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

[Suedesi]

A possibility that nobody seems to want to acknowledge is that we may NEVER develop a vaccine that is safe/effective enough to roll out globally. We still haven’t got a vaccine for any other type of coronavirus (e.g. SARS or MERS) that’s good enough to be used on the scale we need. And that’s despite several years of trying.

How hard did we try though? SARS and MERS were poorly transmissbale from human to human - they're mostly zoonotic - animal to human (civic cats/camels). So only those individuals who are in contact with the animals are at risk. My understanding is that the number of deaths and the economic consequences of both MERS / SARS were a rounding error.

This is different, everyone is feeling it right now becasue of the economic shutdown, stay at home orders and the fact that people had to adjust their entire life in light of something that has been extremely disruptive, not to mention those that have lost a family member. So I suspect, this will take a priority until we find a vaccine.

 

[Revan]

What do we think might be the true case fatality rate of SARS-CoV-2?

Somewhere around 0.5% IMO (with good medical support). Iceland has tested 5%+ of their population, and currently, it is 0.46% there, with 8 cases in serious/critical condition (8 deaths so far, so if all those in serious conditions die, then the death rate increases to 0.9%). Diamond Princess with 100% testing has a death rate of 1.7% (which can still go higher, some people are still in bad conditions), but they had a very skewed distribution (it is a cruise ship after all, so old people were over-represented and young people under-representing).

I think it might be slightly lower than 0.5%, and I would be extremely surprised if it is over 1%.

 

[Prometheus]

Somewhere around 0.5% IMO (with good medical support). Iceland has tested 5%+ of their population, and currently, it is 0.46% there, with 8 cases in serious/critical condition (8 deaths so far, so if all those in serious conditions die, then the death rate increases to 0.9%). Diamond Princess with 100% testing has a death rate of 1.7% (which can still go higher, some people are still in bad conditions), but they had a very skewed distribution (it is a cruise ship after all, so old people were over-represented and young people under-representing).

I think it might be slightly lower than 0.5%, and I would be extremely surprised if it is over 1%.

Have you seen the CFR for Germany now? I remember we had a discussion about this when their CFR was 0.6%. It's now 2.4%. South Korea is at 2.1%.

 

[Revan]

With the common cold there are too many strains, 200 or more. They're always circulating and when you get one it doesn't really give you any immunity against it or any other strain. With Covid19 there are only a handful if that.

The flu has less strains to begin with, only 10 or 20 of them cause the majority of infections, and they don't all circulate at once.

Additionally, only 25% of common colds are caused by coronaviruses, and there are 4 different coronaviruses that cause them. So not only there are many strains, but there are 4 different viruses.

Plus, the common cold is not a big deal. Most of the people even go to work/school when they have it (unlike the flu, which typically puts people on the bed for a week or so). I don't think there is so much incentive for vaccines for the cold, and with so many viruses and strains, it is probably very hard to have an effective vaccine. Even the flu vaccine, actually protects people from what scientists believe to be the most common strain (for that season) for 3 different viruses.

 

[Suedesi]

Somewhere around 0.5% IMO (with good medical support). Iceland has tested 5%+ of their population, and currently, it is 0.46% there, with 8 cases in serious/critical condition (8 deaths so far, so if all those in serious conditions die, then the death rate increases to 0.9%). Diamond Princess with 100% testing has a death rate of 1.7% (which can still go higher, some people are still in bad conditions), but they had a very skewed distribution (it is a cruise ship after all, so old people were over-represented and young people under-representing).

I think it might be slightly lower than 0.5%, and I would be extremely surprised if it is over 1%.

Fair enough, that's what I'm seeing as well. Testing has been heterogenous across the US, but globally South Korea and Iceland used to do the most testing and now Germany also doing a lot and the figures I'm seeing vacillate between 0.37% and 0.66%. This is an average figure, obviously CFR for 80 year olds could be as high as 15% and for children is probably 0%.

 

[barros]

Well said.

After or before they said the virus wasn’t human to human transmitted? The same organization who ignored Taiwan’s warnings? Same organization that’s ok with wet markets after SARS and now this covid-19. They are a joke and basically useless to the world besides China’s interests.

 

[Suedesi]

Have you seen the CFR for Germany now? I remember we had a discussion about this when their CFR was 0.6%. It's now 2.4%. South Korea is at 2.1%.

Source please.

 

[Revan]

Fair enough, that's what I'm seeing as well. Testing has been heterogenous across the US, but globally South Korea and Iceland used to do the most testing and now Germany also doing a lot and the figures I'm seeing vacillate between 0.37% and 0.66%. This is an average figure, obviously CFR for 80 year olds could be as high as 15% and for children is probably 0%.

Germany, unfortunately, is much worse than that (around 2.5%), but it could be that a large number of people are not diagnosed despite being sick. South Korea have a similar figure.

To be fair, for capita, they are nowhere near the top. UAE is the second-highest after Iceland, and they have around 0.55%, though they have more people who got sick recently so it can become higher. Luxembourg are third, but they have a high fatality rate of 2%. Malta is fourth and have a rate of around 0.75%. Bahrain is fifth at testing and has a fatality rate of 0.45%.

Singapore has not done extreme testing, but they have been good at quarantining people early and doing contact tracing. Their death rate is at 0.3%.

 

[Prometheus]

Source please.

Here. In my opinion the true CFR is going to be around 2%.

 

[Wibble]

Where are people getting 19/20 being a particular bad flu season? It was miles better than both two and three years ago: https://www.gov.uk/government/statistics/weekly-national-flu-reports-2019-to-2020-season

I was listening to More or Less talking about this too earlier on, on how COVID-19 is killing off a lot of people who otherwise might have gone in a worse-than-average flu season.

That is idiotic because the death numbers we are using are actual daily numbers, it is irrelevant if someone may or may not die of something else later in the year. I can also bet that virus caused deaths for this whole year will be way higher than normal and that is with the measures we have in place that will also incidentally reduce flu deaths. By that logic you might as well get rid of medicine, food production regualtion and hygiene regulations because, hey, we are all going to die sometime. feckit.

 

[Wibble]

Here. In my opinion the true CFR is going to be around 2%.

Australia is running at about 1% of those tested. So it will be well below 1% as most people who have had it won't have been tested.

 

[Skills]

That is idiotic because the death numbers we are using are actual daily numbers, it is irrelevant if someone may or may not die of something else later in the year. I can also bet that virus caused deaths for this whole year will be way higher than normal and that is with the measures we have in place that will also incidentally reduce flu deaths. By that logic you might as well get rid of medicine, food production regualtion and hygiene regulations because, hey, we are all going to die sometime. feckit.

Or even just stop treating terminal cancer patients - because well who cares if they get an extra few years of life. It's horrible way of putting a value on human life.

 

[Revan]

Here. In my opinion the true CFR is going to be around 2%.

How then it is a bit below that in Diamond Princess despite the extreme age shift there?

And why Iceland who has done more testing that any other country is at 0.45% (with just a few critical cases)?

 

[Wibble]

Just had a virus expert on the morning news here, he reckons Stockholm is “likely” up to 30-40% infected already.
Crazy numbers if so, 30% would mean almost 700,000 people.

With just over 1000 deaths nationally that makes a fatality rate the same or less than Flu? Seems highly unlikely.

 

[Revan]

Australia is running at about 1% of those tested. So it will be well below 1% as most people who have had it won't have been tested.

Yep. But at the same time, the number of those who are still infected is quite higher than the number of those who are healed. And while the death rate = number of deaths/number of infected, you can expect that some of those who are infected today, might die in the next few weeks and so the ratio will increase. Which is what eventually happened in Germany and South Korea.

But it did not in places who are doing much more testing (those that I mentioned). Until we have something more, I think that Iceland numbers should be the point of reference (though the main problem there is the relatively small sample).

 

[Wibble]

Or even just stop treating terminal cancer patients - because well who cares if they get an extra few years of life. It's horrible way of putting a value on human life.

The best way to elongate human lifespan would be to only give medical treatment to older people - let natural selection do its work.

However, I think I see a flaw in the cunning plan.

 

[Revan]

With just over 1000 deaths nationally that makes a fatality rate the same or less than Flu? Seems highly unlikely.

I think there was some random testing there a week or two, that found 2.5% of the people carrying the virus. Now, that is the number of people who were infected at that moment, so it is a lower bound (some people might have been already healed and so no traces of the virus). However, with the disease having an exponential spread, the number of healed should be relatively small, pretty much negligible, so you can assume that 2.5% is more or less the correct number.

The sample was a few hundred people though, and I am not sure how representative it was (for example, did they also do kids etc)?

30-40% is too good to be true.

 

[Prometheus]

Australia is running at about 1% of those tested. So it will be well below 1% as most people who have had it won't have been tested.

Unfortunately, I don't think it will stay at about 1% (considering the trajectory that South Korea, Germany etc who had it well below 1% for while took).

 

[Wibble]

Yep. But at the same time, the number of those who are still infected is quite higher than the number of those who are healed. And while the death rate = number of deaths/number of infected, you can expect that some of those who are infected today, might die in the next few weeks and so the ratio will increase. Which is what eventually happened in Germany and South Korea.

But it did not in places who are doing much more testing (those that I mentioned). Until we have something more, I think that Iceland numbers should be the point of reference (though the main problem there is the relatively small sample).

We are testing more than most (2% of the population tested so far), our daily infections are way down and we are only using about 80 ventilators in total with 63 deaths to date. So I'd be surprised if the fatality rate doesn't drop further but we could also see a rise as you describe as deaths of already sick people occur later when there are even fewer infected due to the restrictions. I guess we also won't really know the rate until much later when we have an accurate figure for what % have been infected and recovered without being sick enough to be tested. If we hadn't let cruise ships land hoards of sick people we would have been in an amazingly good situation.

 

[Raees]

They criticized the US for banning flights to China (how on Earth this comes from an organization that is supposed to be about the health).

Only three days before China locked Wuhan, WHO said that the virus is not transmitting human to human, which was laughable. Yeah, hundreds of people ate infected bats or something.

They didn't declare this a pandemic until the situation became manageable in China.

And then the disgraceful treatment for Taiwan, just check the interview with that Canadian vice-chair of WHO.

They are totally corrupted and the entire top hierarchy needs to be fired. They would find a good job in China anyway, so it is all fine for them.

------

Now, don't get me wrong, President Twat is doing this mostly to shift the blame for himself. And while he was right on banning the flights to China et al., he did feck all in between to prepare for the inevitable pandemic. So, in some level, I agree that the discussion is a bit academical, probably nothing would have changed if WHO acted faster and weren't essentially doing a PR job for China. But at the same time, it needs to be the World Health Organisation, not a propaganda machine for one of the superpowers. China is very good at hiding information, no need for the other countries to pay money to some organization that then does that for China.

Agree with all this. There was a wonderful article about the changing nature of the WHO and how it has become increasingly corrupt and ineffective ever since it ‘overplayed’ it’s hand in other potential pandemics and since then it has become a shadow of its former self since the great work it did with Sars.

 

[Skills]

Anyone have any stats on the tests hit rate over time, for each country?

i.e. you do 20k tests & get 8000 positive results. Would be interesting how that's changed over time, as that tells how your testing capacity is keeping up with the infection

 

[Wibble]

Anyone have any stats on the tests hit rate over time, for each country?

i.e. you do 20k tests & get 8000 positive results. Would be interesting how that's changed over time, as that tells how your testing capacity is keeping up with the infection

Ballpark Australia is finding 1.5% of those tested to be infected - very ballpark based on testing being in the region of 20k per million people (varies by state) and us having just over 6k confirmed cases.

 

[Regulus Arcturus Black]

so you can assume that 2.5% is more or less the correct number.

And yet for the 2 weeks leading up to 8th April, 7.5% of women giving birth in Stockholm were bearing the virus.
And the virus only shows in lab results for around the first 5 days that you are bearing it.
So it is likley much higher than 7.5%.

 

[Regulus Arcturus Black]

With just over 1000 deaths nationally that makes a fatality rate the same or less than Flu? Seems highly unlikely.

1000 deaths now Wibs, but that number will keep increasing as even if it was a crazy figure like 30%, many of those in risk groups would not have died from it yet.
We won’t know for another couple of weeks though here when antibody tests are trusted enough and roll out. So realise I’m heavily on the side of optimism.

 

[Prometheus]

How then it is a bit below that in Diamond Princess despite the extreme age shift there?

And why Iceland who has done more testing that any other country is at 0.45% (with just a few critical cases)?

With regards to Iceland how many people and what percentage of the population is infected? Testing alone doesn't tell you that much.

The data from Diamond Princess is fascinating, but there are people still in critical care, right? So we don't have true CFR yet either.

 

[Regulus Arcturus Black]

With regards to Iceland how many people and what percentage of the population is infected? Testing alone doesn't tell you that much.

The data from Diamond Princess is fascinating, but there are people still in critical care, right? So we don't have true CFR yet either.

When talking about the CFR, does anybody know if kids between 1-16 are commonly tested in any country?

 

[Prometheus]

And the virus only shows in lab results for around the first 5 days that you are bearing it.

What do you mean?

 

[Revan]

With regards to Iceland how many people and what percentage of the population is infected? Testing alone doesn't tell you that much.

The data from Diamond Princess is fascinating, but there are people still in critical care, right? So we don't have true CFR yet either.

1720 people tested positive, 8 deaths so far (with 8 others in serious/critical care). Over 36k testings which should be somewhere between 5-10% of the population (I assume many people tested multiple times). The trend does not seem to be too bad, the number of new infections is on single digits.

 

[Regulus Arcturus Black]

What do you mean?

See below, they have said that due to the difficulty to culture the virus after the first 5 days (unless a patient is very sick), the test will only pick up a positive result for the first 5 days.

It is difficult to spread the virus after the first five days of illness, as long as you are not really sick.
"When you have a mild infection, you see that the levels of culturable virus fall sharply after five days, after which it is difficult in studies to show that the virus particles can spread further," says Karin Tegmark Wisell, head of the department of microbiology at the Public Health Authority.
Karin Tegmark Wisell.

Viruses, unlike bacteria, do not live. However, active or inactive virus is differentiated, ie the virus's ability to lead to infection. And that ability gets worse the longer it goes.
- The first five days you have high levels of the virus that can also pass on to new people, but after five days they decrease levels, says Karin Tegmark Wisell.

 

[Revan]

And yet for the 2 weeks leading up to 8th April, 7.5% of women giving birth in Stockholm were bearing the virus.
And the virus only shows in lab results for around the first 5 days that you are bearing it.
So it is likley much higher than 7.5%.

I hope this is true, would be really great news. Even if it just 10%, it means that the virus is much less lethal than we thought.

I don't understand the 5 days thing.

 

[Regulus Arcturus Black]

I don't understand the 5 days thing.

see above.

 

[Suedesi]

Germany, unfortunately, is much worse than that (around 2.5%), but it could be that a large number of people are not diagnosed despite being sick. South Korea have a similar figure.

To be fair, for capita, they are nowhere near the top. UAE is the second-highest after Iceland, and they have around 0.55%, though they have more people who got sick recently so it can become higher. Luxembourg are third, but they have a high fatality rate of 2%. Malta is fourth and have a rate of around 0.75%. Bahrain is fifth at testing and has a fatality rate of 0.45%.

Singapore has not done extreme testing, but they have been good at quarantining people early and doing contact tracing. Their death rate is at 0.3%.

I'm talking about the true case fatality rate though and I know that that's hard to come by because there's an inherent severity bias on testing. Many cases go unreported because people with milder symptoms may not seek medical attention. In the US for example the only people who'll get tested, especially in the early stages are people who are really showing severe symptoms. Even now, tests are not readily available, there's a limited supply per testing site, and you have to queue up for hours. Then it's not exactly a pleasant experience getting that swab through your nose until it hits resistance. Point being, I can see mildly symptomatic people not getting tested. And to be fair, the numerator could also be under-reported causing another (bigger) skew.

So simply dividing number of deaths (likely under-reported) by number of individuals diagnosed (very likely under-reported) needs some adjustments.

When H1N1 hit, the CFR was initially deemed to be much higher, it was only once we appreciated how prevalent it was that the CFR came so far down (I think it's 0.1%)

I think the Imperial College model used an IFR of 0.9% and the Oxford study used a CFR of 0.14%. I recall seeing an article in the Lancet pegging the CFR in Germany at 0.37%. Probably we won't truly know until we do retrospective studies looking at antibodies to understand how prevalent it is. Personally, I think it's in the 0.5% range (obviously that's an average, people in different age brackets and with different preexisting illnesses will carry different risks).

 

[Revan]

see above.

Yep, sorry was writing my post when you posted it, so didn't see it.

I still don't understand if after 5 days even if there is less virus to be spread, why does the testing shows as negative?

 

[Prometheus]

See below, they have said that due to the difficulty to culture the virus after the first 5 days (unless a patient is very sick), the test will only pick up a positive result for the first 5 days.

That's not what you said, though. It says the virus spreads less after 5 or so days. You said:

And the virus only shows in lab results for around the first 5 days that you are bearing it.

This is false.

Regarding your question, I think South Korea for example has been testing everyone including children.

 

[Revan]

I'm talking about the true case fatality rate though and I know that that's hard to come by because there's an inherent severity bias on testing. Many cases go unreported because people with milder symptoms may not seek medical attention. In the US for example the only people who'll get tested, especially in the early stages are people who are really showing severe symptoms. Even now, tests are not readily available, there's a limited supply per testing site, and you have to queue up for hours. Then it's not exactly a pleasant experience getting that swab through your nose until it hits resistance. Point being, I can see mildly symptomatic people not getting tested. And to be fair, the numerator could also be under-reported causing another (bigger) skew.

So simply dividing number of deaths (likely under-reported) by number of individuals diagnosed (very likely under-reported) needs some adjustments.

When H1N1 hit, the CFR was initially deemed to be much higher, it was only once we appreciated how prevalent it was that the CFR came so far down (I think it's 0.1%)

I think the Imperial College model used an IFR of 0.9% and the Oxford study used a CFR of 0.14%. I recall seeing an article in the Lancet pegging the CFR in Germany at 0.37%. Probably we won't truly know until we do retrospective studies looking at antibodies to understand how prevalent it is. Personally, I think it's in the 0.5% range (obviously that's an average, people in different age brackets and with different preexisting illnesses will carry different risks).

Yep, agree with all of this. I also think it would be around 0.5%, plus minus 0.3% but obviously it is just a hunch.

 

[Regulus Arcturus Black]

I still don't understand if after 5 days even if there is less virus to be spread, why does the testing shows as negative?

Ohh I can’t give you a great explanation but they said the levels drop off so dramatically that it becomes extremely difficult to culture it in a lab and therefore almost impossible to detect for a positive result after 5 days. (In the vast majority of cases).

 

[Regulus Arcturus Black]

That's not what you said, though. It says the virus spreads less after 5 or so days. You said:
This is false.

Regarding your question, I think South Korea for example has been testing everyone including children.

see above....

Any link on Korea by any chance?

 

[Skills]

See below, they have said that due to the difficulty to culture the virus after the first 5 days (unless a patient is very sick), the test will only pick up a positive result for the first 5 days.

The quote seems to be referring to spreading the virus. If it's in a sample, I think it will still come up in a PCR which is basically a chemical reaction to replicate for the virus' strand of RNA.

The problem with the test though is, the samples can degrade. I think they're having this problem in the middle east because its so hot. Not my field though.

 

[Revan]

Ohh I can’t give you a great explanation but they said the levels drop off so dramatically that it becomes extremely difficult to culture it in a lab and therefore almost impossible to detect for a positive result after 5 days. (In the vast majority of cases).

So then when they release someone from the hospital as being 'healed' how do they know that this is really the case (if the test shows negative in any case after 5 days)?

 

[Regulus Arcturus Black]

So then when they release someone from the hospital as being 'healed' how do they know that this is really the case (if the test shows negative in any case after 5 days)?

Well they would be the ”unless very sick” group wouldn’t they?

again...


It is difficult to spread the virus after the first five days of illness, as long as you are not really sick.

"When you have a mild infection, you see that the levels of culturable virus fall sharply after five days, after which it is difficult in studies to show that the virus particles can spread further," says Karin Tegmark Wisell, head of the department of microbiology at the Public Health Authority.
Karin Tegmark Wisell.

"When you have a mild infection, you see that the levels of culturable virus fall sharply after five days, after which it is difficult in studies to show that the virus particles can spread further”