The mortality rate of 2% is consistent with the number of cases and deaths reported by other countries.
Is it that there are a large number of undiagnosed cases? That is kind of a given and is probably also the case in other countries.
The timespan between first case and until it gets reported to who and quarantines start is less than a month. To me that seems very fast (but I am just a layperson).
My wife, when she went to the hospital to be diagnosed, said that they had a separate room for those that were diagnosed with having the Wuhan virus, and a separate room for those that did not.
She saw several people in that room, and yet over the next few days, only one new case was reported from that hospital.
I don’t know if this is due to unconfirmed or bad diagnosis, but this is just yet another red flag in a country full of red flags.
As for my wife, she only had a respiratory infection and got medicine for it. She’s better now, but now her mother is sick -.-
I don't know why they would do that, but they are accused of doing this kind of thing frequently.
If they sat on the news of the virus for an extended period they might have known the mortality rate they needed to align with long before the rest us.
Deaths are easy to count. Minor cases of the virus are likely the most common sort, and never show up in a hospital at all.
Numbers don’t line up based on a basic statistical analysis.
Checkout these videos for reference. https://www.youtube.com/watch?v=hSIt496d82s
In short, we have no idea, and it’s very dishonest to claim that either number is remotely reliable at this point.
Less severe cases on the other hand have a tendency to end up unreported, not in the hospital. Neither deadly. Still leaves a number of never reported cases. All in all, unreported cases are likely to be higher than unreported deaths. As a result, qualitatively speaking, mortality should be lower.
Of course, but that doesn’t mean that mortality will be lower. A much smaller number of unreported deaths can shift the rate upward. At a 2% mortality rate, you only need one unreported death for every 50 unreported infected to maintain the same rate. That might be laughably high or laughably low. We just don’t know.
But the people in the best position to know, the Chinese government, seem to be taking this pretty damn seriously.
And there are also rumors out there saying the lack of medical resources. Sick people couldn't get proper medical treatment and dying at home or somewhere. Because they didn't get diagnosed before they die, so the number won't be added to the official number. Don't know if it's true or how many people are dying there, but sure it's terrifying.
About misreporting, they did do it back in January, mainly because they want to control the panic as they always do, (and probably they didn't know it's gonna be this bad), but it should be much better now (I hope).
The data I got is that among the people who really got the virus, positive rate of the test is only 30% - 50%. So false negative rate is as high as 50-70%.
The news report (in Chinese):
As a new disease, with the first cases possibly being acquired as early as late November 2019, it wasn't until mid to late January 2020 that city and national authorities appeared to start taking the outbreak seriously.
I'm not aware of other novel outbreaks outside of China and how quickly those have attracted notice, though there's the case of the 1976 initial outbreak of Legionaire's Disease, reported within a week of first outbreak (though the disease was both fast-acting and rapidly lethal for many victims). However epidemiologists also realised that there had been previous, unrecognised outbreaks, dating to the 1950s. See:
https://en.wikipedia.org/wiki/1976_Philadelphia_Legionnaires...
The case of HIV/AIDS in the US and elsehwere would be a case of a disease with ascribed social and moral assocations, for which early responses were very much delayed, on of several examples of stigma associated with the disease: https://en.wikipedia.org/wiki/Discrimination_against_people_...
Reponse to the 2012 MERS outbreak appears to have been swift -- in November of 2012: https://en.wikipedia.org/wiki/2012_Middle_East_respiratory_s...
The 2003 SARS epidemic, also emerging in China, also first emerged in November, but was not internationally reported until the following March:
https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...
(The fact that SARS, MERS, and 2019-nCoV all appear to have emerged during November may be significant.)
Point being:
- China are slow to detect, report, and respond to new contagious epidemics. Notably so in the case of SARS, and less so, but still, with 2019-nCoV.
- Other countries, including the US, have had similar failures.
- Early unofficial public disclosure of 2019-nCoV was prosecuted by Chinese authorities, though at what direction is unclear.
- Trust between the people and the government is somewhat frayed.
- There are also numerous actors with incentives to make the most of any missteps of the government, or to inflate distrust.
Several of those groups have legitimate gripes against the Chinese government, and I've seen reports associated with Falun Gong, Hong Kong, and Taiwan specifically. I've not seen any associated with Tibet or Uygher populations. And there are various rabble-rousing actors elsewhere, doomers, and conspiracists (generally of the nutcake variety).
This ... clouds information. Many of the criticisms are legimate, some are not, and sorting fact from fiction (both between and within reports) is challenging. China are in the position where both locked-down and unfettered communications are potentially harmful -- the first for preventing accurate information from being available to both public and government, the latter for allowing agents provacateurs to rumourmonger, exaggerate bad news, and spread active disinforation. This is strong shades of attacks the West has seen over the past several years (within the US, UK, EU, and elsewhere), some of it from China itself.
How China responds will be interesting.
However I would like to inquire why you see Dr.Li's detention as evidence of "shutting down initial reports of the outbreak"?
First of all we do not have any kind of real insight on what Dr.Li was actually saying, and what was the severity of his reprimandation.
When something is on the lose that has the potential to kill millions, you need to be quick and purposeful in controlling the message. Wrong information can make people underprepare, but it can also make people overprepare.
The letter of admonition he received has been posted, see:
https://en.m.wikipedia.org/wiki/Li_Wenliang#/media/File%3A李文...
https://en.wikipedia.org/wiki/Li_Wenliang
I don't speak or read Chinese but can rely on multiple news reports (e.g., BBC: https://www.bbc.com/news/world-asia-china-51403795, SCMP: https://www.scmp.com/news/china/society/article/3049561/dr-l...) and Wikipedia's inclusion and characterisation as strongly reliable indicators.
The BBC is the UK's national broadcaster. SCMP is owned by the Alibaba group, a major mainland China corporation. Each clearly labels Dr. Li as a whistleblower. SCMP's story includes a highlighted summary "China’s health authorities and the public have offered their condolences over the death of the doctor, whom police tried to silence in the early days of the outbreak".
Both articles focus on Li's acts in breaking the nCoV story -- without really wanting or intending to -- the initial negative response of Wuhan police, and the narrative now, from authorities such as Zeng Guang, chief epidemiologist at the Chinese Centre for Disease Control and Prevention (reported in the SCMP story) that "that the eight people punished by the police should be held in 'high regard'", again, quoting the SCMP directly.
As for ongoing suppression of discussion adjacent to the nCoV outbreak, messages of support for Li and criticism of the Chinese government continue to be censored:
The top two trending hashtags on the website were "Wuhan government owes Dr Li Wenliang and apology" and "We want freedom of speech".
Both hashtags were quickly censored. When the BBC searched Weibo on Friday morning, hundreds of thousands of comments had already been wiped.
(From the BBC story.)
From [1]: The “seasonal” reflects the fact that viruses can’t tolerate high heat and humidity, preferring the cool and dry conditions of winter and spring, Webby said. That’s why flu, as well as the four coronaviruses, are less prevalent in warm, humid months.
1: https://www.statnews.com/2020/02/04/two-scenarios-if-new-cor...
Also less prevalent in warm and humid regions (though spread in Singapore and Thailand is ... interesting).
This is among the reasons my concerns' been on a breakout in North Korea, which has both a meterological and political/epidemiological climate that seems highly favourable to outbreak of a disease such as 2019-nCoV.
Though it's politically viable to order a near-complete shutdown of transportation and travel, the likelihood of this being effective (particularly against high-level party members breaking quarantine), or pragmatically possible to sustain (what exists of the PRK economy likely requires people in close contact), limiting epidemiological effectiveness.
As a reminder, don't mix this rate with case fatality (or lethality) rate, which is counted on ended cases and is about 30%. This is your real chance when you're infected.
You can't take a case into account until you know its outcome. What am I missing?
0. https://medical-dictionary.thefreedictionary.com/lethality+r...
No idea where you got that 30% from. Even in Wuhan, with its medical infrastructure close to the breaking point, we are talking about 4.9%.
31,211 confirmed cases and 637 deaths in China. Makes a rate of roughly 2.04%. And I trust the WHO to get the calculation behind that right.
Another stat is that there are roughly 700 deaths and 2400 recoveries, which would indicate a mortality rate of 23%. Of course, this suffers from the same delay issue as the 2% calculation (T_death < T_recovery). But the possible range is 2% < M_rate < 23%
This paper gives a discussion of different biases:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504518/
There's a standard paper on this topic the authors I forget atm but all estimates will be biased. The best estimates are sort of unintuitive and account for estimated time-to-death and the time since diagnosis.
According to https://coronavirus.app/ we have 34955 infected, 726 dead, 2287 recovered as of now. Total resolved cases are dead + recovered, which is 3013. Fatality rate is 726 / 3013 = 24.1%. At the time of my original post it was 30%.
The correct way to calculate A's case fatality rate would be to select a cohort, Group B, for example: everyone infected in the first week. And calculate:
(deaths in Group B by Feb 9th) / (deaths in Group B by Feb 9th + recovered in Group B by Feb 9th)
An incorrect way to calculate A's case fatality rate would be:
(deaths by Feb 9th) / (deaths by Feb 9th + recovered by Feb 9th)
This is incorrect because "deaths by Feb 9th" includes all deaths from people infected between Jan 1st and Feb 2nd, while "recovered by Feb 9th" only counts the recovered patients who were infected between Jan 1st and Jan 9th. The above equation basically expands to:
(deaths in Group C by Feb 9th) / (deaths in Group C by Feb 9th + recovered in Group D by Feb 9th)
Where:
Group C: infected between Jan 1st and Feb 2nd
Group D: infected between Jan 1st and Jan 9th
Since disease A is spreading exponentially, it's clear that Group C is a few orders of magnitude larger than Group D.
There has been some discussion about changing the guidelines to discharge patients after 3 days without viral titre but I'm not sure if this has been adopted. Any comment about recovery time would have to be made after the dust settles.
So unless you believe authorities are getting with hiding hundreds of deaths at hospitals being under international scrutiny, while simultaneously hiding the fact that dead people pile up at their homes, this theory seems kind of unlikely. Especially since international numbers outside of mainland China are more or less in line.
Test your information against samples from people with relations to ground-truth. Then you can panic.
But hey, you want to panic, go for it. But do it for yourself. Because now the "independent" media, the "propaganda" and the WHO numbers are more or less the same.