COVID-19

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GeenDienst
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Re: Wuhan Coronavirus

Post by GeenDienst » Sat Jan 25, 2020 2:41 am

TopBadger wrote:
Fri Jan 24, 2020 1:07 pm
Puts me in the mind of this:
The more research has been done, the less evil that one got, for a 5000 years ago kinda thing. The earlier idea that they were slaves has gone away, rather. But, yes, they didn't do a lot of voting and they did get stuff built.
Just tell 'em I'm broke and don't come round here no more.

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Re: Wuhan Coronavirus

Post by mikeh » Sat Jan 25, 2020 11:30 am

GeenDienst wrote:
Sat Jan 25, 2020 2:41 am
TopBadger wrote:
Fri Jan 24, 2020 1:07 pm
Puts me in the mind of this:
The more research has been done, the less evil that one got, for a 5000 years ago kinda thing. The earlier idea that they were slaves has gone away, rather. But, yes, they didn't do a lot of voting and they did get stuff built.
Imagine telling London they're not going anywhere. Or indeed, imagine telling your favourite Brexit-voting small town they're not going anywhere. People will be making unnecessary journeys just to stick it to the authorities. Compliance with the state will at least mean people aren't moving about very much, the main aim of the lockdown (whether or not the consequences of that make it a good intervention). The analysis of that will be very useful information for next time. And there will be a next time.

I vaguely recall seeing a presentation at a conference years back that talked about restrictions of movements in mexico during the swine flu outbreak in 2009. Going to be vague on the details but in essence-
A little bit of lockdown was a bit effective, mid-range lockdown was the best (no sporting events, shut schools, but keep airports open though checks and extra stuff were put in place). Mass lockdown (e.g. shutting airports and other public transport) involved people saying "er... no, we're off" and heading off into the sunset anyway. Movements were actually more than the lesser-lockdown options.

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bob sterman
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Re: Wuhan Coronavirus

Post by bob sterman » Sat Jan 25, 2020 2:12 pm

Couple of observations...

Wuhan hospitals appear at a glance to be more modern and better equipped than many UK district hospitals!

Some videos of chaotic scences in Wuhan hospitals seems to suggest that large numbers of ambulatory potential patients are turning up at hospitals - creating crowds where infected and uninfected people are mingling. Those crowds will be a mixture of people who don't have coronavirus (yet), others with mild cases who could recover at home, and others who are seriously ill and require hospitalisation.

What could be done to stop this happening here once cases start to arise?

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Re: Wuhan Coronavirus

Post by Herainestold » Sat Jan 25, 2020 7:51 pm

We have to hope that the Chinese can stop this. If they don't we are done for.
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bob sterman
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Re: Wuhan Coronavirus

Post by bob sterman » Sat Jan 25, 2020 7:57 pm

Just saw an article that stated that among the people waiting at Wuhan's Red Cross Hospital one woman complained "It takes at least five hours to see a doctor".

:o

UK A&Es can't manage that for many patients - outside of flu season.

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Re: Wuhan Coronavirus

Post by Herainestold » Sat Jan 25, 2020 8:11 pm

bob sterman wrote:
Sat Jan 25, 2020 7:57 pm
Just saw an article that stated that among the people waiting at Wuhan's Red Cross Hospital one woman complained "It takes at least five hours to see a doctor".

:o

UK A&Es can't manage that for many patients - outside of flu season.
We dont realize how bad our system is. We have been propagandized to believe it is the best in the world. It is not. We have been told to look down at the Chinese, but in reality their acute health care system is far superior to our own≥
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Re: Wuhan Coronavirus

Post by lpm » Sat Jan 25, 2020 11:01 pm

GeenDienst wrote:
Sat Jan 25, 2020 2:41 am
TopBadger wrote:
Fri Jan 24, 2020 1:07 pm
Puts me in the mind of this:
The more research has been done, the less evil that one got, for a 5000 years ago kinda thing. The earlier idea that they were slaves has gone away, rather. But, yes, they didn't do a lot of voting and they did get stuff built.
Thanks for the link. Highly recommended long read. And marvellously off topic.
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lpm
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Re: Wuhan Coronavirus

Post by lpm » Sat Jan 25, 2020 11:03 pm

Herainestold wrote:
Sat Jan 25, 2020 7:51 pm
We have to hope that the Chinese can stop this. If they don't we are done for.
Ah yes, "done for", a technical bit of jargon but one often used by epidemiologists.
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lpm
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Re: Wuhan Coronavirus

Post by lpm » Sat Jan 25, 2020 11:43 pm

The tabloids are predictably stupid. But the broadsheets now are joining them - don't appear to understand the meaning of a quarantine. The "let's evacuate our citizens from Wuhan and bring them safely home" approach is perhaps slightly flawed.
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Re: Wuhan Coronavirus

Post by Squeak » Sun Jan 26, 2020 12:21 am

lpm wrote:
Sat Jan 25, 2020 11:01 pm
GeenDienst wrote:
Sat Jan 25, 2020 2:41 am
TopBadger wrote:
Fri Jan 24, 2020 1:07 pm
Puts me in the mind of this:
The more research has been done, the less evil that one got, for a 5000 years ago kinda thing. The earlier idea that they were slaves has gone away, rather. But, yes, they didn't do a lot of voting and they did get stuff built.
Thanks for the link. Highly recommended long read. And marvellously off topic.
Agreed. A fascinating article, albeit at a wild tangent to the rest of this thread. :)

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Re: Wuhan Coronavirus

Post by Gfamily » Sun Jan 26, 2020 1:21 am

lpm wrote:
Sat Jan 25, 2020 11:43 pm
The tabloids are predictably stupid. But the broadsheets now are joining them - don't appear to understand the meaning of a quarantine. The "let's evacuate our citizens from Wuhan and bring them safely home" approach is perhaps slightly flawed.
They're just in denial (NB - purely posted as an auditory callback to the Pyramids meme above!)
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Re: Wuhan Coronavirus

Post by mikeh » Sun Jan 26, 2020 10:48 am

Colleagues have put together this analysis of historic population movements in China at dates prior to and post the current lockdown. It's mostly provision of information rather than new analysis though figures 2 and 3 show risk of transmission within China based on likely movements prior to the lockdown.
https://www.worldpop.org/events/china

It shows the extent to which likely travel will have been averted. Also quantifies historic international air travel from China cities, Bangkok receiving highest volume of passengers from China (see table 4).

Worth noting also table 6, Africa cities receiving flights/passengers from China. Cairo tops the list by some distance, plus also travel measured in the thousands to Lagos, Abuja and even Kinshaha.
Fair number of China migrants in Africa, mining being a big employer. Much of the malaria in China is now due to importation from migrant workers with declining numbers of cases being due to endemic malaria (as it goes, often in border towns where the pesky mozzies tend to fly over the border from Laos and Myanmar). But if China-Africa travel results in cases being located in rural areas, then may be where health services are less well equipped to manage testing and any required isolation. (Though of course population densities are lower).

But, disentangling a low-profile outbreak of mild to moderate respiratory infectious disease symptoms in a sub-Sahara African village, from a situation where you need the people in spacesuits and machines that go bing, whilst ensuring the cultural and social norms of the local populations are addressed appropriately and thus ensuring best possible compliance...?
I mean that's complicated and really , the response to an infectious disease threat is where the western world cocked up in the 2014/15 Ebola outbreak. And the efficiency of state control in African countries isn't perhaps as effective as in, let's say, China (and the effectiveness of what they're doing there remains to be seen). People take the piss out of the social scientists and anthropologists, but they can really help during public health emergencies.

From an epidemiological point of view, this is fascinating. I'm learning a lot.

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Re: Wuhan Coronavirus

Post by mikeh » 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

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Re: Wuhan Coronavirus

Post by sTeamTraen » Sun Jan 26, 2020 10:07 pm

A French friend who is, shall we say, "somewhat persuadable" sent me an audio clip today via Facebook that claims to be from "A friend who is visiting China at the moment". It claims that there are 200,000 cases in China, that there will shortly be an epidemic in France caused by Chinese tourists or French people returning from China, and encouraging people to stockpile two weeks worth of supplies because French cities are going to be locked down soon (along with lots of other predictions and instructions).

Quite how someone who is "just visiting China" has become an expert in public health is not clear. I don't know if this woman is real or broadcasting from Moscow, but if enough people start taking this seriously, some of the panic and shortages will become self-fulfilling. :(
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Re: Wuhan Coronavirus

Post by jimbob » Sun Jan 26, 2020 10:17 pm

sTeamTraen wrote:
Sun Jan 26, 2020 10:07 pm
A French friend who is, shall we say, "somewhat persuadable" sent me an audio clip today via Facebook that claims to be from "A friend who is visiting China at the moment". It claims that there are 200,000 cases in China, that there will shortly be an epidemic in France caused by Chinese tourists or French people returning from China, and encouraging people to stockpile two weeks worth of supplies because French cities are going to be locked down soon (along with lots of other predictions and instructions).

Quite how someone who is "just visiting China" has become an expert in public health is not clear. I don't know if this woman is real or broadcasting from Moscow, but if enough people start taking this seriously, some of the panic and shortages will become self-fulfilling. :(
Yup, I saw a tweet by someone claiming that people were dropping in the streets in China and somehow this fact was both covered up and also the multiple videos they were posting showing this had got through the Chinese censorship.
Have you considered stupidity as an explanation

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Re: Wuhan Coronavirus

Post by mikeh » 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.

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Re: Wuhan Coronavirus

Post by jimbob » Sun Jan 26, 2020 10:43 pm

I did wonder if there was a horror movie they'd been taken from
Have you considered stupidity as an explanation

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Re: Wuhan Coronavirus

Post by Chris Preston » Sun Jan 26, 2020 10:51 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.
We all know that you cannot believe anything the Daily Mail writes.
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Re: Wuhan Coronavirus

Post by sTeamTraen » Mon Jan 27, 2020 12:05 am

jimbob wrote:
Sun Jan 26, 2020 10:17 pm
Yup, I saw a tweet by someone claiming that people were dropping in the streets in China and somehow this fact was both covered up and also the multiple videos they were posting showing this had got through the Chinese censorship.
Yes: The Chinese government is covering it up, the Western media are colluding to prevent panic spreading, but TruthSeeker45678293 has direct access to the current death toll in real time.
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Re: Wuhan Coronavirus

Post by Bird on a Fire » Mon Jan 27, 2020 12:23 am

What about this conspiracy theory?

The Chinese government stole the corona virus from a Canadian research facility after which it escaped.

"A Canadian government scientist at the National Microbiology Lab in Winnipeg made at least five trips to China in 2017-18, including one to train scientists and technicians at China's newly certified Level 4 lab, which does research with the most deadly pathogens. Xiangguo Qiu — who was escorted out of the Winnipeg lab in July amid an RCMP investigation into what's being described by Public Health Agency of Canada as a possible "policy breach" — was invited to go to the Wuhan National Biosafety Laboratory of the Chinese Academy of Sciences twice a year for two years, for up to two weeks each time. "This will be third-party funded, and therefore no cost to [the Public Health Agency of Canada]," say the documents, obtained through access to information requests. The identity of the third-party was redacted. During a Sept. 19-30, 2017, trip, she also met with collaborators in Beijing, the documents say, but their names have also been blacked out. [People working inside the lab] who asked not to be identified for fears of retribution, say there have always been questions about Qiu's trips to China — and what information and technology she was sharing with researchers there. "It's not right that she's a Canadian government employee providing details of top-secret work and know-how to set up a high-containment lab for a foreign nation," one employee said. [Source] (https://www.cbc.ca/news/canada/manitoba ... -1.5307424)

So she went to the Wuhan National Biosafety Laboratory multiple times, which is a newly certified Level 4 lab that does research with the most deadly pathogens. She may have brought the virus with her.

The lab is located in Wuhan, close to the Yangtze (Address). When the facility was being built there were already worries that a virus could escape. "In 2017, as the opening of the lab approached, scientists told the publication Nature of their worries that one of those killer viruses could ‘escape’ and go on to infect members of the public. Tim Trevan, a Maryland biosafety consultant, said he had fears China’s culture could make the institute unsafe because ‘structures where everyone feels free to speak up and openness of information are important’." Source

In a Nature article it is stated that "the SARS visus has escaped from high-level containment facilities in Beijing multiple times". Source

The point of outbreak of the virus is said to be the Huanan Seafood Market, which is about 20 kilometers or a half hour drive away from the Wuhan National Biosafety Laboratory if you look it up on Google Maps. I'm not entirely convinced.

Edit: spelling
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Re: Wuhan Coronavirus

Post by Bird on a Fire » Mon Jan 27, 2020 12:24 am

More seriously
I was wondering a bit ago too how reporting gets affected by things like cultural influences and corruption. Say an epidemic breaks out in a culture where, for example, potentially harmful folk remedies are likely to be attempted prior to hospitalization, would what skew the apparent fatality rate? You might either end up with higher fatalities or lower, depending on if people tend to die at home with their illness going unreported. Artificially high costs of medical care due to things like bribery and internal bloat, and a legal system allowing those bills to pass on to family members, might lead to fewer folks ending up in hospital as well, plus doctors being unwilling to admit their patient died of anything that might be seen as preventable in case they're attacked. At that point you'd need complex statistical analysis to determine the true death rate, which might require some significant lead time for data collection and validation.

It's just, while yes I think the Chinese government are a bunch of lying shitstains, I also wonder how much of the lying is actually deliberate and how much of it is just the natural consequence of various systemic issues. Like maybe what they're trying to cover up isn't so much that an epidemic is happening, since that's pretty obvious, but more the fact that despite multiple past issues with epidemics China appears to have made very little progress developing comprehensive protocols to handle them, possibly suggesting a deep systemic weakness to biological warfare.

Maybe China is caught in a mix of officials trying to make the epidemic seem less bad, unreliable data making it impossible to know how bad it really is, and military interests trying to avoid letting other nations know that their infection protocols are so bad that a random goat virus could easily wipe out an entire region.
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Re: Wuhan Coronavirus

Post by lpm » Mon Jan 27, 2020 9:34 am

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
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?
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bob sterman
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Re: Wuhan Coronavirus

Post by bob sterman » Mon Jan 27, 2020 10:51 am

It must be fiendishly difficult to predict how a virus will behave and the problems it will cause outside of the context where it first emerges.
E.g. R0 will be very different in a highly urban setting with large extended families cohabiting and widespread use of mass public transit than in more suburban setting, with only small family groups cohabiting and widespread single person use of cars.

Also surely the case fatality rate is going to be very different among patients with access to ITU care vs patients with access to only basic medical care vs patients with no access to medical care?

So R0 and case fatality rate can be context dependent rather than intrinsic properties of the virus.

E.g.

Overreliance on early estimates of R0 made in one country can lead to policy decisions in another country that may be suboptimal for that country.”

Ridenhour, B., Kowalik, J. M., & Shay, D. K. (2018). Unraveling R0: Considerations for public health applications. American Journal of Public Health, 108, S445-S454. doi:10.2105/AJPH.2013.301704

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Re: Wuhan Coronavirus

Post by science_fox » Mon Jan 27, 2020 10:57 am

If anyone wants to do their own research on it, (or build a variant).

https://twitter.com/ProteomicsNews/stat ... 8496855041
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Re: Wuhan Coronavirus

Post by lpm » Mon Jan 27, 2020 11:16 am

bob sterman wrote:
Mon Jan 27, 2020 10:51 am
It must be fiendishly difficult to predict how a virus will behave and the problems it will cause outside of the context where it first emerges.
E.g. R0 will be very different in a highly urban setting with large extended families cohabiting and widespread use of mass public transit than in more suburban setting, with only small family groups cohabiting and widespread single person use of cars.

Also surely the case fatality rate is going to be very different among patients with access to ITU care vs patients with access to only basic medical care vs patients with no access to medical care?

So R0 and case fatality rate can be context dependent rather than intrinsic properties of the virus.

E.g.

Overreliance on early estimates of R0 made in one country can lead to policy decisions in another country that may be suboptimal for that country.”

Ridenhour, B., Kowalik, J. M., & Shay, D. K. (2018). Unraveling R0: Considerations for public health applications. American Journal of Public Health, 108, S445-S454. doi:10.2105/AJPH.2013.301704
Individuals must have their own R0, based on how social they are and how they travel, and local communities will have a R0 based on the local average such as suburban living and travelling alone in a car. But would this only matter for small outbreaks like SARS? Once you get to hundreds of thousands of people it all averages out? Over 50% of the world live in cities, mostly pretty similar to China's.

Or is it something like

- an "unhindered" R0 of 3.0 - the ratio when it's spreading unknown with no prevention

- a "hindered" R0 of 2.0 - when it's known and being held back by travel bans, self-quarantining and extra hygiene measures

- a "hindered 1st world" R0 of 1.5 - small families in suburbia with private cars and wide-spread public education of hygiene

Given these would all be > 1.0, the policy decisions for a country like the UK should be the same regardless of the actual rate? It's coming and it will spread. Yesterday I saw a TV advert for a Beechams cold placebo which basically said "Don't let a cold stop you from going out and about" with pictures of people being sociable. In a country where government can't barricade the roads, the emphasis has to be instead on individual responsibility.
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