LonghornDXB

Large cities need to look at HK and Singapore

Medium size countries need to look at Korea

Countries with an outbreak in one pocket of the country need to look at China (If Italy succeeded in isolating the northern provinces Europe may have fared better)

Japan is an anomaly, maybe the UK is closest to it in behavior - island state with somewhat relaxed attitudes to the virus

LapLap

I’ve succumbed to something nasty (the fever, headaches and chest tightness have been pushing me to a conclusion about what) and am thinking less straight than usual - I’m probably leaping over way too much of what’s there in my rush to see my own expectations and assumptions.
The on the ground, from the front lines data I want the government to take into account is in this article
https://elpais.com/espana/madrid/202...sanitario.html
But, as trueblu explained, the Imperial figures don’t show that.
Am feeling a bit sorry for myself that my government has released some relevant, informative data just when my capacity to try and make sense of it is at its nadir (not that I wouldn’t have struggled at the best of times). But this is where you guys come in. Thank you!

ezefllying

My question is, really, how a large country could actually stamp out every domestic case and not see outbreaks pop up. Because, if China really succeeded in doing so without isolating every single infected individual (which seems virtually impossible), shouldn't there be a resurgence, as the epidemic models would seem to predict? Otherwise, it seems like there's something else -- about the virus's transmissibility, or about the quality of the public Chinese data -- at play.

In short, if China can truly stamp out, rather just mitigate, the virus in 10 weeks, can the West? And would that mean our expectations of 6-12 months of extensive social distancing are excessive? (Of course, I hope that's true, but I haven't seen any authoritative sources to suggest that.)

GUWonder

This situation is going to provide quite some interesting lessons to those interested in biological warfare preparedness and ought to be a lesson to the world about the potential dangers that may come in the future from biological warfare agents. Unfortunately, those lessons will likely not keep much useful attention for long enough and in meaningful enough ways in this day and age.

GinFizz

(bolding by abcx)

Good question - that number also threw me for a while. First let's agree there is no question about the 30% figure (for percentage of hospitalized cases that require ICU). I also get that number from looking at their data in Table 1 (and you will see that already in the part of my post that you originally quoted), and also 5 is close enough to 30% of 15 to not quibble about (for the 80:15:5 numbers you mention).

So regarding the 4.4%, it is not made clear in the text, but my reading of this article suggests that this figure is a percentage of *all infections* (including asymptomatic cases) - whereas the 15%/5% numbers you have seen mentioned previously are based on fractions of confirmed cases (there has been of course a long running debate about how many cases are being missed because they show only very mild or no symptoms).

Why do I think that? Four things:

(1) 4.4% of *symptomatic* cases doesn't pass my sanity check just from inspection of Table 1: the percentage there for hospitalization for the age group 40-49 is given as 4.9%, with higher values for all age groups above this. In that case simple math tells us that to get a mean value of 4.4% then more than half of the cases must be for ages less than 40;

(2) If I use the 2018 UK census population data, and their "% of symptomatic cases requiring hospitalization" in Table 1 I get an average value of 7.8%. Now this is almost double that 4.4% value - so either I ballsed up the calculation or there is something else going on. I'll ignore that first possibility for now, not on account of arrogance, but because in the text the authors also write at the start of the same paragraph containing the 4.4% figure: "Analyses of data from China as well as data from those returning on repatriation flights suggest that 40-50% of infections were not identified as cases [12]". Take 50% of my 7.8% value and we are now close enough to 4.4% that the influence of distribution shape can take over.

(3) For their model they need to track the total number of cases (symptomatic and asymptomatic) as even the asymptomatic cases can spread further the viral infection.

(4) Maybe all that is unnecessarily complicated - as just taking an average of the values in the column "% of symptomatic cases requiring hospitalization" gives an average of 9.7% - and taking 45% of that (the average of "40%-50%") gives a value of 4.4%, so maybe their numbers are already normalized by age-distribution (if so this is not clear to me in their text).

So, to summarize:
(1) The difference you asked about is that the numbers you question are relative to confirmed cases only;
(2) The data to support this are in the paper that you reference;
(3) Fair cop - 9.7% (lets call it 10%) is different enough to 15% that the two numbers shouldn't be conflated (if that was one of your concerns).

trueblu

I really DO believe that China has gotten on top of their domestic outbreak, but yes, the entire population remains vulnerable, as I've mentioned before. So the country and population is at risk of new flare-ups, especially from imported cases (and some undocumented domestic cases). That's why the draconian quarantine measures for incoming pax...inbound flights to China are packed full (of expat Chinese)...I would guess outbounds are going empty...

China needs to keep this up until there's a vaccine, as do any other countries e.g. S. Korea, that are pursuing similar strategies. BBC reported today that UK is now going to attempt (I doubt they will be successful with the measures they've introduced) the same, but also acknowledges that if so, measures would need to stay in place for 5-18 months...

tb

GinFizz

In addition to trueblu's points above, remember also that 13000 infections outside Hubei is just an average of 500 people per province (in reality some had very few, and some 1000+ as far as I recall). But those were the *total* number of cases - so spread out over around 7 weeks (but concentrated mostly over 4 weeks). So with those numbers, combined with the restrictions on movement, extensive tracking of contacts, and limiting spread though wearing masks, it does seem that finding and removing all cases has been possible.

Given what is happening now in Europe and America it is perhaps worth noting also that the timing of the Chinese New Year holiday did not help with the initial spread across China of cases, but it did make it easier to put in place a period of 3-4 weeks of very restricted social movement, as this could be enacted largely just by extending a nationwide shutdown that was already in place. And although for most of China it was not a "total lockdown" (as in Wuhan), everyone did mostly stay at home (just going outdoors in their local vicinity and for shopping) for much of this time.

But yes, you are correct that China is still susceptible to a resurgence of cases, either from imported infections, or untracked clusters (though the latter is harder and harder to imagine, given the way that viral spread occurs and the fact that a lot of health monitoring is still going on).

MSYtoJFKagain

Cancelled all my travel for the next 2 months at least. I think everyone should be doing the same given that being a unwitting carrier and bringing it to an unaffected country/county/town is a horrible thing to do.

GadgetFreak

I think we maybe could have stopped this very early (January maybe) with very stringent measures but we didn’t. Now it will change the country, and the world, for at least a generation, and not for the better. Many people will die, many businesses will go bankrupt. Lives and families destroyed. I don’t think there is a way around it. Even now in the US they aren’t dealing with this as the emergency it is. Just the flu, or perhaps in the future they will group this with the bubonic plague.

GUWonder

Untracked clusters is not hard to imagine, and I'm not sure it's gotten harder and harder to happen even in China. People who believe that quarantine is something they can't/don't want to face (or face again) or don't want to see others near them face (face again) may for some time try to be an untracked carrier or part of an untracked cluster of carriers (regardless of whether it's from community spread or "imported"). The wisdom of such behavior is of course very much in doubt in my mind (and that's to put it in a very generous way), but I have no doubt that there are people who behave like that anyway. With all the "work at home" advisories, maybe it's even easier to be "hidden" when there has been this growing body of people going with the "work at home" advisory, with most of those advisory-followers not being in quarantine.

bobbytables

bubonic plague, seriously? The one that killed 50% of people it infected as opposed to <1%?

GadgetFreak

What percentage did it infect? But those details maybe don’t matter. This could kill a hundred million worldwide depending of a few variables such as speed at which people get it. If it’s fast the mortality rate may be more like 3%-5%. A lot of people that could have been saved will die because of no treatment. It’s destroying businesses, jobs and changing the way we live. Some things will recover somewhat, others probably not. This is very likely a history changing event. Not the flu.

Sjoerd

Is anyone here still planning unnecessary travel (to a place further than easy driving distance from home) for the next 3 months or so?

nk15

Italians sending messages to themselves of 10 days ago, about what they should have done...Trying to warn us...
https://www.businessinsider.com/coro...n-video-2020-3

One of the more proactive US governors....
https://www.msn.com/en-us/news/us/oh...?ocid=primedhp

The generational divide and the threat from younger people not taking this seriously or care enough and keep on partying at home or outside...
https://www.msn.com/en-us/news/world...?ocid=primedhp

FlitBen

Beyond containment, the overall trend of cases becomes meaningless. It is your local trend of critical cases that is key. The record shows that most of those infected will recover, so stay hopeful.