Re: Coronavirus
Posted by Chris in Tampa on 3/8/2020, 10:55 pm
This has the potential to be a lot worse than the flu. This might change people's habits this year to lessen the number of people who die from this point on for the rest of this season. Maybe that will continue in future years.

This post is going to seem like I am trying to be alarming, but I really just want people to prepare. Especially for those who are older and/or have a preexisting condition. I just want people to be prepared by having supplies, like food, medicine and cleaning supplies.

From 2010 to 2019, influenza is estimated to infect between 9,300,000 and 45,000,000 each year in the U.S. That resulted in between 12,000 and 61,000 deaths. (https://www.businessinsider.com/coronavirus-compared-to-flu-mortality-rates-2020-3 ) While it's something that could change, it's believed that this coronavirus is more transmissible than the flu. (Google "r0" for various information on that and maybe specifically "r0 coronavirus") Most of the information suggests that. However, as aggressive action is taken it can be spread less.

Why hasn't it spread to a lot more people yet? It still might spread considerably worldwide, but because of aggressive containment efforts in some countries, that hasn't happened to the extent that it would be considered a pandemic. The question is, will the U.S. be willing to be as aggressive as other countries? We don't do anything each year for the flu, at least when it comes to containment. We have a vaccine that helps for the flu, but we will not have one for this coronavirus until perhaps a year at least. (actually available to the public) Let's assume this coronavirus is equally as transmissible as the flu. The earliest evidence says it is more transmissible, but let's assume it is equal to the flu for comparison purposes. (but it could be less so, we don't know enough about this virus yet)

There have been various numbers presented for the mortality rate.

If we didn't take any measures at all, what could happen in the U.S.? Some areas areas are taking some measures, some which are fairly aggressive. But most are not. Let's look at some numbers. We don't know how this will act into summer and these numbers would be over a full year. The flu season will begin to lessen as we get toward summer before it picks back in the fall. That could happen with this virus too, or maybe it will still be bad during the summer too. If we took a look from now until March 2021 for example, what could the numbers be? We likely won't have a vaccine until at least a year, though maybe that would get rushed if they didn't do as much clinical trials.

The season flu kills about 0.1% of those that get it each year.

The population of the U.S. is estimated to be 329 million. (https://www.census.gov/popclock/)

Below: If the death rate is ... How many people could die.

I want to stress that I don't think these numbers will happen, but it is important to understand what's the worst that could happen if we don't do enough to contain it. But again, this is based on the number of people who get the flu in a season. We are already far into flu season, so consider what this could be like if the coronavirus continued into early next year. The rate it spreads is variable and based on such things as the vulnerability of the population and what measures you take to reduce the spread.

What if 9,300,000 people get it?

1.4% ... 130,200
2.0% ... 186,000
3.4% ... 316,200

What if 45,000,000 people get it?

1.4% ... 630,000
2.0% ... 900,000
3.4% ... 1,530,000

This may be more contagious than the flu, but we really don't know fore sure. Those are obviously very high numbers that are very, very unlikely. There have been 3,097 deaths and 80,699 known cases in China according to the Johns Hopkins map. (https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6)

We certainly hope there are many more cases that were minor enough that people didn't get tested. That would mean the death rate is less. But we have to go with what we know.

Those numbers above assume that the virus is as contagious as the flu. They assume we do nothing to try to contain it, which we make no such effort each year for the flu. (Maybe nursing homes and hospitals do take some extra precautions) We have a vaccine for the flu and we don't for this new coronavirus.

The reason why China's numbers are not increasing as much is because they took drastic action. They had everyone stay home for awhile. Italy is doing that now. But Italy had their death toll jump by 133 in a single day, to 366 in the country now. They are quarantining 16 million people, a quarter of their country, to reduce the spread. How that is going to work is uncertain. What it means is even uncertain. Some things will still be open, but people are supposed to stay home as much as possible. Those who break the quarantine could face 3 months in jail. They are trying to do something drastic.

If they could try to keep less people from getting it, like China, it could be a kind of reset, where you get back to tracing it back to where they got it and maybe quarantining the people they come in contact with.

If you don't reduce the spread, millions could get it and hospitals would be overwhelmed if perhaps the 20% that contracted it developed serious conditions. Those scary numbers above are what we could face if we do nothing. We are not doing nothing, but we are also not coming close to what we could be doing. In perhaps no more than a week, thousands of people will be known to have this in the U.S. Soon after it will probably be in the tens of thousands. In reality, it's going to be higher because we aren't testing people.

If we had been testing people we would understand that in many places we should have already been telling people to stay home more. By the time we get testing to the extent that we know an area has a growing community spread problem, a lot of people are going to have it. And Americans just aren't ready to be told to stay home. Some don't have a choice and must work to keep their job. Will a local government force people to not go to work? (So their employer can't fire them for not showing up) Will they shut all the schools in an area when needed? How we restrict movement will determine how many people die from this. I don't see the federal government leading on this. Maybe when the death toll gets a lot worse we'll see more, but for now this is going to be on the states and local governments to do something.

This is going to be a disaster for nursing homes. That's why I think the death toll from this will unavoidably, already, be a thousand or maybe even more based on the spread we've already seen. It's already spread enough that even if most everyone across the country didn't go out, enough are already infected among the most vulnerable population. And we are getting into the stage now where the number of cases are going to go up significantly. In part due to testing more, but also because it's been spreading in parts of the U.S. for seven weeks now.

I still don't know if other countries have nursing homes to the extent that we do. If not, and they have older relatives live with them, we could be in for a more significant death toll compared to other countries.

Here's why there is great concern for those who are older:



Chart from: https://www.businessinsider.com/coronavirus-compared-to-flu-mortality-rates-2020-3

Sources:
Early Chinese paper on 44,672 cases: http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51
CDC death rate in influenza: https://www.cdc.gov/flu/about/burden/past-seasons.html
From that page I clicked compared the 2018-2019 link where they give the number of cases and deaths for each age range.

I wanted to verify the CDC numbers.

2018-2019 Estimated Influenza Numbers (subject to revision)
AgeDeaths/CasesDeath Rate (Percent)
0-4266/3,633,104 = 0.000073215630.007%
5-17211/7,663,310 = 0.000027533790.003%
18-492,450/11,913,203 = 0.000205654180.021%
50-645,676/9,238,038 = 0.000614416170.061%
65+25,555/3,073,227 = 0.008315363620.832%


The numbers match the chart except for the 5-17 age range. (0.003% for 2018-2019 compared to chart which says 0.01%) I didn't average other years so maybe an average over all the years available might be closer to 0.01, like the chart.

Again, these numbers on the virus are preliminary and will change. The best way to keep the death toll low is to reduce the spread until there is a vaccine. But that will take very aggressive measures. In case the federal, state and local governments don't do what they need to do, we all need to be prepared, especially if you are older and/or have a preexisting condition that makes you more susceptible.

The person who manages the CDC page takes off weekends, so there are far more cases than what the CDC reports:
https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html
They say 164 cases (+49 repatriated citizens) and 11 deaths.

It's at least 550 now, in at least 34 states, with at least 21 dead.



There was a webinar from the American Hospital Association, which they said this about:

"The American Hospital Association said the webinar reflects the views of the experts who spoke on it, not its own."

And:

"The AHA regularly hosts webinars and conference calls that include a variety of voices and opinions that seek to provide relevant information to professionals at hospitals and health systems that are on the front lines of preparing for and protecting their patients and communities," a spokeswoman for the AHA told Business Insider in an emailed statement. "The slides you shared reflect the various perspectives of field experts and should not be attributed to the AHA."

And the person who gave it estimated these figures:

- 4.8 million hospitalizations associated with the novel coronavirus
- 96 million cases overall in the US
- 480,000 deaths

Story:
https://www.businessinsider.com/presentation-us-hospitals-preparing-for-millions-of-hospitalizations-2020-3

That's just one person presenting a worst case scenario. Hopefully long before anything like it, we've shut most things down to reduce the spread.

But it is a reason why people should, like hurricane season, be prepared. Not panic, be prepared just in case. And if you are older and have a preexisting condition, you should already not be going out as much.
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Coronavirus - Thread #1 (Posts from February 29th - March 29th) - Chris in Tampa, 2/29/2020, 2:00 am
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