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RE: OT - The New Coronavirus

 
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RE: OT - The New Coronavirus - 2/26/2020 2:40:25 AM   
Zorch

 

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quote:

ORIGINAL: Chickenboy


quote:

ORIGINAL: Zorch

Let's not panic or joke about COVID-19. It's very real, but it has not yet been declared a pandemic. PLEASE read https://www.sciencenews.org/article/when-coronavirus-spread-reach-u-s-communities-cdc BEFORE responding to this post.

People who travel, or associate with people who do travel, are most at risk.

A summary of COVID-19 effects, based on 72,314 Chinese cases:

Mild: 81% (36,160 cases)
Severe: 14% (6168 cases)
Critical: 5% (2087 cases)

2.3% (1023 people) of the Chinese cases were fatal.

Thank you.


Sorry, Zorch. As a diagnostician, I balk at using the Chinese figures verbatim. Too fraught with political / party influence and glossing over the messy details of diagnostics. Their case definition has changed repeatedly through the outbreak and their case tallies are no more than symptomatic assessments in most cases. And, as I stated before, finding this viral agent in the presence of clinical symptoms (fever, respiratory disease) without ruling out the causality of those other primary respiratory diseases (influenza, bacterial pneumonia, TB, emphysema, etc.) makes assignation of any percentages to this disease impossible.

Without knowing the numerator and the denominator of the equation, you're left guessing how apt the data is to fit the model. If tens of millions of Chinese have been exposed and developed no symptoms and 2,000 cases were fatal, then it's not a 2% case fatality rate, but a .01% case fatality rate.

If you insist on using the Chinese figures verbatim, then you should rejoice at their latest declarations about the rapid waning of the disease. According to their press, Hubei province (home to 64,287 of the 77,262 Chinese cases) only had 450 cases on February 24. A dramatic slowdown. Please remember that the massive 'surge' in cases from Hubei coincided with the change in case definition a week or so ago.

Outside of Hubei, there are are 13,000 cases in China. For about 1.1 billion people. So that would work out to about 4,250 cases (assuming equal distribution for CONUS as China ex-Hubei) potential. x 2% 'case fatality' rate = 85 people. Awful-particularly for them and their families. But that shouldn't bring us to our knees freaking out and screaming that the sky is falling. Remember we collectively yawn about losing 40,000-65,000 people annually from flu.

But the economic consequences of China's overreaction and the stemming of their economic growth may be with us for a while. It's important not to conflate this with the boogeyman of this particular virus on our particular home turf.

I agree that the published figures reflect a lot of uncertainty, and are not necessarily applicable to other countries. And, as a Dr., you understand viruses far better than me. The need to make people aware of COVID-19 and take it seriously will inevitably result in overstatement/misunderstanding that does more harm than good. You'd think public health officials would compare COVID-19 to influenza to put it in perspective...

I agree that the economic impact is likely to be the most remembered.

(in reply to Chickenboy)
Post #: 61
RE: OT - The New Coronavirus - 2/26/2020 2:42:50 AM   
balto

 

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Its only a matter of time until someone with Lime disease gets the Corona virus.

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Post #: 62
RE: OT - The New Coronavirus - 2/26/2020 2:51:34 AM   
Lobster


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quote:

ORIGINAL: balto

Its only a matter of time until someone with Lime disease gets the Corona virus.


So does someone get lime disease from too much Key Lime Pie? Or maybe they work in a limestone quarry. Could be a condition from drinking too many Mojitos.

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Post #: 63
RE: OT - The New Coronavirus - 2/26/2020 3:17:03 AM   
Lobster


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quote:

ORIGINAL: Chickenboy

Didja hear a word about that? Probably not. All eyes are on the bright bouncing ball of a novel mild respiratory virus and whatever the Chinese say about their 'offical tally'. The worst aspects of this disease stem from the wild overreactions and the unintended consequences wrought by bad public health policy.



Actually annual deaths due to the flu is often mentioned. So yeah I didja hear about that because it seems to be that standard that any virus is compared to. And if the Chinese had initially taken this seriously we probably wouldn't even hear about this by now because it would have been nipped in the bud. But they were worried about wild over reactions so now we are at this point. Exactly how bad is it or will it get? I don't want to find out. But I guess you're down with waltzing through a room full of people who already have it. Hey, why don't you get a room in that cruise ship in Japan and test out your theory about how innocuous it is.

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Post #: 64
RE: OT - The New Coronavirus - 2/26/2020 7:04:21 AM   
RangerJoe


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A respirator is a breathing device that filters all of the air that you breathe. Think more of a gas mask than a cloth or paper mask that you would see the public wearing or medical staff in an operating room.

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Post #: 65
RE: OT - The New Coronavirus - 2/26/2020 9:43:24 AM   
demyansk


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We have enough diseases out there, China enjoys this crash in the stock market and the communist country knew about this for months, remember Chernobyl? We need to monitor our immigration and that's why we are not getting killedm

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Post #: 66
RE: OT - The New Coronavirus - 2/26/2020 12:13:41 PM   
sPzAbt653


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quote:

ORIGINAL: RangerJoe
A respirator is a breathing device that filters all of the air that you breathe. Think more of a gas mask than a cloth or paper mask that you would see the public wearing or medical staff in an operating room.

Thanks RJ, I think they sell those at the Home Depot:
https://www.homedepot.com/b/Safety-Equipment-Respirator-Masks-Half-Mask-Respirators/3M/N-5yc1vZclkyZ30

Due to Current Events, Supplies are Limited!

(in reply to RangerJoe)
Post #: 67
RE: OT - The New Coronavirus - 2/26/2020 12:45:42 PM   
Erik Rutins

 

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Lots of apples to oranges here. Our Milan office is isolating and working from home due to the government advice in Northern Italy where this is currently spreading, so this is pretty real for us and I've been doing some research as the spread outside of China continues. A few informed opinions below based on that research (I am not a doctor).

There may be a tip of the iceberg effect with the mortality rate, there may be far more asymptomatic or mild cases in China, but the head of WHO's mission there just said that he didn't think so. He thinks the 2-4% range is probably real, which would be 10-20x normal flu mortality. We can certainly hope that he is wrong, though the hospitalization rate even outside of China for the known cases has been higher than what we normally see from the flu.

In addition, they're seeing that for older folks and folks with any chronic cardiovascular illness, it's 2-5x worse than that. Depending on the baseline mortality, this could be worse or equivalent to a bad flu.

Based on the hospitals in the epicenter being overloaded beyond the breaking point for weeks, it also seems doubtful this is as mild as the flu. The fact that it seems to start in the lungs binding to the ACE2 receptor also seems likely to make it more dangerous and more similar to SARS (though so far clearly less severe). We can't know for sure, but in the next week or two with more data outside of China, we should have a better estimate and hopefully also better containment.

Based on the extreme measures taken by China, which will be harder in a free country if not impossible, it seems likely this will be harder to contain outside of China and as a novel virus people will not have immunity to its spread. There's also the fact that some people seem able to spread it pretty efficiently when only mildly ill. Therefore, I think it's likely we'll see proportionally wider spread outside of China, even if it is eventually controlled.

What we can see of what may be going on in Iran, where the deputy health minister is also infected after downplaying the outbreak there, is concerning given that regime's somewhat apocalyptic views and the already ongoing of export of cases to the rest of the middle east.

If this becomes entrenched in multiple countries with sub-par health systems, the ongoing import of cases to other locations may overwhelm any containment measures.

Here in the US, we still do not have adequate testing capacity for this and we've had travel ongoing with South Korea, Japan and Italy, where there are significant outbreaks. The likelihood is that somewhere in the US right now, spread has started and will be discovered only if the mortality is in fact higher than the circulating colds and flu.

In terms of preparations, based on the containment strategy that seems most appropriate for a potentially much higher mortality virus, I'd suggest having a month of food and prescriptions on hand to make sure that if you end up in an area where you are ordered to isolate yourself, that you can make it through. If this cannot be contained and it is actually in the 2-4% range, then we're looking at the 1918 Spanish Flu 2.0.

Regards,

- Erik




< Message edited by Erik Rutins -- 2/26/2020 1:15:02 PM >


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Post #: 68
RE: OT - The New Coronavirus - 2/26/2020 1:14:26 PM   
RangerJoe


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I wonder if there are any experiments that indicate that massive oral consumption of ethanol will help defeat this virus. I know that red wine (the darker the better) has anti-viral, anti-bacterial, and anti-fungal properties. I also wonder how many deaths are caused by secondary infections.

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Post #: 69
RE: OT - The New Coronavirus - 2/26/2020 1:54:41 PM   
operating


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Just got over having the flu (worst, first 2 weeks, then 2 weeks in lungs) never went to doctors and took over the counter meds. Take note of all the survivors of this new Caronavirus that have recovered that went on to have normal lives. My pharmacist told me flu shots do not work once you are sick, pharmacists will only give flu shots when you are healthy (before getting flu) and not for at least 2 weeks after you had been sick. Also learned that flu shots are for the most part done (offered) between August and December (September-October being prime time) because flu almost always happens during the winter. Testing for new virus med will not be completed for a number of months, by which time it will be summer.. Feel this crisis will blow over in a couple of months..

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Post #: 70
RE: OT - The New Coronavirus - 2/26/2020 2:39:37 PM   
Scott_USN

 

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So no zombie apocalypse this year?

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Post #: 71
RE: OT - The New Coronavirus - 2/26/2020 2:49:29 PM   
RangerJoe


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Probably not. Although I did look like one about five and a half years ago.

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Post #: 72
RE: OT - The New Coronavirus - 2/26/2020 3:07:19 PM   
Blond_Knight


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Matrix has an office in Milan?

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Post #: 73
RE: OT - The New Coronavirus - 2/26/2020 3:13:10 PM   
Blond_Knight


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Professor without knowing precisely the cause, would you say its time for our viewers to crack open each others skulls and feast on the goo inside?

< Message edited by Blond_Knight -- 2/26/2020 3:16:20 PM >

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Post #: 74
RE: OT - The New Coronavirus - 2/26/2020 3:19:15 PM   
Scott_USN

 

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quote:

ORIGINAL: RangerJoe

Probably not. Although I did look like one about five and a half years ago.



Last time I got the flu couple years ago. Felt like one!

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Post #: 75
RE: OT - The New Coronavirus - 2/26/2020 3:39:39 PM   
Chickenboy


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From: San Antonio, TX
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quote:

ORIGINAL: Erik Rutins
If this cannot be contained and it is actually in the 2-4% range, then we're looking at the 1918 Spanish Flu 2.0.


Lots of 'ifs' and apples to oranges, indeed, Erik. I think that outcome exceedingly unlikely.

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Post #: 76
RE: OT - The New Coronavirus - 2/26/2020 3:59:09 PM   
Zorch

 

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quote:

ORIGINAL: Chickenboy


quote:

ORIGINAL: Erik Rutins
If this cannot be contained and it is actually in the 2-4% range, then we're looking at the 1918 Spanish Flu 2.0.


Lots of 'ifs' and apples to oranges, indeed, Erik. I think that outcome exceedingly unlikely.

I agree that outcome is unlikely, provided basic measures like travel bans and quarantines are followed. Their importance should not be underestimated.

(in reply to Chickenboy)
Post #: 77
RE: OT - The New Coronavirus - 2/26/2020 4:28:38 PM   
Erik Rutins

 

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quote:

ORIGINAL: Chickenboy
Lots of 'ifs' and apples to oranges, indeed, Erik. I think that outcome exceedingly unlikely.


I'm glad to hear that and I think it is unlikely, but not a zero probability.

I'll be more confident if in a week we see the outbreaks in Europe and South Korea getting under control, and when we see diagnostic testing capability increased and expanded to all states and all affected countries. Right now, I'm reading the CDC can handle about 100 tests per day with a 1-2 day turnaround time and somewhere around 5 states can do the testing themselves, which is ideal in terms of a quicker turnaround. They are saying it may take another couple of weeks before all states can do the testing themselves and really get our surveillance capacity to where it needs to be to identify and contain any outbreaks quickly. With cold and flu season at its peak, our ability right now to be able to distinguish this from the background noise is not ideal.

Regards,

- Erik



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Post #: 78
RE: OT - The New Coronavirus - 2/26/2020 4:32:31 PM   
RangerJoe


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quote:

ORIGINAL: Scott_USN


quote:

ORIGINAL: RangerJoe

Probably not. Although I did look like one about five and a half years ago.



Last time I got the flu couple years ago. Felt like one!


I had pneumonia where the lower 2/3 of my left lung was as dense as the liver, I had a blood clot in my right thigh but they could not check the calf because it was too swollen, I had an infection on the top of my right foot that when they removed the dead tissue the hole was 5.5 by 4.5 cm, I had a systemic infection, and when I was at a clinic my blood pressure was over 59. Then I drove myself to the hospital where I was for 17 days. Some pretty nurses there but unfortunatly they were married. I have pictures of the foot wound while it was healing for Zorch to enjoy looking at.

I also lost 50 pounds in 35 days and I was water bloated from drinking 3 liters or so of water every day plus 7 to 9 IVs a day, each IV was 1/2 to 1 liter. When they finally let me use the toilet they put something in to catch the liquid output. It held one litre and the cup runneth over . . . I could feel it draining from my kidneys.

_____________________________

Seek peace but keep your gun handy.

I'm not a complete idiot, some parts are missing!

“Illegitemus non carborundum est (“Don’t let the bastards grind you down”).”
― Julia Child


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Post #: 79
RE: OT - The New Coronavirus - 2/26/2020 6:04:32 PM   
Chickenboy


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From: San Antonio, TX
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quote:

ORIGINAL: Erik Rutins


quote:

ORIGINAL: Chickenboy
Lots of 'ifs' and apples to oranges, indeed, Erik. I think that outcome exceedingly unlikely.


I'm glad to hear that and I think it is unlikely, but not a zero probability.

I'll be more confident if in a week we see the outbreaks in Europe and South Korea getting under control, and when we see diagnostic testing capability increased and expanded to all states and all affected countries. Right now, I'm reading the CDC can handle about 100 tests per day with a 1-2 day turnaround time and somewhere around 5 states can do the testing themselves, which is ideal in terms of a quicker turnaround. They are saying it may take another couple of weeks before all states can do the testing themselves and really get our surveillance capacity to where it needs to be to identify and contain any outbreaks quickly. With cold and flu season at its peak, our ability right now to be able to distinguish this from the background noise is not ideal.

Regards,

- Erik




Yeah. Laboratory bottlenecks are a real issue in confirming diseases in a timely fashion. Lots more work to be done at the national and state level both for this. The symptomatology of diagnosis and inability to distinguish this from garden variety respiratory diseases in the same environment make for problematic diagnostics. And that's in *this* country. I shudder to think of how other countries with lesser resources or lesser standards of medicine will grapple with the introduction.

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Post #: 80
RE: OT - The New Coronavirus - 2/26/2020 6:12:24 PM   
Orm


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quote:

But the economic consequences of China's overreaction and the stemming of their economic growth may be with us for a while. It's important not to conflate this with the boogeyman of this particular virus on our particular home turf.

Are you sure that China hasn't been underreacting?

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Post #: 81
RE: OT - The New Coronavirus - 2/26/2020 6:23:17 PM   
Zorch

 

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quote:

ORIGINAL: Orm

quote:

But the economic consequences of China's overreaction and the stemming of their economic growth may be with us for a while. It's important not to conflate this with the boogeyman of this particular virus on our particular home turf.

Are you sure that China hasn't been underreacting?

I would argue that public health officials in any country, given a similar threat of unknown severity, would choose to error on the safe side until the severity of the disease was definitely established. What looks like over-reacting to us might have seemed entirely appropriate 4 months ago and 10,000 miles away.

(in reply to Orm)
Post #: 82
RE: OT - The New Coronavirus - 2/26/2020 6:25:25 PM   
Chickenboy


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quote:

ORIGINAL: Orm

quote:

But the economic consequences of China's overreaction and the stemming of their economic growth may be with us for a while. It's important not to conflate this with the boogeyman of this particular virus on our particular home turf.

Are you sure that China hasn't been underreacting?


I don't want this to get political on this thread, so can't answer your question directly here. Hope you understand. But, no, I really don't think China has been 'underreacting' in this instance.

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Post #: 83
RE: OT - The New Coronavirus - 2/26/2020 6:32:13 PM   
Chickenboy


Posts: 25099
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From: San Antonio, TX
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quote:

ORIGINAL: Zorch


quote:

ORIGINAL: Orm

quote:

But the economic consequences of China's overreaction and the stemming of their economic growth may be with us for a while. It's important not to conflate this with the boogeyman of this particular virus on our particular home turf.

Are you sure that China hasn't been underreacting?

I would argue that public health officials in any country, given a similar threat of unknown severity, would choose to error on the safe side until the severity of the disease was definitely established. What looks like over-reacting to us might have seemed entirely appropriate 4 months ago and 10,000 miles away.


I'm not so willing to give carte blanche, Zorch. Some of the responses have been, well, terrifying and seem to go well beyond the bounds of reasoned interventional strategies.



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Post #: 84
RE: OT - The New Coronavirus - 2/26/2020 6:37:38 PM   
Zorch

 

Posts: 7517
Joined: 3/7/2010
Status: online

quote:

ORIGINAL: Chickenboy


quote:

ORIGINAL: Zorch


quote:

ORIGINAL: Orm

quote:

But the economic consequences of China's overreaction and the stemming of their economic growth may be with us for a while. It's important not to conflate this with the boogeyman of this particular virus on our particular home turf.

Are you sure that China hasn't been underreacting?

I would argue that public health officials in any country, given a similar threat of unknown severity, would choose to error on the safe side until the severity of the disease was definitely established. What looks like over-reacting to us might have seemed entirely appropriate 4 months ago and 10,000 miles away.


I'm not so willing to give carte blanche, Zorch. Some of the responses have been, well, terrifying and seem to go well beyond the bounds of reasoned interventional strategies.



I'm not giving Carte Blanche (or Bank Americard). I'm just saying it's hard for people elsewhere to judge the situation there and then.

(in reply to Chickenboy)
Post #: 85
RE: OT - The New Coronavirus - 2/26/2020 7:29:42 PM   
Orm


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From: Sweden
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quote:

ORIGINAL: Chickenboy


quote:

ORIGINAL: Orm

quote:

But the economic consequences of China's overreaction and the stemming of their economic growth may be with us for a while. It's important not to conflate this with the boogeyman of this particular virus on our particular home turf.

Are you sure that China hasn't been underreacting?


I don't want this to get political on this thread, so can't answer your question directly here. Hope you understand. But, no, I really don't think China has been 'underreacting' in this instance.

I do understand. And I didn't intend for it to get into political territory.

Thank you for your answer.

What have me somewhat concerned, is that my thinking is that this virus is deadlier to people who is reasonably healthy, than for example the flu.

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Post #: 86
RE: OT - The New Coronavirus - 2/26/2020 8:28:13 PM   
operating


Posts: 3000
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quote:

ORIGINAL: Scott_USN

So no zombie apocalypse this year?

Who knows where this virus will go from the 54 diagnosed cases in the US (a nation of approximately 330,000,000)? It just seems to me the media is going way over-board making a fuss about it. The last thing out of the Pandora's Box was "HOPE", the salvation of mankind..

(in reply to Scott_USN)
Post #: 87
RE: OT - The New Coronavirus - 2/26/2020 8:35:13 PM   
Chickenboy


Posts: 25099
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From: San Antonio, TX
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quote:

ORIGINAL: Orm


quote:

ORIGINAL: Chickenboy


quote:

ORIGINAL: Orm

quote:

But the economic consequences of China's overreaction and the stemming of their economic growth may be with us for a while. It's important not to conflate this with the boogeyman of this particular virus on our particular home turf.

Are you sure that China hasn't been underreacting?


I don't want this to get political on this thread, so can't answer your question directly here. Hope you understand. But, no, I really don't think China has been 'underreacting' in this instance.

I do understand. And I didn't intend for it to get into political territory.

Thank you for your answer.

What have me somewhat concerned, is that my thinking is that this virus is deadlier to people who is reasonably healthy, than for example the flu.


You may want to see my 'take' on this aspect of disease reporting on the WiTP:AE cross-thread. PM me if you want any additional clarification on my thoughts.

_____________________________


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Post #: 88
RE: OT - The New Coronavirus - 2/26/2020 8:41:02 PM   
Chickenboy


Posts: 25099
Joined: 6/29/2002
From: San Antonio, TX
Status: offline

quote:

ORIGINAL: Zorch


quote:

ORIGINAL: Chickenboy


quote:

ORIGINAL: Zorch


quote:

ORIGINAL: Orm

quote:

But the economic consequences of China's overreaction and the stemming of their economic growth may be with us for a while. It's important not to conflate this with the boogeyman of this particular virus on our particular home turf.

Are you sure that China hasn't been underreacting?

I would argue that public health officials in any country, given a similar threat of unknown severity, would choose to error on the safe side until the severity of the disease was definitely established. What looks like over-reacting to us might have seemed entirely appropriate 4 months ago and 10,000 miles away.


I'm not so willing to give carte blanche, Zorch. Some of the responses have been, well, terrifying and seem to go well beyond the bounds of reasoned interventional strategies.



I'm not giving Carte Blanche (or Bank Americard). I'm just saying it's hard for people elsewhere to judge the situation there and then.


Yes. I'm sure it is. But just because "The Emperor is far away and the mountains are high" doesn't justify some actions that have been taken.

_____________________________


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Post #: 89
RE: OT - The New Coronavirus - 2/27/2020 2:29:27 AM   
Erik Rutins

 

Posts: 34398
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FYI: https://www.davisenterprise.com/local-news/newly-diagnosed-coronavirus-patient-being-treated-at-uc-davis-medical-center/

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