19 votes

COVID-19 situation in the US progresses in three ways in Washington state: first death, first case in a healthcare worker, and first possible outbreak

17 comments

  1. spit-evil-olive-tips
    Link
    Some informed speculation from a scientist at Fred Hutch (an extremely well-regarded cancer research center here in Seattle) based on genome sequencing of the virus done by the Seattle Flu Study...

    Some informed speculation from a scientist at Fred Hutch (an extremely well-regarded cancer research center here in Seattle) based on genome sequencing of the virus done by the Seattle Flu Study

    https://twitter.com/trvrb/status/1233970271318503426

    This strongly suggests that there has been cryptic transmission in Washington State for the past 6 weeks
    ...
    I believe we're facing an already substantial outbreak in Washington State that was not detected until now due to narrow case definition requiring direct travel to China.
    ...
    Our best current expectation is a few hundred current infections. Expect more analyses tomorrow.

    8 votes
  2. [16]
    freestylesno
    Link
    It is so unclear how much of an issue this is. Friends who are doctor's and pharmacist's tell me it's nothing more then the flu. Unlike the flu we don't have preventative measures against it. Tim...

    It is so unclear how much of an issue this is. Friends who are doctor's and pharmacist's tell me it's nothing more then the flu. Unlike the flu we don't have preventative measures against it.

    Tim foil hat engaged, China released it to pull the media away from Hong Kong. It's a engineered virus to destabilize countries.

    1. [13]
      nothis
      Link Parent
      Friends of mine who are doctors and pharmacists tell me wildly different things because they're not epidemiologists and have no fucking clue. The mortality rate is still unknown but estimated in...

      Friends of mine who are doctors and pharmacists tell me wildly different things because they're not epidemiologists and have no fucking clue. The mortality rate is still unknown but estimated in the 2% range, which is way higher than the flu, which is closer to 0.1%. So COVID-19 might be 20 times more deadly. There is no reason to "panic", as there never is in pretty much any situation, but I'm a bit tired of this argument. It's a new disease that already killed thousands which we still have a chance of containing to some degree. And tinfoil-hat-theories about China (who lost several Hong Kongs worth of money and trust in this) don't help anyone.

      24 votes
      1. [11]
        reese
        (edited )
        Link Parent
        Ditto for the most part. With COVID-19, I've seen two prevailing ignorance-based narratives: It's not a big deal. It's a conspiracy. Regarding the first narrative, "it's not a big deal," any new...

        Ditto for the most part. With COVID-19, I've seen two prevailing ignorance-based narratives:

        1. It's not a big deal.
        2. It's a conspiracy.

        Regarding the first narrative, "it's not a big deal," any new disease that kills anyone is a big deal, principally one we don't know much about. At first, reports indicated that the mortality rate was lower than the flu, and that's when the hand waving really got under-way. Yet, anyone paying the slightest modicum of attention could ascertain that the virus was spreading rather quickly under, I'll emphasize, a tight-lipped, authoritarian regime. While it's still hard to tell how the virus will spread on a global scale, so far we're looking at a relatively high mortality rate. And even if it were lower or as low as the flu, thousands of people are dying.

        I agree with the parent comment that we should not panic, but I doubt we can contain this virus before it spreads everywhere. I can't say I know for sure, but it's highly probable that the virus has already spread more than we know, since so many of the affected are asymptomatic, and those with symptoms may not visit the doctor for a whole host of obvious reasons I need not explain. Ultimately, we can hope for three things:

        1. Mother Nature steps in to our benefit.
        2. We get the virus, but don't die from it.
        3. We get a vaccine.

        The second hope seems likely for most at this point, but the third is nigh-inevitable at some point.

        Anyway, as for the second narrative, "it's a conspiracy," I get it. Everyone wants an explanation. Would I be surprised to learn that the virus was basically a lab accident? No, to the dismay of many on Tildes. That said, Occam's razor and a history of similar cases suggest a simpler explanation based on the evidence we have so far. Reality always comes first, and fictional tropes second, unless you're writing sci-fi.

        5 votes
        1. [10]
          ibis
          Link Parent
          I think it's important to not underestimate the severity of the disease, but also to not be alarmist. People have been making comparisons to the spanish flu and acting like the world is ending. As...

          Regarding the first narrative, "it's not a big deal," any new disease that kills anyone is a big deal, principally one we don't know much about.

          I think it's important to not underestimate the severity of the disease, but also to not be alarmist. People have been making comparisons to the spanish flu and acting like the world is ending.

          As far as I can tell, all current evidence suggests that only the elderly and people with pre-existing conditions are at risk. Thousands of people are dead, but thousands of people die from the regular flu every year as well.

          I'm not trying to say that corona virus isn't a "big deal" - because it obviously is. But it's important to maintain perspective. Society as we know it is not crumbling. Your average person is not likely to be in danger - the main impact on most of us is imposed measures to stop us from spreading the disease to people who are vulnerable to it.

          1 vote
          1. [7]
            CALICO
            (edited )
            Link Parent
            It's a subjective thing, when to be alarmed. The Spanish Flu infected 500 million of the 1.8 billion* people on the planet at the time, and killed 50–100 million. That's about 28% of the...

            It's a subjective thing, when to be alarmed.

            The Spanish Flu infected 500 million of the 1.8 billion* people on the planet at the time, and killed 50–100 million. That's about 28% of the population infected, with a 10–20% mortality rate leaving 2.8–5.6% of the world population dead by the time it was over. It was also the worst epidemic in modern history. COVID-19 doesn't have to be the worst, to still be really fucking bad.

            Most of the infections and deaths are in China, and personally I don't trust the accuracy of their numbers. However, we work with what we have. We're at approximately 87k infected, and 3k dead. That's about 3.4% mortality. How much of the world will become infected has yet to be determined. But if we use the 28% figure from the Spanish Flu, with a world population of ~7.8 billion, that's 2.2 billion infected and 74.3 million dead. By percentage that's not nearly as bad as Spanish Flu, but it's objectively a lot of people. Is that potential figure worthy of alarm? (rhetorical question, it's subjective)

            Maybe more than 28% of the world will become infected. Maybe containment and quarantine work out and it's not nearly that much. Maybe the mortality rate will rise with a larger sample size; maybe it will be lower. However, world leaders and people of influence becoming fearful is how meaningful action is taken to reduce its impact in the first place. Best case scenario, world leaders get really scared, make some drastic decisions that severely limits the spread, and we'll all be laughing about how scared we all were about something that didn't turn out to be a big deal.

            Something important as well, is that death is not the only bad thing that could happen to an infected person. I've seen reports that COVID-19 can result in organ damage, just like SARS. To my knowledge none has been peer reviewed this far, but I've read reports of circulatory, respiratory, neurological, and reproductive damage in survivors. How true that is, and it's prevalence among survivors, is an unknown at this time to the best of my knowledge. But it's something to keep in mind. We could be looking at hundreds of millions of people by the time this is over with lasting damage done, and not everyone lives in a place with adequate or affordable healthcare.

            *estimated. Records aren't super great, but it was somewhere around that number.

            edit: I didn't proofread

            7 votes
            1. [3]
              cfabbro
              (edited )
              Link Parent
              Not trying to undermine your points at all, since I largely agree with you... but just for accuracy's sake and to provide a source: If the Chinese CDC is to be believed, as of Feb 11 it was ~72k...

              Not trying to undermine your points at all, since I largely agree with you... but just for accuracy's sake and to provide a source: If the Chinese CDC is to be believed, as of Feb 11 it was ~72k possibly infected (~45k confirmed) with a 2.3% fatality rate overall, but a 49% rate amongst the already critically ill:
              http://www.cidrap.umn.edu/news-perspective/2020/02/study-72000-covid-19-patients-finds-23-death-rate

              2 votes
              1. [2]
                CALICO
                Link Parent
                According to the World Health Organization's most current COVID-19 Situation Report (29 Feb), there are 85,403 confirmed cases globally, and 2,924 deaths. That's 3.4% at this time. How this...

                According to the World Health Organization's most current COVID-19 Situation Report (29 Feb), there are 85,403 confirmed cases globally, and 2,924 deaths. That's 3.4% at this time.
                How this effects people across age groups, of various health status, in various enviornments, is something we'll only have the pleasure of knowing if and when this spreads further.

                4 votes
                1. cfabbro
                  Link Parent
                  Thanks for the more reliable (IMO) link. And ooof, that's quite a bit scarier than the Chinese CDC report. :(

                  Thanks for the more reliable (IMO) link. And ooof, that's quite a bit scarier than the Chinese CDC report. :(

            2. [3]
              ibis
              Link Parent
              The Spanish Flu was devastating because it could kill healthy young adults and children. Most victims of the corona virus are elderly. I'm not trying to be disrespectful to the elderly here - I...

              The Spanish Flu was devastating because it could kill healthy young adults and children. Most victims of the corona virus are elderly. I'm not trying to be disrespectful to the elderly here - I know that a loss of any human life is tragic, and they will be missed and grieved by their family. But people don't die of 'old age' - they get old and frail and their bodies can't fight off disease. Mortality rates alone are not a great indicator of how serious a disease is - this has come up before when the impact of breast cancer and prostate cancer are compared.

              That's about 3.4% mortality.

              As far as I'm aware, no experts are claiming the mortality rate is this high. It's an evolving situation and no one knows for sure, but this does not seem like a reasonable figure given what has been widely reported.

              I've seen reports that COVID-19 can result in organ damage, just like SARS. To my knowledge none has been peer reviewed this far, but I've read reports of circulatory, respiratory, neurological, and reproductive damage in survivors.

              Circulatory, neurological, and reproductive damage seems unlikely considering that it's a respiratory virus. The disease has now been around for almost three months - if this was a serious concern, I suspect we would know by now.

              2 votes
              1. [2]
                CALICO
                (edited )
                Link Parent
                Coronavirus has a history of this very thing. SARS and MERS—both of which are Coronaviruses—can access intestinal cells and do well for themselves there, for example. Extrapulmonary Symptons in...

                Circulatory, neurological, and reproductive damage seems unlikely considering that it's a respiratory virus.

                Coronavirus has a history of this very thing. SARS and MERS—both of which are Coronaviruses—can access intestinal cells and do well for themselves there, for example.

                Extrapulmonary Symptons in Coronaviruses:

                Clinical Course and Outcomes of Critically Ill Patients With Middle East Respiratory Syndrome Coronavirus Infection.
                Systemic Viral Infections and Collateral Damage in the Liver.
                Acute renal impairment in coronavirus-associated severe acute respiratory syndrome [pdf]
                Severe neurologic syndrome associated with Middle East respiratory syndrome corona virus (MERS-CoV)
                Neurological Complications of Middle East Respiratory Syndrome Coronavirus: A Report of Two Cases and Review of the Literature
                ACE2 Expression in Kidney and Testis May Cause Kidney and Testis Damage After 2019-nCoV Infection

                As far as I'm aware, no experts are claiming the mortality rate is this high

                According to the World Health Organization's most current COVID-19 Situation Report (29 Feb), there are 85,403 confirmed cases globally, and 2,924 deaths. That's 3.4%. As the sample size continues to grow, this number may change in either direction.

                3.4% isn't that bad, to be honest. SARS was several times that, and MERS was around 10x as deadly. How many people die has less to do with the mortality rate, and more to do with how many people worldwide become infected. SARS and MERS were both rather small outbreaks, COVID-19 has already infected more than the both of those combined.

                The Spanish Flu was devastating because it could kill healthy young adults and children. Most victims of the corona virus are elderly...

                I'm not really concerned with who all is at risk, what matters to my mind is that people are at risk. Yes, most deaths will be among the elderly. I'm not sure why that matters. We all die of something, that's true. But if there's an illness spreading around the world that would end your life before your body was going to give up on itself, maybe we should concerned by that.

                4 votes
                1. ibis
                  Link Parent
                  The death rate is heavily impacted by how wide-spread testing is. That's why, taken in context, no expert is actually expecting/reporting a mortality rate of 3.4%. Most are reporting between 1 and...

                  According to the World Health Organization's most current COVID-19 Situation Report (29 Feb), there are 85,403 confirmed cases globally, and 2,924 deaths. That's 3.4%. As the sample size continues to grow, this number may change in either direction.

                  The death rate is heavily impacted by how wide-spread testing is. That's why, taken in context, no expert is actually expecting/reporting a mortality rate of 3.4%. Most are reporting between 1 and 2%, and the latest data suggests it will go below 1% as testing becomes more widespread (eg. https://twitter.com/thehowie/status/1234103571236499456).

                  I'm not really concerned with who all is at risk, what matters to my mind is that people are at risk. Yes, most deaths will be among the elderly. I'm not sure why that matters. We all die of something, that's true. But if there's an illness spreading around the world that would end your life before your body was going to give up on itself, maybe we should concerned by that.

                  I feel like this is an unfair characterisation of my stance. I think the point that the spanish flu killed healthy young adults is extremely relevant and it would be irresponsible to ignore it if you're going to make comparisons to the Corona Virus. I think maintaining perspective is extremely important - especially because it seems inevitable now that the disease will (/has already) spread around the world. I don't think I ever implied that the corona virus is of no concern and people dying doesn't matter.

          2. [2]
            krg
            Link Parent
            You might want to give this rundown a read.

            You might want to give this rundown a read.

            4 votes
            1. ibis
              Link Parent
              A lot of the points raised in the article are good. I agree that the disease will place a major strain on medical supplies and facilities (though I disagree with some of the specific maths used),...

              A lot of the points raised in the article are good. I agree that the disease will place a major strain on medical supplies and facilities (though I disagree with some of the specific maths used), and I agree that we should all be prepared to self-quarantine to stop the disease spreading to vulnerable people.

              But I take issue with this:

              A recent paper suggested 80% of all cases are mild but 20% of those infected required hospitalization and 14% of those hospitalized require intensive respiratory treatment. 10.

              The sentence may be technically true, but it is misleading reporting. The linked study is just a descriptive and exploratory data analysis of health records. It does not attempt to extrapolate the results to the total population of infected people. It is just giving some summary stats.

              The sample is obviously going to be bias towards severe cases, and even then 1.2% had no symptoms at all (how/why they were tested in the first place is anyone’s guess). We can assume that the actual proportion of infected people with no or mild symptoms is much larger, as they wouldn’t have gone to the doctor to be tested in the first place.

              No expert is actually suggesting that 20% of people infected will be hospitalised.

              The fact that the author makes the distinction between confirmed cases and actual cases when talking about the spread of the disease, but not on its impact on the mortality/hospitalisation stats, is dishonest imo. I get that they are trying to make a call to action, but they aren’t helping the situation by spreading misleading info.

              3 votes
      2. bhrgunatha
        Link Parent
        Yes, that theory definitely doesn't pass the common sense test. I also read it was an accident at a bio-engineering research lab which is more plausible but still doesn't defeat occam's razor in...

        Yes, that theory definitely doesn't pass the common sense test.
        I also read it was an accident at a bio-engineering research lab which is more plausible but still doesn't defeat occam's razor in my opinion. It's a natural mutation and process just like all the others - HIV, H5N1, SARS, Zika, Ebola...
        They're perhaps worse due to how far humanity has spread and how interconnected we are now but we're also much better prepared to respond and cope than at any time in history.
        That's not to downplay how serious it may get or to dismiss the real human tragedy that is affecting people, just to add a little perspective.

        3 votes
    2. ibis
      Link Parent
      Why would China release an engineered virus on their own country? They have been the worst impacted and they are taking the most extreme measures to try and contain it. Their cities are in lock...

      Why would China release an engineered virus on their own country?

      They have been the worst impacted and they are taking the most extreme measures to try and contain it. Their cities are in lock down, people are being told to stay home from work, the streets are empty.

      17 votes
    3. Deimos
      Link Parent
      Please don't help spread conspiracy theories like this. The concerns are definitely being exaggerated in some ways, but it's still a serious issue that's killing a lot of people, and is going to...

      Please don't help spread conspiracy theories like this. The concerns are definitely being exaggerated in some ways, but it's still a serious issue that's killing a lot of people, and is going to kill a lot more. Muddying the waters with misinformation is the opposite of helpful.

      17 votes