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#Post#: 96--------------------------------------------------
Re: estimating the cfr
By: epsilon Date: February 11, 2020, 6:06 am
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I generally avoid drawing conclusions from official china
numbers from Wuhan/Hubei (I have some more trust in the chinese
numbers outside Hubei). This is not to say, the official lie
intentionally, rather I think it is simply a problem of capacity
and chaos in an near-overwhelmed health system)
Fortunately there are many studies now, that model the spread
and severity of the epidemic using only non-china data and air
travel models.
The other point we all should keep in mind is that you cannot
simply mix numbers from before Jan 23 (i.e. before the drastic
isolation measures) with the numbers after the shutdown.
Before the shutdown we probably had real exponential community
transmission with case doubling of 3 days. (You can even use the
official numbers to see that because for case doubling
estimation it does not matter whether the numbers are off by a
factor of ten)
Now, after the sutdown (plus one incubation period) i.e. roughly
after February 1, we see about linear growth which means that
the isolation measures work in so far as exponential spread is
stopped (R_effective <= 1)
Unfortunately there is still no sign that the isolation measures
are enough to not only slow down but actually END the epidemic
(R_effective << 1)
This is crucial, because isolation cannot be maintained forever.
#Post#: 97--------------------------------------------------
Re: estimating the cfr
By: gsgs Date: February 11, 2020, 7:01 am
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the numbers of new confirmed cases Hubei ex Wuhan and China ex
Hubei
do really go down.
They did change the definition of confirmed cases somehow and
hospitalizations
are still up , but -same argument- the trend should still show
up,
if they underreport or change the definition abruptly.
-----------------------------
as for the CFR, I verified the 3 weeks lag , I was reading this
:
HTML https://republicanfreedom.com/2020/02/10/the-death-rate-is-up-to-5-the-harrowing-admission-of-a-wuhan-doctor/
found this while searching the link :
HTML https://www.worldometers.inf
o/coronavirus/coronavirus-death-rate/
> Days from first symptom to death: 14 days
#Post#: 99--------------------------------------------------
Re: estimating the cfr
By: epsilon Date: February 11, 2020, 4:28 pm
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[quote]the numbers of new confirmed cases Hubei ex Wuhan and
China ex Hubei
do really go down.[/quote]
This is a good sign that control or even containmant works for
prepared cities. They had a head sart of 2 weeks on Wuhan.
And they really implemented drastic measures (e.g. school
closures) right from the start even when they had mainly
imported cases fro Wuhan.
We should probably do the same now in our on cities/countries.
But I'm afraid we are only managing this RE-actively instead of
PRO-actively.
What I still not understand is why new infections in Wuhan do
not decrease drastically. They live in maximum isolation for 3
weeks now. How could they continue infectiong each other.
Airborne transmission ?
See also this very recent paper :
HTML https://www.medrxiv.org/content/10.1101/2020.02.08.20021253v1
reproductive number R_c, i.e. the transmissibility of the virus
AFTER isolation/quarantine measuers in China still larger than
1. (Epidemics can only be stopped if R_c < 1.)
My take: Even the draconic chinese isolation measures not yet
sufficient.
#Post#: 100--------------------------------------------------
Re: estimating the cfr
By: gsgs Date: February 11, 2020, 11:44 pm
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no measures were really successfull in the past to stop
pandemics
or even to isolate cities, countries,continents - keeping the
virus out.
Even in times without air-travel, railroad.
And all the papers, the modelings said that it can't be stopped,
just delayed,mitigated to some degree.
So I was surprised when the Chinese numbers went down.
And I'm not sure, that it were the measures. There should be
differences
from city to city but apparantly in no city, in no country
except maybe Wuhan it did take off yet.
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HTML https://flutrackers.com/forum/forum/internet-communication/avian-flu-diary/828940-covid-19-dealing-with-imperfect-numbers
#Post#: 108--------------------------------------------------
Re: estimating the cfr
By: epsilon Date: February 13, 2020, 11:25 am
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[quote author=gsgs link=topic=31.msg100#msg100 date=1581486296]
apparantly in no city, in no country except maybe Wuhan it did
take off yet.
[/quote]
Yes. That's a very interesting observation that I cannot explain
at the moment.
Given the extremely explosive epidemiologic parameters (latest
research: R0>4, doubling each 2.4 days!) we should be really
seeing signs of large scale outbreaks some where else by now.
It's impossible that they perfectly identified an isolated all
exported cases everywhere.
But all we see is small to mid sized, controlled clusters of
50-100 cases in Singapor and on the cruise ship.
Maybe its just too early.
Remember in Wuhan it was silently circulating from end of
November until end of December when the first signs of pneumonia
clusters revealed themselves.
The next 2-4 weeks are key !
#Post#: 111--------------------------------------------------
Re: estimating the cfr
By: gsgs Date: February 14, 2020, 7:11 am
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Wuhan city had about 42,000 people infected by Jan 29, 2020,
[official number : 2251]
HTML https://crofsblogs.typepad.com/files/2020.02.10.20021774v1.full.pdf
the number of infected persons in other provinces fell within
the range of 9-15,000,
[meant presumably 9000-15000 on Feb.09]
[official number = 6351]
most conservative estimate of 21,000 infections in the cities in
Hubei province except Wuhan, [on Feb.09]
[official number : 12729]
so the official numbers were underestimating his conservative
estimates
by a factor of
19 (Wuhan,Jan29)
1.6 ( Hubei ex Wuhan , Feb09 )
1.4 ( China ex Hubei, Feb09 )
#Post#: 112--------------------------------------------------
Re: estimating the cfr
By: epsilon Date: February 14, 2020, 1:28 pm
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My personal estimate (educated guess) is that prevalence of
infections already reached up to 1% of the Wuhan population
(i.e. 100k of 10M) before they shut the city down.
Also, very recent paper estimated that 900 infected air
passengers travelled from Wuhan tp 300+ cities outside china in
the 2 weeks before the travel ban.
Yet another study estimated that 3 imported seed cases spark
community outbreak with 50% probability.
So if those studies are not too far off, it seems pandemic is
inevitable.
Concerning cfr I still think it could be "only" 0.5% BUT only
with fully functional health system. Otherwise 5%, 15% ?
In one study, 15% need at least additional oxygen, 5% ICU.
Health system collapse is, IMO, the most worrysome risk with
COVID19 because the shortage of hospital cpacity and protective
equipment (and the new studies showing very high infection risk
for doctors and nurses could lead not only to large number
massive fear-based non-compliance of HC workers)
#Post#: 114--------------------------------------------------
Re: estimating the cfr
By: gsgs Date: February 15, 2020, 3:55 am
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can it be worse here than in Wuhan ?
And with your estimate Wuhan has a very low CFR.
They have the 3 weeks death-delay since shutdown now.
And why is the pandemic inevitable, when China apparently
succeeded to control it
despite all these initial cases without knowledge what helps ?
Are we so much worse than China ? Then quickly change the laws
for
quarantine and such, import Chinese doctors and nurses,.
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