Nemo wrote: ↑
Tue Mar 24, 2020 10:30 pm
smcj wrote: ↑
Tue Mar 24, 2020 9:58 pm
Too bad there aren't enough tests to find out who is right. If they are right in 3 months this is over and containment is a waste of time
I don’t buy it. At yesterday’s White House briefing they said New York had a 25% positive test return, but the national average is 8%. If there’s widespread infection the national percentage would show it.
Or so it seems to my dilettante’s mind.
If it's 25% where are the dead? If Oxford is right and I think we can call them a trusted news source China has been lying. A very different story took place. China detected a Corona virus in Wuhan and panicked. They covered it up and allowed 5 million of the rich and well connected to escape before lock down. Then they had to lie about the numbers to explain all the dead. This made the entire world panic based on their lies of a high fatality rate when in reality they had let it burn for months. The 5 million who escaped had spread it to the entire world almost instantly. We never had the slightest chance at containment. The fallout from this will be truly epic if Oxford is correct.
That isn’t quite right. First, the 5m who left Wuhan were mostly regular people who didn’t leave the country, they fled to other parts of China. China has tracked the ones who went to other cities but obviously not those who went to other countries.
The paper trail on how this was identified by local doctors, then ignored by local government, then picked up on by national government is pretty much all out in the open, so the timeline is what it is.
They’re not lying about case numbers. However the testing itself understated the true prevalence by 60-80%. People who were quarantined in lockdown, got it, then recovered with only mild or no symptoms often were not tested. Only those who have symptoms and/or close contact with a positive case get tested (which is the protocol in all Asian countries, though some are now testing all foreign arrivals as a matter of course). We know that up to 80% of cases are asymptomatic or only have mild flu-like symptoms.
Interestingly there are documented reports of a cluster of unusual pneumonia cases in northern italy in late November, raising the question of where this really started. However that is a little academic. Northern Italy has a lot of sweatshops making clothes with Chinese labor. whichever way it went, it was the crowded urban environment in China that provided the potential for rapid growth.
The mortality rate seems to depend heavily on the ability of the healthcare system to, well, care. The Koreans experienced a case-based mortality rate of 0.1%. Why? Because they tested the most intensively and treated aggressively. Italy reports a case-based mortality rate of about 8%, because testing is slow and treatment resources constrained. Unfortunately we can’t separate the effects of broader testing to reveal the true mortality rate and better treatment, but from a public health perspective, we don’t need to, the conclusion is the same, you need to do both.
That China's infection rate magically stopped made no sense. Containment is not that effective. It was not containment but herd immunity. Cause this shit just don't look real otherwise. I think we put too much faith in shitty RT PCR tests and not enough in out own senses. Things have not looked right from an epidemiological standpoint for weeks.
Lockdown in China is completely different from lockdown in, say, Italy or Florida. People respect the rules. But yes, the tests are not great. False positive rates are about 50%. Nowhere can I find reports of the false negative rates. Most countries in asia are doing multiple tests per subject to reduce the diagnostic error rate.
One other observation. In most Asian countries if you go into hospital with symptoms for this you will get a first-line drug treatment, not just steroids plus ventilator. They’re not waiting for results of the WHO trials. Anecdotal results of these are good. However in the US, that would be an off-label drug use which nobody would pay for and the doctors would be unwilling to prescribe. So it’s fair to assume that the treatment received in the US will be a lot less aggressive than elsewhere.
Which brings me to your first, and the most interesting question. Where are the dead. The answer is simple; undiagnosed and therefore uncounted. I hope nobody does the estimates of that, as it will just add to the panic, and the panic is probably more dangerous than the virus.