SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

iKnowNothing said:
Such detailed posts @Revan and @Ekkie Thump. Mathematically, where do you think we are on a global scale? It appears that China and S Korea are now much more stable (and recovering) whereas the numbers and the dataset presented does not currently show the scale and the severity of infection in the UK and US. Does this mean these two countries can somehow get away without any significant/scathing impact?
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The UK and US are in relative infancy of the outbreak VS China and South Korea. So as of yet it’s really not that easy to know for sure.

Also, for example the UK is only testing those with severe enough symptoms that they end up hospitalised. This effectively means there will be significant transmission and infection which goes undetected or uncounted, because they have relatively mild symptoms and hence don’t go to hospital and don’t get tested.

Without being tested you don’t go into “official” confirmed cases. All in all it means judging spread by confirmed cases is wholly going to be misleading.
 
rpitroda said:
I think it’s just a fluke, too.

For example if initial transmission happens in university accommodation, VS say a hospital or a care home, you would expect the mortality rates to be wildly different.

Now obviously you’d expect that over X number of cases, the averages would align eventually by maybe it just hasn’t yet. It’s not entirely improbable.
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Thing is, the initial infection has taken in January. Heck, patient 0 in Italy was traced to Munich. So even, if they were lucky at the beginning, the virus has been circulating there for 2 months. They have had some of the most relaxed constrains in Europe, heck gyms are still open (expected to be closed tomorrow or Tuesday), and next to no testings. So it is hardly that they have done a Singapore, and isolate everyone.

It has to be a fluke somehow, just I have no idea how. That is why I am curious.
 
Revan said:
I thought that they tested everyone.

The study is old, but the number of casualties has not increased, while the number of infected has increased for 50 or so (it was 696 the last time I checked). No idea if the asymptotic ones showed symptoms later.
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Yeah they definitely did. I was speaking of under-reporting of cases showing mild symptoms globally rather than on the cruise ship itself. When extrapolating to the 10x figure Vallance arrived at there's those that never knew they had it, those that don't report it and get better and those that have just been told to self isolate and subsequently get better without treatment.
 
iKnowNothing said:
Such detailed posts @Revan and @Ekkie Thump. Mathematically, where do you think we are on a global scale? It appears that China and S Korea are now much more stable (and recovering) whereas the numbers and the dataset presented does not currently show the scale and the severity of infection in the UK and US. Does this mean these two countries can somehow get away without any significant/scathing impact?
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Mathematically, I think we are screwed. As I said a few days ago, tens of millions of victims (worldwide) in the best case scenario. Obviously, this is without taking into account 'the behavioral change' which seems to have started happening in the last few days (and it will continue increasing).

EU/UK/US is fecked either way, but probably (and hopefully) much less fecked than I though. If it stops with only a few thousand (or even low tens of thousands) of deaths in the big countries, then that is pretty good. Left it on the wild, the forecasts were 20-70% getting infected, with a mortality rate of 1-5%, leaving the number of deaths to 15m - 270m worldwide. In the US the forecasted number of deaths was calculated at 200k-2m with a best conservative guess at around 400k. Hopefully, we don't have these types of scenarios, and the social distancing will help us to have a much lower (order(s) of magnitudes) lower number of fatalities (and by definition infections).
 
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They’ve Contained the Coronavirus. Here’s How.
Singapore, Taiwan and Hong Kong have brought outbreaks under control — and without resorting to China’s draconian measures.

On Jan. 21 in Taiwan and on Jan. 23 in both Hong Kong and Singapore — all three governments have implemented some combination of measures to (1) reduce the arrival of new cases into the community (travel restrictions), (2) specifically prevent possible transmission between known cases and the local population (quarantines) and (3) generally suppress silent transmission in the community by reducing contact between individuals (self-isolation, social distancing, heightened hygiene).

But each has had a different approach....


https://www.nytimes.com/2020/03/13/opinion/coronavirus-best-response.html
 
Ekkie Thump said:
Yeah they definitely did. I was speaking of under-reporting of cases showing mild symptoms globally rather than on the cruise ship itself. When extrapolating to the 10x figure Vallance arrived at there's those that never knew they had it, those that don't report it and get better and those that have just been told to self isolate and subsequently get better.
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But that is weird. Why only half of the infected people in the cruise ship did not show any symptoms if it is much more elsewhere? Sure, the age distribution will help (more older people there than in the UK, much less young people there than in the UK), but it won't be 10x, right?
 
I was thinking about hotels. The industry is going to take a massive hit anyway, but anyways the government's can make use of them as quarantine rooms? Its probably way too costly
 
sglowrider said:
They’ve Contained the Coronavirus. Here’s How.
Singapore, Taiwan and Hong Kong have brought outbreaks under control — and without resorting to China’s draconian measures.

On Jan. 21 in Taiwan and on Jan. 23 in both Hong Kong and Singapore — all three governments have implemented some combination of measures to (1) reduce the arrival of new cases into the community (travel restrictions), (2) specifically prevent possible transmission between known cases and the local population (quarantines) and (3) generally suppress silent transmission in the community by reducing contact between individuals (self-isolation, social distancing, heightened hygiene).

But each has had a different approach....


https://www.nytimes.com/2020/03/13/opinion/coronavirus-best-response.html
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First one was critical and where the European countries failed big time. It's hard enough to detect sources of transmissions within your own country but we've let wildcards in constantly. That game at Anfield last week will end up killing 100s of people.
 
Ekkie Thump said:
Yeah, Diamond Princess is the best dataset we have so far. Word of caution on the asymptotic numbers though. According to the study they are relying on figures from Feb 20th and they define "asymptotic" as being "self assessed or tested positive before symptom onset." Maybe I missed it (or misunderstood) but it doesn't seem like there's any data on what proportion of those went on to show symptoms. Maybe there's data on that elsewhere?

I guess another optimistic thing that should be mentioned is that in addition to the asymptotic those who only progress to very light symptoms would also significantly under-report too.
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I'd guess cruise ships generally poplated by older people and it's been touted that the younger you are, the more likely you are to experience milder or no symptoms so the dataset could be pretty flawed?
 
Wumminator said:
With all these zero hour contract people going off...

How long before public sector workers are put onto statutory sick pay? If countries are going like Australia and governments are paying for all electricity/water bills, I think they’ll have to.
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Lots of UK public sector workers are employed fixed term in the UK nowadays, and the financial year ends on 31st March. Whatever measures are brought in, won’t cover everyone.

Even mortgage companies deferring payments by a month or two isn’t going to mean shit, when you expectedly lose your job or cannot find the next one, and you have a gap of several months more in receiving a salary.
 
Skills said:
First one was critical and where the European countries failed big time. It's hard enough to detect sources of transmissions within your own country but we've let wildcards in constantly. That game at Anfield last week will end up killing 100s of people.
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Its not like there wasn't any advance notice. The first case was reported in early December. But there were rumblings of it back in November.

Kenya is being very pro-active -- it announced a national lockdown yesterday. They have only 3 reported cases in the country as of today.
 
Skills said:
First one was critical and where the European countries failed big time. It's hard enough to detect sources of transmissions within your own country but we've let wildcards in constantly. That game at Anfield last week will end up killing 100s of people.
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I think you’re allowing your interest in football to bias your perspective. What %age of global visitors to the UK in the last month were the Atletico fans? We could have banned all international flights at that point and it would have made no difference.
 
Wumminator said:
With all these zero hour contract people going off...

How long before public sector workers are put onto statutory sick pay? If countries are going like Australia and governments are paying for all electricity/water bills, I think they’ll have to.
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This is a point Im most interested in. The government are introducing all these tax breaks for Business yet havent said anything about what happens with people who work at places that dont offer sick pay or in hospitality jobs that will most likely be unemployed after a lockdown. People have enough money for food, rent and bills etc, give them SSP and they cant afford any of them..
 
Revan said:
16 new cases in China (without lockdown outside of Hubei), a reduction from yesterday. 74 new cases in South Korea (without lockdown), a reduction from yesterday.

I assume that the worst has passed (at least about the first wave) in both countries. The number of cases per day in South Korea is essentially a Gaussian (graph attached).

Both countries were worse than any other country until last week, so I guess it is safe (to some degree) to assume, that it is possible to have an epilogue that does not require 70% of people to get infected or get "herd immunity". And there are templates to emulate right there on how to do this right.

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I wonder if the individualistic nature of a lot of western cultures has and is making it harder for us to contain it compared to the Asian countries.
 
iKnowNothing said:
Such detailed posts @Revan and @Ekkie Thump. Mathematically, where do you think we are on a global scale? It appears that China and S Korea are now much more stable (and recovering) whereas the numbers and the dataset presented does not currently show the scale and the severity of infection in the UK and US. Does this mean these two countries can somehow get away without any significant/scathing impact?
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I genuinely don't know enough to formulate a competent answer with regards to China/SK/Japan etc. I guess it's possible that they can restrict it, but if (or when) it goes wild elsewhere in the world then re-introduction is a real possibility, as is its re-emergence from within if they fail to completely root it out. I guess they can then repeat their processes from a position of readiness and are then perhaps more decisive in nailing it down early but we can only wait and see.

I'm more confident of my understanding of what will happen in countries like the UK if it's taken as a given that 60% (40 million) will get it in less than a year. Studies seem to show that 5% of tested patients require ICU treatment. According to one (small) study the average length of stay in an ICU for these patients was 10 days. If that's even in the ballpark of being true there is no scenario or distribution in which a country's health service will not be quickly overwhelmed and the number of bodies climb towards the moon.

There's some reason to hope that the infection is far more widespread than is known and that the death rate/ICU rate is subsequently lower than feared. The case study of the Diamond Princess does provide some data for that. Mortality rate is currently hovering around 1% and the average age of patient was around 60. This means it's skewed data and will likely describe both a higher death rate and higher medical requirement than is to be found in wider society (average age in Italy is 48 for example). How much is unclear but that could be extremely significant and might mean there's still a fighting chance of at least holding the worst predictions at bay.
 
My father is 68. He also has high blood pressure and diabetes.

He is a doctor. He has his own practise and is going out everyday to treat the ill.

I'm worried. If he gets the disease, its not good. But he is a doctor and has responsibility to help the sick.

I dont know if I should just ask him to stay at home for now.
 
Revan said:
They are not doing intensive testing, in fact, they are doing almost no testings at all (at least in Munich). Don't know how it can be a fluke.



Indeed. My Italian friends laugh at Germans for not passing at red traffic light (while walking) even at 11 of night. Germans are very disciplined.

Also, the social distancing there would be much more natural.
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But if that were the case, Germany would have lower infections rates as well. But Covid-19 is spreading the way it is in other countries, just for some reason nobody is dying.
 
Revan said:
But that is weird. Why only half of the infected people in the cruise ship did not show any symptoms if it is much more elsewhere? Sure, the age distribution will help (more older people there than in the UK, much less young people there than in the UK), but it won't be 10x, right?
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I agree with you. It might actually be fewer than half those on the cruise ship that didn't show symptoms - an unknown number maybe hadn't played out the disease long enough to present. Vallance's 10x figure has to include a) those that remained asymptotic throughout and are now clear, b) those who were still at the asymptotic stage when he spoke c) those who were currently experiencing symptoms but weren't yet tested and d) those who experienced symptoms, recovered, and never appeared in the figures. I don't know but I think Vallance's figures would have to rely much more heavily on insufficient reporting/testing overall than on the single specific of there being x amount of asymptotic cases. In any case 10x seems a stretch, but then I'm not privy to the methods/stats they're using to model.
 
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I'm hopeful the government will ramp up the seriousness of their rhetoric now rather than the initial "just wash your hands" message. Intended or not people took that as it not being serious.

People need to be scared into order and the quicker people adjust to social distancing (however awkward or wierd) then perhaps businesses can operate just a little bit longer.
 
RedTiger said:
I had a grand total of 5 tables last night and I told the customers it would better if they had just ordered take-out. One couple in particular were just so adamant in their lackadaisicalness that it really wound me up, the more I tried to explain about keeping infections down for the sake of icu patients, the more they dug their heels in. A lot of people will be facing the kiss of karma soon enough.
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Unfortunately it also increases the chances of people passing it on to others, who may suffer much worse than themselves meaning they still don't think about it oo much.
Mr Pigeon said:
Ah, a fellow scholar. Always good to see.

Sorry, back on topic. Scarlett Johansson is fit as feck.
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I would like to add a 3rd to this, but it should be shown for the record that I feel it should be expressed in a much more charming way.
 
We’re up to 4 confirmed cases now, having had our first confirmed case last Thursday. One of them on a vent in ICU, the other 3 stable.
 
Cash flow is critical in all businesses. The first industries to take a hit are anything to do with travel and tourism. My wife works for Viking Cruises and they have halted all operations around the world. Princess have done the same and I'm pretty sure all the other cruise companies are the same. They are all heading for port and there are questions about where they can all dock. Viking cruises are offering 100% refunds or 125% credit note for a cruise further down the line. The industry has been growing at a terrific rate for the last 20 years but it may never recover from this. Its carnage.

The airlines are asking for immediate financial assistance or very shortly there will be no airlines. These two industries on their own employ massive numbers of people and if their employers don't have any money they will be laying off huge numbers of people very soon.

How the Government view this is hard to fathom out because I don't see how they can just give away the huge sums of money required to keep companies afloat. (No pun intended) They can't bail everybody out. Can they?
 
blue blue said:
Cash flow is critical in all businesses. The first industries to take a hit are anything to do with travel and tourism. My wife works for Viking Cruises and they have halted all operations around the world. Princess have done the same and I'm pretty sure all the other cruise companies are the same. They are all heading for port and there are questions about where they can all dock. Viking cruises are offering 100% refunds or 125% credit note for a cruise further down the line. The industry has been growing at a terrific rate for the last 20 years but it may never recover from this. Its carnage.

The airlines are asking for immediate financial assistance or very shortly there will be no airlines. These two industries on their own employ massive numbers of people and if their employers don't have any money they will be laying off huge numbers of people very soon.

How the Government view this is hard to fathom out because I don't see how they can just give away the huge sums of money required to keep companies afloat. (No pun intended) They can't bail everybody out. Can they?
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I don't know how much is feasible or required but we found 500 billion quid down the back of gran's sofa on 8th October 2008. Of course that then led to a decade of austerity.
 
TMDaines said:
I think you’re allowing your interest in football to bias your perspective. What %age of global visitors to the UK in the last month were the Atletico fans? We could have banned all international flights at that point and it would have made no difference.
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They would have stayed in hotels, hostels etc and ate out and went drinking in large groups. It’s very feasible that they have directly and indirectly infected lots. It was a crazy decision to let them in when many matches were already BCD
 
Revan said:
I assume the lockdown will be temporarily, only to stop the catastrophic spreading that is happening. Gradually, I assume that the restrictions will be loosened, but still keeping social distancing and recommending work from home for those that can do it. Schools is a bit difficult to know, probably there is going to be some form of e-learning for another year and a half.

China is not in lockdown, only the province centered around Wuhan is. The other regions are functional, but apparently people are cautious and keeping social distancing. Japan, Korea, Vietnam, Singapore, Hong Kong are all doing well without going on lockdown.

If everything goes well, we might expect restrictions to loosen around July/August, while in meantime the countries being prepared for a potential second wave. Also, there are already some anti-virals (or even malaria pills) which have shown good promise, with more testing going on, so we might have good news shortly.

And viruses are weird. H1N1 just went away after infecting 1 billion people or so. Maybe this one might do similar, or might mutate to something less lethal, maybe the summer might help our fight against it, etc. Also, maybe this is not as bad as we think. The estimate R0 is from 1.3 (similar to flu) to around 4. SARS and Ebola were around 2 and they were contained.

Or maybe nothing will work, and then the survivals will create herd immunity, but I have become optimistic in the last few hours.
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Save the optimism for later this week. Strict Wuhan style lockdowns clearly work, but we will not know until Friday if the kind of lockdown that will be accepted by a Western audience works - please stay indoors but we won't force you to. A spike in Italian cases this weekend was expected and predicted by authorities, due to people's behaviour last weekend, but now we have to hope cases start to fall. If they don't then i don't know how we can slow it down.
 
mav_9me said:
Where are you located?

I'm ICU physician in USA.
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Trinidad. Working in internal med. We’ve not had reason for anyone outside of the thoracic med/ICU teams to have to see these patients thus far. Hoping it stays that way :lol: Though I know it’s gonna fall into all our laps if the number of cases explode.
 
TMDaines said:
Yes, because the only thing preventing us being in a better place is the same two senior advisors guiding Jeremy Corbyn or any other Labour leader for the past twenty years.
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The only reason that there are such a shortage of critical care beds is 10 years of Tory cuts to the NHS so don’t come that the Tories are better in a health crisis because it just won’t wash.
 
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