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Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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The official number of cases as counted by the Japanese government does not include two people who tested positive without symptoms.
Ivory Coast: A suspected case in Ivory Coast is not yet confirmed.
Brazil: There are currently no confirmed cases in Brazil. A post which went viral on Twitter was a hoax.

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Here this is the end all update right now.

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TLDR: Do not panic, the world is monitoring the situation closely. Be critical of media reports that are often designed to illicit an emotional/political response. There are capable people on top of this including epidemiologists, clinicians, etiological researchers (me), the list goes on. The virus is an emergency in China and now deemed a public health emergency of international concern (PHEIC): https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)

It's basically a boost to funding/various resources needed to contain the threat. WHO will ensure proper public health policies. There is more pressure on member nations to coordinate. This is not a pandemic, it is further recognition that the situation warrants more measures going forward

 


Wish I could post more, but here's a mini primer on the whole situation with some of my insights. For the most part, I've noticed that discussion on Reddit concerning the Wuhan coronavirus seems to be on point, scientifically. Aside from the occasional fear mongering, misinformation, anti-China sentiment, and jokes about Plague Inc, I feel like general knowledge (at least on Reddit) on the epidemic is pretty decent which is always nice to see. Of note, there is research done on social media during these disease outbreaks (2009 pandemic etc). Your comments might be used in a study that influences public health policy.

For questions, please visit the askscience megathread. There's no such thing as a stupid question, just a stupid answer. Please do ask if you're worried or unsure.


What do you need to know?

As of 23:59 Jan 29, there are officially:

7711 confirmed cases in China across 31 provinces

5794 suspected cases in 30 provinces. 81947/88693 are under medical observation

170 deaths and 1370 are severe cases. 162/170 deaths occurred in Hubei province (where Wuhan is). The rest are within various provinces in China

  • 17 deaths range from 48-89 years old. 14/17 deaths are of the elderly above 65 years old. Most have pre-existing conditions that seem to predispose to a more severe disease presentation. People who are already sick prior to infection may be more at risk due to decreased immunity. Some of these people had hypertension, diabetes, and heart disease. Death was typically the result of severe respiratory failure but includes others like multi-organ failure. Info on some of the remaining deaths is currently unknown

  • Healthy people have died

  • 124 people recovered

90 exported cases: Thailand (14), Japan (11), Hong Kong/Singapore (10), Taiwan (8), Macao/Australia/Malaysia (7 each), USA/France (5 each), Germany/South Korea/UAE (4 each), Canada (3), Vietnam (2), Nepal/Cambodia/Finland/Sri Lanka (1 each)

Please refer to the live trackers for the most up-date statistics

Initial symptoms

  • cough

  • fever (pyrexia possible absence in young individuals)

  • fatigue, discomfort (malaise), shortness of breath (dyspnea), dizziness, chest tightness, headache, muscle aches, chills, sore throat

  • possible atypical presentations in immunosuppressed/elderly.

Treatment

No cure, care is supportive to relieve symptoms. Drugs and vaccines are being explored.


Rough Timeline of Some Key Events

Date 2019-nCoV
Dec 1 Earliest known patient with symptom onset
Dec 24 Collection of genomic sequence based on atypical pneumonia
Dec 31 WHO notified
Jan 1 Seafood market is closed + decontaminated
Jan 8 Novel coronavirus identified
Jan 10 Dr. Zhang (Shanghai) releases genome, first fatality
Jan 13 1st exported case in Thailand
Jan 19 First diagnostic test
Jan 20 Human-Human transmission confirmed
Jan 23 CEPI funding of vaccine development, quarantine begins
Jan 28 Australia is 1st to grow virus outside China
Present/Onwards animal modeling, identification of reservoir, pathogenesis, pathophysiology etc

Some things healthcare professionals are doing + will do

  • Largest quarantine in the history of public health (~15 cities: with a combined population ~56 million)

  • Diagnostic testing: Molecular diagnostics, cell culture, microscopy, antigen/antibody detection, serosurveys

  • Genomic analyses: gives us an idea of drug targets, transmission, etc

  • vaccine development: at least 4 different vaccines confirmed,

  • Preparation of animal modeling: testing clinical manifestations etc

  • Epidemiological tracking: people at risk, super spreaders, R0 value etc


Some Insights
  • It shares a crucial protein with SARS. We're targeting this for drugs. Existing compounds are already being tested in China for treatment

  • Use of masks alone is insufficient to prevent infection. It can worsen problems if people believe all you need is a mask. Other hygiene measures are needed: wash hands, sneeze/coughing into a disposable tissue, maintain distance of >1 meter https://www.who.int/publications-detail/advice-on-the-use-of-masks-the-community-during-home-care-and-in-health-care-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak

  • Incubation period for the first 425 patients was 5.2 days. R0 differs by study. If R0 > 1, the epidemic will increase. We aim to reduce this number to < 1. R0 = 2.2 so on average, each patient will infect 2.2 other people

  • Of the first 425 patients: 240 (56%) were male. No cases for children under age 15. 84 cases for ages 15-44. 179 cases between ages 45-64. 162 cases for age 65 and over. Incubation period for the first 425 patients was 5.2 days. Nearly half of cases occurred people over age 60. It's possible that children are infected but show milder symptoms. In the coming weeks, once developed, a seroprevalence study (where we test your blood serum) will give us a much better idea.

  • What we're monitoring is whether exportation of cases in other countries can sustain transmission. This is crucial leading up to a pandemic. Circulation within the community is bad news. It's why surveillance, isolation, and why close contacts are being monitored.

  • China does deserve some credit. If you compare the timeline with the SARS outbreak, we are doing way better (availability of data, transparency, measures of control, research etc). China hid reports of SARS and took 4 months to report to the WHO. It took 5 months to even identify it was a coronavirus and sequence the genome. We had a genome to analyze in lab within 11 days of their announcement to WHO. I remember laying in bed and jumping up when I was notified that the complete genome was available, pretty excited

  • I also want to stress that it is quite easy to sit behind a screen and throw blame around. Granted there are certain contributing factors leading to this outbreak but in my opinion, there is a time to address those. At the moment, there needs to be a focus on containment and research. If you're outside of China and worried about it, consider how it would feel to be in China. There are good people doing good work


Resources

★ = highly recommended


"Technical" resources - PUBLICLY AVAILABLE

 

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so shit has blownt up a bit eh?

in the future where i live they are having like 20 exchange students coming in from central china wuhan area. ok then! lets give it a go. most of us are now avoiding china town and other restaurants of similar flavor profiles. lunar NE events are being cancelled. gonna be some shit i tell you. gonna last for at least the next 2 or 3 months. 

future man reporting in. 

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23 hours ago, BurntEyes said:

I'm good as I strapped on my hazmat suite and oxygen tanks. 

Though it does make fapping a little tricky and my clients find the suit disruptive in meetings.

I read that last sentence after writing... Should modify given the softballs it's lobbing up... but I'm going all in. Do your worst Surly.

This is the point where NowThis started to get turned on. 

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Fun times at ABIA this afternoon.  Going through pre-check, you are still vulnerable for that random selection to test your hands.  (if you haven't yet, download Hanniabl Burress' bit about this procedure, almost as funny as giving up Bill Cosby).  Anyway, I can't remember the last time this happened to me, if it ever did.  The agent is overly-apologetic, but the 45-second consequence is of no concern to me.  My worry is that I watched about 6 people in front of me as he did to a Chinese national (I saw her passport) who was sporting a surgical mask.  And they never fucking wipe those things off and never change out the pads except maybe at the end of a full business day.  Obviously, the odds are slim, but it's also just fucking gross that no vendor has come up with a disposable version of that wand thingy.  And of course, I see her around gate 16 while I'm searching for hand sanitizer and she's probably 80 years old and looks 20 minutes from death anyway, a perfect host for the common cold and flu which is what we really should fear.  

Fun times.  Noodle salad.  And no beverage service on this flight due to turbulence.  

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We are nearing the end of the first two-week incubation period for those outside of China, although most were presenting in 3-7 days.  Next few weeks should be fun as we see whether the quarantines worked, and if H2H is as bad as A2M.   We should also see a lot more folks who had been positive starting to be cleared as they get their second negative test.  

Edited by atomheartbevo
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Fuucckkkkk

https://www.cnn.com/2020/01/30/health/us-coronavirus-thursday/index.html

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An American who flew out of China on a chartered flight tried to leave a Southern California military base where authorities have been monitoring nearly 200 people for coronavirus symptoms, health officials said.

The person, who was not identified, has been ordered to stay in quarantine at the March Air Reserve Base near Riverside, California, until the "entire incubation period or until otherwise cleared," Riverside County Public Health said in a statement Thursday. The incubation period will be 14 days.

"This action was taken as a result of the unknown risk to the public should someone leave MARB early without undergoing a full health evaluation," the agency said.

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Bunch of to foilers and chicken littles here. Worry about the flu

 

So far this flu season, at least 2,900 people in the US are estimated to have died of the flu, according to data released Friday by the CDC. That's 800 more deaths than estimated the previous week. 

Flu cases and hospitalizations because of the flu have also risen sharply since the season began in October. CDC estimates there have been at least 6.4 million flu illnesses and 55,000 hospitalizations.

 

https://www.google.com/amp/s/amp.cnn.com/cnn/2020/01/03/health/flu-week-52/index.html

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18 minutes ago, UT_OB1 said:

Bunch of to foilers and chicken littles here. Worry about the flu

 

So far this flu season, at least 2,900 people in the US are estimated to have died of the flu, according to data released Friday by the CDC. That's 800 more deaths than estimated the previous week. 

Flu cases and hospitalizations because of the flu have also risen sharply since the season began in October. CDC estimates there have been at least 6.4 million flu illnesses and 55,000 hospitalizations.

 

https://www.google.com/amp/s/amp.cnn.com/cnn/2020/01/03/health/flu-week-52/index.html

Do you know what virus humanity has been taking vaccines for since 1938? It rhymes with flu.

Yes, the flu is dangerous and will kill more people than the Wuhan Virus this year. That doesn’t mean a NEW virus that humanity has developed zero immunity for should be laughed at and let burn through the population. No one is ignoring the flu. We just don’t want another 5K tacked on to the yearly 30K 
 

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2 hours ago, atomheartbevo said:

We are nearing the end of the first two-week incubation period for those outside of China, although most were presenting in 3-7 days.  Next few weeks should be fun as we see whether the quarantines worked, and if H2H is as bad as A2M.   We should also see a lot more folks who had been positive starting to be cleared as they get their second negative test.  

NowThis even thinks this is a step too far

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22 minutes ago, atomheartbevo said:

9841 infected (129 outside of China)

214 dead (all China).  

Still keeping to a logistic curve.   Broken record, but still would like to know how many they are testing a day, and whether the jumps are from a backlog of testing, plus how many are testing negative.  

I’m hoping the delay in accurate numbers is because China is just being China rather than because an apocalyptic Government chaos.

taken on its face I would think the jump is more due to China trying to do damage control and now that it has progressed the number might spring up because they had been holding them down so to say.

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Bunch of to foilers and chicken littles here. Worry about the flu

 

So far this flu season, at least 2,900 people in the US are estimated to have died of the flu, according to data released Friday by the CDC. That's 800 more deaths than estimated the previous week. 

Flu cases and hospitalizations because of the flu have also risen sharply since the season began in October. CDC estimates there have been at least 6.4 million flu illnesses and 55,000 hospitalizations.

 

https://www.google.com/amp/s/amp.cnn.com/cnn/2020/01/03/health/flu-week-52/index.html

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Yep, normal flu has killed more but the mortality rate with coronavirus appears to be much higher than the normal flu.  Mortality rates of normal flu are something between .01% and .02% in the US.  Ive seem estimates from China for the coronavirus like 2%.

I believe the 1918 Spanish flu’s mortality was 20-30% with up to 6% of the worlds population dying. 

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American Airlines pilots union is filing suit to stop AA flights between China and the US.  Italy and Israel are halting all traffic and screening any Chinese coming in.  

They have over 100,000 “under observation”.  And given that suspected cases is growing much faster than confirmed, it really seems like the testing is the bottleneck.

But we are still going to wait on stopping air traffic from China.  

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Asymptomatic transmission confirmed

Maybe a registration site. German person to person infection was prior to symptom development. Not good.

”Previously, Chinese officials said they believed asymptomatic transmission had occurred in patients there, but public health authorities elsewhere expressed skepticism. "We haven't been able to confirm by data ... transmission during the asymptomatic phase," CDC Director Robert Redfield, MD, said on Tuesday.”

”the Chinese woman "had been well with no signs or symptoms of infection" while in Germany on Jan. 20 and 21, "but had become ill on her flight back to China" where she tested positive for the virus on Jan. 26.”

 

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Not great news. 

At least 10% die 

As of 25 January, of the 99 patients:

  • 57 were still in hospital 
  • 31 had been discharged
  • 11 had died

This does not mean the death rate of the disease is 11%, though, as some of those still in hospital may yet die and many others have such mild symptoms they do not end up in hospital.

Link: https://www.bbc.com/news/health-51214864

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Men are slightly more screwed. 

However, more recent figures suggest a more even gender split. The China Centers for Disease Control and Prevention said 1.2 men were infected for every 1.0 women. 

There are two possible explanations for the difference:

  • Men could be more likely to become severely ill and need hospital treatment
  • Men, for social or cultural reasons, may have been more likely to be exposed to the virus at the beginning of the outbreak

Dr Li Zhang, at the hospital, says: "The reduced susceptibility of females to viral infections could be attributed to the protection from X chromosome and sex hormones, which play an important role in immunity."

And those who were already sick

Most of the 99 had other diseases that may have made them more vulnerable to the virus as a "result of the weaker immune functions of these patients":

40 had a weak heart or damaged blood vessels due to conditions including heart disease, heart failure and stroke

A further 12 patients had diabetes

Edited by atomheartbevo
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3 hours ago, atomheartbevo said:

9841 infected (129 outside of China)

214 dead (all China).  

Still keeping to a logistic curve.   Broken record, but still would like to know how many they are testing a day, and whether the jumps are from a backlog of testing, plus how many are testing negative.  

Can you post that curve visualization again? 

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  • hayden_horn changed the title to Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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