Author Topic: Coronavirus preparedness  (Read 120982 times)

Merlion

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Re: Coronavirus preparedness
« Reply #50 on: February 24, 2020, 11:04:42 AM »
Please stop making such wild predictions. It contributes to uninformed hysteria and misinformation.    This is not the influenza pandemic of 1917-1919, and our global health care system is not what it was 100 years ago.

No credible epidemiologist is suggesting that the US will have ~100MM cases from this virus.  Now that we know what this virus is and can monitor and test for it, its pretty clear that the lethality is on the lower end of the spectrum.  As with all outbreaks, as we learn about its effects the mortality rates tail off; that's what we are seeing here.

Transmission is also not a random act of fate.  There is a great deal that individuals can (and should!) do to minimize their risk, and those with very good health habits can push their transmission risk down to negligible numbers in all but the most infected and population-dense locations.

You can find a wealth of up-to-date information here:
https://www.cdc.gov/coronavirus/2019-nCoV/summary.html

In fact, Marc Lipsitch, Harvard Professor of Epidemiology and Director of the Center for Communicable Disease Dynamics, has said he expects 40-70% of the worldwide population to be infected over the next year. The question is about what % will be symptomatic (and what % of those will be severe cases)

Would appreciate a link to the source.  From what I've read, Lipsitch is echoing an R0 (additional transmissions) of between 1-2 and like the WHO agrees it has pandemic potential, but I have not seen the 40-70% claim.  It is interesting that many of those testing positive now from the Princess had very mild, 'cold-like' symptoms.

Behind a paywall, unfortunately. https://www.wsj.com/articles/how-many-people-might-one-person-with-coronavirus-infect-11581676200

He did elaborate on a twitter thread, where he explained the big unknown is what % will be symptomatic: https://mobile.twitter.com/mlipsitch/status/1228374615501574146

I think most of the passengers testing positive should have only mild symptoms. Unfortunately 3 passengers have died already, and more are seriously ill.  questions that is still unknown is what % of infections will be mild or asymptomatic. A higher number means that spread might be easier, but overall fatality rate lower. This is a key question epidemiologists are trying to figure out right now and will help give us all an idea of just how concerned we should be.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #51 on: February 24, 2020, 11:10:19 AM »
As I stated, the 0.3 % rate if 20% of the population was eventually infected (not unreasonable as Spanish flu infected 30% and we were a much more spread out population then) would lead to 200 k deaths, 0.6% 400 k deaths, it's possible the fatality rate might be higher as these are very early numbers.  It's somewhat reassuring that cases outside China seem to tend to the lower fatality rate BUT we don't have good one month followup on most of those cases yet.   Italy has 5 deaths and 200 some cases identified at present (likely it's been circulating more than we know though so the fatality rate may end up lower).

The 65% fatality rate was among patients admitted to the ICU.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #52 on: February 24, 2020, 11:13:16 AM »
As for cancelling travel plans in May or later - I suspect by then it will be moot as there should be outbreaks all over and hopefully the government will have given up on quarantine as a strategy.  By that time you're probably just as likely to get exposed here as there.

I'm still planning to go to my conference in another state at the end of May if they don't cancel it.  Many conferences though have already been cancelled.

Fru-Gal

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Re: Coronavirus preparedness
« Reply #53 on: February 24, 2020, 11:16:55 AM »
Yesterday I stocked up on dry beans (10lb bag), 20lb bag of rice, 25 lb of flour (we go through that size bag every few weeks anyway), a small bag of powdered milk, salt, sugar, 10 cans of tuna, an extra bag of pet food. Also started saving water, which is something I've been meaning to do forever. Not trying to buy anything we wouldn't eat. I may get a bunch of cans of Dennison's Chile con Carne. Also bought a new can opener since the other was broken.

While social media, which did not exist with SARS, has made this seem worse, from the moment video began coming out of Wuhan I began to wonder at the government reaction, especially the disinfectant spraying. It's explained by the sheer numbers of patients who simultaneously need intubation, and yet...

One interesting outcome may be more open rebellion against the CCP by Chinese citizens.

Yesterday CDC said it is likely to be a pandemic, but of low risk to US citizens.

I have some healthcare training and usually never concerned about other flu epidemics (I do get my shot). I have wanted to build up some disaster supplies anyway, because we've had multiple natural disasters in our area in the last few years.

My parents are avid world travelers and quite old and had to rush home from Hong Kong 2 years ago because of viral respiratory syndrome. My dad almost died. Took months to recover. I worry about them now because they constantly get viral colds. I assume they get flu shots.

My concern is not that our household will get ill, but that our local school district, etc, will be shut down and stores will get emptied. I'd rather be prepared.





Cassie

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Re: Coronavirus preparedness
« Reply #54 on: February 24, 2020, 11:17:51 AM »
Frugal, my main concern is flying for a long time with recirculated air. A great way to get sick.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #55 on: February 24, 2020, 11:22:00 AM »
Another recent study:

" A total of 1,716 health workers have become infected and 5 have died (0.3%)."  So far. Given the trajectory of the spread, if we are at 0.3% of healthcare workers infected that have died so far, there will likely be further deaths among this group as many of these infections would be recent (and it can take a couple weeks or more to die of this). Will there be twice as many deaths in this group when a month has passed, or 3 times? That would be a 0,6% or 0.9% fatality rate, among a baseline healthy group.  Again, my numbers are basd on the data that is coming out.

https://www.ncbi.nlm.nih.gov/pubmed/32064853

frugaldrummer

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Re: Coronavirus preparedness
« Reply #56 on: February 24, 2020, 11:25:55 AM »
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Frugal, my main concern is flying for a long time with recirculated air. A great way to get sick.

Yes, I will be driving to my conference.  However touching surfaces on the plane is still probably the more likely source of an infection.  (I got a wicked norovirus infection from a long plane trip once).




Fru-Gal

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Re: Coronavirus preparedness
« Reply #57 on: February 24, 2020, 11:26:44 AM »
@Cassie, I am no fan of planes and airports for environmental reasons plus the fact that even as a small person I am STILL crammed in a tiny space with someone on either side encroaching on my #$%@ arm rests and worst of all, it's just a tube of germs in the sky LOL. Last flight I took my seat mate wiped EVERYTHING down with disinfectant. Can't blame her.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #58 on: February 24, 2020, 11:38:20 AM »
BTW if you are one of those who don't believe this is going to affect us and it's all going to be a big nothing-burger, you should be buying stocks today:

https://www.yahoo.com/entertainment/media-stocks-set-global-markets-135626162.html

I personally am waiting for it to go lower before starting to buy back in with the cash I set aside.

nereo

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Re: Coronavirus preparedness
« Reply #59 on: February 24, 2020, 11:42:46 AM »
As I stated, the 0.3 % rate if 20% of the population was eventually infected (not unreasonable as Spanish flu infected 30% and we were a much more spread out population then) would lead to 200 k deaths, 0.6% 400 k deaths, it's possible the fatality rate might be higher as these are very early numbers.  It's somewhat reassuring that cases outside China seem to tend to the lower fatality rate BUT we don't have good one month followup on most of those cases yet.   Italy has 5 deaths and 200 some cases identified at present (likely it's been circulating more than we know though so the fatality rate may end up lower).

Please don't call the 1917-1918 pandemic the "Spanish Flu" for all the same reasons why we shouldn't call this the "Chinese Virus".
See: https://www.cdc.gov/coronavirus/2019-ncov/about/related-stigma.html

I can't believe you are seriously comparing epidemics and society 100 years ago to present. The differences are so extreme it's completely meaningless.  Back in 1918 there as a complete and utter lack of coordination between health care providers, there were no antivirals, no ability to track patients, no respirators, antiseptic practices, etc.

you keep making meaningless extrapolations from small samples while ignoring the considerable amount of data and recommendations available to us.

FWIW, the World Health Organization just released a statement in the last hour that this virus does not meet the pandemic definition: WHO experts aren't seeing an "uncontained global spread of this virus, and we are not witnessing large-scale severe disease or death

It could become a pandemic, as manu other diseases have.  But currently that's not a foregone conclusion, as your alarmist posts keep suggesting.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #60 on: February 24, 2020, 11:53:35 AM »
I agree, Spanish flu is a misnomer (it came about because Spain wasn't censoring its media the way countries involved in WW1 were). However that's the name most people know it by.

It's not an official pandemic today but I'm willing to bet that will change within a month.  It's really pretty near impossible to control a virus where 90% of cases are mild or asymptomatic but still infectious. You can't possibly test or quarantine everybody with what looks like a cold. The Chinese effort has been valiant and has definitely slowed down its spread but it likely will not be successful. Other countries without China's relatively good healthcare (they have ECMO!) and without the kind of social controls China has, will not likely be as successful. (Think  much of Africa and South America). 


frugaldrummer

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Re: Coronavirus preparedness
« Reply #61 on: February 24, 2020, 12:03:53 PM »
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I can't believe you are seriously comparing epidemics and society 100 years ago to present. The differences are so extreme it's completely meaningless.  Back in 1918 there as a complete and utter lack of coordination between health care providers, there were no antivirals, no ability to track patients, no respirators, antiseptic practices, etc.

Yes - things ARE different. Population density is much higher. The baseline health of the average American is worse (obesity and diabetes). Antivirals have not been shown to be effective yet.  The FATALITY rate from the flu in that pandemic may have been higher because of the lack of respirators etc but that has little to do with the infection rate. Air travel facilitates international spread much faster even than troop movements by ship did in 1917.

Given all that a 20% infection rate (over the course of maybe a year if this is seasonal, between this year's infections and next winter) is entirely reasonable as a back-of-the-envelope estimate. It almost exactly matches the infection rate on the Diamond Princess btw. (Arguably higher exposure but also just a relatively short time together).

« Last Edit: February 24, 2020, 12:10:26 PM by frugaldrummer »

frugaldrummer

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Re: Coronavirus preparedness
« Reply #62 on: February 24, 2020, 12:09:40 PM »
But if the real potential for disruption and pandemic illness at a rate 4-8 or more times higher than an average flu season doesn't bother you, by all means go about your business without preparation.  As I've said repeatedly, I think it will be quarantines and other policies that will cause the most disruption not the actual fatality rate. However if 10% of cases are sick enough to be admitted to the hospital, there will be disruption there. My ECMO-nurse niece will be extremely busy. Elective surgeries WILL be cancelled (as they are in my town during any really bad flu season).

nereo

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Re: Coronavirus preparedness
« Reply #63 on: February 24, 2020, 12:22:41 PM »
I agree, Spanish flu is a misnomer (it came about because Spain wasn't censoring its media the way countries involved in WW1 were).  However that's the name most people know it by.

It's not that it's a misnomer - it's that it generates stigma (see linked article), which leads to hate.  I'd disagree that it's the disease "most people know it by" - maybe true of a certain generation but we don't use that term anymore.  Historically people used to call syphilis the "Frenchman's disease"... but that too went away for good reason.

It's really pretty near impossible to control a virus where 90% of cases are mild or asymptomatic but still infectious. You can't possibly test or quarantine everybody with what looks like a cold. The Chinese effort has been valiant and has definitely slowed down its spread but it likely will not be successful. Other countries without China's relatively good healthcare (they have ECMO!) and without the kind of social controls China has, will not likely be as successful. (Think  much of Africa and South America). 

...and yet all sorts of infectious diseases do not go on to become global pandemics. Some do.  Each year influenza has the potential, and most years we are successful at stopping it short from reaching pandemic statrus  Again, I'll refer you back to the WHO, who are stressing today that while the disease has been detected in 34 countries, the best practice for combating the disease remains country-specific.  While China has 'social controls' which are useful for fighting an outbreak, they have their own challenges, including extremely dense population centers with substandard health and safety protocols, and (as detailed in the previous thread on this) a government initially focused on covering up the outbreak rather than addressing it head on.  Other countries have their own challenges, but all have the advantage of knowing far more about this virus than the Chinese did when the first cases popped up around new years.

But if the real potential for disruption and pandemic illness at a rate 4-8 or more times higher than an average flu season doesn't bother you, by all means go about your business without preparation.  As I've said repeatedly, I think it will be quarantines and other policies that will cause the most disruption not the actual fatality rate. However if 10% of cases are sick enough to be admitted to the hospital, there will be disruption there. My ECMO-nurse niece will be extremely busy. Elective surgeries WILL be cancelled (as they are in my town during any really bad flu season).

Oh good lordy.  Most people here are advocating being sensible - which is in line with the CDC's recommendations.  Wash your hands frequently.  Limit direct contact wituh sick individuals.  If you are sick - don't go out in public
.What is this obsession with "Elective surgieries WILL be cancelled".  No they won't.  They might get postponed should your particular area have a rash of cases, but that's unlikely to happen to everyone, everywhere, all at once.  It's exceedingly rare to have surgeons pulled off their normal business in order to treat flu-like cases.  Besides, what percentage of the population do you think have elective surgeries scheuduled in the next few weeks, anyway?

Even with the mortality rates you have linked, you keep predicting infections and mortalities in the US to be an order of magnitude greater than the annual flu.  We shall see, but there's little evidence to back up that catastrophic prediction at this time.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #64 on: February 24, 2020, 12:47:39 PM »
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Each year influenza has the potential, and most years we are successful at stopping it short from reaching pandemic statrus 
  Because we have vaccines. No vaccine for coronavirus in the near future.

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.What is this obsession with "Elective surgieries WILL be cancelled".  No they won't.  They might get postponed should your particular area have a rash of cases, but that's unlikely to happen to everyone, everywhere, all at once.  It's exceedingly rare to have surgeons pulled off their normal business in order to treat flu-like cases


Elective surgeries DO get cancelled during bad flu seasons. It has nothing to do with surgeons treating flu cases. It has to do with hospital bed and nurse availability.  My ex was in a surgical specialty and most of his surgeries were elective. I would say maybe one out of every 3-4 years his surgeries would be cancelled for 2-4 weeks during flu season for this reason. This is in a major city with enough hospital beds. A bad flu season just puts a sudden surge of demand on hospitals, as will coronavirus. 

frugaldrummer

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Re: Coronavirus preparedness
« Reply #65 on: February 24, 2020, 01:02:34 PM »
And having your elective surgery cancelled and rescheduled is not a big deal - UNLESS people have already paid for relatives to travel to care for them post-surgery and made other hard-to-change arrangements, which is the only reason I mention it.

neophyte

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Re: Coronavirus preparedness
« Reply #66 on: February 24, 2020, 01:04:45 PM »
I'm not particularly worried about the virus (except for the sake of an uncle with terminal pancreatic cancer, but from a practical perspective he's only got a few months left anyway). I am slightly concerned about what people could do if they are worried about the virus.

Grocery store shelves in my area do empty out if the forecast calls for an inch of snow or more. (And in really bad conditions can stay that way for a day or two). I grocery shop on foot so bulk buying is out of the question for me. I am planning to stop by the store on my way home a couple times this week and buy a backpack full of extra beans, canned tomatoes and some stuff to throw in the freezer. Why not? I'll eat it all eventually anyway and the extra exercise will be good for me.

I have 2 flights scheduled in April for out of town weddings and no intention of skipping them.

nereo

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Re: Coronavirus preparedness
« Reply #67 on: February 24, 2020, 01:08:32 PM »
your posts are a texbook case of fearmongering.  you say you don't suffer anxiety over this one particular virus, yet your negative predictions far, far exceed others.  Worse, you keep making absolute statements that are almost certainly false.  The one about how "elective surgeries WILL be cancelled" is just one example.  First, even pandemics don't hit every town and city on the same day, and should your city be unfortunate enough to be the epicenter of another outbreak, it's absurd to suggest that previously scheduled surgeries will be out-and-out canceled.  People will still get their surgeries - at worst they might have to wait a few weeks.  Even in areas with bad flu outbreaks people still get their elective surgeries after things subside. 

Your assertion that "200,000 to 1 million people WILL die" in the US is even worse.  It generates hysteria unnecessarily and in contradiction to what our own disease prevention services are suggesting.  Straight-forward disease prevention methods are all that is required to minimize this threat.

These are just two of your sensationalist claims. 

As a self-idenitifed MD you should know that we frequently don't have the correct vaccines for the annual strains of influenza, and that entire communities go woefully undervaccinated.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #68 on: February 24, 2020, 01:21:42 PM »
Which is exactly why we still have up to 60.000 US deaths a year from influenza.

Why is it you think a prediction of 200k to 400 k deaths is so off the mark when scientists working on the math have said 0.3-0.6% fatality rate and this is a new virus that nobody has immunity to? I think a 20% rate of infection is actually conservative, in line with past pandemics like 1917 influenza, and in line with the 600+ cases out of 3,000 people on the cruise ship (possibly more).   Sure , it could fizzle out, or it could mutate to spread faster or become more lethal. I'm just working with the numbers available now and what scientists in the field are publishing.

In the long run it will likely become endemic, recurring seasonally IF it is seasonal, and causing many deaths just like flu virus does. Unfortunately coronavirus immunity does not appear to last beyond a couple of years (at least to cold-type coronaviruses)
so it will be urgent to develop a vaccine.

« Last Edit: February 24, 2020, 01:33:56 PM by frugaldrummer »

nereo

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Re: Coronavirus preparedness
« Reply #69 on: February 24, 2020, 01:27:36 PM »
Which is exactly why we still have up to 60.000 US deaths a year from influenza.

Why is it you think a prediction of 200k to 400 k deaths is so off the mark when scientists working on the math have said 0.3-0.6% fatality rate and this is a new virus that nobody has immunity to?

Because these same scientists that are looking at this in much more granular detail and with a lot more experience than either of us are not calling for such a high body count.

That's the heart of it.  You've started a thread and claimed with certainty that we will see 200,000 to 1MM deaths from this outbreak.  Then you go on to say lots of other questionable and exceedingly unlikely stuff.  ironically, the CDC is almost simultaneously posting guidelines which are at odds with what you claim WILL happen.  You are spreading fear and hype.


chemistk

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Re: Coronavirus preparedness
« Reply #70 on: February 24, 2020, 01:34:44 PM »
I'll be doing nothing to prepare.

I have a conference in Chicago next week that gets a lot of attendance from Asia/India, and this is probably the only point in time over the next few months that I have to even be remotely concerned about this virus.

So what will I do next week? Attend the conference, shake fewer hands than I normally would, wash my own hands more frequently.

Am I worried about bringing this home with me to my wife and 3 kids? Not so much, but life is full of risks, isn't it?

I'd rather be diligent about basic hygiene than be so concerned about something I have such little control over. As a family, we don't plan to change anything about our schedules nor are we going to buy a single grocery item above and beyond what we would typically stock in the house.

For all I know, I've been exposed already. A former employee in my building traveled back from Wuhan just before the restrictions were put in place, and he took no precautions in the building.

What will be, will be.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #71 on: February 24, 2020, 01:38:54 PM »
Show me where a scientists studying this has predicted a number of deaths in the US? Just because they are calming the public right now by saying flu is the bigger risk to any individual in the US right now, does NOT invalidate the fact that there is a good likelihood of pandemic spread to the US of coronavirus in the near future and the deaths that would go along with that. 

You clearly still hope that we can contain this, and it's a nice thought. I think it's highly unlikely at this point.  Come back to this thread in a month and we will see who is right.

BTW - public health statements for public consumption are often slanted to try to keep people from panicking, a real threat. I'm just giving the facts without that rosy coloring because I believe most people here can handle the facts. And as I keep saying - the biggest disruption will come NOT from the virus itself - although it is serious - but if our government attempts large scale quarantine containment.

Queen Frugal

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Re: Coronavirus preparedness
« Reply #72 on: February 24, 2020, 01:40:26 PM »
I live in an area that sometimes gets snow. It is infrequent enough that people panic when they know snow is coming. I remember when this funny video came out about the Bread and Milk:

https://www.youtube.com/watch?v=i6zaVYWLTkU

which I personally find even more funny because both bread and milk make me really sick. Nevertheless, it's completely true that when a snow storm is coming the bread and milk isles around here are EMPTY. And none of us need that stuff anyway.

I suspect there will be a lot of empty bread and milk isles if the virus hits my neighborhood, but I am not stocking up.

I also suspect if the virus sticks around long enough, people will eventually stop panicking and the bread and the milk isles will fill back up.

But it may be a bumpy ride! I would agree with the overall sentiment of this thread that there are going to be plenty of people overreacting in addition to the strain the virus will put on our daily lives - lost business, overworked healthcare system, etc.

nereo

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Re: Coronavirus preparedness
« Reply #73 on: February 24, 2020, 02:06:01 PM »
Show me where a scientists studying this has predicted a number of deaths in the US? Just because they are calming the public right now by saying flu is the bigger risk to any individual in the US right now, does NOT invalidate the fact that there is a good likelihood of pandemic spread to the US of coronavirus in the near future and the deaths that would go along with that. 

You clearly still hope that we can contain this, and it's a nice thought. I think it's highly unlikely at this point.  Come back to this thread in a month and we will see who is right.

BTW - public health statements for public consumption are often slanted to try to keep people from panicking, a real threat. I'm just giving the facts without that rosy coloring because I believe most people here can handle the facts. And as I keep saying - the biggest disruption will come NOT from the virus itself - although it is serious - but if our government attempts large scale quarantine containment.

Wrong again.  My personal opinion is that we will have cases all over the US, and in almost every other country. At present I see no reason and no evidence to contradict the official guidelines and conclude that this will result in over an order of magnitude more severe cases and deaths then we see in a bad influenza season.  At various times you've used individuals restricted to a cruise ship and an influenza outbreak over 100 years ago to defend these positions.

As for summaries, I've linked to them throughout this thread.  Throughout those are fugther links with far greater detail, including risk assessment, the CDC response, etc. None of that thus far suggests the catastrophic pandemic you are alluding to.

yes, one job of agencies like the CDC is to prevent mass hysteria - because a hysterical public is a very bad thing to have.  They are also congressionally obligated to share factual reports.  You do not seem to care that your sensationalist reports may contribute towards hysteria, nor are your arguments about extrapolating cases from centuries-old pandemics or confined passengers on a cruise ship even remotely useful. Your use of absolutes is particularly alarming.  As others have said, 'do no harm' - an oath any physician should be familiar with.  Telling people that they WILL be confined, they WILL lose their elective surgeries, this WILL kill hundreds of thousands, your hospital WILL be over-run with patients is dystopian. Will it happen in a few US locations for a week or two?  possibly.  But it's unlikely most Americans will suffer and be inconvenienced to the degree you are suggesting. 

I'm happy to revisit this as the situation develops.  in the meantime please, let's not let extremely pessimistic predictions get ahead of all available data.



frugaldrummer

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Re: Coronavirus preparedness
« Reply #74 on: February 24, 2020, 02:18:04 PM »
An update on Italy:
http://www.salute.gov.it/portale/news/p3_2_1_1_1.jsp?lingua=italiano&menu=notizie&p=dalministero&id=4091



"    219 people are infected with the new Sars-CoV-2 coronavirus in Italy. Of these 5 people have died and one person has recovered. 

    These are the official figures communicated today at the 12 noon conference by the Commissioner for the emergency of civil protection, Angelo Borrelli. 

    Of the 213 people under observation and treatment, 99 are hospitalized with symptoms, 23 are in intensive care and 91 are in home isolation.  "

The fact that half the infected people are hospitalized would suggest either 1) that the fatality rate is higher than we suspect OR 2) more likely, that contact tracing is failing and there are actually another several hundred infected people out there that are mild and haven't been found.

If we go by that Chinese study of 200 early patients where 65% of ICU patients died, and there are 23 in ICU now plus 5 deaths already, we could expect another 13 deaths maybe, bringing the fatality rate in this group of 213 to 18/213  = 7.8 % which would be an unusually high fatality rate. Let's say they are putting people in the ICU more easily than  in China, so let's say only half of the ICU patients are equivalent to those early Chinese patients, so only 9/28 total of  them die. That would be 9/213 or a 4.2 % fatality rate. To bring that down to the 2% rate among hospitalized patients reported out of China there would have to be 450 cases total, which means about 237 undiagnosed infected people in the community.  To bring it down to the 0.3% fatality rate that I've been discussing as the low end, there would have to be about 3,000 total infected people in the community .  So - either the fatality rate is higher than expected (viruses can mutate to become more or less severe), or more likely, the virus has already silently spread much further than we suspect. 
« Last Edit: February 24, 2020, 02:21:18 PM by frugaldrummer »

frugaldrummer

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Re: Coronavirus preparedness
« Reply #75 on: February 24, 2020, 02:30:10 PM »
Note - they are now reporting 7 total deaths in Italy, I think the two deaths in Venice are thought to possibly be separate from the outbreak near Milan and the report above does not include them

https://www.thelocal.it/20200224/latest-deaths-coronavirus-italy



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Re: Coronavirus preparedness
« Reply #76 on: February 24, 2020, 02:47:15 PM »
frugaldrummer, I really think it's best for your mental health if you stop following the news.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #77 on: February 24, 2020, 02:50:48 PM »
And as for the contention that 100 million US infections is not feasible, here's part of the Wikipedia entry for the 2009 swine flu epidemic:
"The 2009 flu pandemic in the United States was a novel strain of the Influenza A/H1N1 virus, commonly referred to as "swine flu", that began in the spring of 2009. The virus had spread to the US from an outbreak in Mexico.[116]

As of mid-March 2010, the U.S. Centers for Disease Control and Prevention (CDC) estimated that about 59 million Americans contracted the H1N1 virus, 265,000 were hospitalized as a result, and 12,000 died."

59 million Americans infected - despite flu vaccines - so I don't think 100 million US infections from a novel coronavirus that seems equally if not more contagious than the flu is unrealistic. And remember, the 0.3% - 0.6% fatality per infection rate comes from research scientists doing fancy math on the early data, not from me.

BDWW

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Re: Coronavirus preparedness
« Reply #78 on: February 24, 2020, 02:55:36 PM »
My wife and I have discussed which dog we're going to eat first. Admittedly it was in the context of a different conversation, but the decision still stands.

nereo

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Re: Coronavirus preparedness
« Reply #79 on: February 24, 2020, 02:55:50 PM »
@fruggaldrummer - you are so concerned with trying to prove how you could be right, that you aren't considering doing what is right.

Furthering hysteria on this helps no one.

Per today's CDC situational summary (2/23/2020)
Situation in U.S.

Imported cases of COVID-19 in travelers have been detected in the U.S. Person-to-person spread of COVID-19 also has been seen among close contacts of returned travelers from Wuhan, but at this time, this virus is NOT currently spreading in the community in the United States.


Stop sensationalizing this.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #80 on: February 24, 2020, 02:57:52 PM »
I never said it is spreading in the US at this point. I am saying it most likely WILL be soon.  And that official statement pointedly says nothing about the future.

And for the umpteenth time - I'm not concerned about the virus - even though it may be bad-ish - but about the consequences of quarantine and other ill-advised containment issues.

GoCubsGo

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Re: Coronavirus preparedness
« Reply #81 on: February 24, 2020, 03:04:41 PM »
Ok frugal drummer.  So you say 1 million out of 335 million in the US will die.

China has 1.3 billion people so they will have 4 million dead

India also has 1.3 billion people.  Add another 4 million.

So you are saying between 3 countries 9 MILLION people will die?

Really?

OtherJen

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Re: Coronavirus preparedness
« Reply #82 on: February 24, 2020, 03:05:52 PM »
My wife and I have discussed which dog we're going to eat first. Admittedly it was in the context of a different conversation, but the decision still stands.

We have a couple of rabbits, but husband and I have both agreed that they're probably both too old to be edible. Fortunately (for them and us) we have about 10 lbs of leftover Christmas ham and a similar quantity of raw pork shoulder in the freezer.

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Re: Coronavirus preparedness
« Reply #83 on: February 24, 2020, 03:10:46 PM »
My wife and I have discussed which dog we're going to eat first. Admittedly it was in the context of a different conversation, but the decision still stands.

Don’t let the second one see you - it will be bad for his mental health!

CrustyBadger

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Re: Coronavirus preparedness
« Reply #84 on: February 24, 2020, 03:21:16 PM »
Imported cases of COVID-19 in travelers have been detected in the U.S. Person-to-person spread of COVID-19 also has been seen among close contacts of returned travelers from Wuhan, but at this time, this virus is NOT currently spreading in the community in the United States.


Stop sensationalizing this.

In all fairness, the current official CDC guidelines for testing for COVID-19 are that the patient be known to have a history of travel to China (and that they are exhibiting fever+ respiratory symptoms.  OR that the person be a health care worker caring for someone with confirmed COVID19.

So I don't know how they can be saying that there isn't any community spread.  They aren't testing for it.  They have only tested about 400 patients total, all with connection to travel to China only.  (or mostly)


slappy

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Re: Coronavirus preparedness
« Reply #85 on: February 24, 2020, 03:24:29 PM »
Ok frugal drummer.  So you say 1 million out of 335 million in the US will die.

China has 1.3 billion people so they will have 4 million dead

India also has 1.3 billion people.  Add another 4 million.

So you are saying between 3 countries 9 MILLION people will die?

Really?

Sounds like Thanos has all the infinity stones again.

American GenX

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Re: Coronavirus preparedness
« Reply #86 on: February 24, 2020, 04:02:59 PM »
An update on Italy:
http://www.salute.gov.it/portale/news/p3_2_1_1_1.jsp?lingua=italiano&menu=notizie&p=dalministero&id=4091



"    219 people are infected with the new Sars-CoV-2 coronavirus in Italy. Of these 5 people have died and one person has recovered. 

    These are the official figures communicated today at the 12 noon conference by the Commissioner for the emergency of civil protection, Angelo Borrelli. 

    Of the 213 people under observation and treatment, 99 are hospitalized with symptoms, 23 are in intensive care and 91 are in home isolation.  "

The fact that half the infected people are hospitalized would suggest either 1) that the fatality rate is higher than we suspect OR 2) more likely, that contact tracing is failing and there are actually another several hundred infected people out there that are mild and haven't been found.

If we go by that Chinese study of 200 early patients where 65% of ICU patients died, and there are 23 in ICU now plus 5 deaths already, we could expect another 13 deaths maybe, bringing the fatality rate in this group of 213 to 18/213  = 7.8 % which would be an unusually high fatality rate. Let's say they are putting people in the ICU more easily than  in China, so let's say only half of the ICU patients are equivalent to those early Chinese patients, so only 9/28 total of  them die. That would be 9/213 or a 4.2 % fatality rate. To bring that down to the 2% rate among hospitalized patients reported out of China there would have to be 450 cases total, which means about 237 undiagnosed infected people in the community.  To bring it down to the 0.3% fatality rate that I've been discussing as the low end, there would have to be about 3,000 total infected people in the community .  So - either the fatality rate is higher than expected (viruses can mutate to become more or less severe), or more likely, the virus has already silently spread much further than we suspect.

I think it's a lot worse than "they" want you to believe.  I don't see how this doesn't eventually get a foothold in a the community and spread like crazy, with no vaccine to keep things in check.  This thing is just getting started.  Hold on to your hats, and watch those investments drop.

nereo

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Re: Coronavirus preparedness
« Reply #87 on: February 24, 2020, 04:17:38 PM »
Imported cases of COVID-19 in travelers have been detected in the U.S. Person-to-person spread of COVID-19 also has been seen among close contacts of returned travelers from Wuhan, but at this time, this virus is NOT currently spreading in the community in the United States.


Stop sensationalizing this.

In all fairness, the current official CDC guidelines for testing for COVID-19 are that the patient be known to have a history of travel to China (and that they are exhibiting fever+ respiratory symptoms.  OR that the person be a health care worker caring for someone with confirmed COVID19.

So I don't know how they can be saying that there isn't any community spread.  They aren't testing for it.  They have only tested about 400 patients total, all with connection to travel to China only.  (or mostly)
Community spread is between individuals who have had no contact with people from an infected area (eg china). They are testing, extensively. There is a protocol for potential identification and a real time RNA assay for positive ID

nereo

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Re: Coronavirus preparedness
« Reply #88 on: February 24, 2020, 04:19:42 PM »
I never said it is spreading in the US at this point. I am saying it most likely WILL be soon.  And that official statement pointedly says nothing about the future.

And for the umpteenth time - I'm not concerned about the virus - even though it may be bad-ish - but about the consequences of quarantine and other ill-advised containment issues.
That’s the whole problem. If doesn’t particularly matter whether you care or not. The problem is your sensationalizing if it - that others might.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #89 on: February 24, 2020, 04:55:49 PM »
Quote
Community spread is between individuals who have had no contact with people from an infected area (eg china). They are testing, extensively. There is a protocol for potential identification and a real time RNA assay for positive ID
'

I have not seen any evidence that they are testing randomly for undetected community spread. In fact given that test kits are in short supply that would be irresponsible. So far they are only testing people with at-risk histories or suspicious pneumonias.  But that would mean there could be a delay once community spread gets going - as there seems to have been in Italy.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #90 on: February 24, 2020, 05:00:41 PM »
Quote
Ok frugal drummer.  So you say 1 million out of 335 million in the US will die.

China has 1.3 billion people so they will have 4 million dead

India also has 1.3 billion people.  Add another 4 million.

So you are saying between 3 countries 9 MILLION people will die?

Really?

I said an upper limit estimate of 1 million in the US might be possible, yes, although 200k - 400k seems more likely. Here is the wikipedia entry for the 1918 flu (and remember the US population was much smaller then):

Quote
The Spanish flu pandemic of 1918, the deadliest in history, infected an estimated 500 million people worldwide—about one-third of the planet's population—and killed an estimated 20 million to 50 million victims, including some 675,000 Americans

So yes, if we hit the upper limit it is a possibility. Hopefully we can slow it enough to figure out better treatments - the Chinese are doing some work with chloroquine but everything is very early. 

nereo

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Re: Coronavirus preparedness
« Reply #91 on: February 24, 2020, 05:16:35 PM »
Again with the 1918 Influenza pandemic? 
Remember this was on the rails of a war with some 60MM soldiers, before most people had running water or in many cases electricity, before we understood what a virus really was, before anyone thought to track cases or coordinate health care.

You are comparing apples to turkeys here.

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Re: Coronavirus preparedness
« Reply #92 on: February 24, 2020, 05:47:28 PM »
Ok. Frugaldrummer, here's an article that does a pretty good job of communicating that this virus is going to spread, there's a pretty good chance that lots of people will get it, but we don't really need to panic. No, it's not a scientific article. Are the numbers exactly right? I'm sure they're not. But I do know that it's an example of decent communication about something that is scaring people silly right now. You might take some lessons from it, before you face IRL consequences for inciting panic.

https://www.theatlantic.com/health/archive/2020/02/covid-vaccine/607000/

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Re: Coronavirus preparedness
« Reply #93 on: February 24, 2020, 05:47:57 PM »
Community spread is between individuals who have had no contact with people from an infected area (eg china). They are testing, extensively. There is a protocol for potential identification and a real time RNA assay for positive ID

Yes, community spread is between individuals who have had no contact with people from an area known to be infected (eg China).  I agree with you on that.

However, they have not been doing that.

As you can see from this CDC table, updated today  the TOTAL amount of tests administered has been 426.   That's since Jan 26th I think.   Average of 6 per day.

https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

(That's not counting the testing they are doing on the quarantined coronavirus patients off of the Diamond Princess.)

They have been testing people who meet the criteria for testing, listed here:

https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html

They were supposed to send testing kits out to 5 cities to begin community spread testing, but the kits were faulty and aren't going to be replaced till mid-March, last I read.


frugaldrummer

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Re: Coronavirus preparedness
« Reply #94 on: February 24, 2020, 06:00:05 PM »
Quote
Ok. Frugaldrummer, here's an article that does a pretty good job of communicating that this virus is going to spread, there's a pretty good chance that lots of people will get it, but we don't really need to panic. No, it's not a scientific article. Are the numbers exactly right? I'm sure they're not. But I do know that it's an example of decent communication about something that is scaring people silly right now. You might take some lessons from it, before you face IRL consequences for inciting panic.

https://www.theatlantic.com/health/archive/2020/02/covid-vaccine/607000/

Sibley - I don't see how you think that article was more calming that what I said. The article says 40-70% of the world population could get this (!) - a much higher number than the 20 to possibly worst case 30% numbers I was using. The article says, as I have said, that quarantine and containment efforts are likely to do more harm at this point and that the virus is not likely to be contained. I've already said 90% of cases will probably be mild or asymptomatic (the article gives no estimate).  And I've used an excellent scientific report with all kinds of wonky sophisticated math which estimated the 0.3-0.6% fatality rate which I have been using (with an awareness that if higher than 20% infection rate occurs, or if the actual infection fatality rate is higher, the number of deaths could be higher).

Just because there's more fluffy writing in between those facts doesn't mean that article isn't actually MORE terrifying than what I've been saying. In fact, that article is rather reckless in using that 40-70% infection rate quote from Lipsitch as I haven't seen that kind of high estimate anywhere else and no numbers to back that up.

CrustyBadger

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Re: Coronavirus preparedness
« Reply #95 on: February 24, 2020, 06:19:22 PM »
frugaldrummer, to answer your original post, what concerns me most and what I'm trying to prepare for is to make sure we have a continuous supply of needed drugs.

My husband is an organ transplant recipient and needs certain critical medications.  If he misses even a few he could start to reject his organ.  I don't know how much wiggle room we have for missing a dose, but he has only once so far gone without for two days, and that was a real emergency, with me driving around town trying to locate a pharmacy that could refill his prescription.

We do get three months at a time, but can't refill until a few days before they are due to run out.  So for example right now, he has a few weeks left on his prescriptions.

I am VERY concerned about the effect of this "global health emergency" on our pharmaceutical supply, and I don't think I am being in any way alarmist to say so.  Many experts agree that this is a serious concern, as much of the ingredients for our medications come from China, even if they are then sent to India and other countries for processing.

I would like to get his doctor to write at least an extra months prescription for his key medications, which I will pay for out of pocket since insurance won't cover it.

As for worrying about certain foods or items running out at the grocery store, that just doesn't bother me very much.  There's always a workaround, or people can do without for longer than we think.  But I am concerned about vital medications.

nereo

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Re: Coronavirus preparedness
« Reply #96 on: February 24, 2020, 06:25:13 PM »
There is an acute difference between what a person says might happen, but acknowledging an enormous amount of uncertainty, and your claims of what WILL happen.

The article is also talking to experts and summarizing their estimates, an important distinction.

An important point which you seem to keep overlooking is how far out in front we are of this compared to other, previous and more deadly epidemics. People are commenting about how testing kits are in short supply in some areas - five weeks ago the world was just learning aboutt try its spread - three weeks ago we sequenced it, and less than two weeks ago we developed the real time detection assay. We have never had a response this quickly before for any virus.

So we are back to this being similar to influenza, both in terms of transmission and lethality. Yes if needs to be taken seriously, but even if  containment ultimately fails one possible scenario is our fifth seasonal global pathogen.

American GenX

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Re: Coronavirus preparedness
« Reply #97 on: February 24, 2020, 06:35:01 PM »

The fatality rate mentioned above is much lower than what I had read elsewhere.

Study of 72,000 COVID-19 patients finds 2.3% death rate

http://www.cidrap.umn.edu/news-perspective/2020/02/study-72000-covid-19-patients-finds-23-death-rate

    39 or yonger, the death rate 0.2%.
    in their 40s, it is 0.4%
    in their 50s, it is 1.3%,
    in their 60s, it is 3.6%
    in their 70s, it is 8%.
    80 and older, it is 14.8%.
    Men are more likely to die (2.8%) than women (1.7%).

frugaldrummer

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Re: Coronavirus preparedness
« Reply #98 on: February 24, 2020, 06:43:49 PM »
Crusty Badger - you are right to be concerned about his meds. Transplant patients are especially vulnerable. You might want to speak to his transplant physician about this and see if they can get an override at the pharmacy to dispense the meds early. (You probably can't get a longer supply but it doesn't hurt to ask for that too).  My good friend had a heart transplant a year ago, I'd best speak with him about this issue as well.

I have similar concerns as my lung cancer boyfriend is on good amounts of morphine, which can only be filled monthly - he's on enough that he could have terrible withdrawal if he runs out.  Similarly one son is a recovering addict on buprenorphine who also can only get one month filled at a time and would suffer horrible withdrawal. I'm not sure how to get around that really.

I'm also a thyroid patient and will make sure I have plenty of my meds stocked up as I couldn't function at all without it.  However my thyroid meds are made in Spain so hopefully they will continue to be available.

frugaldrummer

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Re: Coronavirus preparedness
« Reply #99 on: February 24, 2020, 06:47:38 PM »
Quote
The fatality rate mentioned above is much lower than what I had read elsewhere.

We are talking about two different rates. The two percent number is the fatality rate among people hospitalized with the disease. That number has been holding somewhat steady.  That number however doesn't take into account all the people who are mild cases (or asymptomatic) and never get admitted to the hospital.  The 0.3 - 0.6% number is an estimate of what percentage of total people infected would die.