Coronavirus 2019-2020 thread (no unsubstantiated rumours!)

Brumby

Brumby

Major
Bltizo said:
Nope, his commentary (if you can call it that -- hysteria is a better word for it) was already shut down by other epidemiologists and virologists on Twitter for missing essential context and being needlessly dramatic.
His follower count has benefited significantly from his tweet chain however.
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A useful tweet that has a much more accurate and level headed take on the numbers:
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Also, the study that he was citing had already updated its R0 score to 2.5 based on newer data.



This is an evolving epidemiological picture, and we are still at the early stages of knowing the extent and lethality of this virus.
People like Dr Feigl-Ding who know that they have some level of public exposure and may generate public "trust" from their positions, should know how important it is to report on things calmly and accurately without unnecessary flourish that might generate panic --- which in turn has the potential to generate harm.
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The R0 of 3.8 was the initial number used in the modelling prediction based on assumptions and whatever data set prevailing at that time. The R0 number will change over time as fresh data becomes available. It should also be noted Jonathan Read headed that research paper. Have you actually read the research paper? It can be found here.
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The one doing the twitter round and is being criticised for being dramatic was commenting on the R0 of 3.8 as being of pandemic level. The twitter discussions involving Jonathan Read is far from being shut down - that is simply a narrative of your own creation.

I deal with facts and make my own judgment accordingly.

So what are the facts .

(1)The infection rate of this new coronavirus is basically twice as fast as SARs. This is taken from the research paper and corroborates with what we know of SARs in terms of infected population within the same time period.
A comparison of the efficiency of transmission in this outbreak and in SARS outbreaks can be seen as well in simple comparisons of doubling times in each outbreak. In SARS, doubling times varied from 4.6 days to 14.2 days depending on setting (doubling time, Td=6.0 (1358 over 63 days, Singapore), Td=4.6 (425 over 41 days, Hong Kong), Td=14.2 (7919 over 185 days, overall)) (Lipsitch et al. 2003). Using the counts of confirmed cases as of 22 January (444) and assuming the outbreak began on 15 December 2019, we find a doubling time of 4.1. However, using our estimates of the size of the outbreak on 1 and 21 January (24 and 11,257 people respectively) we estimate a doubling time of 2.3. We note this is similar to estimates from the SARS outbreak in Hong Kong (Lipsitch et al. 2003).
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(2)The incubation period is basically twice as long as SARs. Just on these two points, how reasonable is WHO's initial;estimate R0 of 1.5 to 2.4 as opposed to SARs of R0 of 2 - 5. The basic facts itself doesn't support the two comparison in terms of incubation period and infection rate as R0 is dependent on these variables, among others.

(3)We then get to the silly R0 comparison that is being used to support the notion that it is not too bad when compared to other infectious diseases.
upload_2020-1-27_10-55-27.png

The reason why measles, smallpox and rubella has such high R0 is because they are highly contagious and they can infect others while in incubation. SARs in comparison do not infect others during incubation. This leads me to the biggest bombshell to-date that the Chinese government has just dropped.

(4)Over the weekend, the China's health minister Ma Xiaowei made a startling statement Sunday about the Wuhan coronavirus: He said people can spread it before they become symptomatic.
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From the same article this is the immediate reaction from experts.
"This is a game changer," said Dr. William Schaffner, a longtime adviser to the US Centers for Disease Control and Prevention.
It's much harder to contain a virus -- to track down a patient's contacts and quarantine them immediately -- if the patient was spreading the disease for days or weeks before they even realized they had it.
"It means the infection is much more contagious than we originally thought," said Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. "This is worse than we anticipated."
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The research paper that is being criticized for a high R0 of 3.8 might just turned out to be the low end of the number given that comparable diseases that can infect during incubation like smallpox has a R0 of 5-7.
 
Blitzo

Blitzo

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@adiru

What part of "no unsubstantiated rumours" do you not understand??

 
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Blitzo

Blitzo

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Brumby said:
The R0 of 3.8 was the initial number used in the modelling prediction based on assumptions and whatever data set prevailing at that time. The R0 number will change over time as fresh data becomes available. It should also be noted Jonathan Read headed that research paper. Have you actually read the research paper? It can be found here.
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The one doing the twitter round and is being criticised for being dramatic was commenting on the R0 of 3.8 as being of pandemic level. The twitter discussions involving Jonathan Read is far from being shut down - that is simply a narrative of your own creation.

I deal with facts and make my own judgment accordingly.

So what are the facts .

(1)The infection rate of this new coronavirus is basically twice as fast as SARs. This is taken from the research paper and corroborates with what we know of SARs in terms of infected population within the same time spend.


(2)The incubation period is basically twice as ,long as SARs Just on these two points, how reasonable is WHO's initial;estimate R0 of 1.5 to 2.4 as opposed to SARs of R0 of 2 - 5. The basic facts itself doesn't support the two comparison in terms of incubation period and infection rate as R0 is dependent on these variables, among others.

(3)We then get to the silly R0 comparison that is being used to support the notion that it is not too bad when compared to other infectious diseases.
View attachment 57037

The reason why measles, smallpox and rubella has such high R0 is because they are highly contagious and they can infect others while in incubation. SARs in comparison do not infect others during incubation. This leads me to the biggest bombshell to-date that the Chinese government has just dropped.

(4)Over the weekend, the China's health minister Ma Xiaowei made a startling statement Sunday about the Wuhan coronavirus: He said people can spread it before they become symptomatic.
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From the same article this is the immediate reaction from experts.

The research paper that is being criticized for a high R0 of 3.8 might just turned out to be the low end of the number given that comparable diseases that can infect during incubation like smallpox has a R0 of 5-7.
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I have read the paper, and I've also been tracking what epidemiologists and virologists have been saying about the paper and also the way it was commented on by Dr Feigl-Ding online.
And as I mentioned, the original author also revised it to 2.5 from 3.8
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The R0 of this virus will be established over time as more data comes in. Regardless of what the R0 is, the kind of apocalyptic commentary that Dr Feigl Ding put out is not helpful to the public and frankly is irresponsible from a public health figure.
Furthermore, R0 is not the only function that is important in establishing the effect of a new virus; the PFC (proportion of fatal cases) or in general, the "lethality" of a virus is also important.
Again, I cannot recommend this particular thread of tweets enough:
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It is one thing to express the seriousness of a situation and to promote public health vigilance, but it is something else entirely to start off a tweet with "HOLY MOTHER OF GOD" based on initial papers for a new virus where we still don't know much about.


I'm not criticizing you for sharing the article, but I'm criticizing Dr Fiegl Ding and other health professionals that frankly should know better than to discuss this so sensationally when there is still so much we don't know about. They should know how their tweets and commentary would be reported, and they should know that the situation is evolving, and they should know that people are concerned, worried and that generating panic is never useful for anyone.
 
Blitzo

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vincent said:
Blitzo is far more qualify than the rest of us at judging medical information.
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I'm not a virologist or an epidemiologist but I am a medical doctor and I've had the same level of education in medical school about population health and infectious diseases as my other colleagues.
But the discussion at hand is not really that relevant to qualifications.

I don't claim to be an expert but I have a vested interest in seeking good health outcomes and accurate and non-sensationalist reporting of information.
The last thing we need is sky-is-falling commentary from experts who should know better, when the situation is still so early.

If we have any resident subject matter experts in the field on SDF, I think we would all welcome some input, but IMO it is most important at this stage to emphasize that the situation is an evolving one, and avoid "HOLY MOTHER OF GOD" type commentary.
 
supercat

supercat

Major
R0 is a theoretical number that assumes that no preventive or treatment measures have been taken whatsoever. Once prevention and treatment start, R0 can be reduced substantially, even below 1, which indicates that the disease will stop spreading and die out. So far people have started wearing mask and washing hands. Traveling is restricted for 40-50 million people. Trials of treating the infection with some HIV meds will soon commence. All of these could potentially reduce R0. Currently, the estimate for R0 is allover the place. Let's wait and see.
 
vesicles

vesicles

Colonel
Just took a look at Dr. Ding's publication record. On paper, he is very well cited and well published. However, if you dig a little deeper, you will see that each of his highly cited publications typically has hundreds of (maybe even over a thousand) authors. And it seems that he has never been a senior author on any of his highly cited papers. He's simply one of the guys with his name buried in the middle of the pack, which is where you don't want to be. You want to be either at the beginning to show that you have done most of the work, or in the end to show that you are one of the big bosses supervising the study. Never in the middle... And the studies with him as the senior author seem to be all poorly cited. Maybe this is the nature of epidemiology studies? Don't know...

And I would like to echo many here and suggest that everyone calms down. We are far from a "pandemic". Do your own diligence, stay at home, wash your hands, wash your face. Stay away from crowded places. Most importantly, stay calm. Eat good food and take plenty of rest. A good immune system will help you in any situation.

I work at the largest medical center in the world and we have over 160K medical/research personnel working at the Texas Medical Center in Houston, Texas. I have not heard any serious warning of any kind. Several years ago during the Ebola outbreak, we were all ordered to take safety courses to learn how to handle contaminated materials. Warning signs were placed all over the places in all the buildings. This time, nothing. All my clinician colleagues are going about their business as usual. So let's calm down.
 
Blitzo

Blitzo

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vesicles said:
Just took a look at Dr. Ding's publication record. On paper, he is very well cited and well published. However, if you dig a little deeper, you will see that each of his highly cited publications typically has hundreds of (maybe even over a thousand) authors. And it seems that he has never been a senior author on any of his highly cited papers. He's simply one of the guys with his name buried in the middle of the pack, which is where you don't want to be. You want to be either at the beginning to show that you have done most of the work, or in the end to show that you are one of the big bosses supervising the study. Never in the middle... And the studies with him as the senior author seem to be all poorly cited. Maybe this is the nature of epidemiology studies? Don't know...

And I would like to echo many here and suggest that everyone calms down. We are far from a "pandemic". Do your own diligence, stay at home, wash your hands, wash your face. Stay away from crowded places. Most importantly, stay calm. Eat good food and take plenty of rest. A good immune system will help you in any situation.

I work at the largest medical center in the world and we have over 160K medical/research personnel working at the Texas Medical Center in Houston, Texas. I have not heard any serious warning of any kind. Several years ago during the Ebola outbreak, we were all ordered to take safety courses to learn how to handle contaminated materials. Warning sings were placed all over the places in all the buildings. This time, nothing. All my clinician colleagues are going about their business as usual. So calm down.
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I would also add that even someone who is a brilliant researcher or a brilliant clinician doesn't mean one is safe from being inappropriate in the way that one relays information in a public domain like social media.
 
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