sciinfo

The vast majority of people don't have an intuitive understanding of exponential growth.

People not trained well in math and science don't even have/know the tools to help them understand it analytically.

We need (much) better math education for people studying all majors.

Most severe cases require trained medical staff. Since ~20% of infections requires hospitalization, no healthcare system is prepared for an exponential rise in SARS-CoV-2 infections.

Most fatalities are from pneumonia. Lots of details are available all over. You may want to read up.

No healthcare treatment in real life can be sufficient for an exponential growth of severe cases that require skilled staff and specialized equipment.

Health service ranking focuses on treatment I suppose. We need a different ranking for epidemic prevention and control.

A hotel speeded up the international outbreak of SARS in 2003.

"The Metropole Hotel hastened the international spread of the 2003 SARS outbreak by the index case infecting visitors from Singapore, Vietnam, Canada as well as local people via close contact with the index case and the environmental contamination. The one-week quarantine of more than 300 guests and staff at the Metropark Hotel during the 2009 H1N1 swine flu exposed gaps in the partnership with the hotel industry. The subsequent guidelines for the hotel industry from the Centre of Health Protection focused largely on the maintenance of hygiene within the hotel premises."

https://globalizationandhealth.biomedcentral.com/articles/10...

"This hotel is infamous as ground zero for a SARS ‘super spreader’ in the 2003 outbreak—here’s what happened"

https://www.cnbc.com/2020/02/14/hong-kong-hotel-hosted-super...

Yes, I think I might have mixed up stats of different kinds (Posting too late at night, sorry).

However, the point stands that fatality rates will likely go up a lot if medical resources are overwhelmed. Long-term lung damage is also another risk for younger people and its rate will also go up.

If most people don't care to prevent infection, the hospitals and medical resources will soon be overwhelmed, the death rate will surge from 0.5-4% (no exact figure at the moment) to 10-20% like earlier in Wuhan. When viral load in the environment becomes sufficiently high, some young people will be taken away by it too, as in the case of several Wuhan doctors who sacrificed themselves under that circumstance.

Among the ~16-19% who are hospitalized and recover, you may suffer through weeks of pneumonia and your lungs could be damaged long-term.

Even if you're lucky to be among the 80% who survive without hospitalization, you could still be the vector who directly or indirectly infect someone you care about.

The first patient was confirmed after having been intubated for >= 4 days. On average it takes 9 days from infection to ARDS, which requires intubation, according to a Lancet study. She was confirmed 5 days ago (on Feb 23rd). So she could be infected 9 + 4 + 5 = ~18 days ago.

Since only around 20% of patients require hospitalization, we can estimate there are ~5 infected in her cohort. With doubling time outside China at 5-6 days, that means around 3 doublings: 2^3 * 5 = 40 infected today (Many of them will not show serious symptoms; some who will require admission have not progressed to that stage yet.) So far we have assumed that all hospitalized cases are detected, however.

Some who are hospitalized might still not be detected, since without a test or a CT scan, its symptoms are similar to other viral pneumonia. Let's say infected per detected is a factor of 1.5-4. Very rough estimates: ~60-160 infected in the Bay Area now.

https://www.wired.com/story/community-spread-coronavirus/

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Doubling time outside China: https://ncov.r6.no/

It's in fact 1.5 beds per 1000 capita according to World Bank data.

https://data.worldbank.org/indicator/SH.MED.BEDS.ZS

Doctors and nurses are exposed to a much higher viral load than most people. In Wuhan, they may also overwork and have insufficient sleep.

There seems to be many cases of young patients dying in Iran. Either because there are way more cases than being officially reported or (hopefully not) the virus has mutated to affect the young more, or both.

The first hypothesis is likely based on the number of infections found in international travellers who went to Iran. We still cannot rule out the second hypothesis though.

A 23-year-old woman soccer player: https://www.reddit.com/r/Coronavirus/comments/faadg4/a_23_ye...

A male nurse talking of 8 deaths in one night during his shift. 23-year-old female (same case?), 29- and 30-year-old males, 50-year-old female among them. (1-minute clip)

EDIT: It's just n=8, but 37.5% dying at age 30 or below is most likely drawn from a different distribution from 0.6% among the 70,000+ cases in the largest Chinese study (where the worldometers data comes from).

EDIT 2: Based on a link in a sibling comment, only 7 deaths among 20-29 yo and 18 deaths among 30-39 yo in the n=44,672 Chinese report.

https://twitter.com/AlinejadMasih/status/1232779487647031302

http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9...

I read that South Korea is developing them and it's close to ready. They probably need them for their own people first though.

It's a huge opportunity for a startup/company to create a home test kit for COVID-19. Massive global market for the product and growing exponentially.

Doing well & doing good at the same time.

I have followed the news closely, the CFR might decrease a bit in Hubei because China has reinforced it with 20,000 medical staff and hospitals. They also have found some better treatments (not a cure, to be clear).

The approx. 20% hospitalization figure is the elephant in the room. Even if reduced to 10% or 5%, it would still overwhelm medical resources of any country.

The point is if a country gets complacent, it could be too late to contain it without drastic measures and mass sufferings.

The doubling time is about 6 days for cases around the world excluding China. Graphs here: https://ncov.r6.no/

This means several people in contact with the unconfirmed infected case may not yet self-isolate and can spread it around during the wait time.

For people thinking it is just like SARS, MERS, or Swine Flu, check out these graphs: https://ncov.r6.no/

Social distancing, avoiding crowds and certain events, washing hands routinely and before meals, wearing masks when ill would help reduce the spread speed a lot.

Wearing masks also helps set a new social norm. It is now common in Taiwan subways and trains--basically everyone wears a mask.

Here are estimates from MRC Centre for Global Infectious Disease Analysis at Imperial College:

=> Estimated fatality ratio for infections 1% (including those who with mild cases and don't go to see doctors)

=> Estimated Case Fatality Rate (CFR) for travellers outside mainland China (mix severe & milder cases) 1%-5%

=> Estimated CFR for detected cases in Hubei (severe cases) 18%

The last line (18%) applies when the outbreak becomes prevalent in an area and overwhelm hospital capacity.

No country has sufficient ventilators, ECMO machines, and medical staff if infections become widespread since about 20% of infections requires hospitalization. People who need medical care from other causes would suffer from resource shortages as well. If not contained, dozens of cities around the world may become Hubei!

Marc Lipsitch, Professor of Epidemiology at Harvard, believes that it might infect 40-70% of population (excl. kids) without effective control measures. His articles here: https://twitter.com/mlipsitch/status/1232504457377861632

--

Reference: Report 4 here: https://www.imperial.ac.uk/mrc-global-infectious-disease-ana...

From Report 6: "we estimated that about two thirds of COVID-19 cases exported from mainland China have remained undetected worldwide, potentially resulting in multiple chains of as yet undetected human-to-human transmission outside mainland China."

For concise interviews with experts and other info: Follow their Twitter at @MRC_Outbreak https://twitter.com/MRC_Outbreak

For people still thinking it is just another SARS, MERS, or Swine Flu, check out these graphs: https://ncov.r6.no/

Here are estimates from MRC Centre for Global Infectious Disease Analysis at Imperial College:

=> Estimated fatality ratio for infections 1% (including those who don't go to see doctors)

=> Estimated Case Fatality Rate (CFR) for travellers outside mainland China (mix severe & milder cases) 1%-5%

=> Estimated CFR for detected cases in Hubei (severe cases) 18%

The last line (18%) applies when the outbreak becomes prevalent in an area and overwhelm hospital capacity. If not contained, dozens of cities around the world may become Hubei!

Ref: Report 4 here: https://www.imperial.ac.uk/mrc-global-infectious-disease-ana....

From Report 6: "we estimated that about two thirds of COVID-19 cases exported from mainland China have remained undetected worldwide, potentially resulting in multiple chains of as yet undetected human-to-human transmission outside mainland China."

Follow their Twitter at @MRC_Outbreak