Merged 2019-nCoV / Corona virus

[Giordano]

Two pieces of news from different ends of the spectrum:

1 - the cruise ship quarantined in Japan has now been cleared of the virus, so it didn't spread further than the 61 cases found.

2 - the Singapore conference that was the origin of the British family's infection while on a skiing holiday seems to be a hotbed for infection, with several others traced to that meeting. It almost seems like there are two strains in play, one more infectious than the other.

As always, time will tell.

I wonder how many of those 61 were already infected when they were officially quarantined and told to stay in their cabins. Perhaps there was not much cabin to cabin spread.

 

[Dr.Sid]

Death rate? I don't think I've seen any numbers that indicate an exponential rate outside China. Probably too few deaths outside China to obtain a reliable rate of increase.

Again, that is to be expected, because there are small number of cases and everybody can get the best care and attention. Might be just that.

 

[Giordano]

If you accept the numbers there is an indication that the rate of new infection is decreasing in China too:
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

I could not find a graph for deaths.

 

[Skeptic Ginger]

You would have thought the authoritarian regime would have cracked down on smoking. Perhaps they see it as a good population control.

Did you not bother to look at the link on smoking in China or my post noting tobacco is a huge revenue generating crop for China?

 

[Giordano]

Do you have a source for this?

If this is true, that's a terrible percentage.

I suppose it depends on how these cases are being counted.

75% of those infected already getting better is not the same thing as if 75% of those infected ever get better. The rapid growth in the numbers means that most of the people identified as infected were only identified a few days or a week or so ago. Therefore they haven't "had a chance" to get better yet.

 

[Skeptic Ginger]

From what I've read of the symptoms, it seems to work in pretty much the same way as tuberculosis (TB) - which, of course, is caused by a specific bacterium - in which the severely afflicted drown in their own phlegm as the infected cells in the lungs haemorrhage one by one. OK, so maybe it's more like pneumonia, except pneumonia tends to be a secondary infection for those already weakened by other illnesses (flu, AIDS, etc.).

TB does not present that way. Tuberculosis creates big abbesses (tubercules) in the lung among other symptoms.

 

[Skeptic Ginger]

The official non-offensive name will be released next week. Then instead of blaming the Chinese direct through the name, people will have to remember something like, "The Procyon virus - ah yes that's the one that killed millions. It originated in Wuhan where the Chinese like to eat wild animals."

But no one will be offended, so the main problem will have been solved.

The Chinese are angling to have the thing renamed NCP - Novel Coronavirus Pneumonia - but I can't see that catching on. National Car Parks - the largest UK car park operator - is bound to object, for starters.

It's already being used.

 

[Vixen]

Did you not bother to look at the link on smoking in China or my post noting tobacco is a huge revenue generating crop for China?

Not good enough/ You could say the same for Scotland where cheap cider had huge sales. The government brought in a law that it cannot be sold cheaply. It gets huge revenues from duties and tax from alcoholic drinks in general (although homegrown cider tends to be exempt, hence its cheapness).

So, you see, a responsible government will discourage things like drinking or smoking heavily. Main reason being, the downfall of its youth and the incredible expense incurred treating lung cancer, pneumonia, COPD, premature babies, bronchitis, etc.,etc.

Any 'huge revenues' made from growing tobacco is cancelled out by the even bigger expenses twenty years down the line.

 

[Vixen]

TB does not present that way. Tuberculosis creates big abbesses (tubercules) in the lung among other symptoms.

It eventually leads to liquidating the lungs so it is a form of drowning.

 

[Meadmaker]

Today's situation report from WHO has 2676 new confirmed cases. Yesterday's had 3419.

Outside of China there were 19 new today and 18 new yesterday. 54 new two days ago.

I think that's pretty good news.

I'm pretty impressed with the modern world. It may be that this thing will get shut down after all.

 

[Planigale]

It eventually leads to liquidating the lungs so it is a form of drowning.

NO!

Half of TB is non-pulmonary. The most fatal form of TB is meningitis. The fatal event in pulmonary (lung) TB is usually a massive bleed from the lungs viz. Mimi (La Boheme), John Keats, George Orwell. Kidney TB might cause renal failure, heart TB will stop the circulation etc.

 

[Giordano]

From what I've read of the symptoms, it seems to work in pretty much the same way as tuberculosis (TB) - which, of course, is caused by a specific bacterium - in which the severely afflicted drown in their own phlegm as the infected cells in the lungs haemorrhage one by one. OK, so maybe it's more like pneumonia, except pneumonia tends to be a secondary infection for those already weakened by other illnesses (flu, AIDS, etc.).

What 2019-nCoV causes is certainly is like a pneumonia, which is just a term to describe an accumulation of fluids in the lungs. There are multiple agents that can cause pneumonia. 2019-nCoV appears to be one of these.

However a comparison of 2019-nCoV to TB is much less useful for a number of reasons. Of course one is a virus and the other is a bacterium. 90% of those infected by TB will enter a dormant form of the disease, with only 10% progressing to an active form, whereas all 2019-nCoV infections are active (whether asymptomatic, mild, or severe). TB primarily replicates and causes its lung pathogenicity in alveolar granulocytic cells, whereas 2019-nCoV primarily replicates to cause its symptoms in alveolar epithelial cells. Even when activated TB takes a fairly long time to progress enough to kill a person on average (about 2 years, although the final event may be a very quick lung hemorrhage); 2019-nCoV of course acts much quicker.

[added in edit] 2019-nCoV appears to cause systemic effects (i.e. on non-pulmonary organs) due to inducing a cytokine storm, but I don't think it replicates outside the lungs. TB can induce cytokines but also clearly does replicate (and also forms inactive nodules) outside the lungs.

 

[Vixen]

NO!

Half of TB is non-pulmonary. The most fatal form of TB is meningitis. The fatal event in pulmonary (lung) TB is usually a massive bleed from the lungs viz. Mimi (La Boheme), John Keats, George Orwell. Kidney TB might cause renal failure, heart TB will stop the circulation etc.

As I said in my original post. The effect is drowning.

From what I've read of the symptoms, it seems to work in pretty much the same way as tuberculosis (TB) - which, of course, is caused by a specific bacterium - in which the severely afflicted drown in their own phlegm as the infected cells in the lungs haemorrhage one by one. OK, so maybe it's more like pneumonia, except pneumonia tends to be a secondary infection for those already weakened by other illnesses (flu, AIDS, etc.).

 

[Planigale]

As I said in my original post. The effect is drowning.

But nothing to do with phlegm which is what you said.

 

[Skeptic Ginger]

Latest numbers are a daily growth if only 7.7%

AND, cure rate vs death rate, 75% of hospitalized patients get better. So far.

Do you have a source for this?

If this is true, that's a terrible percentage.

I suppose it depends on how these cases are being counted.

If one doesn't understand the numbers it looks like 25% admitted are dying. That is not the case at all, one is comparing numbers from different time frames in the course of the infection.

ummm, that most rapid growth was all in China. It might have been not from new cases, but newly identified cases? Like suppose a news article brought people to hospitals ?

Hmmm, how has the death rate been doing? Dropping? Exponential growth? Somewhere in between?

You can't tell from the numbers people in this thread are using!!!!!!!

If you accept the numbers there is an indication that the rate of new infection is decreasing in China too:
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
I could not find a graph for deaths.

We don't know this either. It could simply be they've reached their capacity to test people.


Here are some good sources for understanding that the flow of data on social media has created a lot of amateur sleuths out there trying to draw conclusions that are wildly wrong. I have refrained from mentioning Dunning Krueger but now I'm going to. Here's a good article pointing out the epidemiology science that people throwing numbers around in this thread don't understand.
Swiss Medical Weekly:2019-Novel Coronavirus (2019-nCoV): estimating the case fatality rate – a word of caution More like a lot of words of caution.

At present, it is tempting to estimate the case fatality rate by dividing the number of known deaths by the number of confirmed cases. The resulting number, however, does not represent the true case fatality rate and might be off by orders of magnitude. Diagnosis of viral infection will precede recovery or death by days to weeks and the number of deaths should therefore be compared to the past case counts -- accounting for this delay increasing the estimate of the case fatality rate. On the other hand, cases in official statistics are likely a severe underestimate of the total -- accounting for this underestimate will decrease the case fatality rate. The time between diagnosis and death/recovery and the degree of underreporting will vary over time as well as between cities and countries. A precise estimate of the case fatality rate is therefore impossible at present....
Accordingly, the official numbers of both cases and deaths reported from Wuhan represent the "tip of the iceberg", potentially skewing case fatality estimates towards patients presenting with more severe disease and fatal outcome.

There's an excellent discussion of wide case fatality rate differences between regions.

This is also interesting and one of the reasons as a skeptics site we should be concerned about the numbers being thrown around in this thread:

Current authorities such as the World Health Organization, the Centers for Disease Control & Prevention (USA), the European Centre for Disease Prevention and Control as well as renowned journals are challenged by the rapid generation and dissemination of data, largely published on social media platforms. Thus, new approaches will have to be defined to validate the accuracy of such posts in times where multiple tweets per second are published, sometimes with misleading, sometimes with important information. Modelling the 2019-nCoV epidemic remains challenging as relevant questions are still unanswered. So, despite the dramatic increase of rapidly available data, public health authorities remain torn back and forth between the options of overreacting and frightening the population or underreacting putting citizen at risk in their aim to provide advice to countries and individuals on measures to protect health and prevent the spread of this outbreak.

A more accurate source of data, including documenting where the data is coming from.



Mod comment on case counts from the ProMed report this was posted in:

[There has been much discussion about the discrepancies in reported case fatality rates in Wuhan, Hubei compared with the rest of China. One of the explanations put forth by the Chinese National Health Commission was that Wuhan and Hubei province were not prepared to handle the volume of severe cases requiring ICU care and specialized critical care interventions -- somewhat in keeping with some of the discussion in the article above. Another fact is with time, more and more mild presentations are being tested and confirmed, resulting in increased denominators (number of confirmed cases) observed elsewhere in China and outside of Mainland China, thereby "lowering" the calculated case fatality rates. - Mod.MPP]

And for the fear mongerers among us:Coronavirus tally in epicentre Wuhan may be ‘just the tip of the iceberg’

Coronavirus tally in epicentre Wuhan may be ‘just the tip of the iceberg’ (2020-02-03)
A doctor at the Union Hospital in Wuhan, who declined to be identified, said staff could only test about 100 patients a day, and they had to wait 48 hours for the results. “When the National Health Commission announces the numbers, they’re already two days old,” the doctor said. “We also have to turn away patients with mild symptoms, knowing that many of them will return later [when their condition worsens]. But we don’t have the space in the testing centre, or the hospital beds.”
“There have also been many patients who died of undifferentiated respiratory and undiagnosed pneumonia symptoms in Wuhan since December – before the virus testing kits were made available,” Tsang said. “These cases should have been investigated and counted [in the tally] if confirmed. These are factors pointing to inaccurate reporting of the official figures,” he said.
A doctor at the Tongji Hospital in Wuhan, speaking on condition of anonymity, said the kits were still in short supply. “I don’t know what’s gone wrong – we only have a very limited number of testing kits every day, there’s been no increase yet,” the doctor said.

 

[Skeptic Ginger]

75% of those infected already getting better is not the same thing as if 75% of those infected ever get better. The rapid growth in the numbers means that most of the people identified as infected were only identified a few days or a week or so ago. Therefore they haven't "had a chance" to get better yet.

Yes! This^

Also from one link I posted above, the death rate differs in different regions in China and there are a number of possibilities for that.

 

[Skeptic Ginger]

It eventually leads to liquidating the lungs so it is a form of drowning.

Oh puhleese, stop spouting crap. It is not a form of drowning, it's a form of lost capacity to breathe.

 

[Giordano]

[snip]
We don't know this either. It could simply be they've reached their capacity to test people. [snip]

Yes, the numbers could be wrong because of limited capacity to test, ability to tally accurately, veracity of government reports, etc. Which is exactly why I wrote "If you accept the numbers..." Sorry to be prickly about this but I was both aware of the limitations and sought to qualify my comment appropriately. I don't like having me put in to larger context of not understanding, Dunning Krueger, or people in this thread throwing numbers around that they do not understand when I was careful to indicate the limitations of my statement.

Okay, all's forgiven.

 

[Vixen]

How coronavirus kills (a form of drowning).

 

[Vixen]

What 2019-nCoV causes is certainly is like a pneumonia, which is just a term to describe an accumulation of fluids in the lungs. There are multiple agents that can cause pneumonia. 2019-nCoV appears to be one of these.

However a comparison of 2019-nCoV to TB is much less useful for a number of reasons. Of course one is a virus and the other is a bacterium. 90% of those infected by TB will enter a dormant form of the disease, with only 10% progressing to an active form, whereas all 2019-nCoV infections are active (whether asymptomatic, mild, or severe). TB primarily replicates and causes its lung pathogenicity in alveolar granulocytic cells, whereas 2019-nCoV primarily replicates to cause its symptoms in alveolar epithelial cells. Even when activated TB takes a fairly long time to progress enough to kill a person on average (about 2 years, although the final event may be a very quick lung hemorrhage); 2019-nCoV of course acts much quicker.

[added in edit] 2019-nCoV appears to cause systemic effects (i.e. on non-pulmonary organs) due to inducing a cytokine storm, but I don't think it replicates outside the lungs. TB can induce cytokines but also clearly does replicate (and also forms inactive nodules) outside the lungs.

That makes sense and of course, another key symptom for TB is coughing up bloody matter from the (decaying ) lungs.

An early report I read about coronavirus infection seemed to describe haemorrhaging the cells one by one - as a form of replicating itself - which made me think of TB even though it is caused by a bacterium (and of course we now have powerful antibiotics to treat it).