Coronavirus Crash Open Thread

We have our first reported Hollywood celeb COVID 19 infection. Tom Hanks has stated that he and his wife Rita Wilson, who are in Australia for a film Hanks is working on, have tested positive. Hanks is 63.
https://www.ctvnews.ca/health/coronavirus/tom-hanks-rita-wilson-test-positive-for-coronavirus-in-australia-1.4849491?cache=yes%3FclipId%3D89750%3FclipId%3D104059%3FclipId%3D89531

OMFG I thought I understood what the US health system meant and then I realised you pay to get a Coronavirus test and even if you have insurance you might end up with a massive co-pay!? Or you don’t get a test!??? What the actual????

@Moogue @Yutolia

Every death is a tragedy to the people who love that person. I did not mean to trivialise that, and I’m really sorry it came off that way – it was unintentional.

The point I’m trying to make is that panicking and sensationalising doesn’t help those people. In a pandemic, we have to keep clear heads. We also have to accept that the figures we are seeing now will be subject to change, and at this point in time are almost certainly skewing high, are being given by different countries possibly with different criteria for inclusion, and may well include people who should be excluded. And we have to keep level heads, and not share rumours and unverified figures. When we do so we’re endorsing them, and the most important thing anyone can have right now is reliable information from reputable sources.

@Moogue
I’m sorry, but I need to say again that “required hospitalisation” is a meaningless phrase. How many were there for observation? How many were there because they lived with 5 other people and it was the only place to isolate them? How many had viral pneumonia? Are half of Italy’s cases in hospital there because it’s now Italy’s policy to admit them as a precaution? How many were on ventilators? How many were there because they had mild coronavirus and could have stayed at home, but had fallen down the stairs and broken their leg? How LONG were they in hospital – three hours or two weeks? How ill were they? Does this include day patients or is it people who were actually admitted?

Also, can you please link to where these stats comes from? Because I was looking for hospitalisation stats yest after talking to @Ohlmann, and I couldn’t find anything – medical organisations tend to not give figures in that way, because it is a) inaccurate, for the reasons I’ve given above, and b) alarmist.

It’s called the nocebo effect

@Violet

From JAMA;

“The Chinese Center for Disease Control and Prevention recently published the largest case series to date of coronavirus disease 2019 (COVID-19) in mainland China (72 314 cases, updated through February 11, 2020).1 This Viewpoint summarizes key findings from this report and discusses emerging understanding of and lessons from the COVID-19 epidemic.

…

Among a total of 72 314 case records (Box), 44 672 were classified as confirmed cases of COVID-19 (62%; diagnosis based on positive viral nucleic acid test result on throat swab samples), 16 186 as suspected cases (22%; diagnosis based on symptoms and exposures only, no test was performed because testing capacity is insufficient to meet current needs), 10 567 as clinically diagnosed cases (15%; this designation is being used in Hubei Province only; in these cases, no test was performed but diagnosis was made based on symptoms, exposures, and presence of lung imaging features consistent with coronavirus pneumonia), and 889 as asymptomatic cases (1%; diagnosis by positive viral nucleic acid test result but lacking typical symptoms including fever, dry cough, and fatigue).1

Most case patients were 30 to 79 years of age (87%), 1% were aged 9 years or younger, 1% were aged 10 to 19 years, and 3% were age 80 years or older. 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). Most cases were classified as mild (81%; ie, nonpneumonia and mild pneumonia). However, 14% were severe (ie, dyspnea, respiratory frequency ≥30/min, blood oxygen saturation ≤93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio 50% within 24 to 48 hours), and 5% were critical (ie, respiratory failure, septic shock, and/or multiple organ dysfunction or failure) (Box).1

The overall case-fatality rate (CFR) was 2.3% (1023 deaths among 44 672 confirmed cases). No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8% CFR. No deaths were reported among mild and severe cases. The CFR was 49.0% among critical cases. CFR was elevated among those with preexisting comorbid conditions—10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for hypertension, and 5.6% for cancer. Among the 44 672 cases, a total of 1716 were health workers (3.8%), 1080 of whom were in Wuhan (63%). Overall, 14.8% of confirmed cases among health workers were classified as severe or critical and 5 deaths were observed.1

COVID-19 rapidly spread from a single city to the entire country in just 30 days. The sheer speed of both the geographical expansion and the sudden increase in numbers of cases surprised and quickly overwhelmed health and public health services in China, particularly in Wuhan City and Hubei Province. Epidemic curves reflect what may be a mixed outbreak pattern, with early cases suggestive of a continuous common source, potentially zoonotic spillover at Huanan Seafood Wholesale Market, and later cases suggestive of a propagated source as the virus began to be transmitted from person to person (Figure 1).1

I understand your point that we have to keep a clear head because we’re still learning about all of this, and things are rapidly changing, but remember that “I don’t know” means just that-I don’t know , not “everything is fiiiine”. Quite frankly, I disagree with you that we don’t need to panic. I think we need the right amount of panic, somewhere between Trump “Merica is too Great Again for the Coronovirus” and the Americans building forts out of tolietpapaper.

Let’s put it this way, measles is again, only fatal in .2% of the cases, yet I’m guessing from your rant in the other thread that you probably have a problem with American antivaxxers who “don’t panic” about measles to the point that they fear the measles vaccine more than their kids getting measles. (Obviously not a perfect comparison, as measles causes a lot of lifelong complications, but still makes my point that people need to feel some anxiety in order to take necessary precautions).

even measles has “only” a .2% fatality rate nowadays

As far as I’m aware, the main problem with measles isn’t the fatality rate, it’s that it causes a compromised immune system for years afterwards, making it significantly more likely for other diseases to finish the job.

Of course, we don’t know what kind of long-term effects might happen from contracting covid-19. Suppose there’s no point to borrow trouble from the future for right now, though.

@Violet:

Still don’t know where the hospitalisation figure came from tho; I couldn’t see it in that link.

It’s buried in the big JAMA quote, plus it’s kind of implied rather than explicit:

However, 14% were severe (ie, dyspnea, respiratory frequency ≥30/min, blood oxygen saturation ≤93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio 50% within 24 to 48 hours), and 5% were critical

Assuming that severe-or-worse warrants hospitalization, that adds up to 19% of cases warranting hospitalization. The “20%” figure is then obviously the result of rounding.

@Surplus

Thanks, I guess that’s it.

It’s an assumption, though, as you point out. And we still don’t know things like how long they were hospitalised for, how long that phase of the illness took, how long recovery took, where or how these tests were done, and (considering that a lot of cases are probably unreported) what it means as a percentage of total coronavirus cases. So I’m still very much reserving judgement on what it means for hospital beds, and I still think we should not be flinging it about willy-nilly and scaring people.

Look, if people have made up their minds this is Captain Trips, there’s not a lot I can say – but please do bear in mind who is listening to you. There are a lot of people out there right now who are at risk who are scared and distressed. What they need to hear is “wash your hands, don’t touch your face, perhaps cancel lunch with the girls, and if you get ill don’t go outside. Be sensible, and you have an 80pc chance of being absolutely fine.”

That’s the reverse, after all; “20pc of people who get this are hospitalised” also means “80pc of people recover with no issues.”

nip off the decimal

the media, generally, do not deal in decimals; that’s the preserve of research papers such as the one you have here. I was referring to the fact that the general public will mostly seeing round numbers

The severe category clearly can be called hospitalisation

However, 14% were severe (ie, dyspnea, respiratory frequency ≥30/min, blood oxygen saturation ≤93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio 50% within 24 to 48 hours.

OK, I’ve had another look at it following my comment to @Surplus, and that’s a big assumption. They have been given a blood test and their breathing and oxygen levels have been measured; could have been done at home. They might well have needed oxygen-enriched air. Also could be done at home. I’m sure some of them were in hospital, yes, but this is still not a figure of number of people hospitalised.

You’re clearly determined that medical infrastructure is going to completely collapse and people will be dying in the streets. Good luck with that.

We’re probably going to just go round in circles here, so I’m done – I’ve made all the points I want to say, and I guess I’ll leave it all up to the people reading this now.

“, I’ve had another look at it following my comment to @Surplus, and that’s a big assumption. They have been given a blood test and their breathing and oxygen levels have been measured; could have been done at home. They might well have needed oxygen-enriched air. Also could be done at home. I’m sure some of them were in hospital, yes, but this is still not a figure of number of people hospitalised.

So you ignore the tests results and decide that they weren’t really sick because they could have been tested at home or whatever. OK, but we’re talking about the test results!

Their test results indicated that they were getting into respiratory distress, you don’t wait for people to become critical and die to hospitalize them. Hence, yes “hospitalized” here means “critically sick”, not broken bones or whatever else you said.

Our president just dictated Urgent Decrees, which will close down schools, and universities for a month. Also, all gatherings of over 300 people are cancelled.

As far as governments are concerned, it seems the Brazilian administration has been infected and they were dining with the Trump administration yesterday:

https://www.lavanguardia.com/internacional/20200312/474100754881/jefe-prensa-bolsonaro-positivo-coronavirus-cena-trump-miami.html

At this point it’s tough to determine whether they got it from the Trump administration (remember the guy at CPAC who tested positive and shook hands with Mike Pence?), or whether the Brazilians brought it in.

https://www.prensalibre.com/uncategorized/jair-bolsonaro-esta-bajo-control-medico-por-positivo-de-coronavirus-en-su-jefe-de-comunicacion/

@Naglfar

How’s the hunt for supplies and groceries going? We are only at 22 infected and people are losing their damn minds. There was a lady at the convenience store this morning, buying up all the last of the toilet paper. She had her hands full and was asking the store clerk if she didn’t have any more.

Concerning Trump, I hadn’t heard of that. But it would be rather ironic if it spread through Mike Pence, who was specifically appointed to combat the disease. Somehow I get the feeling that the Trump administration is going to do precisely the opposite and continue downplaying the severity of contagion. Makes you wonder how many world leaders are going to get infected because of their recklessness.

I don’t remember a pandemic spreading this fast before. Italy is a trainwreck.

Well in person classes for my college have. Been suspended until the 27th and my spring break has been extended a week