General / Off-Topic Some numbers and a shortage

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Six healthcare workers have died in China of the new coronavirus and a total of 1716 have been infected, according to a report announced by the government on Friday.
Here's a story to go with that:
 

Tool to keep track.

Singapore is a place to watch with interest.
Well developed and with a competent government, they have COVID19 at large in their community. The British "superspreader" contracted it in Singapore, so we know there is a pool of infected people that have not yet presented to the health services. Most may not have symptoms yet, but should emerge this week.
Found this good piece with the epidemic as a diagram there.
 
The CDC is ramping up its own response to the epidemic by setting up five labs around the U.S. where people with flu-like symptoms can now be tested for coronavirus if their flu results are negative. This comes as scientists around the world race to develop a vaccine.

U.S. Northern Command
is executing plans to prepare for a potential pandemic of the novel coronavirus, now called COVID19, according to Navy and Marine Corps service-wide messages issued this week.

And now, the Food and Drug Administration has pulled its inspectors out of China because of the spreading epidemic. New FDA commissioner Stephen Hahn said no shortages of drugs or devices in the U.S. have been reported, but acknowledged, "the situation is fluid."
* 80-90% of all manufactured pharmaceuticals are produced directly or from raw chemicals made in China.

I told our Admin about the possibility of shortages of VEN drugs. Do not know if it has sunk in.

Going out for supper tonight. Life goes on, till it doesn't.
 
Going out for supper tonight. Life goes on, till it doesn't.
That's kind of my conclusion as well. From what I can see, having been following the numbers each day for a month now, this is going to be a pandemic. It will probably infect 50-90% of the global population. That means it's highly probable for all of us to get infected sooner or later anyhow. I see no reason for the individual to try and avoid getting infected anymore. It will just make your life miserable.

I don't fear the disease right now. I think it's more deadly than the official numbers being spread around, by WHO and others. But I don't think it will wipe out humanity. Not even close. When you calculate the "case/fatality rate" (CFR), you do it after the epidemic is over. Then you take the number of deaths and divide it by the number of cases. If an epidemic has had 1000 cases, and 20 deaths, then the CFR is:

(20/1000) * 100 % = 2%

However, during an epidemic we want to know how deadly a disease is. Since we don't know the final number of cases, instead we try to estimate CFR based on the currently available data. There are different ways of doing that. One is to simple take the current number of cases and the current number of deaths (as of 15. feb):

(1666/69268) * 100 % = 2.4%

That is the official number from WHO. This calculation is wrong, and I'm pretty sure WHO knows that, but remember that the UN and thereby WHO is a club with a lot of members, and some of them have a strong influence on what the WHO is allowed to say. Also, there is general fear that a global panic could be a lot worse than the disease itself.

The problem with the way WHO calculates the CFR is that it assumes correlation between the death toll of a given date with the number of cases for that date. This is wrong because patients who die from the disease have been ill for an amount of time before they die.

Another method of estimating CFR therefore is to look at the number of deaths vs recovered. As of 15. feb, those numbers are 1666 deaths and 9538 recovered. That gives a total number of resolved cases of 11204. The CFR estimate using this method then becomes:

(1666/11204) * 100 % = 14.9%

Before you panic, there's more !!!

The method above does not account for several factors. First of all, there are a lot of unknown cases. Assuming that many of those are mild, and that the Chinese hospitals are so overburdened that they send most non critical patients away, the numbers above are skewed, and therefore also wrong.

An third way of estimating CFR is to first estimate the time from the first symptom until the patient dies. One estimate of that is 7 days. Then we take the number of deaths from day X and find the number of cases from day X minus 7. Problem is we don't know if 7 days is the correct number. It could be anything from 0 (WHO's method) to more than 7 days. If I try to calculate the CFR this way using 0, 3, 5 and 7 days, I get:

1581852880979.png


I think these numbers are the best estimate of a CFR I've been able to calculate so far. Note that the blue and orange lines jump at 11. feb and 14. feb respectively. This is because of the large amount of new cases being reported after China changed the method of diagnosis. Something similar will happen to the grey and the yellow curve in the coming days. Also note that all 4 curves currently has a trend of increasing slowly.

Then there is the question of data reliability. Nobody thinks that all the current cases have been registered. If the true number of cases is higher, and we can trust the number of deaths, then the true CFR will be lower than the estimates above. It's therefore pure speculation to try and estimate the true CFR, but if I was to try, I'd say it's above 2% and below 5%, but probably closer to ~5%, based on the given numbers. If we then include a rough estimate of only 10% of the true number of cases being currently estimated, the CFR drops to 0.5%.

Currently the virus is spreading outside China. Singapore has a large number of cases, which some claim is due to Singapore being better at diagnosing. That might be the case, but it does seem "strange" that a country like Indonesia has zero cases so far. Also Thailand is placed between China and Singapore, and they are reporting much lower numbers than China and Singapore. Both Indonesia and Thailand have economies that depend on tourism. You do the math.

The cruise ship in Japan is an "interesting" population. Because the ship is isolated, and the passengers are largely quarantined in their cabins, it somewhat resembles a total lockdown. Still the virus spreads extremely fast onboard the ship. Today almost 10% of the people onboard have tested positive, and the numbers are rising:

1581854981391.png


A similar trend is seen outside Mainland China:

1581855054615.png


This is far from under control, and I personally don't think it's possible to control it anymore. Still, the chances of survival seems to be between 95% to 99.5%, assuming that people don't panic. I'm worried that they will, once the true scale of this becomes clear to "everybody", and therefore I think it's preferable to start being honest, instead of trying to smother the truth in an attempt to keep the "positive mindsets". This is serious, but to the majority, it's not the end of the World.

One final "positive" story I heard (not welly confirmed), is that it seems that antibodies from blood plasma from recovered patients can be used to treat serious cases. This is not a new method, but it could save a lot of lifes if it works on larger scales.

TELEMMGLPICT000224807915_trans_NvBQzQNjv4Bq900leoZVuq6ru6F43OqP_qW6W4i4yFEIUP0N5kTgY9w.jpg
 
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Funnily enough, the article sort of petered out after more or less agreeing with him by the end, despite the impression of disagreement at the jump. Personally, I don't find it an unreasonably proposition that season, temperature, conditions and climate will all effect the rate of the spread. And a bit of optimism and positivity in the national messaging is to be expected; do you really think the President should issue a statement to the effect that "China is totally effed and we're next" ? I don't think that would be a very good idea.
 
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According to ITV news in the UK when we hit 100 confirmed cases, the UK will basically stop bothering with stats and just tell people who are feeling unwell to stay at home


Now this does raise the question of how it will be able to quantify the mortality rate of the disease if you are told to stay at home for two weeks if you develop cold like symptoms.

Companies will take an absolute hammering as well as people will be within their rights to just sign off work for two weeks with even the slightest illness.

Knowing how many firms in the private sector operate with no slack in the labour force, requiring 100% staff attendance to cope with normal work load levels, then i can see it being a corporate carnage a few months down the track. Many people who are not ill will probably get stressed out with being over burdoned and just get signed off for stress. Ive seen it happen just in the summer months when people are on holiday.
 
Johns Hopkins map here.

It is a Very Bad Idea to accept plasma in China.

China is facing its latest medical scandal after a large batch of human blood plasma treatment was found to be contaminated with HIV.
The batch of intravenous immunoglobulin – an immune therapy treatment made with antibodies from blood plasma – was produced by China’s second-biggest medical blood products manufacturer, the state-owned Shanghai Xinxing Pharmaceutical Company.

Maybe people are familiar with this lady, who tried to campaign against the shoddy practises there:

So they "rectified" it in '96, after literally trying to bludgeon her to death, but still can't produce clean plasma in 2019.

Nevertheless, using plasma is a positive development for anybody in a developed place.
We ought to see an impact on the death rate, maybe save some people.
 
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Johns Hopkins map here.
I might have mentioned it before, but this page is also a good source of information:


And of course the daily reports from WHO. Note that they distinguish between lab confirmed cases and clinically confirmed. The official number from WHO mentioned in the summary still doesn't include the total number.


WHO are also a day or two behind Worldodometer and JHU, but all three sites agree pretty much if you compare given dates, and know how to decipher the WHO reports.
 
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I might have mentioned it before, but this page is also a good source of information:


And of course the daily reports from WHO. Note that they distinguish between lab confirmed cases and clinically confirmed. The official number from WHO mentioned in the summary still doesn't include the total number.


WHO are also a day or two behind Worldodometer and JHU, but all three sites agree pretty much if you compare given dates, and know how to decipher the WHO reports.
Something that I keep finding my mind returning to, and believe me I know this isn't very scientific, is that we're pretty far into the incubation period for this virus in our respective countries, and the statistics we're seeing around the globe almost show us a completely different pathogen compared to what is happening in mainland China. The bottom line is, it almost looks like they're dealing with something more severe than the rest of us are.
 

As I mentioned before, it is a good idea to get your cash before the epidemic.

The deputy governor of the People’s Bank of China said Saturday the government is introducing 600 billion yuan ($85.9 billion) of new cash with four billion yuan ($572 million) in new notes already allocated in the virus’ epicenter in Hubei Province. “Money from key virus-hit areas will be sanitized with ultraviolet rays or heated and locked up for at least 14 days, before it is distributed again,” the deputy governor said at a press conference. Commercial lenders have also been ordered to identify cash taken specifically from hospitals and wet food markets, places with high exposure risk. The South China Morning Post reports the central bank in the southern city of Guangzhou is going one step further and will destroy all notes collected from these sensitive sites.

China has a purchasing system that uses little cash- phones and Weibo are used heavily, so this will not impact people as it would elsewhere. But we recently changed our notes locally, and it was a real headache as not enough supply was available for months. Imagine that you can't get your cash out of the bank because there are no notes. Imagine the lines of people in crowds, and the effect of epidemic spread. Imagine who is waiting in the car park as people try to take scads of $ out.

You do NOT want to be in that bank.

I took out a few K, will be cashing the next salary, and will be spending some on items, like essential drugs, injectables, IV fluids etc. I expect that my house may become a treatment centre for family. You needn't do that, but-
You should also stock up on needed medicines. You know what you need. Get some.


At least three Chinese cities have announced over the past week that they will ban the sales of medicines that treat two of the main symptoms of the virus – fever and cough – to smoke out anyone trying to mask their illness at home.

My fellow cmdrs are reasonable people.
However their governments may not be so intellectually gifted, if you know what I'm saying. Sending tens of millions of extra people to the health service during the epidemic ( Exactly what I need!! said NO Chinese Doctor) might seem like a Great Idea to any twit in office who doesn't think it through. I guarantee you that no matter how dumb something is, a Government somewhere will try it.
 
That's kind of my conclusion as well. From what I can see, having been following the numbers each day for a month now, this is going to be a pandemic. It will probably infect 50-90% of the global population. That means it's highly probable for all of us to get infected sooner or later anyhow. I see no reason for the individual to try and avoid getting infected anymore. It will just make your life miserable.
50% to 90% ? You are serious ?

:unsure:
 
Something that I keep finding my mind returning to, and believe me I know this isn't very scientific, is that we're pretty far into the incubation period for this virus in our respective countries, and the statistics we're seeing around the globe almost show us a completely different pathogen compared to what is happening in mainland China. The bottom line is, it almost looks like they're dealing with something more severe than the rest of us are.
The cruise ship in Japan now has 454 known cases. Out of those, 189 had no symptoms. That's 42%.

So far 1723 people have been tested. That's 47%. Some of the negative tests might be positives that haven't developed enough to be detectable (yet).

I have now been trying to model the characteristics of the virus and the epidemic for a month, and every day it shows something new and surprising. However, the data from the ship are invaluable because it's a small "closed system", outside China, which is highly monitored and documented. So far there has been no deaths and 17 recoveries. Fingers crossed, it continues that way.
 
Sorry if this was already posted. I live in this city, and work within 2 miles of the military base where they are quarantined.

Did not instill confidence in our local medical professionals concerning the containment of COVID 19.

Just grateful the mortaility is so low at this point. The cat is out of the bag.
 
A few % on 90% of the world population, that's still a lot of people.

The key is to be on the safe side.

:)
Yes, if you calculate the number of potential fatalities, it sounds scary, but that's mainly because we don't talk so much about death and dying. That's understandable since it's a pretty depressing subject. However, remember that people die from all sorts of other stuff than Covid-19. Two persons die around the globe every second on any normal day. That's more than 50 million per year. Still, we drive cars, smoke, drink, eat junk food etc.

I think there are somewhere around 5-10 times as many cases as the official numbers claim, and that's worrisome with regards to the spread, but it's positive with regards to the fatality rate, which I still believe will be around ~0.5% in the long run. In that case, first of all, most relatively healthy people will have almost 100% chance of survival.

Another puzzling, but very positive thing is that there seems to be very few children among the infected. Nobody can explain that, but it's still very good news if it turns out to be true.
 
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