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.
You’re right; I’m revising my number in post #25 to 7.8%.
I know the numbers may be way off, but that’s the best we have to work with today.
Key remaining concerns: China has sociopolitical reason to downplay fatality counts, and I don’t see containment working (asymptomatic & contagious for days, with no meaningful amount of testing underway). Korea is the case to watch: significant infection count, rising fast, first-world country with concentrated population, best medical response system you could reasonably hope for.
If you honestly think the normal flu can be fixed by a day under blankets, honestly you do not have the flu.
Not to dismiss your treatment—but if you don’t have a fever, feel like you’ve been hit by a truck, and can barely move for a few days...you don’t have the flu.
In your case, that might be true. But in the world of flu treatment...people (not you) toss the term flu around loosely.
Ok. Have to disagree on that. Never like Andy Griffith. For some strange reason always liked Green Acres. My kids love it for the same reason my brothers and me did when we were kids, that guy Haney and Arnold the pig. Now I like it because of that Gabor lady.
“I’d wait another month for the cases in the ICU in Italy to resolve one way or another before I’d say that for sure.”
I am willing to bet that the vast majority of confirmed cases in Italy are Chinese people who work in the garment factories in Northern Italy:
https://www.ecnmy.org/engage/prato-chinese-stuff-look-around/
https://www.nytimes.com/2010/09/13/world/europe/13prato.html
https://www.nytimes.com/2019/12/05/business/italy-china-far-right.html
https://en.wikipedia.org/wiki/Chinese_people_in_Italy
Completely agree re: SK.
If this were attacking the 20-40yr old demographic and killing them preferentially, like Spanish Flu did, I’d expect this to be the very last thing China would admit. From a simple military preparedness standpoint.
How about the hypothesis that a majority of the infected persons think they have a cold or the flu and don’t even know that they have the corona virus and recover just fine?
This isn’t a game.
I have my reasoning, you have yours.
I’m spending my $ on preps. You’re optimistic enough to spend yours on gambling.
Our lives are the gamble.
The ONLY thing that frightens me a little bit was watching a highly catholic country like Italy on Ash Wednesday deal with this.
Tight spaces. Lots of people.
This is exactly why having it in QOM could only be worse if it were in Mecca at this point. Lots of people, small spaces, shitty hygiene.
We’ll see.
One of the first Italian deaths had a very Italian name and looked very Italian to me though.
YMMV of course.
Had no idea Italy was overrun with chicoms until lately wrt this.
When you have the flu, you know it isn’t a cold. A cold is a punch in the head and a kick to the gut. The flu is a getting hit by a train.
I think the flu has about a 10% asymptomatic ratio. Who knows how many carriers this virus has.
I admittedly did not attend Ash Wednesday services because of this reason.
I to was never wild about the Andy Griffith show, much preferred Green Acres! After hearing from people who have worked with & know Andy Griffith that he is more like the Lonesome Rhodes character from his “face in the Crowd” movie then Andy Taylor the amiable sheriff my childhood reticence seems justified. I also lived in the WV equivalent of Mayberry then. If I wanted to see the show characters all I had to do was walk down the street!
My hubby is actually a GREAT ‘asymptomatic’ carrier of the flu.
He gets the flu and sneezes and clears his head a time or two. He does this with allergies too. But it’s a little more noticeable when he’s actually got the flu. Maybe once or twice an hour. NEVER runs fever or feels bad.
The first time ‘we’ all got the flu before we figured this out. The second time when he did the sneezy thing a cpl times in an hour I ‘made’ him get swabbed. Shocker, it was flu A. His coworkers were grateful for this as he’d done the sneezy bit on sunday and avoided contaminating them at work on Monday.
I’ve never gotten the flu. Not even when I know I’ve been exposed and should have gotten the flu. Yes, I was swabbed. Nurse was shocked I had a house full of flu patients and never got it. I even went back a week later to get swabbed again. No dice, still no flu.
I know it’s not a game.
We disagree on how much it will spread.
I’m more concerned (long term) about the economic impact. It seems reasonable that we will have a recession based on the economic disruption in China and how much our economy is linked to theirs.
And I prep for sure - going through some items now. Previously, the darn cats got to 2-4 bags of items (small) just to chew on the bags.
The highest rate using solid data in industrial society is 1%, but if you look below it is less than 1% (.4% & .5% respectively). Remdesivir has shown promise against other coronaviruses and may be beneficial in this current outbreak. Gilead’s drug is now being tested in China and the U.S. Also, convalescent plasma, a blood product taken from people who have already fallen ill, may have great potential.
Treatment is getting a lot better and they might have cure (increase in chance of survival) in a few weeks. The mortality rate will fall quickly. Next, viruses hate the heat and dry weather. The warmer weather might kill it off.
South Korea, 10 deaths out of 977. (.01)
Cruise ship 3 out of 691. (.004)
Japan 1 out 170. (.005)
I was just addressing the viral issues.
Population impact aside, I expect I’ll survive.
Which, yes, leads to your concern: whatever the fatality rate, the economic impact will be significant. Supply lines are being strained & breaking. Gonna take a long time to recover, and a major setback for “globalism” as businesses & governments realize the cost of relying on other countries.
I joke that I already got the Covfefe20 virus. I'll tell you, I had a fever that would cook an egg and was freezing. I took 800 mgs of Ibuprofin and passed out wrapped like a mummy. I woke up a few hours later and was soaking wet, like I had been in a pool, because my fever broke.
My immune system seems to go into overdrive a lot. I feel like I'm gonna die for a half a day and then a day later can get out of bed. I probably would have died from the Spanish flu.
Still had an upper respiratory infection and felt like crap for another week. Whatever I had was a doozy.
Bad news from Korea: the head of emergency operations overseeing Covid19 outbreak just killed himself.
https://news.naver.com/main/read.nhn?mode=LSD&mid=sec&oid=011&aid=0003699878&sid1=001
If you can get it right now, look into vitamin D3 supplements.
It seems to ‘moderate’ the immune system and let it do what it’s supposed to do without going crazy and killing itself in the process.
I’d love to know the D3 levels of the deceased Chinese virus patients. Was there a link between those levels and ability to survive the virus?
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