/26/2020 5:31:15 PM)

quote:

ORIGINAL: USSAmerica

quote:

ORIGINAL: Chickenboy

I believe that this virus and disease will have a similar trajectory to that of MERS/SARS some 17 years ago. Coronaviruses are not Orthomyxoviruses (influenza) and act differently in transmissiblity and mutation rates, so again the MERS/SARS analog is probably more useful than H1N1 (1918; 2009) or other seasonal influenzas.

In the case of MERS/SARS, the virus circulated amongst mainland China for some time before diagnosed, a bit longer before there was recognition of it by central authorities and then longer yet before there was even a haphazard and incomplete response. International spread was a feature of the disease. Here's a very interesting and concise timeline from the CDC's website:

https://www.cdc.gov/about/history/sars/timeline.htm

To whit: The disease ran rampant in China for a while. Then it spread internationally. Cases that were not laboratory-confirmed were later re-stated (see entry for July 2003) and halved. In between, the overreaction to cases was addressed (de-stigmatization of SARS) and travel advisories lifted after a few months.

A curious thing about the SARS virus was how it disappeared after a year or so. No isolates were recovered post-2004. Poof. Gone. NIH states that the disappearance was due to quarantine and isolation of affected cases and-of course-due to the research money poured into NIH on interventional strategies.

https://www.niaid.nih.gov/diseases-conditions/coronaviruses

COVID-19 does behave somewhat differently in the human host (replicates higher in the respiratory tract versus deeper in the lungs like SARS) and therefore may spread more readily. By nature of its replication patterns, it will also probably have a lower case fatality rate. That's exempting the exacerbatory effects of other co-pathogens (COVID-19 PLUS influenza, streptococcal pneumonia, TB, asthma, emphysema, other respiratory disease in the same patient) of course. I have not seen *any* efforts to parse the effects of COVID-19 from other co-pathogen effects in infected, but this is likely one of the rationale for making sure to get one's annual flu vaccine ASAP if you haven't already done so.

Viruses spread more readily when they make one sick, but aren't fatal. Paradoxically, the sicker people are with a particular virus, the easier it is to diagnose and ultimately contain. The Los Angeles Times had a nice article on this a couple weeks ago.

https://www.latimes.com/california/story/2020-02-18/sars-coronavirus-china-epidemic

What do I think will happen? Something more akin to SARS, albeit with a more significant global spread in the interim. I expect the peak of this will probably not be too far off and that, with the onset of warmer weather in most of the Northern Hemisphere it will abate. I would be surprised if we heard much about this 12 months from now, excepting in cooler climates (you listening, Oz land?) as they slip into their annual influenza cycle.

The economic and social impacts on our increasingly globally connected supply chains are a totally 'nuther question. I'm limiting my observations to the disease cycle and virus longevity in our public per se.




Good stuff, CB. Curious what your thoughts might be on the "mortality rate" aspect of COVID-19.

I read somewhere yesterday that the mortality rate in Wuhan was around 2.4% and everywhere else in China and the rest of the world it was around .7%. I can't site the reference for those numbers, so let's just use them as an exercise. Is it a safe assumption that it's calculated from all the reported deaths and all the total reported infection cases? In other words, isn't it very reasonable that there are many cases that were never officially reported, at least in China/Wuhan, as the individual didn't go to the doctor or a hospital? It seems to me those unreported cases would really cut the official, reported mortality rate. My guess would be cutting the reported rate in half.

Too many assumptions on my part? Am I just way out in left field?


Not at all, USS Mike.

I'm a diagnostician by training and trade. So I need a solid working case definition. "Suspect" versus "Probable" versus "Confirmed" cases mean something very different to me and so do the means at achieving the diagnosis. So the first question I always ask is, "How are you defining a case?" It's the building block of disease interventional strategy and is usually glossed over in the lay press. Unfortunately, it makes all the difference in the world. You would hope to have a diagnosis which is informative, selective and efficient without being too broadly inclusive.

With COVID-19 (or SARS or influenza), do you want a 'case' to be an instance of virus recovery (or PCR positive) from someone? Is that sufficient? A general canvassing of the population regardless of associated illness? Well, that tends to lead to exhorbitantly high numbers of samples being processed and laboratory sample throughput issues. You can't build laboratory capacity sufficient to meet that spike in cases.

Which is why Wuhan changed their reporting measures ('case definition') dramatically a couple weeks ago. A backlog in laboratory confirmation (from 'sick' patients) led to their easing of the case definition to symptomatology. If you have respiratory disease, a fever and/ or CT/MR changes consistent with lower respiratory disease you're a 'case' by the new definition. Hence an overnight 'surge' in cases recogized.

But case numbers based upon self-reported symptomotology are really 'squishy'. They are prone to conflation with myriad other diseases with similar symptoms. Or there may be co-infections. Or they may not be an exact match for what you're trying to measure. Is a person from Wuhan with a severe respiratory disease and no fever a case? How about a person with a fever from Hong Kong with no respiratory component?

If a 'case' is someone that's exposed to the virus, then how many cases are there? Dunno. Virus (PCR) testing has been abandoned as the gold standard at this point. We don't know how many people have been exposed to the virus that haven't gone in for 'confirmation'. I read somewhere that some 15 million Chinese left Wuhan before the 'quarantine' barriers were erected. How many of those had been exposed to the virus. Nobody knows. I think probably a fair number.

I think it's also fair to say that a case fatality rate for an identical pathogen exposure would vary depending on the nature of the medical care sought that may lead to patient survival. Biased comment follows: I doubt the quality of medical supportive care afforded someone in those newly erected Wuhan tent hospitals would approach that of the Mayo Clinic. If your measure is outcomes (death or no death from viral exposure), quality of care variables make a big difference.

Without having a solid grasp on what a 'case' actually constitutes and the numbers exposed that may be aclinical / subclinical, you can't formulate a meaningful 'case fatality rate'. And you can't readily cross-compare case fatality rates with different standards of medicine or baseline diseases of co-morbidity that confound symptomatic diagnoses.

What does my gut say? If your 'case fatality' case definition is: 'people exposed to the virus (and only the virus) that die from the virus (and only the virus)', then that number is very very low. Not zero. But very very low. Other risk factors (additional infectious disease exposure, smoking habits, air pollution, environments that engender person-to-person spread, age of patient, immunosuppressive background diseases, access to antivirals, access to ventilators, etc.) are IMO every bit as important or more important than this virus' unique abilities.




Canoerebel -> RE: OT: Corona virus (2/26/2020 5:37:04 PM)

Thanks, Chickenboy.

This kind of info is why I created this thread. It's one of the reasons I love the Forum. Tremendous spectrum of knowledge here.

P.S. If there's ever a need in the Forum to know songs of southern high country birds, or how to combat thigh chaffing when backpacking, I'm at your service.




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