What are people doing to supplement prom and graduation and grad night? I’m so depressed right now because all of that might be taken away. I hate this all and would hate it if my school closed for the rest of the year and I miss everything I’ve worked hard to celebrate.
Again, because the herd has immunity, and we know the denominator. And “just” measles is no cakewalk - there can be life long consequences, such as depressed immune system etc.
Published in Science Magazine 3/16
86% of cases may be completely undetected.
Lowering fatality rates seen and also ultimately herd immunity post crisis. Also if accurate probably means more of a national lock down is coming down the pike or much stricter curfews etc.
RESEARCH ARTICLE
Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2)
Ruiyun Li1,, Sen Pei2,,†, Bin Chen3,*, Yimeng Song4, Tao Zhang5, Wan Yang6, Jeffrey Shaman2,†
See all authors and affiliations
Science 16 Mar 2020:
eabb3221
DOI: 10.1126/science.abb3221
Abstract
Estimation of the prevalence and contagiousness of undocumented novel coronavirus (SARS-CoV2) infections is critical for understanding the overall prevalence and pandemic potential of this disease. Here we use observations of reported infection within China, in conjunction with mobility data, a networked dynamic metapopulation model and Bayesian inference, to infer critical epidemiological characteristics associated with SARS-CoV2, including the fraction of undocumented infections and their contagiousness. We estimate 86% of all infections were undocumented (95% CI: [82%–90%]) prior to 23 January 2020 travel restrictions. Per person, the transmission rate of undocumented infections was 55% of documented infections ([46%–62%]), yet, due to their greater numbers, undocumented infections were the infection source for 79% of documented cases. These findings explain the rapid geographic spread of SARS-CoV2 and indicate containment of this virus will be particularly challenging.
Yup. I’m aware of that. Just comparing death rates here. I’m not downplaying the seriousness of measles.
Covid-19 is also reported to have potential life long consequences re: lung issues.
Coincidentally, there are currently 17 cases of COVID-19 in Maine and 17 cases in Austin. If the number of cases doubles every six days, there would be 272 Austinites or Mainers with the disease in 24 days. If the number of cases doubles every three days, there would be 4,352 Austinites or Mainers with the disease in 24 days. THIS is why it’s so important to avoid going out as much as possible, to reduce the increase in cases. Let’s see if Maine or Austin is more successful in slowing down the increase! I will check in 24 days, on April 10.
Here is the quote I based this on, from Dora Anne Mills:
“The overall numbers are also a concern. Early epidemiology studies of COVID-19 in China indicate we can expect to see case numbers doubling every six days. More recently, the doubling times seen in Europe and the U.S. have been between two and four days. With 17 known to be infected in Maine, a doubling time of six days could mean that in 24 days 272 Mainers could have COVID-19. With a doubling time of three days (closer to what is actually occurring in the U.S.), that means 4,352 Mainers - without interventions - could have COVID-19 in 24 days. These numbers could be much higher, since we don’t really know how many in Maine currently have COVID-19, given that some early cases indicate community spread in Greater Portland and given that the Maine CDC and NorDx labs were just able to start testing last week. BUT, and this is a critical point - the numbers could be much lower, depending on our individual and collective actions we take now.”
Maine has 32 confirmed cases right now. And indication of how more testing is turning up more cases. Maine has tested 1,335 as of noon on Tuesday, 3/17.
This video has a good explanation of how the reported mortality rate might relate to actual rate of infection:
https://www.youtube.com/watch?v=mCa0JXEwDEk
One problem is that there is generally a +5 day lag between infection and onset of symptoms – and then another +15 days or so before death for the small fraction of people who pass away.
One thing that concerns me is that basically the shelter-in-place measures are coming too late. The way that we could have gotten ahead of this virus was by starting with widespread testing back in January-- then we would have had a better handle on numbers.
That doesn’t mean these efforts aren’t valuable - on the contrary, they will make a huge difference, but the difference won’t be apparent for many weeks. In the meantime, the hospitalization rate, as well as death rate, will continue to climb, because of all the undetected infected people who are walking around right now. I’m afraid that’s a kind of math that is hard for the general public to understand – and I worry about what might happen in the coming weeks now when people are still seeing climbing numbers and are thinking (erroneously) that the hand-washing and shelter-in-place don’t work, and compliance drops off.
I often scan this thread looking for anything positive so thank you @doschicos , for that info about Avigan. Seriously hoping that the research continues to show positive results with that drug and we hear more about that soon.
I have to keep reminding myself that there are tons of brilliant people working on this…that is my way of dealing with the stress/anxiety of it all!
It’s too early to understand the US death rate since the average days until death (based on China) after being admitted to the hospital is 18.5 days. The elderly may succumb to death earlier.
Which means it’s 8 to 16 times more deadly than the flu for those who get counted (those who get tested - both this and the flu have MANY who aren’t tested because it’s not bad enough for them to seek help - or they couldn’t get a test).
If 100 per day die from the flu, 800 - 1600 per day will die from this if it gets to be as widespread. Then add on the numbers who die from the flu.
With the number of negative tests we are seeing even in hot spots, it’s not as prevalent as some are wishing it is to lower stats. If it were, we’d see a LOT more positive tests.
If isolation doesn’t work - mainly due to folks who feel they don’t need to bother - then it’s going to get bad. If isolation works, folks can feel free to say the world “overreacted.” I can live with that (even if it isn’t true). We have to try. One only needs to look at Italy/Europe to see what happens if we “wait” before doing it. One can see success in China and SK (Vietnam too if a pp is correct - no reason to doubt that IMO).
A true hope comes in these meds people are working on. May those be successful… I’d like to see life revert to normal preferably sooner rather than later.
Here is an idea for your Med school lad. Many medical schools are canceling clerkships and removing students from them. I read an article (apologies for not being able to find it now) about one 3rd or 4th year who was setting up a child care service for health care workers whereby these students provide babysitting so folks working in health care can go to their jobs.
That seemed like a good idea. Sure, the parents could bring the virus home…but …it’s a thought.
@WayOutWestMom your thoughts?
Doing some reverse maths here.
We are mostly agreed that there are three countries/conveyances whose numbers we feel might be somewhat reliable, due to widespread testing and a somewhat representative sample (lots of non seniors or at least comparatively healthy and active seniors) and good available health care for all serious cases,
That’s South Korea, Germany and the Diamond Princess.
As of today, according to worldometers, the death rates are, roughly:
South Korea 1 percent
Germany 0.2 percent
Diamond Princess 1 percent
Germany probably lags behind South Korea because of the surge in cases in recent days, so may end up with 1 percent as well.
So take current deaths from times 100 (1 percent, low estimate for a country with a longer history of infection) or 500 (0.2 percent, for countries with recent surges) and you end up with a “shadow” rate of infection.
That would be between 250.300 and over a million for Italy. We know their health care system is overwhelmed and they are doing war time triage.
Between 110.000 and 550.000 for the US. At this point, manageable. Stop the spread now.
Iran, between 100.000 and 500.000. Will end up with triage.
Did I get this right?
Dr. Michael Saag, an infectious disease specialist at UAB wrote an excellent article about COVID-19 (link one). Then he was diagnosed with COVID-19 and is interviewed (remotely) in link 2.
I’d suggest you start another thread to discuss those issues. This thread is already tough enough for a lot of us to wade through, and this kind of concern/issue isn’t a relevant issue for this thread’s topic.
@CindyLeuWho, Yes, if there isn’t a thread in high school life for high school seniors’ issues, definitely make one. Sounds like theres a need.
I don’t think the US will have as positive (comparatively) results as Korea or Europe. We have a substantial uninsured population, more who can barely afford any medical care, and no paid sick leave for tens of millions. Plus a far larger homeless population. All of those factors will increase contagion.
@cindyleuwho. I feel for you. And yes college confidential is a forum dedicated to your journey.
You can post anywhere you’d like.
This particular thread is a bit tense right now for many of the posters. It’s more focused on tracking the disease, information and statistics.
So please don’t take it personally at all. You’re probably upset and a bit scared. It’s ok.
There are a few threads on the “latest post” prompt that are dealing with the more real world concerns, more in keeping with your questions.
Also, as suggested, you can always make a new thread for student senior year concerns.
Please also tell your friends to follow the health guidelines. It will make this end more quickly. You can play an important role in helping us all as an advocate.
My lad was given another assignment… studying for his Step II for two weeks. He’s taking it seriously and doing it. Talk that isn’t official says they may end up needing the med school students for non-emergency things (non Covid). Those things still happen. He’s brushing up on all of the classwork and rotational work he’s done on those - just in case.
Like many at his school, he is eager to be used if they call upon them, though he also fully understands why they aren’t currently using students. Students do not have the hands on experience needed. They’ve shadowed since first year (alongside classes) and have gone into full rotation mode third year. He’s good at taking histories and similar plus his assessments have been spot on earning him some nice accolades, but that’s just not the same thing.
He did connect his GF to two doctors who needed childcare. She was studying to be an EMT and her class is on hold. Win/win for them right now.
As far as the Japanese influenza drug having a positive effect with COVID-19, can anyone find a link to the actual study done in China?
The drug is favipiravir, brand name Avigan.
A big problem with all the media attention to drugs which “may” be effective is that doctors are already under a lot of pressure to do something, and they are putting people on these drugs without clear evidence that they help, and without clinical trials. DH gets contacted by relatives of patients demanding to know why their loved one isn’t on whichever medication they have read about. Of course, DH understands their feelings, and he is patient and kind, but he wants clinical trials if he’s going to use these drugs so that we will be advancing the knowledge of what actually works. Besides, we already know that some drugs lead to a worse prognosis (steroids doubled the deaths in a clinical trial in China).
Some articles about Avigan say it doesn’t work in patients who are critically ill. Does that mean it should be given early, or are did the Chinese researchers actually just observe the fact that Avigan “works” in patients who were going to get better anyway. I can’t find the actual research study, so there’s no way to critique the methods they used etc.
An additional problem is that there is a limited supply of each of these drugs and no way to ramp up production of all of them. If we keep throwing everything at the virus without structured research, we will run out of the drugs before we even figure out what’s effective.
I think it’s important for the public to understand how crucial research is to our efforts to fight this. People may be asked if they want to enter a clinical trial and I hope they know how helpful that would be. Also, it wouldn’t hurt for patients and families to understand that we do not have any proven effective treatments as of now. Just guesses, which is not enough.
"@cindyleuwho. I I feel for you. And yes college confidential is a forum dedicated to your journey.
You can post anywhere you’d like."
Thank you @privatebanker , you are always a gracious and valuable contributor to this forum.