COVID-19 is a very contagious virus.

[denem]

For better or worse, we are depending on China to isolate it.

Over 1,700 medical staff infected with novel coronavirus in China

BEIJING, Feb. 14 (Xinhua) -- A total of 1,716 Chinese medical workers had been infected with the novel coronavirus by Feb. 11, accounting for 3.8 percent of the overall confirmed cases in China, the National Health Commission (NHC) said on Friday.

Among them, six people had died from the virus, standing at 0.4 percent of the country's total deaths, said Zeng Yixin, deputy director of the NHC, at a press conference.

The number of infected medics in Hubei Province hardest hit by the coronavirus outbreak reached 1,502, or 87.5 percent of the national confirmed cases of medical staff, while the figure for the capital city of Wuhan was 1,102, or 73.4 percent of the infected medics in the province.

http://www.xinhuanet.com/english/2020-02/14/c_138783802.htm

[Squinch]

1. That can't be! I was told on DU that it is nothing to worry about!

[PCIntern]

2. Yes. We have a group here who

invariably diminish the impact of disease. As a clinician I am horrified quite frankly.

[smirkymonkey]

6. What do you think the impact will be here in the US?

And how long do you think this pandemic will continue?

[Squinch]

14. Me too. And I don't really trust that we are getting the whole story out of China.

[Silver1]

15. Hey, me too.

Bringing up numbers and data seems to have no effect.

Why, it's just another flu. Nothing to see here.

Blah.

[Squinch]

16. I am in a medical field. Just being in the hospital is a little scary, given the virulence

and the incubation period.

Then the news of the clinician deaths...



I feel like we need to brace ourselves.

[Silver1]

17. I'm not in the medical field

but I live in a densely populated area. There is no way the hospitals could handle large numbers of infected people.

As far as hospital staff, we do have an advantage to the Chinese, which is preparedness. The virus spread there before they even knew about it. We can prepare and take measures rather than trying to catch up. That's a big advantage.

[Squinch]

19. Yes, that's true. And we are not at the mercy of the tests that were so widely used that turned

out to give 50% false negatives.

[Silver1]

20. Do we have better tests?

I haven't read anything about that. It will be good to find out more accurate numbers as far as the severity of this illness. How many cases are mild, moderate, or severe? Accurate numbers, because China is so chaotic their figures aren't reliable at this point.

I'm reading about prevention now. Health and the immune system, eating better, etc.

[Hekate]

21. I'm going in for elective surgery next week (total knee) & after the struggle with Anthem Blue Cross

...over whether I should or should not be an out-patient, I was so relieved yesterday to hear the hospital has no intention of letting me loose at 23 hours, that I had not given a thought to this bug.

Good lord 'n' butter.

Well, it is an orthopedic hospital.

Next door to a university with a significant foreign student population. So where are you gonna take your sick friend when you need an ER?

SMDH. Wish me luck.

[MineralMan]

23. I'm sure you'll be fine.

My wife had a hip replacement a couple of years ago, and the recovery area she spend a day in was pretty much isolated from the rest of the hospital. They're so concerned about infections in joint replacement situations that there really wasn't any communication between that big ward and the rest of the place.

No shared staff, either. I think you don't need to worry at all. You'll be fine, and much happier with your new knee.

Work hard on your physical therapy afterwards, though. It hurts, but your recovery depends on it.

[Hekate]

29. Thanks for the encouragement. As it happens, the old Goleta Valley Hosp underwent a rehab itself....

...after being taken over by Santa Barbara Cottage. It not only looks new and modern, but is now envisioned as a regional orthopedic center. I have to say, when we drove the 40 miles over for the joint-replacement seminar, I was impressed at the sheer number of signs insisting that handwashing saves lives (it does). The nurse who led the seminar said they'd only had one infection in the past 4 (or 5) years, and they tore the place apart tracking it to its source.

So that's good.

[Ms. Toad]

26. Yes - but there are only 15 cases in the US (so far)

You're relatively safe if you're not in a hospital in one of the handful of cities where it has popped up.

[Squinch]

41. Two have been referred from where I work to be tested. It's in NYC.

It will inevitably get here. The only question is when, and how the incubation period will affect us.

[Ms. Toad]

43. You're almost certainly correct.

Although we were at least smart and imposed a quarantine before the evacuees from Wuhan province were allowed to rejoin the general public. (The initial info said screening only, them moved to screening + 3 days, before it moved to the more sensible 14 days.)

Any sense as to whether the two were referred out of an abundance of caution - or a significant likelihood they are actual infections?

[Squinch]

46. They turned out not to be infected, so I'm not sure what the deal was.

[Ms. Toad]

24. Not by me. Not even after getting royally spanked.

On the other hand, I've heard crickets from the spanker since I posted the follow up to the spanker's prediction that it would never kill as many as SARS did, when it took only 3.5 days longer than I predicted to pass the SARS death toll.

[catsudon]

40. i agree

"80,000 people died in 2018 flu season in United States from the standard flu. That is 667 people EVERY DAY during standard flu season in US. Why that is not causing panic and sensational news headlines?"

Because the R0 is greater for coronavirus; and because the hospitalization rate, and the ICU admission rate, are both higher for coronavirus; because coronavirus can be transmitted even before or without symptoms; and because the fatality rate for coronavirus is conservatively estimated to be 20 TIMES that for the flu.

And because a country does not barricade or weld people into their apartment buildings, nor shepherd people with just a fever or contact with someone infected, into mass auditoriums (in English, you know the official word for this place in Chinese is "Noah's Ark Hospital"?) even without indoor toilets, merely for the flu.

Nor does a country quarantine or restrict the movements of 400 MILLION people -- more than the entire population of any country on Earth except China and India -- just for the flu.

Nor does the US, when evacuating people from another country, dress the staffers on the plane, not merely in N95 masks, but full-on NBC containment suits.

[marlakay]

3. I read they won't let CDC in to help

Makes me think they are hiding something not sure what.

[denem]

4. May just be nationalism.

Would we let the Chinese in to work with the CDC on an outbreak here? Probably not.

[lunasun]

27. +1

[Ms. Toad]

28. They are there as part of the WHO team.

Shortly after the team arrived, the number of infected grew by ~15,000 in one day (after leveling off at around 2500-3000 new per day for several days)

Makes you wonder if there is a connection.

[Leghorn21]

5. Numerous cities and towns have been put on lockdown...first town outside of China is now on lockdown

Across China, one of the most common restrictions has been to impose lockdowns on residential areas, with the provinces of Liaoning and Jiangxi, as well as major cities such as Shenzhen, Guangzhou, Nanjing, Ningbo, Chengdu and Suzhou restricting visitors and asking inhabitants to limit trips outside.

https://www.bloomberg.com/news/articles/2020-02-11/china-s-cities-lock-up-residents-to-prevent-spread-of-virus

Partial list ^^ (and poor Wuhan, of course)

BREAKING: Sơn Lôi, a village in northern Vietnam, has been put on lockdown to prevent the spread of coronavirus

Link to tweet

I think it’s just as bad as one could imagine
a very bad deal

[MineralMan]

7. So it seems. Without a vaccine, protective measures

used by medical personnel won't be enough. Exposure is almost certain if you are treating patients.

[Hekate]

22. See my post 21 upthread. As I said, SMDH

[dewsgirl]

8. I used this in another thread, reposting here to perhaps help

others:

. The R0 in the movie Contagion was 1.5.
The R0 Coronavirus is between 2.6 and 6.6. R Naught or R0 is the term used to explain how contagious a virus is. The H1N1 virus in the movie meant 1 and 1/2 people would get sick from having direct contact with the individuals germs. Coronavirus 2 and a half-6.6 individuals will get sick from contact with germs from this virus.
This helped me greatly better understand what we will be facing.

[denem]

9. R0 is a ex post facto measure of contagion.

The number depends not only on how infectious the pathogen may be, but what steps are being taken to prevent its spread to the population. If no measures are being taken, and infected people are going off to their workplaces and grocery stores, that number will be higher than if people are being advised to stay at home.

[dewsgirl]

10. I know the bare minimum, the comparison helped me.

[denem]

11. R0 is good rule of thumb.

and it's all we have. Thank you for posting it. I was just qualifying the implications.

[dewsgirl]

12. Thank you.

[denem]

13. and you :hi:

In the movie Contagion, MEV-1 had a mortality rate of 25-30%. The good news is that COVID-19's mortality is 1-2%. The bad news is that MEV-1 killed quickly. Viral pneumonia can take weeks to treat in hospital. COVID-19 could overwhelm the health system with (relatively) few serious cases.

Yes this is serious. People who are discounting the threat are doing no one any favors.

[dewsgirl]

18. No, they aren't and they are everywhere...i understand not wanting

to worry if you don't have to, this feels different.
Also with China lilely, lying about the numbers on an unbelievable scale, we don't yet know how bad this may get.

[Ms. Toad]

32. Probably closer to 2-4%

The calculated rate based on total number of deady divided by total number infected is more than 2%. A better measure would be to estimate how long from infection to death and use the infected number from that earlier date.

Estimating a week from death to infection puts the calculated death rate at around 4%. (That doesn't take into account unreported mild cases - which would lower it). Between 2% and 4% is probalby a good bet.

[dewsgirl]

35. It's scary with the asymptomatic/mild cases being contagious

for so long. I saw yesterday 5 larger cities are going to begin screening for Covid-19 at hospitals, regardless of travel history. Being that time is of the essence, I wish more were screening, but it is a start.

[Ms. Toad]

31. There's two factors -

How many people does one infected person infect (R0), and over what period of time.

Having an R0 greater than one means the growth will be exponential, having a short transmission period governs how squished together the timeline is. (i.e. if you infect your 2.6 people in 3 days, those people will infect 2.6 more people in the next 3 days, etc. - in contrast if it takes you 10 days to infect your 2.6 people, those people will also have 10 days to infect their 2.6 people and the actual growth of infected people does not happen as quickly)

A number that merges those tww factors together is to think of it as how many new people are infected each day by the currently infected population. It was expanding at a rate of about 1.2 per day. It's slowed to about 1.08 per day (even includint the one day jump of ~15,000 patients)

[Act_of_Reparation]

25. The disease is spread by aerosol droplets.

You have fifty sick people in a big room, hacking virus into the air all day and all night. Makes it hard to protect yourself, even with BSL3 gear.

[Ms. Toad]

33. And it apparently lives on surfaces longer than the average virus.

Up to 9 days (as opposed ot measles which can live ~2 hours). Other coronaviruses live ~4-5 days.

[elias7]

37. I wouldn't be surprised if it stays aerosolized longer

[Ms. Toad]

44. Why?

I think how long something is aerosolized is a matter of physics (a function of the droplet size and environmental conditions). I think that will be relatively independent of the strains fo virus within a family. Do you mean how long does the virus live within the droplets?

[Act_of_Reparation]

34. It's a zoonotic disease, so the likelihood is very high.

Part of the reason we don't have vaccines for SARS and MERS and now Wuhan is because the virus mutates too quickly for a vaccine to be of any use.

[roamer65]

38. Over time, natural selection will play its role.

The less virulent strains will hang around and the more virulent ones will die out.

[jpak]

45. I read that coronaviruses do not mutate like flu viruses - and have a relatively low mutation rates

But we know so little about the COVID-19 virus, it is too early to say definitively....

[yaesu]

36. I have much more confidence in China than 3rd world USA. nt

[roamer65]

39. China being an authoritarian state can make decisions faster.

There are pluses and minuses to it in a pandemic.

[NickB79]

42. I'm really concerned about what will happen in North Korea

https://www.businessinsider.com/north-korea-wuhan-coronavirus-outbreak-handle-medical-supplies-2020-2

The constant malnutrition, lack of even rudimentary medical gear, and xenophobia towards outside help means COVID will tear through the populace like wildfire, and be extremely deadly.