2019-nCoV / Corona virus Pt 2

[angrysoba]

No, but I don’t need an explanation for your claim. You do.

I’ve already explained why I think the mortality rate is higher. I gave you what I consider to be the evidence.

Do you accept it or not? If you do, then fine we agree. If you don’t, why not explain why you don’t.

So which is it?

 

[Skeptic Ginger]

The way I read it is 2 flu seasons, I thought that was clear from the quote I included. They said the winter months BETWEEN 2013-2014 and 2016-2017. They could have meant all four years though I suppose.

How about picking a 2 month total of flu deaths to compare this to? Don't forget to pick some comparable times when the flu wasn't circulating any more widely than the times you are comparing it too.

 

[Skeptic Ginger]

Game between OKC Thunder and Utah Jazz cancelled because one of the player was ill before the game started. Building evacuated. COuld be a false alarm of course, and it could just be a bad burger for lunch, but shows how panicky people are.

It's more than a bad burger. It's an ILI (influenza like illness) with other prime suspects ruled out, COVID test pending.

 

[sir drinks-a-lot]

I’ve already explained why I think the mortality rate is higher. I gave you what I consider to be the evidence.

Do you accept it or not? If you do, then fine we agree. If you don’t, why not explain why you don’t.

So which is it?

I don’t really have a strong opinion either way. In your earlier post you said the mortality was was “sure to be higher” than the flu, so I thought you may have had additional information I hadn’t heard yet.

I tend to agree, but not with a high degree of confidence.

 

[angrysoba]

I don’t really have a strong opinion either way. In your earlier post you said the mortality was was “sure to be higher” than the flu, so I thought you may have had additional information I hadn’t heard yet.

I tend to agree, but not with a high degree of confidence.

Okay. Well there is little point arguing the point then. Let’s say I dial back on “sure” and say “very likely” after almost every expert I have heard on the subject believes it is worse than the flu in terms of mortality.

Maybe the most reassuring statistics are out of South Korea or even the cruise liner. They are somewhere around 1% which may also be skewed towards the high end because of selective testing in South Korea (the most sick people are likely to get tested) and age in the case of the cruise liner. That said, even with those caveats, the numbers seem much higher than we would expect from the flu, I think (IANAE).

 

[Skeptic Ginger]

That's the luxury a billion people bring. NZ wouldn't be able to organise that in a year, let alone the red tape you need to wade through.

Yo - you and I are very much on the same page now.

Not quite. You still keep running numbers based on incomplete data.

Do you think it's time to walk back that whole "Influenza is thousands of times more deadly than coronovirus" thing?

Not quite that either. I will take back "thousands". But we won't know yet how this compares to really bad flu years that definitely look to have been worse than the current coronavirus:

https://www.mphonline.org/worst-pandemics-in-history/

FLU PANDEMIC (1968)
Death Toll: 1 million
Cause: Influenza
A category 2 Flu pandemic sometimes referred to as “the Hong Kong Flu,” the 1968 flu pandemic was caused by the H3N2 strain of the Influenza A virus, a genetic offshoot of the H2N2 subtype. From the first reported case on July 13, 1968 in Hong Kong, it took only 17 days before outbreaks of the virus were reported in Singapore and Vietnam, and within three months had spread to The Philippines, India, Australia, Europe, and the United States. While the 1968 pandemic had a comparatively low mortality rate (.5%) it still resulted in the deaths of more than a million people, including 500,000 residents of Hong Kong, approximately 15% of its population at the time.

ASIAN FLU (1956-1958)
Death Toll: 2 million
Cause: Influenza
Asian Flu was a pandemic outbreak of Influenza A of the H2N2 subtype, that originated in China in 1956 and lasted until 1958. In its two-year spree, Asian Flu traveled from the Chinese province of Guizhou to Singapore, Hong Kong, and the United States. Estimates for the death toll of the Asian Flu vary depending on the source, but the World Health Organization places the final tally at approximately 2 million deaths, 69,800 of those in the US alone.

FLU PANDEMIC (1918)
Death Toll: 20 -50 million
Cause: Influenza
Between 1918 and 1920 a disturbingly deadly outbreak of influenza tore across the globe, infecting over a third of the world’s population and ending the lives of 20 – 50 million people. Of the 500 million people infected in the 1918 pandemic, the mortality rate was estimated at 10% to 20%, with up to 25 million deaths in the first 25 weeks alone. ....

FLU PANDEMIC (1889-1890)
Death Toll: 1 million
Cause: Influenza
Originally the “Asiatic Flu” or “Russian Flu” as it was called, this strain was thought to be an outbreak of the Influenza A virus subtype H2N2, though recent discoveries have instead found the cause to be the Influenza A virus subtype H3N8. The first cases were observed in May 1889 in three separate and distant locations, ... In the end, the 1889-1890 Flu Pandemic claimed the lives of over a million individuals.

Other factors are going to be how effective the COVID vaccine will be. Flu vaccines are constantly battling shifting and drifting flu genomes. And how effective the antiviral drugs will be for COVID. Again, flu strain responses to antivirals vary.

Until we have those questions answered you cannot say COVID is worse than flu. I'm still going with 'flu is worse'.

Actually, I'm just kidding - we all make mistakes and it's clear you've moved on.

This I agree with completely. We've both moved toward the middle.

I'm hoping to Bob that I've made a mistake in suggesting 50,000,000 dead is a possibility, but if some of these "developed" countries don't start acting, it will be all that and more, because in among the talk of Italy, USA, et al, nobody's mentioned India, Brazil, Egypt, Nigeria and other countries with large populations and less-robust systems.

The problem trying to compare these numbers is no one ever counted all these countries' fatalities in all the past flu pandemics.

We are going to see a huge problem when this gets into some of those refugee camps.

Let's compare deaths after the epidemic.

To do so now is dishonest.

I've been telling you that since the start.

 

[Skeptic Ginger]

Actually, we don’t really know the mortality rate of COVID 19 but it is sure to be higher than flu.

No it is not sure. See my post above.

The other important things are that we don’t know the lifecycle of this disease. Will it have a season, like flu, or will it continue on through summer and winter, in both hemispheres and the tropics? I think we don’t yet know.

And of course, no vaccines or immunity yet.

None of that matters except the vaccine and antivirals. Even seasonal flu can have cycles that don't match the usual seasonal patterns.

 

[pipelineaudio]

Sheesh you guys have predicted "there will be panic tomorrow" for about 40 tomorrows now. Give it a rest. Feels like that panic strawman back after 9/11

 

[ceptimus]

In Italy, the total accumulated deaths due to COVID-19 has doubled every two or three days for the last two weeks. This is very different than flu. If the trend continues, expect the total deaths in Italy to pass ten thousand by March 22.

Of course, Italy has now introduced strict controls, so it can be hoped that the 'doubling days' figure will soon increase beyond three.

 

[angrysoba]

No it is not sure. See my post above.

I’m talking seasonal flu, not pandemic flu. But you knew that.

None of that matters except the vaccine and antivirals. Even seasonal flu can have cycles that don't match the usual seasonal patterns.

Surely it does matter. If there is no vaccine or usable antivirals then at least it would be helpful if the virus weakens according to the season.

 

[The Atheist]

Surely it does matter. If there is no vaccine or usable antivirals then at least it would be helpful if the virus weakens according to the season.

Keep your eyes on NZ.

We've done less than USA in trying to keep it out, but we're not showing new infections or community transmission.

Yet.

If it's temperature-sensitive, it will start in the south, where it's much colder. The temperatures in the deep south have been similar to Europe in the past couple of days.

Give us a fortnight and we might have some answers.

 

[Skeptic Ginger]

Sheesh you guys have predicted "there will be panic tomorrow" for about 40 tomorrows now. Give it a rest. Feels like that panic strawman back after 9/11

Who are "you guys"?

 

[Skeptic Ginger]

I’m talking seasonal flu, not pandemic flu. But you knew that.

Surely it does matter. If there is no vaccine or usable antivirals then at least it would be helpful if the virus weakens according to the season.

No, I did not know that. Seems to me few people are making clear distinctions.

You missed my point about the seasons not mattering. They don't necessarily matter for flu either.

 

[Sherkeu]

Not quite. You still keep running numbers based on incomplete data.

What he meant was that NZ could not do the tech and logistical part of delivering things in a "hot zone" like Wuhan had in that amount of time.
If you watched the video of food/medicine delivery there you would see it is quite advanced in terms of controls. Amazing what they could do really, even if the video distribution is 'partially sponsored by the Chinese govt' as youtube admits.

 

[Blue Mountain]

The Canadian cases are currently in British Columbia (west coast), Ontario and BC (the two most populous provinces, somewhat aligned with the east coast of the US.)

You take that back, sir.

Doh! That was a typo and a half! The correct sentence is:

The Canadian cases are currently in British Columbia (west coast), Ontario and Quebec (the two most populous provinces, somewhat aligned with the east coast of the US.)​

Canadian update: deaths remain at 1. Alberta has jumped into the statistics with 14 confirmed cases. As of the last update, numbers (west to east to north) are BC 39, Alberta 14, Saskatchewan and Manitoba 0, Ontario 42 (mostly southern Ontario, as far as I know), Quebec 7; New Brunswick, Nova Scotia, PEI, and Newfoundland and Labrador 0; Yukon, Northwest Territories, and Nunavut 0; and 1 case in a "repatriated Canadian" (location unreported.) Total cases 103.

Public messaging so far has been on self isolation if you come down with flu-like symptoms. I read an article today advising if you want to visit a health-care facility and you have COVID-19 symptoms you should call ahead to alert them to your intention, so they can have an isolated space available when you arrive.

At the federal level, Trudeau announces $1B COVID-19 package as WHO calls global outbreak a pandemic.

The package includes:

• $275 million for additional research, such as vaccine development
• $200 million for federal medical supplies, supports for Indigenous communities and education efforts.
• $500 million for provinces and territories to fund critical health care system needs and to support mitigation efforts, including access to testing, equipment and enhanced surveillance and monitoring.
• $50 million for the Public Health Agency of Canada's COVID-19 communications and public education efforts.
• Enhancement of Canada's work-sharing program to support employers and their employees who experience a downturn due to COVID-19, doubling the length of time they can use work-sharing from 38 to 76 weeks.
• $100 million to support federal public health measures such as enhanced surveillance and increased testing at the National Microbiology Laboratory.
• An additional $50 million to help vulnerable countries prepare for and respond to the virus, supporting efforts of the World Health Organization and other partners.

If nothing else, government messaging on this is consistent. I'm hopeful these measures will help contain the spread, or at least slow it down enough that areas don't get overwhelmed. I'm concerned that schools aren't being closed and sporting events are still happening, and I've heard nothing about instituting these measures.

 

[ynot]

Keep your eyes on NZ.

We've done less than USA in trying to keep it out, but we're not showing new infections or community transmission.

Yet.

If it's temperature-sensitive, it will start in the south, where it's much colder. The temperatures in the deep south have been similar to Europe in the past couple of days.

Give us a fortnight and we might have some answers.

Perhaps NZ's super aggressive sunshine is frying the little buggers .

 

[angrysoba]

No, I did not know that. Seems to me few people are making clear distinctions.

You missed my point about the seasons not mattering. They don't necessarily matter for flu either.

Not necessarily no. That said, with seasonal flu, the seasons are fairly reliable guides to when flu will die down. With this virus we do not have that kind of reassurance as far as we know.

 

[Planigale]

I’m talking seasonal flu, not pandemic flu. But you knew that.



Surely it does matter. If there is no vaccine or usable antivirals then at least it would be helpful if the virus weakens according to the season.

The season does not weaken the virus. Flu is as bad if you get it in summer as it is in winter. Flu is as common in the tropics as it is elsewhere. It is as deadly in the tropics as elsewhere. The seasonality is less marked in the tropics, tending to be associated with the wet season or having a biphasic pattern with two peaks a year. Pandemic flu is not seasonal, endemic flu is.

The seasonality of flu is probably due to humidity not temperature. It may be associated with seasonal behaviour by the host population. It is not due to any intrinsic temperature sensitivity of the virus.

Mortality in flu is also complex. Few people die directly of (endemic) flu. What happens is you get a secondary bacterial pneumonia and die of that. This differs from SARS CoV 2 which directly causes a pneumonia and people are dying from the viral pneumonia. (Flu can cause a direct viral pneumonia, but secondary pneumonia is the more common cause of death. This is why many mortality figures are flu and pneumonia deaths.) Finally probably the biggest mortality from flu is heart attacks and strokes, you look at the excess attributable deaths. Flu significantly increases the risk of heart attack and stroke in the weeks following an infection, some statistics will include these excess attributable deaths in the annual mortality figures. What we don't know is if COVID 19 will be associated with excess attributable deaths from other causes.

So when quoting flu deaths it is important to know exactly what the definition is of a flu death.

To see how CDC estimates US mortality see here.
https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm

 

[angrysoba]

The season does not weaken the virus. Flu is as bad if you get it in summer as it is in winter. Flu is as common in the tropics as it is elsewhere. It is as deadly in the tropics as elsewhere. The seasonality is less marked in the tropics, tending to be associated with the wet season or having a biphasic pattern with two peaks a year. Pandemic flu is not seasonal, endemic flu is.

The seasonality of flu is probably due to humidity not temperature. It may be associated with seasonal behaviour by the host population. It is not due to any intrinsic temperature sensitivity of the virus.

Mortality in flu is also complex. Few people die directly of (endemic) flu. What happens is you get a secondary bacterial pneumonia and die of that. This differs from SARS CoV 2 which directly causes a pneumonia and people are dying from the viral pneumonia. (Flu can cause a direct viral pneumonia, but secondary pneumonia is the more common cause of death. This is why many mortality figures are flu and pneumonia deaths.) Finally probably the biggest mortality from flu is heart attacks and strokes, you look at the excess attributable deaths. Flu significantly increases the risk of heart attack and stroke in the weeks following an infection, some statistics will include these excess attributable deaths in the annual mortality figures. What we don't know is if COVID 19 will be associated with excess attributable deaths from other causes.

So when quoting flu deaths it is important to know exactly what the definition is of a flu death.

To see how CDC estimates US mortality see here.
https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm

Thanks for the information.

That's interesting and it lets me understand something from the study that Marcus attempted to use to compare seasonal flu and COVID 19:

We estimated excess deaths of 7,027, 20,259, 15,801 and 24,981 attributable to influenza epidemics in the 2013/14, 2014/15, 2015/16 and 2016/17, respectively, using the Goldstein index. The average annual mortality excess rate per 100,000 ranged from 11.6 to 41.2 with most of the influenza-associated deaths per year registered among the elderly. However children less than 5 years old also reported a relevant influenza attributable excess death rate in the 2014/15 and 2016/17 seasons (1.05/100,000 and 1.54/100,000 respectively).

Link

So I guess the idea of "flu kills more people then COVID 19" is comparing apples with oranges, and that COVID 19's effects might be felt even after those recovering have been discharged from hospital.

 

[novaphile]

Apparently they were in Oz (Gold Coast) doing pre-production for an Elvis bio-flick.

Wonder if they got infected Down Under, or if they brought it with them?

Next question. If they brought it with them, where did they catch it? Did they haul a whole pre-production crew full of sickies with them?

They've been in Australia since January.

They caught it here.