Coronavirus Global Health Emergency, 2019-nCoV #2

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Snipped.

I also wonder if perhaps reporting "recovered" data is not required, and is just happening on an ad hoc basis rather than systematic, ykwim? That's just a guess.

jmo

Possible - but I think they would be eager to publish any information that could be considered a positive spin. China has historically protected its image to the outside world with vigor. This outbreak is a nightmare for them in MANY different levels.
 
Just my personal opinion here...
I think Hubei was SO OVERWHELMED so quickly, that their reported numbers will never be accurate and should eventually be removed from the equation as more data is obtained from other regions.
IF there is any purposeful underreporting coming from China, I don’t believe it is at the hands of the medical personnel on the front lines. I would imagine that providing accurate reports is not at the top of their priority list.
I’ll also add that MOO - there may have been underreporting from China when this thing started, but at this point in the ball game, there would be no point in further deception. The cat is out of the bag so to speak, and the damage is already done.
China has a long road of recovery ahead of them - both medically and financially.
Agree. It's been my thinking from the start of all this mess. China has and always will control what info gets out. Sadly. I cant even begin to imagine the level of care people are getting with Hospitals stressed to the max. also a factor along with many others as to who recovers and who doesn't. Are they even able to receive early intervention with limited transportation.
 
Okay, continuing my thought process about differing death rates....

It appears that the people traveling from Hubei elsewhere in the world are likely from an educated class - they seem to be associated with universities, businesses for example. Or, they perhaps are tourists who can afford international travel, which again implies a level of education. The people spreading outside of Hubei are likely to be paying attention to news and understand the importance of following medical protocols. Compliance with protocols is a huge factor in stemming the spread so far, imo. Despite hysterical news stories, the numbers around the world are low (currently 148 cases outside of China).

What if a virus hit a population that wasn't as informed or compliant?

Perhaps that is what happened initially in Hubei.

Perhaps the initial cases were from a less educated population - from a population that maybe also wasn't being told what to do by medical and government authorities as the virus was kept secret. And even if they knew info, perhaps wouldn't comply because they needed to get to work, didn't see anything dangerous in live markets, didn't stay home, had underlying health issues, etc. So the virus spread in big numbers fast.

Just a thought....

jmo
 
Snipped.

I also wonder if perhaps reporting "recovered" data is not required, and is just happening on an ad hoc basis rather than systematic, ykwim? That's just a guess.

jmo

Possible - but I think they would be eager to publish any information that could be considered a positive spin. China has historically protected its image to the outside world with vigor. This outbreak is a nightmare for them in MANY different levels.
 
Possible - but I think they would be eager to publish any information that could be considered a positive spin. China has historically protected its image to the outside world with vigor. This outbreak is a nightmare for them in MANY different levels.
One would think. Yet it seems that's not happening, at least right now.
 
Okay, continuing my thought process about differing death rates....

It appears that the people traveling from Hubei elsewhere in the world are likely from an educated class - they seem to be associated with universities, businesses for example. Or, they perhaps are tourists who can afford international travel, which again implies a level of education. The people spreading outside of Hubei are likely to be paying attention to news and understand the importance of following medical protocols. Compliance with protocols is a huge factor in stemming the spread so far, imo. Despite hysterical news stories, the numbers around the world are low (currently 148 cases outside of China).

What if a virus hit a population that wasn't as informed or compliant?

Perhaps that is what happened initially in Hubei.

Perhaps the initial cases were from a less educated population - from a population that maybe also wasn't being told what to do by medical and government authorities as the virus was kept secret. And even if they knew info, perhaps wouldn't comply because they needed to get to work, didn't see anything dangerous in live markets, didn't stay home, had underlying health issues, etc. So the virus spread in big numbers fast.

Just a thought....

jmo

Good point, wrt social class relating to transmission of virus, priveledged global travellers.
 
Just my personal opinion here...
I think Hubei was SO OVERWHELMED so quickly, that their reported numbers will never be accurate and should eventually be removed from the equation as more data is obtained from other regions.
IF there is any purposeful underreporting coming from China, I don’t believe it is at the hands of the medical personnel on the front lines. I would imagine that providing accurate reports is not at the top of their priority list.
I’ll also add that MOO - there may have been underreporting from China when this thing started, but at this point in the ball game, there would be no point in further deception. The cat is out of the bag so to speak, and the damage is already done.
China has a long road of recovery ahead of them - both medically and financially.
Right. I totally agree about the numbers being under-reported - but that just makes the stats look all the more strange, imo. The death rate in under-reported Hubei is about 3% - and that is much higher than elsewhere, where the numbers are more reliable.

So if Hubei is underreporting (which the world thinks it is), then the death rate there is likely much, much higher than elsewhere in the world.

Just makes me curious - mostly in a sort of academic way in examining what numbers tell us (and the dangers when data is kept secret).

jmo
 
I saw a piece a few years back on Medical care in Thailand. If you have access to their top notch Hospitals they are quite impressive.
Perhaps their concoction with HIV drugs stems from experience treating sexually transmitted diseases since Thailand is a place for sex vacations? Middle-aged men from the west visit there for that purpose (yuck, imo). It helps with trade to have a healthy population and healthy tourists.

This thought came to me randomly after reading your post. No basis in fact, just me thinking aloud. Not meant to be offensive or even an opinion....just brainstorming. Could be totally off base.

jmo
 
Right. I totally agree about the numbers being under-reported - but that just makes the stats look all the more strange, imo. The death rate in under-reported Hubei is about 3% - and that is much higher than elsewhere, where the numbers are more reliable.

So if Hubei is underreporting (which the world thinks it is), then the death rate there is likely much, much higher than elsewhere in the world.

Just makes me curious - mostly in a sort of academic way in examining what numbers tell us (and the dangers when data is kept secret).

jmo

True, but take into account that the number of confirmed cases in Hubei is more than likely DRASTICALLY LOWER than the number that are truly infected. If some of the scientific estimates of 75,000 plus were infected over a week ago, the the death rate would drop significantly.
Bottom line - I just don’t think anyone really has a clue at this point.
 
"Officials say the patient being tested for coronavirus in New York City did everything right, and if that patient tests positive, the health department is ready to react.

A person under 40 years old, who had spent time in mainland China, arrived in the city on Thursday and called 911 on Friday after feeling symptoms.

'The symptoms were fever, cough and a runny nose. Like that simple. And they did the right thing for everybody else by coming in and getting care,' said NYC Health Commissioner Oxiris Barbot."

New York City patient being tested for coronavirus 'did everything right'
 
My biggest hope for today is that someone that is currently asymptomatic doesn’t unknowingly attends the Super Bowl !

Tracing contacts and origins would be literally impossible.

edited to add “DOESN’T” as it changes the entire context !!!
 
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The other weird thing that comes to mind when I look at the stats is how the virus was running through Hubei in large numbers before it became internationally known, and it has spread - but not in huge numbers. So....what was preventing the spread during those early weeks, before it was public knowledge?

What the heck was going on in Hubei that it seemingly spread so fast and was so deadly, but only within the province for the most part? Just seems like it would've spread more than it actually has and caused the same percentage of deaths elsewhere.

Was the the initial population in Hubei especially vulnerable, more so than where the virus has spread? If so, why?

jmo

It appears right now that the info from just January 24th, the number of cases in BOTH the mainland and those that have been diagnosed outside of mainland China has doubled on the average ~ every 2 to three days, give or take. I'm not doing statistics, just an eyeball of the Johns Hopkins data that we are all following.

If that hold true, the folks that have come out of mainland china which were supposedly asymptomatic to other countries and is having the same doubling rate of infection so far.... it means that that curve for those outside of Mainland China is about 15 days behind the Wuhan, and would continue to follow the doubling number IF they weren't isolated and quarantined, which they are. MOO, just a stab here IANAD.

So, that should drop off once folks get out and don't transmit afterwards (assuming more coming out will get the disease after they land as were asymptomatic when traveled)

Here's my data and eyeball to MOO about approximate doubling every three days... gets iffy towards the beginning, but wanted to share anyway. And oh yeah, what percentage of these folks are hospitalized? A 1,000 bed hospital for Wuhan looks pretty insignificant in a short amount of time if 63% of mainland is in Wuhan and the requirements for hospitalization are more than a paltry percentage.

DATE ---- Mainland ---- Outside Mainland China
2/1Fri ---- 14,300 ---- 173
1/31 ---- 11,200 ---- 153
1/30 ---- 9,700 ---- 118
1/29 ---- 7,700 ---- 105
1/28 ---- 6,000 ---- 87
1/27 ---- 4,400 ---- 64
1/26 ---- 2,700 ---- 57
1/25Fri ---- 2,000 ---- 40
1/24 ---- 916 ---- 25
data started here on the Johns Hopkins site.. Operations Dashboard for ArcGIS but I'll just continue to 1/2 the numbers every 3 days to go back (assuming testing in beginning in Wuhan wasn't widespread... heck, may not be now but just a stab I'm taking. The doubling in the beginning in Wuhan within 1-2 days in the beginning, was that due to start up testing getting widespread? It's just for discussion and visual, as I'm a visual person.
1/23
1/22 ---- 1000
1/21
1/20
1/19 ---- 500
1/18
1/17
1/16 ---- 250
1/15
1/14
1/13 ---- 125
1/12
1/11
1/10 ---- 62
1/9
1/8
1/7 ---- 31
1/6
1/5
1/4 ---- 15
1/3
1/2
1/1
12/31 ---- 8

Also, I see now what the WHO definition of a contact is at Global Surveillance for human infection with novel coronavirus (2019-nCoV)

Recommendations for follow-up of contacts

Definition of contact
A contact is a person involved in any of the following:
- Providing direct care for 2019-nCoV patients, working with health care workers infected with novel coronavirus, visiting patients or staying in the same close environment of a 2019-nCoV patient.
- Working together in close proximity or sharing the same classroom environment a with 2019-nCoV patient
- Traveling together with 2019-nCoV patient in any kind of conveyance
- Living in the same household as a 2019-nCoV patient within a 14‐day period after the onset of symptoms in the case under consideration.
Monitoring of contacts of probable and confirmed cases (annex 1)
- Contacts should be monitored for 14 days from the last unprotected contact.
- Contacts should self-limit travel and movements. Monitoring by public health authorities can be done through household or virtual visits or by telephone to check for symptoms.
- Any contact who becomes ill and meets the case definition becomes a suspect case and should be tested.
- Any newly identified probable or confirmed cases should have their own contacts identified and monitored.
 
Last edited:
"Officials say the patient being tested for coronavirus in New York City did everything right, and if that patient tests positive, the health department is ready to react.

A person under 40 years old, who had spent time in mainland China, arrived in the city on Thursday and called 911 on Friday after feeling symptoms.

'The symptoms were fever, cough and a runny nose. Like that simple. And they did the right thing for everybody else by coming in and getting care,' said NYC Health Commissioner Oxiris Barbot."

New York City patient being tested for coronavirus 'did everything right'

"The U.S. had seen eight confirmed cases in five states, but New York has now become the 37th state looking into possible cases."
 
"The U.S. had seen eight confirmed cases in five states, but New York has now become the 37th state looking into possible cases."
If 37 states have looked into possible cases and there are only 8 cases in 5 states, that means most possible cases are false alarms.

Which is a good thing - means people are taking it seriously if they suspect they might have it.

jmo
 
It appears right now that the info from just January 24th, the number of cases in BOTH the mainland and those that have been diagnosed outside of mainland China has doubled on the average ~ every 2 to three days, give or take. I'm not doing statistics, just an eyeball of the Johns Hopkins data that we are all following.

If that hold true, the folks that have come out of mainland china which were supposedly asymptomatic to other countries and is having the same doubling rate of infection so far.... it means that that curve for those outside of Mainland China is about 15 days behind the Wuhan, and would continue to follow the doubling number IF they weren't isolated and quarantined, which they are. MOO, just a stab here IANAD.

So, that should drop off once folks get out and don't transmit afterwards (assuming more coming out will get the disease after they land as were asymptomatic when traveled)

Here's my data and eyeball to MOO about approximate doubling every three days... gets iffy towards the beginning, but wanted to share anyway. And oh yeah, what percentage of these folks are hospitalized? A 1,000 bed hospital for Wuhan looks pretty insignificant in a short amount of time if 63% of mainland is in Wuhan and the requirements for hospitalization are more than a paltry percentage.

DATE Mainland Outside Mainland China
2/1Fri 14,300 173
1/31 11,200 153
1/30 9,700 118
1/29 7,700 105
1/28 6,000 87
1/27 4,400 64
1/26 2,700 57
1/25Fri 2,000 40
1/24 916 25
data started here on the Johns Hopkins site.. Operations Dashboard for ArcGIS but I'll just continue to 1/2 the numbers every 3 days to go back (assuming testing in beginning in Wuhan wasn't widespread... heck, may not be now but just a stab I'm taking. The doubling in the beginning in Wuhan within 1-2 days in the beginning, was that due to start up testing getting widespread? It's just for discussion and visual, as I'm a visual person.
1/23
1/22 1000
1/21
1/20
1/19 500
1/18
1/17
1/16 250
1/15
1/14
1/13 125
1/12
1/11
1/10 62
1/9
1/8
1/7 31
1/6
1/5
1/4 15
1/3
1/2
1/1
12/31 8

Also, I see now what the WHO definition of a contact is at Global Surveillance for human infection with novel coronavirus (2019-nCoV)

Recommendations for follow-up of contacts

Definition of contact
A contact is a person involved in any of the following:
- Providing direct care for 2019-nCoV patients, working with health care workers infected with novel coronavirus, visiting patients or staying in the same close environment of a 2019-nCoV patient.
- Working together in close proximity or sharing the same classroom environment a with 2019-nCoV patient
- Traveling together with 2019-nCoV patient in any kind of conveyance
- Living in the same household as a 2019-nCoV patient within a 14‐day period after the onset of symptoms in the case under consideration.
Monitoring of contacts of probable and confirmed cases (annex 1)
- Contacts should be monitored for 14 days from the last unprotected contact.
- Contacts should self-limit travel and movements. Monitoring by public health authorities can be done through household or virtual visits or by telephone to check for symptoms.
- Any contact who becomes ill and meets the case definition becomes a suspect case and should be tested.
- Any newly identified probable or confirmed cases should have their own contacts identified and monitored.
The doubling thing is interesting. Another consideration is when does it peak? At some point, it won't increase anymore. Any models on predicting that, especially the international cases now that protocols seem to be working well?

BTW, I am visual too. I am always making charts, graphs, maps in my life! :)

jmo
 
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