Posted on 02/27/2020 6:15:35 AM PST by Moonman62
Researchers from China's Center for Disease Control and Prevention today describe the clinical findings on more than 72,000 COVID-19 cases reported in mainland China, which reveal a case-fatality rate (CFR) of 2.3% and suggest most cases are mild, but the disease hits the elderly the hardest.
The study, published in JAMA, is the largest patient-based study on the novel coronavirus, which was first connected to seafood market in Wuhan, China, in December, and has since traversed the globe.
Death rate in critically ill: 49% or higher
A total of 72,314 COVID-19 cases, diagnosed through Feb 11 were used for the study. Of the 72,314 cases, 44,672 were classified as confirmed cases of COVID-19 (62%; diagnosis based on positive throat swab samples), 16,186 as suspected cases (diagnosis based on symptoms and exposures only), 10,567 as clinically diagnosed cases (from Hubei province only, diagnoses based on symptoms, including lung x-ray), and 889 as asymptomatic cases (diagnosis by positive test result but lacking typical symptoms).
"Most cases were diagnosed in Hubei Province (75%) and most reported Wuhan-related exposures (86%; ie, Wuhan resident or visitor or close contact with Wuhan resident or visitor," the authors said.
Eighty-seven percent of patients were aged 30 to 79 years (38,680 cases). This age-group was the most affected by a wide margin, followed by ages 20 to 29 (3,619 cases, or 8%), those 80 and older (1,408 cases, or 3%), and 1% each in ages less than 10 and 10 to 19 years.
Of the confirmed cases, 1,023 patients—all in critical condition—died from the virus, which results in a CFR of 2.3%. The CFR jumped considerably among older patients, to 14.8% in patients 80 and older, and 8.0% in patients ages 70 to 79. Among the critically ill, the CFR was 49.0%.
A smaller study today based on 52 critically ill patients at a Wuhan hospital confirms this finding. Thirty-two of the 52 critically ill patients (61.5%) died, and older age and acute respiratory distress syndrome were correlated with mortality.
The authors of the smaller study also found that 30 (81%) of 37 patients requiring mechanical ventilation had died by 28 days.
Less deadly but more transmissible than SARS, MERS
A total of 81% of cases in the JAMA study were classified as mild, meaning they did not result in pneumonia or resulted in only mild pneumonia. Fourteen percent of cases were severe (marked by difficulty breathing), and 5% were critical (respiratory failure, septic shock, and/or multiple organ dysfunction or failure).
In comparison to SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome) coronaviruses, which were both identified in the past 20 years, COVID-19 is likely more highly transmissible but not as deadly, the researchers noted. (SARS had a CFR of 9.6%; MERS has a CFR of 34.4%.) And unlike SARS and MERS, hospital-based outbreaks do not seem to be hallmark of COVID-19 at this time.
"Most secondary transmission of SARS and MERS occurred in the hospital setting," the authors wrote. "Transmission of COVID-19 is occurring in this context as well—3019 cases have been observed among health workers as of February 11, 2020 (of whom there have been 1716 confirmed cases and 5 deaths). However, this is not a major means of COVID-19 spread. Rather, it appears that considerable transmission is occurring among close contacts."
Cruise ship study suggests R0 of 2.28
In other research news, a study in the International Journal of Infectious Diseases uses data from the Diamond Princess cruise ship to calculate COVID-19's reproductive number (R0, or R-naught), or the number of people a single infected person is likely to infect.
Among the 355 passengers who contracted the virus, the researchers calculated an R0 of 2.28, similar to other R0 modeling published in the past several weeks.
Also today, two groups announced major developments in COVID-19 vaccine developments. China's Clover Biopharmaceuticals will partner with GlaxoSmithKline (GSK) on Clover's protein-based coronavirus vaccine candidate, COVID-19 S-Trimer, according to a GSK news release. And the University of Queensland in Australia announced a vaccine candidate is ready for a proof-of-concept study after just 3 weeks in development.
No idea why I am double posting.
You can’t look at “total cases” because most of those are still sick, and some will die.
Even then, 2800 deaths over 82000 confirmed cases is closer to 3%.
When you post those sorts of statements, there's no reason to run numbers.
You do not believe this will be adequately contained and that every one will get it at least once. I think that's wildly pessimistic and basically concedes that no medical or public health measures can contain this. I disagree.
We'll see I guess.
You made an assertion writing something that the article did not state or imply.
You wrote “Japan covering up their cases bigly.”
Sorry if getting called out on embellishing is uncomfortable.
You have inadequate comprehension skills. When a Japanese woman is complaining that she and others can’t get tested, you need to be able to draw a conclusion.
Don’t respond. I hate debating with dummies.
https://m.youtube.com/watch?v=skGhdh8t8i4&t=113s
Watch 0:11 to 0.39. You might don’t understand the language but the guy reporting from near the property inhabited by the Apple general laborers in Shenzhen. The presence of multiple cars with alien license plates indicates that the government encourages migrant workers to get back to work. It seems like true because interstate travel was prohibited before. He also produces a lot propaganda citing the Chinese media by contacts do not confirm. According to this guy China reports that both vaccine and medicine already exist and there is nothing to care about.
Hmmm... When they start testing, do you think they will be accumulating a record of everyone’s DNA?
Thanks. I don’t speak Russian, but I am in HK and deal with Chinese suppliers everyday. It’s almost business as usual. China is more scared of this crashing their economy than anything.
I’m sure Tim Cooke is screaming at Foxconn to keep assembling phones, because he was smarter than Trump, when Trump warned against supply line concentration risk.
Being gay is more important than being right for that creep.
The formula for a Confirmed Fatality Rate is not calculated that way.
The general way to do it is:
Deaths/(Deaths+Recovered.)
Right now the reason why this is probably an incorrect assessment is the numbers from China are crap. The second is that the virus has not been tracked outside of China for a matter of weeks.
Usually, this calculation is done AFTER the fact.
Other concerns are that MOST people with the virus NEVER get counted. As an example, in the US the influenza rate in 2018-2019 was 35.5 Million. Or EXACTLY 10% of the population. Sound fishy? The reason is you simply do not know. Its not dramatic. Its just the way it is.
I am NOT saying this isn’t ending up at 2.5% or whatever. I am just saying at this point the numbers are garbage in.
What everyone MUST remember is that it is contagious, but it does not appear to be “lethal” to a VAST majority of people.
The danger in this is NOT dying. It is overwhelming the system and hurting the economy.
You do NOT want to have to go to the hospital when this stuff is going on. If you are thinking about starting your hang gliding career over the next few months, you might want to put it off until summer.
That's a far cry from what you wrote initially.
Don’t respond. I hate debating with dummies.
It's an open thread and there's no personal attacks (at least by me). But you've been called on inaccurate posting. Please be mindful of that in the future. Thanks,
Change my mind.
It spreads like flu.
It has asymptomatic contagious period of days.
International travel means it can easily be dropped into a new high-density population.
R0 is high enough that it can easily overcome containment; one missed case easily sees exponential growth.
We have practically no detection kits.
I’m not seeing any reason to believe it will “burn out”.
I’m happy to incorporate any limiting factors you can sensibly present.
I want to see this contained & eliminated (fearing my parents won’t survive it).
Just saying “I disagree” doesn’t help. Give me some objective reason to believe it won’t be as bad as I’m computing it.
Interesting point. What about a virus that seems to kill people over 60 in a country with the oldest population on Earth?
I think it is clinically way too early to tell. Much of the issue is contagion in the area. China and cruise ships are on top of each other.
The US is not. Italy is not. People get pretty close in mosques.
Hygiene is a HUGE factor. Personal space and hand washing is a HUGE factor.
Usually these numbers are not calculated in peer reviewed situations until AFTER the epidemic has ended.
I am not suggesting any of this information is disregarded—I am suggesting it should be looked at in context to how this stuff is done in other epidemics.
When presented with facts you keep asking for more, never admitting you are wrong. Keep moving the goal posts. Go watch Columbo or something.
When presented with facts you keep asking for more, never admitting you are wrong. Keep moving the goal posts. Go watch Columbo or something.
I guess we are at loggerheads. I believe that good public health health protocols for dealing with COVID-19 will work and these protocols sill evolve. That includes self-quarantine. You don't believe those will help.
You predict that *everyone* will be infected.
We'll see. Care to make a wager to, payable to FR on if you are wrong I am wrong?
Yes. You are correct.
The issue is not death.
The concern I have been expressing is this:
1. More than a 99% chance you are not going to get seriously ill from this.
2. This will spread fast and any place of “gathering” will be shut down. This means all sorts of transport and commere will be shut down.
3. That shut down and supply chain disruption will impact Q2 and Q3.
The preparation you should be doing is to account for THAT—not masks or meds or anything related to “dying.”
A little extra food in the closet never hurts.
Agree. Also, comparing this to the flu or the cold is ridiculous. Those numbers are based on decades of data across a sample of billions.
Never liked that show much. The Andy Griffith Show - now that's a great show!
Re: 77 - great post. Wish more people would heed.
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