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10 March 2020

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sebastian

If there is enough treatment the death rate seems to be a bit below 1%. But apparently like 5% of people need ICU and 10-15% need oxygen.

From the reports I'm reading from north Italian doctors, once the hospitals are at capacity the death rate goes up a lot(ICU is full etc).

The difference in China vs Korean death rates can be explained by that: Korea was more prepared for the influx of patients so everyone got adequate treatment, while China had to build hospitals while the epidemic was already spreading and early cases weren't getting the help they needed.

It's true that the disease is very survivable with adequate treatment, but if unchecked it will likely overwhelm medical systems and most infected will not get that adequate treatment.

That being said, if/when push comes to shove heroic hospital building efforts are probably possible in the West as well(and according to the Broken Window Fallacy they'll be better for GDP than preventing the diseases in the first place *excuse the dark humour*).

confusedponderer

That corona may be not as less deadly than expected and feared - good for you and everybody. But the point is that we don't know that yet.

Germany's research secretary said recently that it is very unrealistic to expect a vaccination vs corona before 2021. It needs research and tests and that's a couple months away.

In the UK a company offers 4000 € to folks to be professionally infected with corona so they can be used to try treatment and reparation and to develop a vaccination against it. Not a job I'd take.

But then, Trump has said recently that his super smart gut told him everything will fine, and never mind all these negative fake news from "doctors" and WHO, CDC, USAMRID and other utterly incompetent so called 'expert folks'.

Well, guts are full of many things and I'd not necessarily take that much more serious than unasked health and vaccination tipps I may get from a cab driver.

I read yesterday that one person claimed that Albanians are immune against corona and one iirc bulgarian politico claimed his mega aura would protect him and the country from corona and I don't believe that either.

If true, "Hurray!", if not, "Oh dear!".

sebastian

Addendum to my previous post from an Italian medical association: http://www.biotecnologi.org/ecco-perche-il-coronavirus-non-e-una-semplice-influenza/

Translation:

"For example, if we analyze the latest complete data available for the flu (2018-2019) we can observe 812 serious cases, which required hospitalization in intensive care, and 205 deaths (for technicians the data are reported to J10-11). However, this report covers all 33 weeks affected by the disease, with a peak of cases in the 5th week of the year, in which there were 93 ICU hospitalizations and 23 deaths.

What we are recording for coronavirus instead tells a completely different story. In fact, 351 cases requiring intensive care and 131 deaths were registered in this week alone. It is worth pointing out: in just 7 days. That's because there is a doubling of serious cases, which require intensive care, every 2.5 days, a sign that the disease is spreading very quickly.

This means:

that SARS-CoV-2 puts much more stress on the health system than the flu, both because the percentage of patients who need intensive care is higher, and because it needs them for prolonged times.
that the number of cases is STILL growing too rapidly and that this really jeopardizes the stability of the system, which is saturating quickly (not only in terms of beds and machinery, but above all on the medical-health front).

This does NOT mean that those who get sick will necessarily end up in intensive care or that the number of deaths is out of scale (it is good to remember that for secondary complications from flu (for technicians J12-18) it is estimated that in Italy they die every year between 8,000 and 10,000 people), but if we do not rapidly slow down the growth of cases requiring hospitalization (through the reduction of the infection) we will not be able to manage them effectively.

To be clearer: Covid-19 is still going up towards the red dotted line in the figure (which represents our ability to manage the emergency) much faster than we are able to raise it. Already now several hospitals have canceled all non-urgent interventions and reduced the activities on other departments to the bone."

tldr; the problem with coronavirus is that it produces a lot more severe(but still treatable cases). Again, if those overwhelm the hospitals lots of people with normally treatable diseases will die untreated.

bks

So in the cherry-picked example of S. Korea the rate is six-fold greater than the seasonal flu. Since WHO gave a global rate of 3.4% on 20 February, the global rate has not dropped.

Upstater

I am not sure epidemiologists can be certain what the COVID-19 death rate will eventually become.

Having said that, SK's 0.6% death rate is six times higher than the seasonal influenza. Using the president's tweets about influenza mortality, that would mean 162,000 to 420,000 deaths in the US, which is a big deal.

The problem is COVID-19 will easily overwhelm the health care system.

See Rod Dreher in TAC https://www.theamericanconservative.com/dreher/covid19-hospital-beds-overflow-panic-reality-trump/

Terence Gore

corona angst in cute song by hong kong gal

https://www.youtube.com/watch?v=i_QXvh8fVPI

Harlan Easley

I admire your courage. However, the CFR(Case Fatality Rate) is 8 - 15% for those over 70. I enjoy your writing and this blog. And would like to continue to enjoy it. Yes, we may find the CFR is around 1% or a little less. Reports are coming in from Atlanta ER rooms that an influx of patients with bilateral pneumonia are being admitted or other words SARS-CoV-2 infection. It depends on the intensity of the peak and how well our healthcare system responds. Once it burns through the community then community immunization should offer a degree of protection to all.That is why the CDC is recommending 60 and over try to minimize public contact.

Should this affect the stock market and economy. No, the incompetent response from the Trump administration is driving the panic.

He should have come out and said this will be tough hoe going through the first wave and appealed to the patriotism of the youth. Appeal to the younger generations to work through it, avoid their elders, and become infected if need be to offer the community immunization. He blew it.

Keith Harbaugh

If Colonel Lang will permit it, I think several recent articles are worth highlighting:

"Old Ideas in New Bottles"
(A new front group [the "Quincy Institute for Responsible Statecraft"]
preaches restraint while embracing interventionism)
by Philip Giraldi, 2020-03-10,

"Draining the Intelligence Community Swamp"
(New hires will all be Israel's poodles)
also by Giraldi, 2020-03-03

"Makes Sense – DNC Control Agents Created Biden Coalition With Promises of Administration Positions…"
by sundance, 2020-03-09
Sundance concludes by suggesting:

[This] approach of putting the gang back together,
with former President Barack Obama taking control over The Club network and playing the role of puppeteer,
does make sense as to how everyone was so quickly brought to heel. 
It would also explain
who would ultimately be running a Biden administration,
and that would not be Joe Biden.
Now for something more controversial:

"Chinese Scientists Find Genetic Explanation for Coronavirus Discriminating By Race"
by Lance Welton, 2020-03-04
I would be especially interested in hearing what Walrus thinks about that article.


Laura Wilson

Of course, South Korea has a fully-functioning health care system where people feel confident to self-report and know they won't go bankrupt when they call a doctor or go to the hospital. The need for respirators, etc. is also a problem and it would be interesting to know how many they have per population. I hope we are prepared but a relative who is nurse in Phoenix at a 1000 bed hospital could not get a patient tested although the patient personally requested it because of her children and elderly parents. The hospital could not get approval or a test. this was at the end of last week.

And we all know there are NO elderly folks in Phoenix who might be at risk! I am staying home.

turcopolier

All

We are staying home also, but then, at our age we pretty much always do except to visit our fav two or three restos and grocery stores. I am 80 in May. SWMBO is two years younger. We have had a good life. Why are you so afraid? Have you always been so fearful? Milan has a death rate of 6% among the infected? Must be the effect of the Mediterranean diet. Pasta make you live too long? Well if that is true, which I doubt, Italy is doomed, doomed! All of Europe is doomed! doomed! "b", the great doomsayer from MoA is frantic with fear. Be afraid! Be afraid? I will make you a deal. I will tell you all when we are infected if you tell us when you are. You all are filled with sophistic desperation seeking doom. .6% death rate in South Korea of those detected as infected. Try to think about it, or, just try to think about anything at all.

English Outsider

Well, Colonel, it's true that none of us are ever getting out of here alive. But there's surely no harm in attempting to postpone the journey?

I've got next year's wood to get felled. I'd like to hang around long enough to do that. And I've just laid in a stock of whisky in case we have to self-isolate. I'm not going before I've finished that!

As for the pasta, I had the honour of being shown how to make pasta, from the ground up, by an Italian acquaintance who was a professional chef.

It was awesome. All the family was excluded from the kitchen while the operation was performed. My technique with the little pasta machine was appraised and deemed adequate. I was even allowed to see him putting the herbs in the sauce, though I took care not to stand too inquisitively close. His wife whispered to me afterwards "He's never ever allowed anyone to see how he does it before!" so it was really quite a special occasion. I valued it as such and as an encore I was initiated into the mystery of genuine Tiramisu.

But that pasta! Even with two of us working, and one a maestro, it took up what seemed the best part of an afternoon. If they go through all that very often the Italians deserve a longer life expectancy just to make up for it.

Fred

I notice nobody on MSDNCetc ever mention the infection and death rate for Somalia, Senegal or parts in between. It's almost like a giant info op tagged onto a new viral infection but only the West is getting the good news

Eric Newhill

An older American gentleman who was on the cruise ship was flown, with his wife, to quarantine in Nebraska. He had contracted the virus. He's still in quarantine, but appears to be over the illness now and spoke to Fox News via Skype. He says he was especially at risk due to some preexisting medical conditions and his age. He never went on a ventilator. He says he had a high fever and a dry cough and felt pretty ropey for a few days and now feels ok. His wife is fine now as well. Clearly, most people who contract the virus, even those at higher risk, will have an experience like the gentleman from the cruise ship.

It is an axiom in statistical based understanding of reality that you need sufficiently sized samples and unbiased samples. Col. Lang is correct that the reporting has been based on neither.

IMO, some people will die from this just as they do from ordinary flues. Obesity kills far more each year. No hysteria over any of that. Wash your hands and don't rub your eyes or pick your nose (if you're so inclined) until you have washed.

BTW, the main threat here is not pneumonia. Pneumonia is a bacterial infection of one of the lobes of the lung. It can be treated with antibiotics. This virus can - under apparently rare circumstances - cause a complete inflammation of the entire lung(s) absent bacterial infection (per a medical director at the company for which I work). That is when the vent is required.

Also, the flu of 1918 killed by extremely high fever. We aren't seeing that level of fever with this new virus.

Walrus

Firstly, I hope Col. Lang will declare "JJackson" our Coronavirus Czar and perhaps prevail upon him to write more of his excellent commentary on this subject when he thinks it appropriate.

Keith regarding the paper you cited; If I understand your inference correctly; The implied conclusion of your post that the UNZ review author makes is that since the number of ACE receptors is higher in Asians and the virus targets ACE receptors, then Asian ancestry people stand a greater chance of having more and severer disease. He then makes the snide insinuation that this proves Coronavirus is a Bio engineered weapon - probably American made as well if I know the Unz review.

I am not qualified to comment on the alleged science in this paper, however I can think of at least one compelling reason for this observation - the virus evolved in Asia! Do you think its proteins would target receptors found only in Kalahari Bushmen? To put that another way; coincidence is not causality.

Then there is the little matter of whats happening in Italy - not many Asians there.

I also was told by a hands on epidemiologist that the wet markets in Wuhan were swabbed and were swimming in the virus.That statement was accompanied by images of the Wuhan markets - and dead, gutted, Pangolins laid out for sale.

And now a general warning about alleged "Science". I was CEO of a University company for six years. I worked with researchers, doctors, Professors in all the sciences. I have to tell you that they are a cross section of humanity just like everyone else. There are saints and sinners, knaves and thieves among them.

Right now a great deal of money and attention in Universities is being lavished on some virologists, vaccine researchers, epidemiologists and other specialists who are involved in the fight with this virus. There are Nobel prizes to be won and reputations made. Tenure, Professorships! Would it surprise you to know that other scientists are jealous, envious, outraged that their work is not receiving such largesse? Would it surprise you to know that they will do anything to attach themselves to this academic gravy train? Even perhaps write papers that are less than honest? Be very careful of what you hear from Scientists and always check for peer review and the background of the Scientists making the claim. There are already glaring examples of self promotion.

Sebastian, regarding CFR, and I hope JJackson will back me up on this, it is way to early to calculate an authoritative CFR for the simple reason that the disease can be so mild as to be undetected. I was told that initial CFR is always high for this reason. In Melbourne we have the case of Doctor Chris Higgins, who arrived back from the USA with a mild cold that quickly resolved itself, so he thought, but not before he had treated 70 patients. He didn't meet any testing criteria at all.

Please take Col. Langs warning seriously. The greatest enemy is hysteria. I would hope SST remains an island of sanity in this sea of disinformation.

harry

There is an alternative explanation. It sends Cv19 can cause respiratory impairment in approx 20% of cases. This impairment requires treatment. Usually all that is required is oxygen but in a minority of cases aggressive respiratory assistance is necessary. Machines which can oxygenate blood for those whose lungs are temporarily substantially impaired. Early diagnosis allows for quarantines which slows spread of disease. This means there are more beds for treatment. The failure to act aggressively in Italy has resulted in a shortage of hospital resources, which in turn has led to a higher death rate.

blue peacock
Redfield said that hospitals had limited extra capacity at present. Because of a strong, late flu season, hospitals are at 95% capacity or higher.

“We really don’t have a lot of resilience in the capacity of our health-care system,” Redfield said.

.....

In the early stages of an outbreak when the number of cases is small, health officials can focus on tracking down and isolating individual cases. It’s akin to stomping out a few embers that have jumped from a fire.

Redfield said the U.S.’s failure to quickly roll out tests for the virus had impeded the U.S.’s early efforts. Because of flaws with the original CDC tests, it took weeks for state and local labs to get working tests for the virus, hobbling their attempts to identify patients and isolate them.

“If you’re a week late,” Redfield told Congress, “it matters.”

https://www.bloomberg.com/news/articles/2020-03-10/window-to-contain-coronavirus-passed-in-some-places-cdc-says

CDC director Redfield is stating that testing is important for containment.

VietnamVet

Colonel,

The draconian measures undertaken by China, Singapore, Hong Kong, Taiwan and South Korea have curtailed the Wuhan coronavirus outbreak. Expansion there has stopped and new cases are in a decline. This is due to social cohesiveness, good healthcare systems and governments that work. The virus overwhelmed the healthcare systems in Iran and Italy. With medical care, the death rate is similar to seasonal flu. However this virus hits the elderly extremely hard who have no immunity. If the hot spots are not quarantined, the sick who need ventilator equipped ICU beds to stay alive will swamp the healthcare system. It is reported that Italian doctors are so desperate that they are triaging patients and letting the old die. Only treating patients 60 years old and younger.

Since I am old and an ex-Smoker I am sheltering in place. Epidemiologists project that if it runs its course without intervention around a million to a million and half Americans will die due to the virus. The healthcare system reportedly can only treat around 500,000 at once. A containment zone has been established around New Rochelle NY. The Wuhan coronavirus is exploding here into a national epidemic. The virus is highly contagious. Reports indicate at it can be spread in the air over six feet by infected who are asymptomatic. The only way to identify and isolate the spreaders is by lab tests. In the USA the tests failed and are still in very short supply. If the American epidemic turns out to be as deadly as Italy or Iran, it is on the Trump Administration. To date it is responsible for the deadly string of SNAFUs, nothing to fear messaging, not fast tracking new ventilators, protective equipment or preparing more ICU beds. Not believing in science in the first place.

It is in the national interest that all measures are taken to dampen and extend the outbreak to avoid the existential threat of the break down in the American health care system and the needless deaths of elderly Americans.

smoke

If this new interloper were to fell my very old father, whose marbles have been implacably slipping away over the past few years, it would be sad for me and all our family. He bears stoically his survival in a world now mostly beyond his reach. But I think he would regard a knockout blow from this pathogen in the old way of thinking: that pneumonia is an old man's friend.

steve

The time from when people are diagnosed until they died was, on average, 28 days in China. South Korea did an excellent job of testing so odds are that they caught a lot of otherwise asymptomatic people. They also tested quickly so they are ahead of the death curve. They also have generally better medical care than in China. So it is too early to say their real death rate as people have not had enough time to die and they likely take a bit longer there also. So we need to wait to see their actual death rate.

It is looking like the death rate, under good conditions in a health system that doesn't get overwhelmed will end up in the 1%-2% range. Just to put that in perspective mortality from major surgery is generally thought to be about 1.5%.

Doom? Nah, just want to be prepared so that we can be closer to 1% than 2%. If we end up like Italy then we also have 2nd order effects with people dying from other causes because the ICU beds in hospitals are full of Covid patients.

turcopolier

VV
Same negative character you have always been.

turcopolier

harry

Are you talking about the UK?

Fred

VV,

1,000,000 dead? Man will lawyers handling probate make a killing! How many houses will that free up for America's homeless? Will milenials finally be able to pay off their student loans? So much opportunity awaits. I wonder if coffin maker and funeral home stocks are booming? Sadly the only news on the later is a week old story out of the UK. And here I was thinking they had great government run health care.
https://www.standard.co.uk/business/dignity-funeral-homes-shares-surge-on-coronavirus-death-toll-fears-a4376011.html

The Twisted Genius

I'm happy to report that our local Chinese takeout place was doing a booming business tonight. Lots of happy and friendly locals coming in and the crew was working those woks like gangbusters. All those Fox News efforts to brand this as the Chinese or Wuhan flu are falling on deaf ears here in Stafford.

Ulenspiegel

"South Korea death rate is .6%"

Yes. And? Hint: Korea tested a lot.

1) Only 0.6% of the infected die. With a few hundred thousands of infected you kill your ICU departments esp. when you already have many flu and pneumonia cases (secondary infection of flu).


2) The death rate depends on age group. Even with ICU access infected people with age 80+ have a death rate of 20-25%., for 70+ its around 10%.

For good information:

1) This Week in Virology. Very good US podcast.

http://www.microbe.tv/twiv/

2) Prof. Drsosten's podcast (Charite Berlin) only in German.

https://www.ndr.de/nachrichten/info/podcast4684.html


The first is "only " once per week but often with guests. Very good scientific background.

The second is by somebody who is leading expert in the field (he provided the german test) and you get daily update. Some practical aspects of issues in hospitals are discussed.

You can without problem use both to filter out valuable hard data. No need to chase ghosts as result of bogus research and/or scientific conmanship.

turcopolier

TTG

I am happy for the Chinese resto but there is no doubt that the virus originated in China unless it was already here among the universe of viruses.

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