I suggest we should all stop going to the gym, stop going to parties and restaurants and pubs and stop flying on planes. Some working from home days might also be a good idea.
Interesting that this coincides with the replacement of the senior local health officials. Seems unguessable that the daily numbers have actually jumped that much, so presumably there has been a change of approach to reporting.
Apparently they have now started reporting cases (and deaths) that are “clinically diagnosed”, which I’m guessing means they have been diagnosed by doctors based on symptoms, even if not confirmed by lab tests.
Now the question is, are 14,000 new “clinically diagnosed” cases appearing per day or is this a one off correction caused by recognising the backlog? We will see. In any event, as suspected, the death rate is much higher than previously reported - v worrying.
It is of course serious but I suspect that this change relates to a change in reporting rather than a true change in underlying cases. I do think the UK should institute quarantine measures now.
In any event, as suspected, the death rate is much higher than previously reported - v worrying.
My feeling is that this just brings both the reported case numbers and the reported deaths closer to reality.
I note that the Guardian report says that there has been no change in how deaths are recorded. I’m not sure how this can be true since surely before now patients who died of clinical nCoV without being tested would not have been counted as an infection death in the official figures. My understanding is that now they would be, which will inevitably cause an increase in recorded deaths by the difference between clinical nCoV deaths and confirmed nCoV deaths.
Given the lag to death of c2 weeks (sometimes longer) you need to compare deaths with cases a couple of weeks ago. Suspect you end up with a CFR more like 10%. But of course this itself is naive as still relying upon the hopelessly inaccurate guesses/lies coming out of China...
Still hoping Western fatality rates will be much lower (in the WEST I still suspect 1-2% may be about right) But this hoping/guessing doesn’t feel like much of a strategy. 2% is still an epic disaster. And could be worse.
I think our window to stop disaster is closing fast. By the time people (in govt and public) can admit the reality of what is happening to themselves it will be too late.
We should at least be doing simple things like closing key borders, WFH wherever possible limiting social gathering etc. Contact tracing is being done well but its unlikely to be enough.
Yeah CW makes a point on the lag to people dying that has been troubling me about this for a while...
I had thought that the obvious massive under reporting of cases would more than balance that effect out but if the death figures also jump when you 'widen the net' that is troubling.
The number of cases 10 days ago was only just over 20,000. 1,350 deaths against that is something like 6.75% which start to make it look more like SARS in terms of the death rate.
I am nothing like a good enough statistician to know if that sort of maths is the right way of looking at it though.
Looking at SARS (v quickly don’t really have time for this) - the ultimate fatality rate was c10% in Canada too. I think i’m just being naive in hoping the death rate in West will be massively lower.
Lots of experts on twitter discussing changes to diagnostic tests (with all the enthusiasm of lawyers for some strange technical issues) - but most are missing the point that deaths have jumped too. Presumably diagnostic thresholds are not relevant to death ...
Which leads, once again, to the conclusion that these numbers are being more or leas made up. Conveniently the (naive) death rate stays at 2.1-2.2% day after day regardless.
The WHO then uses these numbers and national govts allow them to circulate unchallenged. No-one wants to scare the horses.
Now it may be that ultimately the death rate is anywhere from 0.5-20, and could well land up at 2-3%, but, make no mistake, the 2% number currently circulating is thoroughly dishonest.
The evidence I see (China in lockdown; explosion in cases that is far far faster than SARS and various academic papers suggesting R0 is 3-4) - suggests to me it is far more contagious that SARS.
I think the death rate probably will be lower, but its unclear by how much.
You don’t need to be a doctor to guess the underground should be avoided.
if someone has symptoms but hasn’t tested positive, until yesterday they would have been classified as a “suspected” case (numbers for which have been circulated for a while, but seldom commented on bu the western media). If someone in such a situation died, their death would be recorded as “pneumonia” or whatnot, but not as Covid-19. Now, if a doctor has diagnosed them based on their symptoms, they will be reported as a Covid-19 case and if they die they will be reported as a Covid-19 case.
So it affects both elements. It was expressly announced yesterday that 135 of the 242 were formerly “suspected” cases ie had they died 24 hours before, they wouldn’t have been classified as Covid-19 deaths at all. NB the absolute numbers probably continue to be total bollocks.
Its also not clear whether the 242 was deaths in one day or whether it was inflated by reclassification or earlier deaths, although given the scale of the thing, 240 deaths in a day in a. province of 55million is not inconceivable.
The figures for SARS are not that reliable. Like Covid-19, or anything else, nobody knows how many cases of SARS there really were.
I read something by a professor in HK where he estimated the R0 of the new virus to be lower than SARS. That’s a technical measure of infectious ness. It has in fact infected many more people than SARS, but that doesn’t make it “more infectious”.
yes prof john nicholas estimated the r0 of Covid-19 at 2.2; estimates for SARS are between 2 and 4. So it’s comparable if not significantly lower (assuming both calculations are accurate).
Meanwhile the old bloke who got it on the cruise ship in Japan is about to be discharged from hospital and the super spreader has already been sent home. Did chuckle at the fact that the guy with the deadly virus will get out of quarantine faster than the healthy people left on the ship where it seems to be circulating nicely with the air con, etc.
Basically if you're half way healthy it seems less bad than the cold I've got currently.
This article from the New Scientist gives a clear and simple summary of the rate of infection issues. It predates yesterday’s massive jump in the figures.
Well theres finally a case of it in london, and so begins the culling of the underground, might finally get on the first central line train that comes along rather than fighting my way to get onto the 5th
Why does every call it flu like? It basically causes pneumonia so should be looking at mortality rates for pneumonia and we know that pneumonia generally only kills the very young and very old and those whose health is otherwise compromised.
But age matters. In China, 80 per cent of deaths have been in people aged over 60. While China has a median age of 37.4, the median age in the European Union, for example, is close to 43, meaning more residents may be vulnerable there.
and the average age of tory voters is probably 50+.
Silver linings and all that. 2nd referendum here we come!
Fair points Laz - but I have seen R0 estimates for Covid between 3 and 4. Tbh they feel more consistent with the fact it has spread much faster than SARS.
Agree that may just be because it hasnt been managed properly and that it could still be less contagious than SARS notwithstanding its wider spread. But I think the empirical evidence - shutdown chaos and initial explosion of cases (compared to SARS) - all seem to suggest to me that it is likely more contagious.
And even if not, it may be that we just got very lucky with SARS but this time have run out of luck and will have much more trouble containing it.
On death rate the guys from ICL released a paper suggesting it looks like 1-2% in the West with a pretty worrying risk of being higher. He looks relatively sensible and it seems to align with what we see so far.
Who knows. I remain of the view that there are big downside risks and we should have a more significant policy response until we know more. In 3-4weeks the non China cases will give us a better idea of fatality rate (and we will also know whether containment is working). Until then we should be doing more to limit possible spread. If by then its established and spreading, clearly has a high R0 and fatality rate is 3-5 %, its probably too late to avert a catastrophe and/or the mitigation measures will have to be even more harmful.
Rather than worrying about it go home tonight, rustle up a couple of old friends and have a few beers and a laugh. You'll feel shit but also much happier in the morning.
Rather than worrying about it go home tonight, rustle up a couple of old friends and have a few beers and a laugh. You'll feel shit but also much happier in the morning.
I know we are not used to serious threats and have a great deal of safety and security in our lives. But this sounds like really terrible advice. Head in the sand much ?
There is a fairly remote risk here, but it is an absolutely terrible outcome if it happens. If half the population get this and the death rate is 1% that is 300,000 deaths or about 50,000 more than World War II.
Yes Del Segno - but we are all middle class lawyers who exude a calm professional authority and being alarmist just wouldn’t do now would it?
PS - what you describe - more deaths than WW2 -isn’t a “fairly remote risk” but pretty close to being the current base case.
Its just that its all terribly embarrassing to point that out publicly. After all its only the flu and only old people or diabetic Brexiteers will die so lets not worry people unnecessarily or do anything that might affect the house prices unduly. There’s a good chap.
PS - the sarcasm is directed at the world generally rather than anyone in particular on here - and certainly not Sails whose advice to just go down the pub is, in the circumstances, pretty much sound.
CW you are obviously very interested in this issue but I really cant understand why you are obsessing over the worst case scenarios like this. I strongly recommend you listen to the interviews on the bbc with microbiologist professors, the uk chief medical officer and the like. With all due respect, you are neither.
they are saying that this is a contagious virus, much like the cold or flu are, and that the vast majority of sufferers will suffer an unremarkable course of the illness. The”true” rate of infection may never be known, given that, like the flu, and some other viruses, you can have it with no symptoms. Yes, it is widespread. No, it wont kill us all.
The main issue is what it does to those with compromised immune systems, much like with flu. Your best bet to avoid catching it is with good hygiene, which we should all be doing anyway at this time of year.
here in the uk the hope is that we can fend off large infection of the population before it abates naturally in warmer months (when people spend more time outside and not cooped up) and that maybe before the end of the year we will have a vaccine. At which point hopefully it will affect us all no more than like the flu. Certainly quarantining outside china appears to be working.
By the way, as I expected, the WHO’s resident affable Irishman (and heavyweight public health emergency expert) Mike Ryan conformed that the “spike” was not an actual spike in the occurrence of the disease at all, it was the reclassification of a whole bunch of legacy cases, some going back to the very beginning of the epidemic, as actual rather than suspected cases. The number of newly lab-diagnosed cases yesterday was 1300 I think - a significant fall on the day before.
CW you are obviously very interested in this issue but I really cant understand why you are over the worst case scenarios like this. I strongly recommend you listen to the interviews on the bbc with microbiologist professors, the uk chief medical officer and the like. With all due respect, you are neither.
I am not as worried as CW but the downside risk here is gigantic, if unlikely to happen.
Until we are very sure it is not coming here I really do think we should take it very seriously. And yes, that does mean staying home and not going to the pub, or to sporting events or to a restaurant.
All it takes is one. Just one super-spreader in just one London nightclub where everyone is dancing in a close-packed crowd and breathing in gulps. That’s all it takes. The next day you have 200 cases, most untraceable. Ten days after that you have 2000 cases. Ten days after that, 20,000. After a month 200,000.
What DS said, save my view is that what he describes does not sound to me to be in the least ‘unlikely to happen’. Sounds very likely indeed to me.
But then agreed Im not an expert. Although there are a number of experts who seem to be edging closer to admitting a pandemic is likely. They are obviously subject to professional restraints. Seems to me the risk must be at least 20-30% now. My view is that its more likely than not.
Anyway I have taken on board the fact that I need to calm down. The wisdom of Rof. So am limiting myself to one visit to the subject per day. Mrs Worf (who as you can imagine has had to put up with it almost as much as you lot) is due a Valentines Day lunch and I have work to do.
On my reading, the view the experts seem to be edging toward is the view that there will now probably not be a global pandemic, if suppression efforts in China are maintained.
Anyway I had a lovely couple of pints followed by an excellent steak with good wine and plenty of laughter with good friends. It's Friday and the sun is shining and the weekend is nearly here so all is good in the world this morning.
Laz - Professors Lipsitch (Harvard) and Ferguson (ICL) - seem to me to be going the other way. Whilst there were wide caveats, Lipsitch has said that a pandemic is ‘likely’. Scott Gottlieb (ex CDC director) has not gone as far as to say its likely, but his tweets are clearly becoming increasingly concerned.
Both of these guys are serious academics. In all cases there seems to me to be a natural professional bias towards conservatism.
That said there is clearly a massive effort to trace contacts etc and not as many anecdotal cases in the UK as I had feared we might already have.
I think the issue will be that even if we control it other countries wont and you wont be able to shut out the rest of the world permanently. So although you can mitigate via slowing progress, it will become increasingly difficult and eventually impossible to stop.
So my base remains that we are likely to face widespread transmission in UK at some point over the next 6-9 months and it is likely to kill 1-1.5%, with a very significant risk of it being higher.
Still feels to me like it will be the ‘slow rolling monster’ that scylla predicted at the outset.
Anyway, again, thats me done on the subject for today.
"So my base remains that we are likely to face widespread transmission in UK at some point over the next 6-9 months and it is likely to kill 1-1.5%, with a very significant risk of it being higher"
1 to 1.5% of cases or 1 to 1.5% of the population?
These guys are estimating a CFR in all infections of 1%. 95% confidence interval 0.5-4. Significantly higher rates being estimated in Wuhan. So its ICL London being daft not me.
Yes Ive added 0.5. I think most of the biases are towards assuming it wont be as bad as expected and are likely to be underestimating downsides. All sorts of reasons. Not least there’s a sort of cultural racism/naivety about assuming it “couldn’t be as bad here”.
There are plenty of case histories and other reports etc coming out of China that, even with their biases, clearly show lots of evidence that the 30-50 cohort is fairly badly affected too. (As is sometimes the case with flu).
On both issues I think the outcomes in a strained healthcare system are difficult to judge but - as Ive noted I suspect that there are risks towards the Wuhan type downside.
One other observation. Like the cold it does seem to be something that may be recatchable. Have seem at least one report hinting at this. It could eventually settle in as something that is always with us - like the flu - but 5-8 times more deadly. The cultural and social consequences of that would be very interesting.
(Tbh I think that even if that is not the case and we end up with softer outcomes from the epidemic, there could be significant changes in the way people look at globalisation/capitalism etc). In a world where more and more is happening online, one can easily envisage a trend towards greater physical social distancing, less focus on wealth generation, greater localism etc.
That really is it for the day. As others have rightly said there is not much to be done at this stage. At least by the general public. Ive explained my views as clearly as I can and no-one is compelled to share them.
Right. Definitely now getting on with the rest of life.
The imperial paper is a good read but on the basis of anything I’ve seen, it is not true to say there’s evidence the 30-50 cohort is badly affected. It *is* primarily an elder person’s disease.
That doesn’t make it a prospect to be taken lightly, assuming you are not indifferent to the prospects of your parents becoming
The differences in smoking rates, air quality, population density and prevalences of other lung conditions are pretty good reasons to think it probably would not be as bad here, also.
Sorry misread post - 1-1.5% of infections is where I am coming out (based largely on the ICL article). Which is worse than 1-1.5 of reported cases. But clearly not as bad as 1.5% of population. But epidemics can affect 30-50% of population. So a 0.5-0.75% of population fatality rate would not be inconceivable.
I’m still a bit confused on infectiousness of the thing. Everyone is sceptical about Chinese stats quite rightly but whatever, it’s quite clearly spread very significantly there. But - and I appreciate I’ve been going on about this for a few weeks now - I don’t understand the very limited infections we’ve seen outside China which presumably are fairly reliable and aren’t rising exponentially.
Chinese tourists with the disease were clearly in pretty wide circulation up until a couple of weeks ago. But still there isn’t evidence of anything but tiny clusters of close family members or those on cruise ships etc getting infected. Thailand still only has a total of 34 cases and even if we doubt their numbers, UK is still only showing 9 cases. Anyone with a better understanding of why?
We can’t be sure that there are only 9 cases in the UK - there may be cases going undetected. I agree though, it does seem a bit odd. People have been anticipating a spike in cases outside China for a couple weeks now and the best evidence is that this has not happened. I don’t have a good explanation
most of the people who have caught it in Europe are young / middle aged people who have travelled and come into direct contact with a Chinese person infected - the cluster in France for example seems to be responsible for all the British cases.
The only person to die so far in Europe is an 80 year old.
people who are dying seem to be dying of pneumonia.
It’s not even proved that infectious in China outside Hubei - yet.
One thing you have to bear in mind is that standards of respiratory health in China are generally appalling. Half or more of all men smoke and everyone’s got pneumonia anyway.
Sorry misread post - 1-1.5% of infections is where I am coming out (based largely on the ICL article). Which is worse than 1-1.5 of reported cases. But clearly not as bad as 1.5% of population. But epidemics can affect 30-50% of population. So a 0.5-0.75% of population fatality rate would not be inconceivable.
I think that is entirely plausible. And in the U.K. that would mean 300,000 to 450,000 deaths if not more.
Increasingly amused at Canary Worf's obvious continuing throb-on for this to go pandemic apocalypse juxtaposed with repeated insistences of 'Right - that's it from me / no more posts today' imminently and invariably followed by several more lengthy posts in short order each day predicting greater DDDOOOOOOMMMMM.
If it doesn’t end up going globally pandemic, the likely reason will be the massive containment measures put in place the Chinese government, any praise for whom, however vague or indeed however justified, always comes in for a ferocious slagging on here of course. Fire away. If the world ends up being saved, it’s been saved by the Chinese government. Worry about something like this kicking off in Indonesia or India next time.
Nah bollocks sorry, good and aggressive epidemic control is good and aggressive epidemic control whatever the general moral character of the government. I won’t be having any of that kind of shite from you, cheers
What the fook do the Uighurs have to do with whether the epidemic has been suppressed effectively, anyway?
I’m not even concluding that they have achieved that - just pointing out that if the epidemic IS successfully suppressed then it will be thanks to the chinese government, but everyone on here will deny it. Whixh you then prove by posting something utterly irrelevant to the epidemic management.
I will be thanking them for saving the world from an epidemic if that’s what they do. For those limited purposes only, I don’t really care whether they’re evil or not tbh
I hate linking to this evil publication but this is an article where the leading U.K. professor of epidemiology admits that 400,000 deaths in the U.K. is not an absurd prediction:-
"They are citizen journalists, wanting to provide the "truth" of what is happening in Wuhan, the epicentre of the coronavirus outbreak in China.
They posted videos online, shared pictures and dramatic stories from inside the quarantined city that has been virtually cut off from the rest of the country.
Now, they are nowhere to be found.
Fang Bin and Chen Qiushi were both determined to share what they could about the crisis, reporting from Wuhan, the capital of Hubei province, and sending what they found out into the world.
As a result, they racked up thousands of views on their videos. But their channels have now gone quiet, and those who followed them online fear they may have disappeared for good."
BC ofc its not a bummer. I very much hope it all goes away and I am proved ‘wrong’. Even if it does go away however, I am not wrong to be alarmist about it. The Daily Mail article with professor Ferguson reflects the same level of concern - albeit nearly 3 weeks after Scylla and I arrived at the same conclusion.
BTW 8/9 being OK means 1 is still being cared for. It is entirely consistent with the 1-2% fatality rate envisaged by myself.
The French case that died today - was reported as ‘improving’ a about a week ago and I don’t think was even listed as critical. The disease can take a long circuitous route to finishing folk off.
If you are in a pub or a restaurant or at a nightclub today, the cold icy fingers of death are fumbling at your shoulder. If not this time, next week or the week after Or the week after that he will begin to get some of you .......
Seriously, you have been warned. Get home, get a month’s supply of tinned asparagus and anything else you like and prepare to sit it out without opening the front door.
Tbh - I’m not that worried for next week or two. Plus as a relatively healthy early 44 yr old I can take my chances with it and very likely to be fine. It’s the population risk that matters and the economic and political consequences - which could be pretty dramatic if it gets going - as looks increasingly possible and maybe even likely.
I think this was the same 80 yr old mentioned here. Wouldn’t read too much into tbh, save that, as you know, I remain somewhat unconvinced by the way reporting is so desperate to emphasise recoveries and downplay severity - but when you look at the actual numbers, the lag time, the China reporting and the academic literature - it all points to a disease that probably kills at least 1% and quite possibly a 1 or 2 per cent more. There are still lots of unresolved non China cases and I suspect a few more of them will pop their clogs over the next week or two. Whilst even this won’t prove that much - it is likely to remain consistent with a 1-2% fatality rate.
CW it does not look “increasingly” likely there will be a global epidemic. It is still entirely possible, but there is no way on earth it looks likelier than it did 2wks ago.
I dunno mate - there is now community transmission in Singers and Japan (not sure about HK?). And a lot of other non China cases. Didn’t have that 2 weeks ago. Tbh I thought it was likely 2 weeks ago and remain of the same view - but as it’s not clearly shot away I don’t think it’s become more likely. Still in the balance. Officials and experts are more openly talking about it now though, that is for sure.
Tarquin - I’ve seen an article on that and whilst I’m not expert enough to comment I’m surprised it’s not been discussed more widely.
I am a bit worried if it turns out to be effective at killing Asian people but not others. I don’t readily believe in conspiracy theories but others do and if the CCP is threatened then it might decide to let the people believe that it was a US bio weapon. That would be very bad.
Wouldn’t read too much into tbh, save that, as you know, I remain somewhat unconvinced by the way reporting is so desperate to emphasise recoveries and downplay severity
I don’t think academic commentators are any more willing to talk about global pandemic now than they were two weeks ago. Community transmission has been very limited outside mainland china, and Inam not sure how widespread it has been *within* mainland china outside Hubei and whatever the badly affected neighbouring province is
So far Indonesia has reported zero cases. This is very implausible and means (1) they are missing the cases or hiding them; and (2) they will have a far worse outbreak quite soon.
0
0
Stop going to the pub? Are you fooking serious?
Interesting that this coincides with the replacement of the senior local health officials. Seems unguessable that the daily numbers have actually jumped that much, so presumably there has been a change of approach to reporting.
0
0
This is exactly the opposite of what is being reported on the BBC.
https://www.bbc.co.uk/news/world-asia-china-51482994
Nice to see that markets are also back up to peaks to reflect what is happening on the ground.
0
0
Apparently they have now started reporting cases (and deaths) that are “clinically diagnosed”, which I’m guessing means they have been diagnosed by doctors based on symptoms, even if not confirmed by lab tests.
Now the question is, are 14,000 new “clinically diagnosed” cases appearing per day or is this a one off correction caused by recognising the backlog? We will see. In any event, as suspected, the death rate is much higher than previously reported - v worrying.
0
0
It is of course serious but I suspect that this change relates to a change in reporting rather than a true change in underlying cases. I do think the UK should institute quarantine measures now.
0
0
(By which I mean - cancel public events, encourage WFH, discourage non-essential travel etc)
0
0
My feeling is that this just brings both the reported case numbers and the reported deaths closer to reality.
I note that the Guardian report says that there has been no change in how deaths are recorded. I’m not sure how this can be true since surely before now patients who died of clinical nCoV without being tested would not have been counted as an infection death in the official figures. My understanding is that now they would be, which will inevitably cause an increase in recorded deaths by the difference between clinical nCoV deaths and confirmed nCoV deaths.
0
0
60,000 cases, 1350 deaths is still 2.2% mortality rate.
0
0
The large increase in deaths is the lead story on BBC r4 now. The BBC eventually catches up.
0
0
Given the lag to death of c2 weeks (sometimes longer) you need to compare deaths with cases a couple of weeks ago. Suspect you end up with a CFR more like 10%. But of course this itself is naive as still relying upon the hopelessly inaccurate guesses/lies coming out of China...
Still hoping Western fatality rates will be much lower (in the WEST I still suspect 1-2% may be about right) But this hoping/guessing doesn’t feel like much of a strategy. 2% is still an epic disaster. And could be worse.
I think our window to stop disaster is closing fast. By the time people (in govt and public) can admit the reality of what is happening to themselves it will be too late.
We should at least be doing simple things like closing key borders, WFH wherever possible limiting social gathering etc. Contact tracing is being done well but its unlikely to be enough.
0
1
Yeah CW makes a point on the lag to people dying that has been troubling me about this for a while...
I had thought that the obvious massive under reporting of cases would more than balance that effect out but if the death figures also jump when you 'widen the net' that is troubling.
The number of cases 10 days ago was only just over 20,000. 1,350 deaths against that is something like 6.75% which start to make it look more like SARS in terms of the death rate.
I am nothing like a good enough statistician to know if that sort of maths is the right way of looking at it though.
0
0
there is still massive under reporting even now
under reporting definitely tends to exaggerate the mortality rate
however it’s also true to say there’s a lag on deaths versus cases, obviously
0
0
Stop going to the pub? So basically let the virus win? We need to carry on about our daily business as normal but with vigilance*
*I may be confusing Corona virus with terrorists.
0
0
Looking at SARS (v quickly don’t really have time for this) - the ultimate fatality rate was c10% in Canada too. I think i’m just being naive in hoping the death rate in West will be massively lower.
0
0
It’s already clear the death rate from this is lower than SARS. The analysis I saw said it was less infectious too.
0
0
doctors suggest that the undeground could be a 'hotbed' for covid 19
https://news.sky.com/story/coronavirus-doctors-fear-tube-could-spread-covid-19-as-london-gets-first-case-11932794
0
0
Lots of experts on twitter discussing changes to diagnostic tests (with all the enthusiasm of lawyers for some strange technical issues) - but most are missing the point that deaths have jumped too. Presumably diagnostic thresholds are not relevant to death ...
Which leads, once again, to the conclusion that these numbers are being more or leas made up. Conveniently the (naive) death rate stays at 2.1-2.2% day after day regardless.
The WHO then uses these numbers and national govts allow them to circulate unchallenged. No-one wants to scare the horses.
Now it may be that ultimately the death rate is anywhere from 0.5-20, and could well land up at 2-3%, but, make no mistake, the 2% number currently circulating is thoroughly dishonest.
0
0
How reliable are the figures for SARS...?
0
0
The evidence I see (China in lockdown; explosion in cases that is far far faster than SARS and various academic papers suggesting R0 is 3-4) - suggests to me it is far more contagious that SARS.
I think the death rate probably will be lower, but its unclear by how much.
You don’t need to be a doctor to guess the underground should be avoided.
0
0
diagnostic thresholds are relevant to death
if someone has symptoms but hasn’t tested positive, until yesterday they would have been classified as a “suspected” case (numbers for which have been circulated for a while, but seldom commented on bu the western media). If someone in such a situation died, their death would be recorded as “pneumonia” or whatnot, but not as Covid-19. Now, if a doctor has diagnosed them based on their symptoms, they will be reported as a Covid-19 case and if they die they will be reported as a Covid-19 case.
So it affects both elements. It was expressly announced yesterday that 135 of the 242 were formerly “suspected” cases ie had they died 24 hours before, they wouldn’t have been classified as Covid-19 deaths at all. NB the absolute numbers probably continue to be total bollocks.
Its also not clear whether the 242 was deaths in one day or whether it was inflated by reclassification or earlier deaths, although given the scale of the thing, 240 deaths in a day in a. province of 55million is not inconceivable.
0
0
The figures for SARS are not that reliable. Like Covid-19, or anything else, nobody knows how many cases of SARS there really were.
I read something by a professor in HK where he estimated the R0 of the new virus to be lower than SARS. That’s a technical measure of infectious ness. It has in fact infected many more people than SARS, but that doesn’t make it “more infectious”.
0
0
yes prof john nicholas estimated the r0 of Covid-19 at 2.2; estimates for SARS are between 2 and 4. So it’s comparable if not significantly lower (assuming both calculations are accurate).
0
0
Not sure if this has been posted, but for comparison: https://www.google.com/amp/s/api.nationalgeographic.com/distribution/public/amp/science/2020/02/graphic-coronavirus-compares-flu-ebola-other-major-outbreaks
0
0
Meh: https://www.nationalgeographic.com/science/2020/02/graphic-coronavirus-…
0
1
Meanwhile the old bloke who got it on the cruise ship in Japan is about to be discharged from hospital and the super spreader has already been sent home. Did chuckle at the fact that the guy with the deadly virus will get out of quarantine faster than the healthy people left on the ship where it seems to be circulating nicely with the air con, etc.
Basically if you're half way healthy it seems less bad than the cold I've got currently.
0
0
This article from the New Scientist gives a clear and simple summary of the rate of infection issues. It predates yesterday’s massive jump in the figures.
https://www.newscientist.com/article/2233269-how-bad-is-the-covid-19-coronavirus-outbreak-likely-to-get/
0
1
2% mortality rate is very high for a flu like illness - if this is not closed down we could be looking a deaths in the millions.
0
0
lolling hard at people "stocking up"
0
0
Well theres finally a case of it in london, and so begins the culling of the underground, might finally get on the first central line train that comes along rather than fighting my way to get onto the 5th
0
0
Why does every call it flu like? It basically causes pneumonia so should be looking at mortality rates for pneumonia and we know that pneumonia generally only kills the very young and very old and those whose health is otherwise compromised.
0
0
and the average age of tory voters is probably 50+.
Silver linings and all that. 2nd referendum here we come!
0
0
I'm wondering what's gonna happen when it hits the dense population bits of India and Pakistan.
But then, are they any denser, population wise, than China?
0
0
Shooty they are constantly covered in shit and nothing happens to them, so my thinking is they will just be immune to the virus
0
0
ffs
0
1
Shooty - India has had 6 cases of infections and one serious. No deaths.
0
0
Fair points Laz - but I have seen R0 estimates for Covid between 3 and 4. Tbh they feel more consistent with the fact it has spread much faster than SARS.
Agree that may just be because it hasnt been managed properly and that it could still be less contagious than SARS notwithstanding its wider spread. But I think the empirical evidence - shutdown chaos and initial explosion of cases (compared to SARS) - all seem to suggest to me that it is likely more contagious.
And even if not, it may be that we just got very lucky with SARS but this time have run out of luck and will have much more trouble containing it.
On death rate the guys from ICL released a paper suggesting it looks like 1-2% in the West with a pretty worrying risk of being higher. He looks relatively sensible and it seems to align with what we see so far.
Who knows. I remain of the view that there are big downside risks and we should have a more significant policy response until we know more. In 3-4weeks the non China cases will give us a better idea of fatality rate (and we will also know whether containment is working). Until then we should be doing more to limit possible spread. If by then its established and spreading, clearly has a high R0 and fatality rate is 3-5 %, its probably too late to avert a catastrophe and/or the mitigation measures will have to be even more harmful.
0
0
Rather than worrying about it go home tonight, rustle up a couple of old friends and have a few beers and a laugh. You'll feel shit but also much happier in the morning.
0
0
I know we are not used to serious threats and have a great deal of safety and security in our lives. But this sounds like really terrible advice. Head in the sand much ?
There is a fairly remote risk here, but it is an absolutely terrible outcome if it happens. If half the population get this and the death rate is 1% that is 300,000 deaths or about 50,000 more than World War II.
0
0
What do you suggest doing then?
0
0
Yes Del Segno - but we are all middle class lawyers who exude a calm professional authority and being alarmist just wouldn’t do now would it?
PS - what you describe - more deaths than WW2 -isn’t a “fairly remote risk” but pretty close to being the current base case.
Its just that its all terribly embarrassing to point that out publicly. After all its only the flu and only old people or diabetic Brexiteers will die so lets not worry people unnecessarily or do anything that might affect the house prices unduly. There’s a good chap.
PS - the sarcasm is directed at the world generally rather than anyone in particular on here - and certainly not Sails whose advice to just go down the pub is, in the circumstances, pretty much sound.
0
0
CW you are obviously very interested in this issue but I really cant understand why you are obsessing over the worst case scenarios like this. I strongly recommend you listen to the interviews on the bbc with microbiologist professors, the uk chief medical officer and the like. With all due respect, you are neither.
they are saying that this is a contagious virus, much like the cold or flu are, and that the vast majority of sufferers will suffer an unremarkable course of the illness. The”true” rate of infection may never be known, given that, like the flu, and some other viruses, you can have it with no symptoms. Yes, it is widespread. No, it wont kill us all.
The main issue is what it does to those with compromised immune systems, much like with flu. Your best bet to avoid catching it is with good hygiene, which we should all be doing anyway at this time of year.
here in the uk the hope is that we can fend off large infection of the population before it abates naturally in warmer months (when people spend more time outside and not cooped up) and that maybe before the end of the year we will have a vaccine. At which point hopefully it will affect us all no more than like the flu. Certainly quarantining outside china appears to be working.
0
0
There’s no ground to be glib about it but suggesting nobody goes to the pub or the gym is a bit ridic, at this stage, in england.
0
1
“what you describe - more deaths than WW2 -isn’t a “fairly remote risk” but pretty close to being the current base case”
It’s consistent with base case mortality in the event of an epidemic, but the current base case is there won’t be an epidemic in the first world.
0
0
By the way, as I expected, the WHO’s resident affable Irishman (and heavyweight public health emergency expert) Mike Ryan conformed that the “spike” was not an actual spike in the occurrence of the disease at all, it was the reclassification of a whole bunch of legacy cases, some going back to the very beginning of the epidemic, as actual rather than suspected cases. The number of newly lab-diagnosed cases yesterday was 1300 I think - a significant fall on the day before.
0
0
For those seriously interested in this story - watch Ryan’s daily briefings, which are live streamed in youtube.
Also don’t forget to go to the gym, have a pint and watch some football.
0
1
Being a public health emergency expert seems pretty cool tbh, maybe I'll give it a go
0
0
Get to look all serious on TV plus first dibs on the respirator masks and I assume a room in the government bunker
0
0
It does look good tbf. If I were a medic I’d love to do that sort of thing.
Ryan’s no desk jockey either. He’s spent most of his career as a frontliner. Done surgery at gunpoint in Saddam’s Iraq.
0
0
@minkie13 Feb 20 19:27
I am not as worried as CW but the downside risk here is gigantic, if unlikely to happen.
Until we are very sure it is not coming here I really do think we should take it very seriously. And yes, that does mean staying home and not going to the pub, or to sporting events or to a restaurant.
All it takes is one. Just one super-spreader in just one London nightclub where everyone is dancing in a close-packed crowd and breathing in gulps. That’s all it takes. The next day you have 200 cases, most untraceable. Ten days after that you have 2000 cases. Ten days after that, 20,000. After a month 200,000.
0
0
What DS said, save my view is that what he describes does not sound to me to be in the least ‘unlikely to happen’. Sounds very likely indeed to me.
But then agreed Im not an expert. Although there are a number of experts who seem to be edging closer to admitting a pandemic is likely. They are obviously subject to professional restraints. Seems to me the risk must be at least 20-30% now. My view is that its more likely than not.
Anyway I have taken on board the fact that I need to calm down. The wisdom of Rof. So am limiting myself to one visit to the subject per day. Mrs Worf (who as you can imagine has had to put up with it almost as much as you lot) is due a Valentines Day lunch and I have work to do.
0
0
That’s not all it takes tbh
Im going to a football game tomorrow. Really looking forward to it.
0
0
On my reading, the view the experts seem to be edging toward is the view that there will now probably not be a global pandemic, if suppression efforts in China are maintained.
0
0
Anyway I had a lovely couple of pints followed by an excellent steak with good wine and plenty of laughter with good friends. It's Friday and the sun is shining and the weekend is nearly here so all is good in the world this morning.
0
0
Laz - Professors Lipsitch (Harvard) and Ferguson (ICL) - seem to me to be going the other way. Whilst there were wide caveats, Lipsitch has said that a pandemic is ‘likely’. Scott Gottlieb (ex CDC director) has not gone as far as to say its likely, but his tweets are clearly becoming increasingly concerned.
Both of these guys are serious academics. In all cases there seems to me to be a natural professional bias towards conservatism.
That said there is clearly a massive effort to trace contacts etc and not as many anecdotal cases in the UK as I had feared we might already have.
I think the issue will be that even if we control it other countries wont and you wont be able to shut out the rest of the world permanently. So although you can mitigate via slowing progress, it will become increasingly difficult and eventually impossible to stop.
So my base remains that we are likely to face widespread transmission in UK at some point over the next 6-9 months and it is likely to kill 1-1.5%, with a very significant risk of it being higher.
Still feels to me like it will be the ‘slow rolling monster’ that scylla predicted at the outset.
Anyway, again, thats me done on the subject for today.
0
0
"So my base remains that we are likely to face widespread transmission in UK at some point over the next 6-9 months and it is likely to kill 1-1.5%, with a very significant risk of it being higher"
1 to 1.5% of cases or 1 to 1.5% of the population?
if the latter - don't be daft
0
0
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-2019-nCoV-severity-10-02-2020.pdf
These guys are estimating a CFR in all infections of 1%. 95% confidence interval 0.5-4. Significantly higher rates being estimated in Wuhan. So its ICL London being daft not me.
Yes Ive added 0.5. I think most of the biases are towards assuming it wont be as bad as expected and are likely to be underestimating downsides. All sorts of reasons. Not least there’s a sort of cultural racism/naivety about assuming it “couldn’t be as bad here”.
There are plenty of case histories and other reports etc coming out of China that, even with their biases, clearly show lots of evidence that the 30-50 cohort is fairly badly affected too. (As is sometimes the case with flu).
On both issues I think the outcomes in a strained healthcare system are difficult to judge but - as Ive noted I suspect that there are risks towards the Wuhan type downside.
One other observation. Like the cold it does seem to be something that may be recatchable. Have seem at least one report hinting at this. It could eventually settle in as something that is always with us - like the flu - but 5-8 times more deadly. The cultural and social consequences of that would be very interesting.
(Tbh I think that even if that is not the case and we end up with softer outcomes from the epidemic, there could be significant changes in the way people look at globalisation/capitalism etc). In a world where more and more is happening online, one can easily envisage a trend towards greater physical social distancing, less focus on wealth generation, greater localism etc.
That really is it for the day. As others have rightly said there is not much to be done at this stage. At least by the general public. Ive explained my views as clearly as I can and no-one is compelled to share them.
Right. Definitely now getting on with the rest of life.
0
0
The imperial paper is a good read but on the basis of anything I’ve seen, it is not true to say there’s evidence the 30-50 cohort is badly affected. It *is* primarily an elder person’s disease.
0
0
That doesn’t make it a prospect to be taken lightly, assuming you are not indifferent to the prospects of your parents becoming
The differences in smoking rates, air quality, population density and prevalences of other lung conditions are pretty good reasons to think it probably would not be as bad here, also.
0
0
*succumbing not becoming
0
1
Sorry misread post - 1-1.5% of infections is where I am coming out (based largely on the ICL article). Which is worse than 1-1.5 of reported cases. But clearly not as bad as 1.5% of population. But epidemics can affect 30-50% of population. So a 0.5-0.75% of population fatality rate would not be inconceivable.
0
0
I’m still a bit confused on infectiousness of the thing. Everyone is sceptical about Chinese stats quite rightly but whatever, it’s quite clearly spread very significantly there. But - and I appreciate I’ve been going on about this for a few weeks now - I don’t understand the very limited infections we’ve seen outside China which presumably are fairly reliable and aren’t rising exponentially.
Chinese tourists with the disease were clearly in pretty wide circulation up until a couple of weeks ago. But still there isn’t evidence of anything but tiny clusters of close family members or those on cruise ships etc getting infected. Thailand still only has a total of 34 cases and even if we doubt their numbers, UK is still only showing 9 cases. Anyone with a better understanding of why?
0
0
We can’t be sure that there are only 9 cases in the UK - there may be cases going undetected. I agree though, it does seem a bit odd. People have been anticipating a spike in cases outside China for a couple weeks now and the best evidence is that this has not happened. I don’t have a good explanation
0
0
most of the people who have caught it in Europe are young / middle aged people who have travelled and come into direct contact with a Chinese person infected - the cluster in France for example seems to be responsible for all the British cases.
The only person to die so far in Europe is an 80 year old.
people who are dying seem to be dying of pneumonia.
0
0
It’s not even proved that infectious in China outside Hubei - yet.
One thing you have to bear in mind is that standards of respiratory health in China are generally appalling. Half or more of all men smoke and everyone’s got pneumonia anyway.
0
0
"We can’t be sure that there are only 9 cases in the UK - there may be cases going undetected"
if this is case, and no one is dying or even being hospitalised, so what.
0
0
Canary Worf15 Feb 20 10:38 said:-
I think that is entirely plausible. And in the U.K. that would mean 300,000 to 450,000 deaths if not more.
0
0
Yeah - I guess theoretically people could be being hospitalised with unrecognised coronavirus-related pneumonia but not in substantial numbers
0
1
the only conclusion I am prepared to draw at this stage is that it is too early to draw conclusions m99s
0
0
I am certain that not even 100 people will die in the U.K let alone 300,000
0
0
Let's hope not or BoJo will have an excuse to declare himself world king for life with emergency powers.
0
1
Yeah that went well for Oliver Cromwell
0
1
Increasingly amused at Canary Worf's obvious continuing throb-on for this to go pandemic apocalypse juxtaposed with repeated insistences of 'Right - that's it from me / no more posts today' imminently and invariably followed by several more lengthy posts in short order each day predicting greater DDDOOOOOOMMMMM.
0
0
In more good news, only one of the nine UK confirmed cases of Coronavirus remains in hospital - the other eight all now discharged:
https://news.sky.com/story/coronavirus-all-but-one-of-uk-patients-who-tested-positive-for-virus-has-now-been-discharged-11934646
Bummer, eh, CW?
0
0
If it doesn’t end up going globally pandemic, the likely reason will be the massive containment measures put in place the Chinese government, any praise for whom, however vague or indeed however justified, always comes in for a ferocious slagging on here of course. Fire away. If the world ends up being saved, it’s been saved by the Chinese government. Worry about something like this kicking off in Indonesia or India next time.
0
1
https://www.spectator.co.uk/2019/12/the-chilling-stories-from-inside-chinas-muslim-internment-camps/
0
0
You can sing from the little red book if you like.
0
0
Nah bollocks sorry, good and aggressive epidemic control is good and aggressive epidemic control whatever the general moral character of the government. I won’t be having any of that kind of shite from you, cheers
0
0
What the fook do the Uighurs have to do with whether the epidemic has been suppressed effectively, anyway?
I’m not even concluding that they have achieved that - just pointing out that if the epidemic IS successfully suppressed then it will be thanks to the chinese government, but everyone on here will deny it. Whixh you then prove by posting something utterly irrelevant to the epidemic management.
0
1
The Chinese regime is evil. I won't be thanking them for anything.
0
0
I will be thanking them for saving the world from an epidemic if that’s what they do. For those limited purposes only, I don’t really care whether they’re evil or not tbh
0
0
I hate linking to this evil publication but this is an article where the leading U.K. professor of epidemiology admits that 400,000 deaths in the U.K. is not an absurd prediction:-
https://www.dailymail.co.uk/news/article-8005931/British-scientist-leading-coronavirus-fight-says-forecasts-400-000-UK-deaths.html
0
0
I think we can at least all agree that the Chinese Govt. is excellent at suppression.
0
0
In other wholly unrelated news, where are Fang Bin and Chen Qiushi?
https://www.bbc.co.uk/news/world-asia-china-51486106
"They are citizen journalists, wanting to provide the "truth" of what is happening in Wuhan, the epicentre of the coronavirus outbreak in China.
They posted videos online, shared pictures and dramatic stories from inside the quarantined city that has been virtually cut off from the rest of the country.
Now, they are nowhere to be found.
Fang Bin and Chen Qiushi were both determined to share what they could about the crisis, reporting from Wuhan, the capital of Hubei province, and sending what they found out into the world.
As a result, they racked up thousands of views on their videos. But their channels have now gone quiet, and those who followed them online fear they may have disappeared for good."
0
1
BC ofc its not a bummer. I very much hope it all goes away and I am proved ‘wrong’. Even if it does go away however, I am not wrong to be alarmist about it. The Daily Mail article with professor Ferguson reflects the same level of concern - albeit nearly 3 weeks after Scylla and I arrived at the same conclusion.
BTW 8/9 being OK means 1 is still being cared for. It is entirely consistent with the 1-2% fatality rate envisaged by myself.
The French case that died today - was reported as ‘improving’ a about a week ago and I don’t think was even listed as critical. The disease can take a long circuitous route to finishing folk off.
0
0
If you are in a pub or a restaurant or at a nightclub today, the cold icy fingers of death are fumbling at your shoulder. If not this time, next week or the week after Or the week after that he will begin to get some of you .......
Seriously, you have been warned. Get home, get a month’s supply of tinned asparagus and anything else you like and prepare to sit it out without opening the front door.
0
0
Dude r u high?
i will be monumentally taking the piss in the month or so when when nothing happens. I mean I will take the piss now obvs
0
0
Tbh - I’m not that worried for next week or two. Plus as a relatively healthy early 44 yr old I can take my chances with it and very likely to be fine. It’s the population risk that matters and the economic and political consequences - which could be pretty dramatic if it gets going - as looks increasingly possible and maybe even likely.
0
0
“The French case that died today - was reported as ‘improving’ a about a week ago”
Where was this?
0
0
Perhaps this will illustrate things for y’all
https://www.theguardian.com/world/2020/feb/15/coronavirus-outbreak-wuhan-china
0
0
u have developed some kind of condition where u post the same link on multiple threads m99
0
0
https://www.thelocal.fr/20200131/coronavirus-in-france-what-you-need-to-know
I think this was the same 80 yr old mentioned here. Wouldn’t read too much into tbh, save that, as you know, I remain somewhat unconvinced by the way reporting is so desperate to emphasise recoveries and downplay severity - but when you look at the actual numbers, the lag time, the China reporting and the academic literature - it all points to a disease that probably kills at least 1% and quite possibly a 1 or 2 per cent more. There are still lots of unresolved non China cases and I suspect a few more of them will pop their clogs over the next week or two. Whilst even this won’t prove that much - it is likely to remain consistent with a 1-2% fatality rate.
0
0
CW it does not look “increasingly” likely there will be a global epidemic. It is still entirely possible, but there is no way on earth it looks likelier than it did 2wks ago.
0
0
I agree with you that the eventual mortality rate outside Hubei will tick up. On the other hand in Hubei it will probably eventually tick down
0
0
I dunno mate - there is now community transmission in Singers and Japan (not sure about HK?). And a lot of other non China cases. Didn’t have that 2 weeks ago. Tbh I thought it was likely 2 weeks ago and remain of the same view - but as it’s not clearly shot away I don’t think it’s become more likely. Still in the balance. Officials and experts are more openly talking about it now though, that is for sure.
0
1
Tarquin - I’ve seen an article on that and whilst I’m not expert enough to comment I’m surprised it’s not been discussed more widely.
I am a bit worried if it turns out to be effective at killing Asian people but not others. I don’t readily believe in conspiracy theories but others do and if the CCP is threatened then it might decide to let the people believe that it was a US bio weapon. That would be very bad.
0
0
Genuinely what are you talking about
0
0
https://www.preprints.org/manuscript/202002.0051/v1
On the ACE2 point.
I don’t think academic commentators are any more willing to talk about global pandemic now than they were two weeks ago. Community transmission has been very limited outside mainland china, and Inam not sure how widespread it has been *within* mainland china outside Hubei and whatever the badly affected neighbouring province is
0
0
@perfectly normal human being15 Feb 20 21:29
Good link on ACE2 issue, thanks.
Suggests next victims will be the smoking population of Indonesia and North India.
After that, Polish builders in W9, natch.
0
0
If it becomes rife in India or Indo it will be a motherfooker. 100%
0
0
So far Indonesia has reported zero cases. This is very implausible and means (1) they are missing the cases or hiding them; and (2) they will have a far worse outbreak quite soon.
0
0
I said no more coronavirus chat m99
Join the discussion