Tuesday, March 17, 2020

CORONAVIRUS IS STILL UNDER 3% FATAL ACROSS ALL AGE GROUPS. STOP THE PANIC!

Thread by @sagaplague: Here is the report of the WHO-China Joint Mission on Coronavirus Disease ...

THESE TWO GRAPHS SHOW WHAT OUR CDC SHOULD BE DOING, AS CHINA DID, TO BRING COVID-19 TO AN END.

THEY MUST TEST, TEST, TEST SO THEY CAN ISOLATE CARRIERS! 


Thread by @sagaplague: Here is the report of the WHO-China Joint Mission on Coronavirus Disease ...

AS THE FOLLOWING PEER-REVIEWED STUDIES AND W.H.O. DATA SHOW MOST CLEARLY, THE OVERALL DEATH RATE FOR CORONAVIRUS IS INDEED LESS THAN 3%.
IT'S 2.3%, ACTUALLY. 


WHY ISN'T OUR MSM (MAINSTREAM MEDIA) REPORTING THIS AND THE CDC'S OWN FACT THAT THE H1N1 (MAINLY B/VICTORIA STRAIN) FROM OUR ONGOING "NORMAL" FLU SEASON HAS A DEATH RATE OF 7.1%, BORDERING ON THE 7.3% AT WHICH POINT CDC DECLARES AN EPIDEMIC?

[FLU SEASON BEGAN IN OCTOBER, 2019.]

WHY ISN'T ANYONE ASSURING AMERICANS AND THE REST OF THE WORLD THAT COVID-19 IS NOT A MEDICAL APOCALYPSE?

WHY AREN'T THE "EXPERTS" TROTTED OUT BY OUR 'NEWS AGENCIES' TELLING US THAT, GLOBALLY, THERE ARE 183,257 KNOWN CASES OF COVID-19 WITH  7,177 DEATHS GLOBALLY COMPARED TO 36 MILLION CASES OF INFLUENZA IN JUST AMERICA WITH AT LEAST 22,000 DEATHS, INCLUDING 144 CHILDREN HERE
?




WHY ISN'T CDC AND THE MEDIA MENTIONING THAT OUR FLU SEASON IS FAR FROM OVER, THAT WE STILL HAVE WIDESPREAD FLU IN 49 STATES AND THE VIRGIN ISLANDS AND PUERTO RICO, THAT 5 MORE CHILDREN DIED OF FLU JUST LAST WEEK? 

WHY HASN'T CDC UPDATED THEIR 'WEEKLY FLU REPORT' SINCE MARCH 7, 2020?


WHY CREATE PANIC OVER COVID-19 YET IGNORE THE ALARMING STATISTICS ON INFLUENZA? 


CHINA HAS A GRIP ON THEIR COVID-19 OUTBREAK. 

Based on all 72,314 cases of COVID-19 confirmed, suspected, and asymptomatic cases in China as of February 11, a paper by the Chinese CCDC released on February 17 and published in the Chinese Journal of Epidemiology has found that:

-- 80.9% of infections are mild (with flu-like symptoms) and can recover at home.

-- 13.8% are severe, developing severe diseases including pneumonia and shortness of breath.

-- 4.7% as critical and can include: respiratory failure, septic shock, and multi-organ failure.


-- In about 2% of reported cases the virus is fatal..

"In China overall, the severe or critical cases among health workers also DECLINED—from 45.0% in early January to 8.7% in early February.

In light of this rapid spread, it is fortunate that COVID-19 has been mild for 81% of patients and has a very low overall case fatality rate of 2.3%.

Among the 1,023 deaths, a majority have been ≥60 years of age and/or have had pre-existing, comorbid conditions such as hypertension, cardiovascular disease, and diabetes. Moreover, the case fatality rate is unsurprisingly highest among critical cases at 49%, and no deaths have occurred among those with mild or even severe symptoms."

SEE ESPECIALLY   
TABLE 1. Patients, deaths, and case fatality rates, as well as observed time and mortality for n=44,672 confirmed COVID-19 cases in Mainland China as of February 11, 2020.

Risk of death increases the older you are.

Relatively few cases are seen among children.



Pre-existing illnesses that put patients at higher risk:

COVID-19 Fatality Rate by COMORBIDITY:

*Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%).
This probability differs depending on pre-existing condition.

The percentage shown below does NOT represent the share of deaths BY pre-existing condition.
Rather, it represents, for a patient with a given pre-existing condition, the risk of dying IF infected by COVID-19.

-- cardiovascular disease - 13.2% 
-- diabetes  - 9.2%

-- chronic respiratory disease  - 8.0%

-- hypertension  - 8.4%
-- cancer  - 7.6%

-- NO pre-existing conditions  - 0.9% 



COVID-19 Fatality Rate by AGE:

*Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). This probability differs depending on the age group. The percentages shown below do not have to add up to 100%, as they do NOT represent share of deaths by age group. Rather, it represents, for a person in a given age group, the risk of dying if, IF infected with COVID-19.  
AGE
DEATH RATE
confirmed cases
DEATH RATE
all cases
80+ years old
21.9%
14.8%
70-79 years old
8.0%
60-69 years old
3.6%
50-59 years old
1.3%
40-49 years old
0.4%
30-39 years old
0.2%
20-29 years old
0.2%
10-19 years old
0.2%
0-9 years old
no fatalities

As you can see, the rate remains very low up to ages 60-69

In general, relatively few cases are seen among children.

Findings from the Huang et al study published on The Lancet: 

COMMON SYMPTOMS
AT ONSET OF ILLNESS
(Huang et al study) 
Fever
98%
Cough
76%
Myalgia (muscle pain)
or Fatigue
44%
LESS COMMON SYMPTOMS:
Sputum production
(coughing up material)
28%
Headache
8%
Haemoptysis(coughing up blood)
5%
Diarrhea
3%


Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)
[THIS IS A 40-PAGE PDF COMPILED/MADE PUBLIC 16-24 February 2020.]

The major findings are described in six sections: the virus, the outbreak, transmission dynamics, disease progression and severity, the China response and knowledge gaps. More detailed descriptions of technical findings are provided in Annex C.

Early cases identified in Wuhan are believed to be have acquired infection from a zoonotic source as many reported visiting or working in the Huanan Wholesale Seafood Market.
As of 25 February, an animal source has NOT yet been identified.

  In China, human-to-human transmission of the COVID-19 virus is largely occurring in families.

The Joint Mission received detailed information from the investigation of clusters and some household transmission studies, which are ongoing in a number of Provinces.

Among 344 clusters involving 1308 cases (out of a total 1836 cases reported) in Guangdong Province and Sichuan Province, most clusters (78%-85%) have occurred in families.
Household transmission studies are currently underway, but preliminary studies ongoing in Guangdong estimate the secondary attack rate in households ranges from 3-10%. 

Transmission in closed settings
There have been reports of COVID-19 transmission in prisons (Hubei, Shandong, and Zhejiang, China), hospitals (as above) and in a long-term living facility.

The close proximity and contact among people in these settings and the potential for environmental contamination are important factors, which could amplify transmission. Transmission in these settings warrants further study."
WITH THAT IN MIND, IS IT REALLY A GOOD IDEA TO FORCE PEOPLE TO "SHELTER IN PLACE"? 

PROBABLY NOT, RIGHT?  

SINCE CHINA IS AWARE OF THIS FACTOR, WHY ISN'T OUR CDC ALSO AWARE?
OR ARE THEY AWARE AND STILL NOT TESTING ENOUGH ON PURPOSE? 



I HAD TO TAKE MY OLDER DOG COMPANION TO THE VETERINARIAN YESTERDAY AND WAS TOLD THAT THE CLINIC HAD SUSPENDED IN-ROOM CONSULTATIONS SO THAT WE COULD VISIT WITH OUR VET IN THE MUCH LARGER WAITING ROOM WITH MORE DISTANCE BETWEEN US...AND IT MADE PERFECT SENSE. 
I NOTICED STAFF WIPING DOWN SURFACES (INCLUDING DOOR HANDLES) ALMOST INCESSANTLY. 

THEY WEREN'T GLOVED OR MASKED, HOWEVER, BUT BOTTLES OF HAND SANITIZER WERE EVERYWHERE. 

GOOD NEWS FROM THE WHO/CHINA STUDY

"Children-
Data on individuals aged 18 years old and under suggest that there is a relatively low attack rate in this age group (2.4% of all reported cases).

Within Wuhan, among testing of ILI samples, no children were positive in November and December of 2019 and in the first two weeks of January 2020."


WHAT CHANGED?
SCHOOLS CLOSED, CHILDREN WERE AT HOME IN A CLOSE FAMILY ENVIRONMENT WITH UNTESTED BUT INFECTED PARENTS?


"Symptoms of COVID-19 are non-specific and the disease presentation can range from no symptoms (asymptomatic) to severe pneumonia and death."

THAT'S WHY MASS TESTING SHOULD BE ABSOLUTELY MANDATORY.
SOMEBODY TELL THE CDC! 


TEST MORE IN ORDER TO LOCATE "CHAINS OF INFECTION" AND STOP THEM. 

"Using available preliminary data, the median time from onset to clinical recovery for mild cases is approximately 2 weeks and is 3-6 weeks for patients with severe or critical disease.
Preliminary data suggests that the time period from onset to the development of severe disease, including hypoxia, is 1 week.

Among patients who have died, the time from symptom onset to outcome ranges from 2-8 weeks. An increasing number of patients have recovered; as of 20 February


WHY DON'T MAINSTREAM MEDIA REPORT THIS INSTEAD OF FEAR-MONGERING THE MASSES INTO PANIC?

"China’s bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic.

A particularly compelling statistic is that on the first day of the advance team’s work there were 2478 newly confirmed cases of COVID-19 reported in China.

Two weeks later, on the final day of this Mission, China reported 409 newly confirmed cases.

This decline in COVID-19 cases across China is real." 


I WISH THE CDC HAD PAID HEED TO THIS HERE IN AMERICA! 

"Much of the global community is not yet ready, in mindset and materially, to implement the measures that have been employed to contain COVID-19 in China.

These are the only measures that are currently proven to interrupt or minimize transmission chains in humans.

Fundamental to these measures is extremely proactive surveillance to immediately detect cases, very rapid diagnosis and immediate case isolation, rigorous tracking and quarantine of close contacts, and an exceptionally high degree of population understanding and acceptance of these measures.

Achieving the high quality of implementation needed to be successful with such measures requires an unusual and unprecedented speed of decision-making by top leaders, operational thoroughness by public health systems, and engagement of society." 



For countries with imported cases and/or outbreaks of COVID-19 1.

1. Immediately activate the highest level of national Response Management protocols to ensure the all-of-government and all-of-society approach needed to contain COVID-19 with non-pharmaceutical public health measures;

2. Prioritize active, exhaustive case finding and immediate testing and isolation, painstaking contact tracing and rigorous quarantine of close contacts;

3. Fully educate the general public on the seriousness of COVID-19 and their role in preventing its spread;

4. Immediately expand surveillance to detect COVID-19 transmission chains, by testing all patients with atypical pneumonias, conducting screening in some patients with upper respiratory illnesses and/or recent COVID-19 exposure, and adding testing for the COVID-19 virus to existing surveillance systems (e.g. systems for influenza-like-illness and SARI); and

5. Conduct multi-sector scenario planning and simulations for the deployment of even more stringent measures to interrupt transmission chains as needed (e.g. the suspension of large-scale gatherings and the closure of schools and workplaces).


IT WORKED FOR CHINA AND SOUTH KOREA, BOTH NATIONS NOW SEEING DECLINE IN NEW CASES, BOTH NATIONS NOW SEEING FAR MORE RECOVERIES THAN NEW CASES. 

IF OUR CDC CAN MANAGE TO FIND A WAY TO IMPLEMENT WHAT THEY KNOW ARE BEST RESPONSES, INCLUDING MASS TESTING, WE CAN SEE AN END TO THIS THING, AND BY NEXT YEAR'S FLU SEASON MAYBE, JUST MAYBE, AMERICANS WON'T BE SO EASILY PANICKED AND RISK SEEING MARTIAL LAW DECLARED TO CONTAIN, NOT THE VIRUS, BUT HYSTERIA





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STAY UP-TO-DATE ON BTH CORONAVIRUS AND H1N1 FLU SEASON WITH THE FOLLOWING LINKS:

COVID-19 Coronavirus - Update



Weekly U.S. Influenza Surveillance Report







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