Coronavirus 2019-2020 thread (no unsubstantiated rumours!)

solarz

Brigadier
I‘m well aware of the benefits of 20/20 hindsight, but the health authorities' responses cannot be excused on the ground of being in the flu season. The people who were alarmed by early January were not the members of the lay public or even ordinary healthcare workers, they were respiratory and radiology specialists in some of Wuhan's top hospitals. They certainly knew what a normal or even a particularly nasty flu season looked like. Also at the end of December Wuhan health authority had already announced there were cases of pneumonia caused by an unknown virus, so at the novel part of 'completely novel and highly infectious virus' was already known. What did health authorities in Wuhan do when healthcare workers began to develop pneumonia?

Quote from the first Caixin article:

Not only were they not disclosing the infections among healthcare workers, multiple hospitals in Wuhan began to lock up CT scans of healthcare workers in the infectious disease management departments to keep them away from their colleagues in the clinical departments and only informing the infected healthcare workers personally by telephone. Caixin thought this was unlikely to be a spontaneous decision by multiple hospitals (because it's very unusual) and had to come from the health authorities. Note at the same time the hospitals were locking up evidence of healthcare workers infections in the infectious disease management departments, Wuhan health authorities were telling the public that there was no evidence for human to human transmission.

Also note that the National Health Commission required the following three individually necessary and jointly sufficient conditions for a diagnosis: 1. contact history with the seafood market. 2. fever. 3. genetic sequencing to demostrate the presence of the novel virus. So even if a patient had both the symptoms and the virus, they still couldn't be diagnosed if there were no contact history with the market. I could understand if they required (contact history AND symptoms) OR (symptoms AND virus), but contact history AND symptoms AND virus? I found it very difficult to explain the logic behind this except they were trying to cover up human to human transmission.
Once again, your post reads as someone looking to confirm their conclusions.

First of all, no, not even medical specialists can know about a new virus without actual data telling them so. Specialists are not fortune tellers. An "unknown virus" does NOT automatically mean a new virus! It just means a virus that has not been identified. Each type of virus needs a specific test to be identified, and each test requires time to complete, often days. When faced with an unidentified virus, doctors need to narrow down the list of possible candidates based on their diagnosis and order the tests for the shortlisted candidates. In order to confirm that the virus is completely new, they would have needed to eliminate all other possibilities. This takes time!

Second of all, limiting access to private, personal, health information, and only informing the person involved, is the normal and expected practice of most developed nations, and one of the primary reason for upholding this right to privacy is precisely because people can be discriminated against based on their medical conditions. When faced with rumors of a new SARS outbreak, it is perfectly reasonable to step up the handling of private information in order to prevent any panic and discrimination among the healthcare staff. Think about it for a minute: if you were infected with COVID-19 right now, would you want your boss and your colleagues to find out before you did?

Third, the presence of lung infection among healthcare workers is still not a smoking gun for a novel virus. CT scans do not reveal the genetic sequence of the pathogen. Those healthcare workers could have been infected by any number of infectious diseases that normally circulates during flu season. Healthcare authorities need to make decisions based on data, and there simply wasn't enough data at the time to determine the presence of a completely new and highly infectious virus.

Finally, I am no health expert, and perhaps @manqiangrexue, @vesicles, or @Bltizo can provide more info, but it seems to me that location is necessary to establish the presence of an actual outbreak. You could have a group of people showing similar symptoms and testing positive for the same virus, but if they caught it because they were eating, just as an example, the same brand of contaminated food, then that would have very different implications than if they were all visiting the same market! Remember that at the time, they had no idea how the virus was transmitted. In any case, the doctor quoted in the article stated that it wasn't the location that was difficult to obtain, it was the genetic sequencing. I think it's pretty obvious that genetic sequencing is necessary to establish the presence of a new virus.
 

Rettam Stacf

New Member
Registered Member
What 4 letter words?

Please show me. You getting hyper excited over my wonderings.

Have a soothing cup of Wulung tea and remember to take your meds.
My message is not directed just at you. That is why I use "Come on guys". If it come across that it is just aiming at you, my sincere apology.

I was indeed sipping my Iron Guan Yin while writing the original message.
 

Jura

General
Yesterday at 9:51 AM
LOL once it's over, I'll be able to figure what I should've used, if there's no new source making this effort futile

now specifically what I do is I picked a certain
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with only four parameters, two of which have a clear meaning:

one is the upper asymptote = max. number of cases, another is the inflection point = a turn,

and I've kept the functional form, but the solution is pretty sensitive to a choice of the points for the fit:

at first (Sunday at 1:30 PM) I didn't consider an initial buildup and the solution underestimated the top asymptote,

then a member told me I should, but that solution overestimated current (last two days) numbers (Today at 7:11 AM),

so I refitted Today at 8:17 AM

to see the inflection point around Feb 6, which seemed reasonable based on
supercat, Today at 4:38 AM

and will let it be
... about time
 

Jura

General
and here's the official, accompanied by this picture:

Aerial photo taken on Feb. 12, 2020 shows patients infected with the novel coronavirus walking into the temporary hospital converted from Wuhan Sports Center with medical staff in Wuhan, central China's Hubei Province. (Xinhua/Xiao Yijiu)
China's Hubei reports jump in new cases of COVID-19 after diagnosis criteria revision
Source: Xinhua| 2020-02-13 11:03:02
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Brumby

Major
My understanding is that the new categorization only applies for Hubei and not for outside of Hubei because outside of Hubei they have the resources to test everyone due to reduced patient demand, whereas Hubei's labs are likely overwhelmed.

In other words, the fact that they are using clinical diagnosis in Hubei is likely going to lead to an overestimation of the actual number of people who actually have coronavirus (until they actually get positive lab tests), because they're choosing to be safer and more cautious even if it makes the numbers look higher than they are.


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The conversation goes beyond some statistical number of over or under estimation as the pertinent issue is health care management both on a macro and micro basis and more fundamentally is about access to appropriate heath care for the Hubei population affected by the virus. Prior to today's announcement, AFAIK there were 4 tests needed to confirm a case and the fourth test confirming the specific virus being in backlogged. Until there is confirmation from the 4th test, patients with symptoms supported by CT scans and nucleic acid tests were denied hospital admission. The fallout from this whether by design or default is that the number of cases were under reported; fatalities associated from it were not counted as corona virus related and sadly many affected were not given proper health care; not isolated and left on their own to deal with the problem.

The new diagnosis criteria, allows for the use of CT scans, in addition to nucleic acid tests, in the confirmation process in Hubei province. There had been criticism that earlier diagnostic criteria for the coronavirus were too stringent, and experts had called for the inclusion of CT scanning as a key basis for diagnosis.
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Bltizo

Moderator
Staff member
The conversation goes beyond some statistical number of over or under estimation as the pertinent issue is health care management both on a macro and micro basis and more fundamentally is about access to appropriate heath care for the Hubei population affected by the virus. Prior to today's announcement, AFAIK there were 4 tests needed to confirm a case and the fourth test confirming the specific virus being in backlogged. Until there is confirmation from the 4th test, patients with symptoms supported by CT scans and nucleic acid tests were denied hospital admission. The fallout from this whether by design or default is that the number of cases were under reported; fatalities associated from it were not counted as corona virus related and sadly many affected were not given proper health care; not isolated and left on their own to deal with the problem.

The new diagnosis criteria, allows for the use of CT scans, in addition to nucleic acid tests, in the confirmation process in Hubei province. There had been criticism that earlier diagnostic criteria for the coronavirus were too stringent, and experts had called for the inclusion of CT scanning as a key basis for diagnosis.
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IMO the most important thing the new diagnosis provides is that it enables better contact tracing and and more confident isolation measures that reduces the number of people who have the virus that might be missed out.

As far as criteria for admission into hospital, I have some doubts as to how much this new diagnosis method will change things.
If a patient is going into respiratory failure or with other severe symptoms, but have yet to test positive in the lab for the virus, I would be surprised if they were not admitted into hospital -- in the same way that a patient having symptoms of a heart attack should still be admitted into hospital for treatment.
OTOH, patients who test positive in the lab for the virus but who are either asymptomatic or minimally symptomatic should be able to self-isolate at home and only present to hospital if they are symptomatic.

Considering the demand for hospital beds, I would be surprised if such a triage system was not already in place.

Additionally, I would be surprised if the people who were added to the list today were not drawn significantly from the number of patients that were already categorized under the "suspected" category.
 

shanlung

Junior Member
Registered Member
My message is not directed just at you. That is why I use "Come on guys". If it come across that it is just aiming at you, my sincere apology.

I was indeed sipping my Iron Guan Yin while writing the original message.
Thank you for quoting my message.
Keeping that immortal before it got nuked and banished into oblivion.

Which was why I thought you referring to me specifically.

Tieh GuanYin can also be soothing to the soul. Should be drank before thinking and writing.
Especially for those that railed against China and how inferior China is to the rest of the world which exercise FREEDOM OF PRESS AND EXPRESSION AND DEMOCRACY

We will see about that when phase 2 get going. And the Western World can show how their FREEDOM OF PRESS AND EXPRESSION AND DEMOCRACY will save their people.

Do remember that while those judge with gay abandon and write their judgement here on the power of rioters , opps demonstrators for freedom in Hongkong, and the power of FalunGong and all forces intending to overthrow CCP , the thinking behind their judgement will also be judged by us.

And those kind of people are too full of themselves if they think they come out covered with glory. When more likely than not, it is the entire opposite.

I think I go back to my little cup of Wulung tea and take a few sips now.
 

OppositeDay

New Member
Registered Member
Once again, your post reads as someone looking to confirm their conclusions.

First of all, no, not even medical specialists can know about a new virus without actual data telling them so. Specialists are not fortune tellers. An "unknown virus" does NOT automatically mean a new virus! It just means a virus that has not been identified. Each type of virus needs a specific test to be identified, and each test requires time to complete, often days. When faced with an unidentified virus, doctors need to narrow down the list of possible candidates based on their diagnosis and order the tests for the shortlisted candidates. In order to confirm that the virus is completely new, they would have needed to eliminate all other possibilities. This takes time!

Second of all, limiting access to private, personal, health information, and only informing the person involved, is the normal and expected practice of most developed nations, and one of the primary reason for upholding this right to privacy is precisely because people can be discriminated against based on their medical conditions. When faced with rumors of a new SARS outbreak, it is perfectly reasonable to step up the handling of private information in order to prevent any panic and discrimination among the healthcare staff. Think about it for a minute: if you were infected with COVID-19 right now, would you want your boss and your colleagues to find out before you did?

Third, the presence of lung infection among healthcare workers is still not a smoking gun for a novel virus. CT scans do not reveal the genetic sequence of the pathogen. Those healthcare workers could have been infected by any number of infectious diseases that normally circulates during flu season. Healthcare authorities need to make decisions based on data, and there simply wasn't enough data at the time to determine the presence of a completely new and highly infectious virus.

Finally, I am no health expert, and perhaps @manqiangrexue, @vesicles, or @Bltizo can provide more info, but it seems to me that location is necessary to establish the presence of an actual outbreak. You could have a group of people showing similar symptoms and testing positive for the same virus, but if they caught it because they were eating, just as an example, the same brand of contaminated food, then that would have very different implications than if they were all visiting the same market! Remember that at the time, they had no idea how the virus was transmitted. In any case, the doctor quoted in the article stated that it wasn't the location that was difficult to obtain, it was the genetic sequencing. I think it's pretty obvious that genetic sequencing is necessary to establish the presence of a new virus.
1. COVID-19 was first reported to public health authorities on 12/27. The doctor who made the discovery had tested the patients for influenza, common cold and so on before reporting.

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甲流、乙流、合胞病毒、腺病毒、鼻病毒、衣原体、支原体等与症状相关的检查,她都让病人做了一遍,但结果都不是。那时候,张继先开始认识到事情的严重性。
Public health authorities announced 'viral pneumonia of unknown cause' on Dec 31. On Jan 5 a Shanghai lab sequenced the virus from a sample sent from Wuhan (per protocol) and confirmed its a novel coronavirus. The lab immediately informed both Shanghai and national health authorities. China's medical-surveillance network had done a fantastic job!

2. I made a mistake here. The afflicted healthcare workers were denied access to their own chest CT scans. This was unusual and clearly an attempt at information control (although not necessarily a cover-up).

3. Again the question is not whether it's a novel virus, they knew by Jan 5 it was. The question was human to human transmission. The doctor who first discovered COVID-19 immediately suspected it's infectious (as an entire family of three were infected).

According to the first Caixin article, on Jan 5 a doctor with no contact history to the seafood market was suspected of having COVID-19 (later confirmed). CT scan confirmed lung infections. It was never mentioned in the Caixin article but it would be surprising if no tests were done to exclude other known causes for pneumonia. There were soon (one on Jan 6) other suspected cases emerging among healthcare workers too, many of them later diagnosed as having COVID-19. It would be surprising if none of them were tested to exclude other known causes for pneumonia. Given how fast the health authority announced 'viral pneumonia of unknown cause', it shouldn't take more than four days to test for the known causes to a high standard (high enough to allow the announcement in the first place). So by Jan 10 or Jan 11 at latest it should have became clear that healthcare workers without exposure to the seafood market also had 'viral pneumonia of unknown cause'. What's the odds of having two such diseases emerging at the same time? Yet the health authorities were still denying human to human transmission. Again, no smoking gun for a deliberate cover-up but to think there's no cover-up you had to believe a medical-surveillance network that was super efficient at identifying the disease and the virus for lay patients suddenly became inefficient when it came to healthcare workers, when they should had became more alert as a novel coronavirus had just been discovered.

4. The criteria were not for identifying a outbreak but for identifying individual cases. Again I'm no medical expert and I stand to be corrected, but I cannot think of a good reason to disallow a individual case with both the symptoms and the presence of the virus (confirmed by full sequencing) from being confirmed, other than to prevent confirmed cases with no exposure to the seafood market. As for the doctor's stress on the strictness of condition 3 rather than condition 1, I would imagine both the doctor and the journalist would want to avoid making or being seen as making a direct accusation against the National Health Commission.
 

Gatekeeper

Senior Member
Registered Member
This is so true. It doesn't require further comments from me.

Racism against Chinese and China! How to Yellow-Cake a Tragedy: the NY Times Spreads the Virus of Hatred, Again... Instead of voicing support or encouraging solidarity–“We are Wuhan”—western corporate media have chosen to go all out to criticize and demonize China, sparing no effort to recycle and rekindle ugly, racist, orientalist, and dehumanizing tropes, using any perceived misstep, pretext, and shortcoming to tar China and the Chinese. One virulent narrative is that this is deliberate Chinese bioweapon to reduce population, another narrative, no less toxic and virulent, alleges that the Chinese leadership, out of a “fear of political embarrassment”, suppressed free speech and silenced the flow of information “at critical moments”, “allowing the virus to gain a tenacious hold”, thus creating the conditions for a lethal epidemic that has led to the deaths of hundreds and the infection of thousands... Bashing China on “Free Speech”

“In times of crisis, for western nations, the normal response is ‘We are Paris, NY, etc’. When it comes to Asia and China, the measured response is: ‘You deserve this because of your dirtiness, immorality, and bat-eating communist dictatorship’; ‘You would rather control your citizens than save lives’. This is often followed up by some variant of nuke China’.”

Complete story:

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