Items tagged with: epidemics


US overtakes Italy & China to lead world in COVID-19 cases at 82,179

This occurred a few minutes ago according to Worldometers Coronavirus tracking, on Thursday, March 26, 2020, one day later than I'd forecast 5 days ago. And my three week old exponential projection of US confirmed cases remains largely accurate. New confirmed cases in the US are occurring at twice the daily rate of the next highest country, Spain -- nearly 14,000 at this moment, vs. 6,800.

In other news, global confirmed cases crossed the half-million mark and should surpass 1 million within the week.

US weekly growth remains about 10x. The country will cross the 100,000 confirmed-case mark within the next two days, and 1 million in another week, probably around April 4.

Given that testing seems to lag actual cases by about a factor of 80, based on multiple inference paths, and exponential growth should slow as both nearly half the population is already infected (new hosts are harder to find, possibly with natural resistance), and, I hope, public health containment efforts should start bending the curve downwards, the March 6 projection should be highly pessimistic (erring in overstating cases) beyond early April. Testing lag may continue to catch up with it for some time though. Uncharted waters for a nonexpert Space Alien Cat.

Wash your hands. Stay the fuck home. Flatten the curve.


#covid19 #coronavirus #publicHealth #StayTheFuckHome #FlattenTheCurve #epidemics

11 charts that explain the coronavirus pandemic

What symptoms are most common, which groups are most at risk, and more.

(Vox) 3-17-2020

The headline chart for me is the confirmed case count by country, normalised to days since 100 local cases.

The US, along with Spain, France, and Germany, are trending in line with Italy, only lagged by days.

Factoring in relative population gives the US slightly more breathing room, but at present trends, by absolute cases, it is ten days behind Italy. Factoring in relative size, about 5.5x the population (330m rather than 60m) buys about 2.5 doubling periods, which appear to be about 3 days, so an additional week.

The US has about 18 days to prepare for current conditions now being observed in Italy.

For France, Germany, and Spain: less than a week.


#covid19 #coronavirus #epidemics #italy #spain #germany #france #unitedstates

How much is coronavirus spreading under the radar?

(Nature) 3-13-2020
...A telltale sign of covert transmission in communities is finding a few confirmed but unrelated cases, with no recent history of international travel. That means these cases are connected through a hidden web of infections. The ideal way to know how many people in a community have had coronavirus infections , [Jeremy]Farrar says, is to collect blood samples from people in every age group, looking for antibodies against the coronavirus, which show that someone has previously been infected. Data from such serology studies, as they are called, can then be used to accurately determine rates of fatality and transmission. But such studies take time. “We need to make policy decisions and clinical decisions now,” Farrar says. “You can’t say, ‘Let’s wait a month until we have the data.’”

Can scientists estimate the size of an outbreak without widespread testing?

Yes. Experts say that they compare various lines of evidence. One estimate begins with the number of deaths in an area. Farrar calls this a “guesstimate” because each of the variables researchers are using right now are subject to change, introducing uncertainty at each step in the calculation. However, it goes something like this: Data from China suggest that about three weeks passes between when a person feels sick and dies from COVID-19. And if you assume a case fatality rate of roughly 1%, a back-of-the-envelope calculation suggests that each death represents about 100 cases in the first week. Right now, he adds, you can expect the epidemic to double each week if those cases aren’t identified and isolated — bringing the estimate to 400 at the time of death. Because the error bars on each of these variables are large, epidemiologists check their figures against further information....

#covid19 #coronavirus #monitoring #estimation #epidemics #publicHealth
Du kannst auch auf develop wechseln, aber dann icht täglich automatisiert pullen sondern Fragen ob der Zustand grade stabil genug dafür ist.

Meistens ist das der Fall, aber dieses Wochenende sind die Early-Adopter / Alpha-Tester gefragt Probleme zu finden, damit die zögerlichen Beta-Tester die dann schon nicht mehr aushalten müssen ;-)

The COVID-19 Virus: How to stay safe: Practical advice from epidemic expert Laurie Garrett on how to remain safe.

Masks are all but useless, or worse, at prevention. Do wear if infection known or suspected. Wear gloves. Reusable, washable, are sufficient.

#COVID-19 #ncov-2019 #coronavirus #epidemics #LaurieGarrett
The Wuhan Virus: How to Stay Safe

Wuhan Coronavirus: Case classification standards change causing reported-cases spike

A key issue in any observation-based data is changes to the criteria for observation. That's coming to play in the 2019-nCoV outbreak numbers today, with Reuters and other sources reporting "Coronavirus death toll leaps in China's Hubei province":
[T]he 2,015 new confirmed cases reported in mainland China on Wednesday were dwarfed by the 14,840 new cases reported in Hubei alone on Thursday, after provincial officials started using computerized tomography (CT) scans to look for infections.

Hubei had previously only allowed infections to be confirmed by RNA tests, which can take days to process and delay treatment. RNA, or ribonucleic acid, carries genetic information allowing for identification of organisms like viruses.
The current reports stand at 60,330 confirmed cases and 1,369 official deaths, according to current data at Wikipedia. I'll note that fifteen days ago based on then-current trends, projection without epidemiological containment was for 200,000 cases, 10,000 deaths. Thankfully, even with a broader inclusion criteria, we're well below those values. Containment does largely appear to be working, and the epidemic may be further self limiting. (More below.) My existing projections are based on the earlier criteria and should not be applied to the broader clinical-diagnosis numbers.

Numbers reported depend on observational criteria. In general, my recommendation is to look to the case count as a trend indicator, across successive periods with consistent criteria, and for deaths as a far stronger magnitude indicator.

That is: we know that the cases were underreported. That's been widely criticised, and I suspect you'll see reports now of a sudden explosion in cases as Another Dire Sign. It's ... more complicated than that. Case reports to date have largely been a function of:
  • Limited numbers of virus test kits sensitive to the 2019-nCoV specific RNA (viruses don't have DNA, so this is the equivalent).
  • Testing of severe cases only. For non-severe cases (the majority), home isolation and care are largely sufficient.
  • Accepting most cases as "suspected" rather than confirmed.
The new numbers should be compared against earlier "suspected" cases, not "confirmed" cases. What are now being included are clinically diagnosed cases, based not on a definitive RNA test, but on symptoms as presented at a clinic, largely CT scans of lungs, among other measurements. This is actually very common in medical practice, and many conditions are diagnosed based on symptoms rather than a definitive test, often because symtoms are far more accessible (a case of availability heuristic), faster, cheaper, and in virtually all cases, sufficient. It's nice to have a definitive diagnosis, but not necessary. My understanding is that test kits have often been reserved for medical personnel themselves, many of whom have been infected with 2019-nCoV.

As before, epidemiological and public health responses are most important. If you are in an outbreak area (China, generally), rather than rushing out to buy masks (of marginal use), make sure you have and are using cleaning supplies, and minimise hand-to-face transmission. Wash surfaces, door handles, light switches, bannisters, and other contacted surfaces. Disinfect (spray bleach) around bath and toilet facilities. Use alcohol-based hand-sanitisers. (Again, antibacterial treatments do not work for viruses, that's wasted money.) Wash your hands frequently. Avoid crowded public spaces. Wipe down shopping trolly handles and other surfaces if possible. Be aware of what you're touching (elevator controls, any public touch-screen devices, keyboards, etc.). If you are infected and must go out, wear a mask but primarily to protect others --- you're limiting spread of droplets from your mouth and nose. (It's possible that applying table salt to the masks may increase their anti-viral properties, possibly by spraying with a saline solution.)

Expect to see travel bans and restrictions in place both within and transiting China for another few weeks, possibly months.

The real risk with 2019-nCoV is that it escapes containment and becomes a recurring annual disease much as the current common cold and influenza, though with far greater impacts. Given its high mortality rates, this could have severe impacts worldwide (deaths in the 10s to 100s of millions), though it's likely that this would eventually moderate. That's the scenario people are hoping to avoid.

Risks remain high, the containment trends still look very positive. Coronavirus fares poorly at higher temperatures and humidities -- odds of it spreading especially within the subtropical and tropical regions, and particularly in summer months, are fairly low. This means that China and neighbouring countries (again, notably North Korea with limited public health and public information resources and practices), Europe, and North America are probably most at risk. Community transmission elsewhere has remained low (cruise ships being a notable exception), and deaths outside China are also extremely rare: 2 (Hong Kong and Japan) despite 9,525 cases outside of China.

Fingers crossed.

The other notable news is that the Chinese Communist Party chiefs of Wuhan City and Hubei Province have both been sacked for their mishandling and information suppression of the 2019-nCoV initial outbreak. Again, China and the world could have had an additional 4-6 weeks' prior notice of the disease had initial reports not been covered up, before the mass internal migration of Chinese New Year celebrations. That was extreme misgovernance, and I expect to see more heads fall, possibly higher up, as well as further political reforms toward free speech within China.


#nCoV2019 #coronavirus #china #wuhan #hubei #epidemics

Mostly uniformed notes on Coronavirus, Wuhan, China, and the online response

I'm not a sinologist, sinophile, nor antisionist. I'm not an expert on China, or epidemics, or eastern-region politics. But I watch and observe, and occasionally comment. This story is an interesting one, but my observations are largely speculation, exceptions generally being cited or referenced.

There are two elements of this story I'm finding fascinating, both involving viral propogation. One is biological, the other epistemic.

The Plague

It's been about nine days since I posted my exponential growth 2019 nCoV observation, followed (in comments) by predictions that containment efforts begun arond 22 Jan would start showing clear evidence in new case data by early February, and that mortality should start falling by the 15th - 22nd, another 2-3 weeks out.

The first is bearing out, the second may be beating my initial projection. Both of these trends are encouraging.

I'll emphasise: I'm not a medical professional or epidemiologist. I read and study a lot, I've watched earlier outbreaks, and I've a fairly strong stats and data background which informs views of data. But really: I'm just some guy in a cat mask making guesses on the Internet.

That said:

* Signs are encouraging.
* The risk remains very real. We'll likely see somewhere in the neighbourhood of 100,000 cases (plus or minus a factor of 2) and 1,000 or so deaths (same). I think it's unlikley we'll see grossly more, say 10x, that.
* Quarantine, containment, education, public awareness, travel and commerce restrictions, and (within pandemic regions) frequent decontamination, are very much the order of the day.
* Effective treatments are few and will probably not emerge before the epidemic peaks or subsides. Mostly health professionals are limited to treating symptoms and secondary infections, with mixed effectiveness.
* There may be some nontraditional treatments or precautions which prove effective. No, I'm not talking crystals or Goop, but potential practices to reduce particle spread or make the virus less comfortable within hosts. Salt-impregnated masks have been mentioned favourably. I could think of other possible approaches, I won't bother mentioning them simply as rumour and misinformation spreading is already more than problematic.
* Given limited treatment, beds, an diagnostic kits, I'd argue that conclusively testing every presenting case is not a useful use of resources. Confirming infections among medical personnel is, but otherwise, triaging serious cases in to care, and directing less-serious cases to self-quarantine seems reasonable. We're talking city-wide, province-wide, and country-wide control where populations number to 10 million, 100 million, and 1 billion, respectively. This is a very large-scale problem. The goal is containment and management, not acute treatment of every individual case.
* Limitations on public knowledge of disease, germ theory, medical capabilities and limitations, and public health methods, is a challenge here. China's large population includes a very large undereducated population. (Though its educated population dwarfs that of any other country on Earth, possibly excepting India.)
* Failure to continue effective management could change all of this. The goal is to work effectively.

Media and Politics

The media and online response is ... interesting.

I've seen several long YouTube monologues, the first I believe by the individual known as "Brother Mask", another by a civil rights attorney, giving first-hand reports from within Wuhan itself. Many of the reports of conditions seem accurate. Some of the criticisms arising from them ... possibly less so. There have also been numerous posts in various places -- Mastodon and Diaspora, though of course many on Twitter, Reddit and elsewhere.

It's clear that many are seeing this as a propaganda opportunity to be used against the Chinese government. And there are certainly numerous criticisms which are valid.

Given the flood of online propaganda aimed at Western states in recent years, notably by Russia, but also China, generally following a "torrent of distraction" rather than "hose of reality distortion" favoured by Moscow. Seeing this now turned at China is ... interesting and ironic.

I don't consider myself a supporter of China, though I am impressed by the progress it's made most especially in recent decades. China is simply huge, and operates at scales the rest of the world fails to comprehend -- Wuhan is the city of 11 million you'd never heard of until two weeks ago. The country has faced, and does face immense challenges, and whilst not executing perfectly, has succeeded in many ways that deserve recognition. As do its failures. I'm often critical of elements of China's behaviours, both domestically and abroad (Uyghers, Tibet, and elsewhere). China is much like the proverbial Chinese symbol for crisis: opportunity and threat.

The main reason ideologically-driven discussions, debates, or (far more often) screaming matches are so boring is that they're simply so uninformative. The positions are well-established, the participants rarely principled or in good faith, and quite often themselves blinded to realities they'd prefer not to confront.

It's abundantly clear that China grossly mishandled the outbreak of 2019-nCoV, much as it did SARS in 2003, though not managing to cover up the epidemic as long in this instance. The death, or is it martyrdom, of Li Wenliang, is portentious. Unconfirmed reports of 800 million Weibo posts within 2.5 hours of its annoucement. It seems at least possible that changes to central control over information flows may occur, though the legacy of Tienanmen Square still looms large, and information regarding it remains tightly controlled. Chinese partisans have been engaged in petty battles over map definitions within the 2019-2020 Wuhan Coronavirus Outbreak Wikipedia page, as evidenced by the Talk page. Yes, Wikipedia has its conflicts and attempts at manipulation, but they occur in public and are often countered.

China's own meddling with both independent Taiwan and Hong Kong appear to be backfiring badly in terms of trust in the CCP and central government. That seems somewhat just desserts, though not always epistemically valid information.

At the same time, there's what seems strongly to be hay-making by opponents of the government, quite possibly even factions within the CCP battling against each other (my speculation), and quite likely entities or factions within Taiwan and Hong Kong, as well as the usual rabble-rousers, xenophobes, ecouragers of chaos (viz: Stephen Bannon), and general whackadoodles worldwide.

The interesting situation is that China seems to be approaching a point at which neither a closed-down media system, nor a wide open one, is risk-free. The first, had it persisted only a few weeks longer, could have had us talking a bound an epidemic ranging into the millions of cases and tens or hundreds of thousands of deaths, as well as global economic disruptions lasting months (and a likely risk-based reduced exposure to China). The second, while guarding against the "tell the emperor what pleases him" failures of rigid control, also enables the enemies of the emperor to speak freely. It seems all but certain that China will have to move out of its comfort zone here.

Or ... and if this path is chosen, all but certainly with the assistance of all the usual Silicon Valley suspects we've come to know and love ... institute an even more pervasive, flexible, and effective set of internal and external informational firewalls which permit the flow of critically important information whilst somehow managing to disrupt attempts at political opposition.

I don't find the second possibility overly likely from a technical standpoint, but Orwell and Huxley seem to have been winning the War for the Internet so far, and it seems unwise to not give them their nod.

Norbert Wiener, the father of Cybernetics, had a strong experience with information controls during World War II, as he worked on numerous research projects for the US government and military. After the war, his assessment was that the security restrictions on communications hurt the Allied forces more than they helped. For the most part, the enemy was already aware of the research projects, so the spread of information to the enemy was not meaningfully curtailed. But the Allies, working with limited technical and intellectual personnel resources, were hurt more by the duplicate, slowed, and inefficient progress made on the projects due to the communications restrictions.

Whether Wiener's view was accurate or merely his own personal bias, I'm not sure. But China is likely to be debating the same question, if not now, then soon.

#china #coronavirus #ncov2019 #wuhan #LiWenliang #propaganda #media #epidemics #tienamen #uygher
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