COVID-19

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bob sterman
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Re: Wuhan Coronavirus

Post by bob sterman » Mon Jan 27, 2020 11:53 am

Thanks. Of course prevention measures affect R0 too.

One other thing that just occurred to me - perhaps someone with more knowledge could explain whether this could be a factor?

If transmembrane angiotensin-converting enzyme 2 is the critical cell entry point for this coronavirus - could polymorphisms in the ACE-2 gene also be an important factor? E.g. both within and between populations?

* Just edited to add - perhaps not?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1090578/

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Re: Wuhan Coronavirus

Post by jimbob » Mon Jan 27, 2020 3:49 pm

mikeh wrote:
Sun Jan 26, 2020 9:38 pm
Latest coronavirus data suggests
- 4.8 days from infection to showing symptoms
- From showing symptoms to isolation 3-4 days
- R0 (how many new cases will an infected person create) is estimated <3
- This coronavirus has higher pandemic risk than SARS, but efforts have significantly decreased that pandemic risk

https://www.biorxiv.org/content/10.1101 ... 5.919787v1
How does this 4.8 days line up with the 14 days the media keeps reporting? Or am I misunderstanding something?
Have you considered stupidity as an explanation

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Re: Wuhan Coronavirus

Post by Herainestold » Mon Jan 27, 2020 4:04 pm

I would say 90% of the stuff on social media is nonsense, and probably most of the MSM commentary is equally fallacious.

Still there is scary info out there:
Scientist and scholar Eric Toner, quoted above in an excerpt from a Friday interview with the business-news channel CNBC, explained that China’s efforts to contain the current outbreak of a fast-moving upper-respiratory illness are “unlikely to be effective.”

‘Probably, the cat’s already out of the bag.’
Eric Toner, M.D.





Toner, an M.D. and researcher at the Johns Hopkins Center for Health Security, took part in a simulation, undertaken in partnership with the World Economic Forum and the Bill & Melinda Gates Foundation, that posited such a disease could kill 65 million people within 18 months under the right circumstances.

Coronaviruses, with SARS and MERS among that group, are infections of the respiratory tract that can lead to illnesses like pneumonia or the common cold.

Toner told Business insider during an interview that he hasn’t completed research on the current strain of the Wuhan coronavirus, known as 2019-nCoV, but said that the death toll could run in the millions if the influenza were resistant to modern vaccines and was as easy to catch as the common flu

It still looks like the exemplary measures being taken by Chinese authorities will be effective. Certainly not 100% effective but will prevent a major pandemic. Unfortunately Chinese people will die in greater numbers than people in the west. And China will get no credit for taking the hit to protect the rest of the world.

https://www.marketwatch.com/story/scien ... latestnews
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Re: Wuhan Coronavirus

Post by Martin Y » Mon Jan 27, 2020 4:37 pm

mikeh wrote:
Sun Jan 26, 2020 10:23 pm
I had the Daily Mail email me with a link to some of those videos and asking me to comment. I wrote a polite response back (and they did seem to be grateful for the various bit of info I did pass through that weren't about commenting on faked videos). But, and I know you'll perhaps find this hard to believe, but they did manage to still find a way to post a page full of the videos with a screaming headline at the top of it.

Mind you, the Mail has now called me a 'top UK scientist' or something along those lines, so I'm naturally well in favour of them from now on.
You should get "top UK scientist" or whatever it was on a tee shirt.
Or maybe a surgical mask.

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Re: Wuhan Coronavirus

Post by Martin Y » Mon Jan 27, 2020 4:43 pm

I recall some days ago, when there were only a few hundred cases known, it was noted that there were no cases reported in under-25s. Does anyone know if that curious statistic still holds (or at least if a strong age disparity still holds, rather than there literally being zero young cases)?

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Re: Wuhan Coronavirus

Post by mikeh » Mon Jan 27, 2020 5:06 pm

Martin Y wrote:
Mon Jan 27, 2020 4:43 pm
I recall some days ago, when there were only a few hundred cases known, it was noted that there were no cases reported in under-25s. Does anyone know if that curious statistic still holds (or at least if a strong age disparity still holds, rather than there literally being zero young cases)?
Strong disparity still holds, I'll go and look up the latest cases but surprisingly few children diagnosed as cases. Might have some kind of pre-existing immunity (not uncommon), might be asymptomatic most of the time and hard to diagnose as cases. Or may be some social/cultural aspect in China that is influencing it.

Still mostly the elderly or those with pre-existing conditions that predispose them a bit.
As I just told the Turkish news (hopefully I'll find a quote from them I can put on the back of the t-shirt with the Mail quote on the front)

If I did get a t-shirt, the number of caveats i'd have to put in the small print though would leave little room for anything else, including arms and neck, I'd imagine.

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Re: Wuhan Coronavirus

Post by mikeh » Mon Jan 27, 2020 5:22 pm

lpm wrote:
Mon Jan 27, 2020 9:34 am
I'm getting confused about speed of spread. Flu has a R0 of about 1.5 but it moves very fast through a population. Sweeps through, after a month there's a lot of cases. But the reduction in susceptible population of course also happens fast, so the curve peaks and a month later it's into the residual tail of the curve.

Is this because flu is contagious very quickly, e.g. I get it and give it to two people within a day? While for some other virus I don't infect two people until ten days after I caught it?

So is this a key variable that we need to know? That knowing the R0 is 2.8, say, is not sufficient to model the speed of spread?
Basically yes, a in fact nice summary I shall endeavour to remember in future. In epidemiology class, we're taught something along the lines of these three things (which naturally I've just lifted off an academic website over there somewhere)

- The rate of contacts in the host population
- The probability of infection being transmitted during contact
- The duration of infectiousness.

So for example, the probability of infection being transmitted during the contact. Tuberculosis is deep down in the lungs, and harder to catch, usually via a hacking cough and an aerosol from some fresh sputum making its way over to you. But, from memory, the R0 for TB is usually about 1.5-2, similar to flu or coronavirus. However, TB cases last a lot longer (rarely clears without treatment). So despite the same number of secondary cases from an index case as for flu or coronavirus, TB is never going to cause a mass panicked outbreak because it's not as 'fast' as its other respiratory-disease causing friends.

Obviously with rate of contacts, a big crammed urban population will be different to a rural area, and it'll be different in China compared to UK or Canada or Chad. And duration of infectiousness will vary from person to person, And the incubation period before being able to transmit the disease, plus how infectious you are at the very early stages of infectiousness (symptomatic or not symptomatic).
All of this affects the numbers of cases you're going to get, even if the number of people you as a case are infecting is similar to other less/more scary stuff.
jimbob wrote:
Mon Jan 27, 2020 3:49 pm
mikeh wrote:
Sun Jan 26, 2020 9:38 pm
Latest coronavirus data suggests
- 4.8 days from infection to showing symptoms
...
How does this 4.8 days line up with the 14 days the media keeps reporting? Or am I misunderstanding something?
And on this point, that 4.8 is the average (thus far), the 14 days is the upper likely limit, which handily is the one the media will be tending to use. And about 3-5 days is a fairly typical period of time for stuff like this.

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Re: Wuhan Coronavirus

Post by lpm » Mon Jan 27, 2020 5:42 pm

First confirmed transmission outside China - someone in Canada caught it from her infected husband. Why is Canada always hit? Loads of immigration from China?
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Re: Wuhan Coronavirus

Post by jimbob » Mon Jan 27, 2020 6:04 pm

mikeh wrote:
Mon Jan 27, 2020 5:22 pm
jimbob wrote:
Mon Jan 27, 2020 3:49 pm
mikeh wrote:
Sun Jan 26, 2020 9:38 pm
Latest coronavirus data suggests
- 4.8 days from infection to showing symptoms
...
How does this 4.8 days line up with the 14 days the media keeps reporting? Or am I misunderstanding something?
And on this point, that 4.8 is the average (thus far), the 14 days is the upper likely limit, which handily is the one the media will be tending to use. And about 3-5 days is a fairly typical period of time for stuff like this.
Cool, thanks - what sort of distribution do you usually get with such diseases? Some sort of Poisson curve?
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Re: Wuhan Coronavirus

Post by Herainestold » Tue Jan 28, 2020 1:10 am

lpm wrote:
Mon Jan 27, 2020 5:42 pm
First confirmed transmission outside China - someone in Canada caught it from her infected husband. Why is Canada always hit? Loads of immigration from China?
Poorly funded pseudo-American style health care system?
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Re: Wuhan Coronavirus

Post by Herainestold » Tue Jan 28, 2020 1:16 am

How to communicate effectively:
Peter Sandman, a former professor of journalism at Rutgers University and a risk-communications guru, says the one thing public officials (or the media) should never do is tell people not to panic. That’s because, in crisis situations, people rarely do panic.

Prof. Sandman actually has a brilliant list of tips for those who need to calm people’s fears about unknown threats such as the coronavirus:

Don’t over reassure; talk about most likely scenarios rather than worst case ones;
Acknowledge uncertainty; paradoxically, saying “I don’t know” reassures the public;
Deliver clear, consistent messages;
Don’t be dispassionate; when experts speak of their personal fears, it makes them more relatable;
Give people things to do to protect themselves, such as urging handwashing; what fuels fear is powerlessness;
Don’t worry about panic, as was already mentioned.
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Re: Wuhan Coronavirus

Post by Martin_B » Tue Jan 28, 2020 2:32 am

Herainestold wrote:
Tue Jan 28, 2020 1:10 am
lpm wrote:
Mon Jan 27, 2020 5:42 pm
First confirmed transmission outside China - someone in Canada caught it from her infected husband. Why is Canada always hit? Loads of immigration from China?
Poorly funded pseudo-American style health care system?
Not Canada - theirs is more a European-style health care system.

LPM may be correct in the high immigration rates from China; Canada has a large Chinese population (~5%, or ~2 million) and a similar number of non-Chinese Asians.

The USA has ~1.5% Chinese, the UK ~0.7%. Australia has a similar proportion to Canada (with half the population!).
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Re: Wuhan Coronavirus

Post by basementer » Tue Jan 28, 2020 4:01 am

Martin_B wrote:
Tue Jan 28, 2020 2:32 am
Herainestold wrote:
Tue Jan 28, 2020 1:10 am
Poorly funded pseudo-American style health care system?
Not Canada - theirs is more a European-style health care system.
Hence this: https://www.reddit.com/r/breakingbad/co ... in_canada/
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Re: Wuhan Coronavirus

Post by nefibach » Tue Jan 28, 2020 12:36 pm

Useful map of cases, including data on outcome: https://gisanddata.maps.arcgis.com/apps ... 7b48e9ecf6

It's worth noting that, despite the overwrought handwringing from the media, the vast majority of cases and all the deaths are still in China. Also worth noting that the number of confirmed cases listed is going to be well below actual number of cases.

A Twitter list of epidemiologists and other experts: https://twitter.com/EpiEllie/lists/coronavirus-experts

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Re: Wuhan Coronavirus

Post by mikeh » Tue Jan 28, 2020 12:37 pm

From the WorldPop data linked upthread, Canada has much less travel from China than the USA, and on a par with Germany and UK.

Almost certainly just coincidence that Canada is 'the first' in terms of importing infectious disease from China, based on poor public recall and recall bias of two or three outbreaks. In the next three scary outbreaks, it could be Chipping Norton in the news.

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Re: Wuhan Coronavirus

Post by shpalman » Tue Jan 28, 2020 12:41 pm

It has arrived in Germany by the way. https://www.theguardian.com/science/liv ... db2faeca43
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Re: Wuhan Coronavirus

Post by shpalman » Tue Jan 28, 2020 1:06 pm

having that swing is a necessary but not sufficient condition for it meaning a thing
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Re: Wuhan Coronavirus

Post by nefibach » Tue Jan 28, 2020 2:25 pm

BMJ's 2019-nCoV archive, which is all available outside their paywall: https://www.bmj.com/coronavirus

And this is a fascinating perspective from inside Wuhan itself: http://chinamediaproject.org/2020/01/27 ... c-actions/

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Re: Wuhan Coronavirus

Post by Herainestold » Tue Jan 28, 2020 8:54 pm

I never realized that there were many Chinese in Canada.
Curiously, Chinese embassy in Canada suggests wearing masks and avoiding crowds.
Interesting that they have the health of Canadian citizens in mind more than Canadian authorities.

The announcement came on the same morning that China’s embassy in Canada started telling people to wear face masks in crowds and to curtail gatherings, to avoid spreading the coronavirus – advice that far exceeds that offered by local Canadian authorities.

“Please avoid travelling to crowded areas as much as possible, and do not organise or participate in party activities as much as possible. If you have to go to a public place with a large number of people, it is recommended to wear a mask and wash your hands and disinfect regularly,” said the new advisory, issued by the embassy on Tuesday morning.

The advisory also tells travellers who have recently returned to Canada from Wuhan, the epicentre of the disease, to “self-quarantine themselves at home for two weeks.
r
“Others coming from China who may be exposed to the virus should also be isolated as much as possible,” it says.
https://www.scmp.com/news/world/united- ... -confirmed

http://ca.china-embassy.org/chn/sggg/t1736623.htm
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Re: Wuhan Coronavirus

Post by bob sterman » Tue Jan 28, 2020 9:17 pm

nefibach wrote:
Tue Jan 28, 2020 12:36 pm
Useful map of cases, including data on outcome: https://gisanddata.maps.arcgis.com/apps ... 7b48e9ecf6
Does anyone know why the "recovered" total is so low? Does it genuinely mean that thousands are currently in hospital? Or do some confirmed cases recover without it being officially recorded?

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Re: Wuhan Coronavirus

Post by Matatouille » Wed Jan 29, 2020 7:25 am

bob sterman wrote:
Tue Jan 28, 2020 9:17 pm
Does anyone know why the "recovered" total is so low? Does it genuinely mean that thousands are currently in hospital? Or do some confirmed cases recover without it being officially recorded?
My completely lay-person's guess is because we're so early in the outbreak, with control measures only recently in place that until now most cases have infected multiple others, resulting in a ballooning cases count with most infected in the recent past. This would mean that a big proportion (perhaps a majority of cases to date) are still symptomatic and so only a few earlier cases can yet be considered "recovered".

People with acshual knowledge, is that way off?

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Re: Wuhan Coronavirus

Post by sTeamTraen » Wed Jan 29, 2020 9:50 am

Herainestold wrote:
Tue Jan 28, 2020 8:54 pm
I never realized that there were many Chinese in Canada.
Curiously, Chinese embassy in Canada suggests wearing masks and avoiding crowds.
Interesting that they have the health of Canadian citizens in mind more than Canadian authorities.
They probably feel the need to be seen to "do something" about a problem that non-Chinese Canadians might attribute to immigrants, resulting in anti-Chinese hostility. On the other hand, the Canadian authorities have to go on the evidence, which is likely to be that masks are not much use and will probably scare people. Politics is never far away from public health.
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Re: Wuhan Coronavirus

Post by Woodchopper » Wed Jan 29, 2020 10:04 am

nefibach wrote:
Tue Jan 28, 2020 12:36 pm
Useful map of cases, including data on outcome: https://gisanddata.maps.arcgis.com/apps ... 7b48e9ecf6

It's worth noting that, despite the overwrought handwringing from the media, the vast majority of cases and all the deaths are still in China. Also worth noting that the number of confirmed cases listed is going to be well below actual number of cases.

A Twitter list of epidemiologists and other experts: https://twitter.com/EpiEllie/lists/coronavirus-experts
Thanks, those are useful.

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Re: Wuhan Coronavirus

Post by mikeh » Wed Jan 29, 2020 12:38 pm

Matatouille wrote:
Wed Jan 29, 2020 7:25 am
bob sterman wrote:
Tue Jan 28, 2020 9:17 pm
Does anyone know why the "recovered" total is so low? Does it genuinely mean that thousands are currently in hospital? Or do some confirmed cases recover without it being officially recorded?
My completely lay-person's guess is because we're so early in the outbreak, with control measures only recently in place that until now most cases have infected multiple others, resulting in a ballooning cases count with most infected in the recent past. This would mean that a big proportion (perhaps a majority of cases to date) are still symptomatic and so only a few earlier cases can yet be considered "recovered".

People with acshual knowledge, is that way off?
Pretty much it, I think the 'recovered' number here specifically means 'those we've booted out of hospital because they're definitely 100% clear and not about to spread it about like they did before we got them in here". And as you can imagine, they're applying quite the safety net to that. A more useful stat at this precise point in time is the fatality rate hovering around 2.5-3% mark, indicating that most patients will go on to 'recover'.

(Edited to add that I * think * that's what 'recovery' means here, happy to be corrected in I'm wrong)

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Re: Wuhan Coronavirus

Post by mikeh » Wed Jan 29, 2020 12:41 pm

Ah this is helpful. The Indian government appears to be recommending homeopathy for treating coronavirus infections.
https://pib.gov.in/PressReleasePage.aspx?PRID=1600895#

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