Tracking the next pandemic: Avian Flu Talk |
Maybe this is Like the Flu After All-My CFR Theory |
Post Reply |
Author | |
BabyCat
V.I.P. Member Joined: January 26 2020 Status: Offline Points: 15175 |
Post Options
Thanks(0)
Posted: March 04 2020 at 9:39pm |
Some interesting trends in the data regarding CFR...and a theory (which I'm sure many scientists are trying to figure out0 South Korea, which has done over 160,000 tests, has uncovered 5,766 confirmed infected, and they have seen "only" 35 deaths. If the currently accepted CFR was as expected, we would expect to see 196 deaths with a 3.4% CFR, or 115, with a 2%. But we don't see that many deaths. Think about that. With 35 deaths in a well-sampled population, implies a CFR of about 0.6% right now. They are certainly counting most, if not all of the deaths. Perhaps they are getting closer to the true number of infected, the denominator in the CFR. People are assuming that many of the mild cases were missed in China and elsewhere. Maybe that's correct, and is shown by S. Korea's aggressive testing. Perhaps the 2% or 3.4% overall figures are way off at the moment. Scientists haven't had a chance to take samples of its prevalence in the average population, as it's so new, so hard to get a handle on attack rate and prevalence in a population. They are just getting antibody testing (to confirm if previously exposed) off the ground. This might make sense of the data we are seeing in Iran, and the US. If it's only a 0.6% CFR, then we would multiply deaths by 167 to get an approximation of 1833 US infections which is about the estimate that some experts have suggested in the US, as well as to arrive at a figure of about 500,000 infected in China, which would make a heck of a lot more sense from the actions of the government. In Iran, with 92 deaths, would imply about 15,000 infected. Maybe a LOT more people are/were infected, recovering/ed, and don't/didn't even know it! Maybe it IS not so bad after all? Or did South Korea just get AHEAD of the infection to death 3-4 week timeline? |
|
Thorne!
Adviser Group Joined: February 07 2020 Status: Offline Points: 2695 |
Post Options
Thanks(0)
|
To play the other side; The U.S. has run about 600 tests and identified about 60 cases outside of the Diamond Princess. I'm not certain how many fatalities there are not counting the DM, but lets say 6 out of the 11 reported deaths, which I'm thinking is very much a low ball figure. Makes for easy math though. Now, I suppose if the U.S. were running 10,000 tests per day like South Korea the numbers would be quite different! |
|
CRS, DrPH
Expert Level Adviser Joined: January 20 2014 Location: Arizona Status: Offline Points: 26660 |
Post Options
Thanks(0)
|
Mortality from a viral pulmonary infection is a complex matter. One of the big risk factors seems to be pre-existing medical conditions, especially cardiovascular. In China, men smoke like thieves, and women don't, so many deaths were in elderly smoking male patients. This is almost identical to the epidemiological patterns we saw during the first Legionnaire's Disease Outbreak, when elderly male American Legion conference attendees were infected from the hotel's cooling water system. The epidemic curve is still early, we are still learning. It is heartening and interesting that children are being spared; our last pandemic, H1N1 "swine flu" in 2009, was particularly savage on children, causing many deaths. |
|
CRS, DrPH
|
|
Pandemic
Adviser Group Joined: January 31 2020 Location: UK Status: Offline Points: 2725 |
Post Options
Thanks(0)
|
I wondered if diet plays a part on the immune systems. Western countries diet and immune system may influence CFR!?. Did we consider that our responce to the case load maybe critical. Wuhan was swamped and healthcare was overburdened. Time will tell how we deal with massive increase.!! |
|
Flubergasted
V.I.P. Member Joined: February 04 2020 Location: USA Status: Offline Points: 2130 |
Post Options
Thanks(0)
|
I am not convinced that viral pneumonia deaths are all being tested. A friend called me this morning and told me her husband died of viral pneumonia. He was under isolation until he left the hospital AMA due to hallucinations. If they tested him, they did not tell her. |
|
Hazelpad
Adviser Group Joined: September 09 2014 Status: Offline Points: 6910 |
Post Options
Thanks(1)
|
Or perhaps South Korea may have imported more cases of the S type of virus ( less severe) rather than the L type. The S type if circulating should out compete the L type as it would be able to circulate in the community better than the one that causes severe disease and immobilise a the patients more. In Wuhan only approx 4% of patients had milder type of virus and over 93% had the bad one. Outside Wuhan other China regions had over 36% of the milder version circulating. They are working on a hypothesis that this is why Wuhan CFR was so much higher than the rest of China. Below is link to paper showing genetics of the 2 strains. Even if you are not into the genetics of virus download the PDF and go to Fig 4. You will see 2 dots. The blue represents the severe L tyoe and the red the less severe S type. Now if you look at the lines coming out of each dota that's the countries each type has gone to. South Korea got both from China (as did US). So maybe an outside possibility Korea have more S type circulating. Hz x At the moment only 2 types described and I think each may have a different CRF, but then its collective isnt it https://academic.oup.com/nsr/advance-article/doi/10.1093/nsr/nwaa036/5775463#.XmIyROhJG8I.whatsapp |
|
BabyCat
V.I.P. Member Joined: January 26 2020 Status: Offline Points: 15175 |
Post Options
Thanks(0)
|
Yes, thanks for that. I think you're right. The differences in fatality better explained by the different strains. Just like 1917-1918 waves. |
|
Post Reply | |
Tweet
|
Forum Jump | Forum Permissions You cannot post new topics in this forum You cannot reply to topics in this forum You cannot delete your posts in this forum You cannot edit your posts in this forum You cannot create polls in this forum You can vote in polls in this forum |