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Thread: Coronavirus with an R0 of 3 or beyond

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    Coronavirus with an R0 of 3 or beyond

    Not wishing to alarm anyone, but I was just watching the movie "Contagion" about a worldwide SARS-type viral outbreak, that the current coronavirus pandemic seems to be mirroring closely, when I came upon the most important characteristic of any outbreak, the so-called R0 - number, which indicates how contagious a disease is. R1 means one infected person will infect 1 other on average, 2 means 2 will be infected and so on. Anything beyond 3 would indicate an unstoppable global pandemic, though of course the death rate can vary and with coronavirus, it seems relatively benign, compared to say SARS or Ebola. However, the R0 number is a concern and some studies show it goes to 3 or higher. Supporting article from a reputable medical journal below.

    https://www.statnews.com/2020/01/26/...e-experts-say/

    Containing new coronavirus may not be feasible, experts say, as they warn of possible sustained global spread

    Some infectious disease experts are warning that it may no longer be feasible to contain the new coronavirus circulating in China. Failure to stop it there could see the virus spread in a sustained way around the world and even perhaps join the ranks of respiratory viruses that regularly infect people.

    “The more we learn about it, the greater the possibility is that transmission will not be able to be controlled with public health measures,” said Dr. Allison McGeer, a Toronto-based infectious disease specialist who contracted SARS in 2003 and who helped Saudi Arabia control several hospital-based outbreaks of MERS.

    If that’s the case, she said, “we’re living with a new human virus, and we’re going to find out if it will spread around the globe.” McGeer cautioned that because the true severity of the outbreak isn’t yet known, it’s impossible to predict what the impact of that spread would be, though she noted it would likely pose significant challenges to health care facilities.

    The pessimistic assessment comes from both researchers studying the dynamics of the outbreak — the rate at which cases are rising in and emerging from China — and infectious diseases experts who are parsing the first published studies describing cases to see if public health tools such as isolation and quarantine could as effective in this outbreak as they were in the 2003 SARS epidemic.

    And the warnings come as the United States reported over the weekend finding three more cases, the country’s third, fourth, and fifth. Two were diagnosed in California. One is a traveler from Wuhan, where the outbreak is believed to have started, who was diagnosed in Orange County. The other is someone who visited Wuhan who was diagnosed in Los Angeles County. The fifth case was diagnosed in Arizona and is a student at Arizona State University; the person had also traveled to Wuhan.

    Confirmed infections within China climbed to nearly 2,750 and the death toll rose to 80.

    China’s health minister, Ma Xiaowei, warned Sunday that the virus seems to be becoming more transmissible and the country — which has taken unprecedentedly draconian steps to control the virus — was entering a “crucial stage.”

    China’s actions — which include shutting off flights and trains from some affected cities and effectively putting tens of millions of people into quarantine — may not be enough to stop the virus, experts said.

    “Despite the enormous and admirable efforts in China and around the world, we need to plan for the possibility containment of this epidemic isn’t possible,” said Neil Ferguson, an infectious diseases epidemiology at Imperial College London who has issued a series of modeling studies on the outbreak.

    There may be as many as 100,000 cases already in China, Ferguson told The Guardian newspaper on Sunday, adding the model suggests the number could be between 30,000 and 200,000 cases. “Almost certainly many tens of thousands of people are infected,” he told the British newspaper.

    The Bill and Melinda Gates Foundation announced Sunday it is donating $10 million to the response to the virus. Half the money will be given to Chinese groups to help them in containment efforts. The other half will be given to the African Center for Disease Control to fund its efforts to help African countries prepare to have to cope with the new infection.

    Also on Sunday, World Health Organization Director-General Tedros Adhanom Ghebreyesus tweeted that he is traveling to Beijing to meet with Chinese authorities to offer support and to learn more about the outbreak.

    The WHO so far has not declared the outbreak a global health emergency, though Tedros, as he is know, has said the spread of the new virus is a crisis for China and a risk to countries beyond it. The WHO declined to label the outbreak a global health emergency of international concern on the advice of a panel of experts who met Wednesday and Thursday, though those experts were split on whether a PHEIC should be declared.

    This outbreak is caused by a virus — currently known as 2019-nCoV — that belongs to the same family as the viruses that caused the SARS outbreak and which cause sporadic flare-ups of cases of MERS on the Arabian Peninsula.

    The SARS virus caused an explosive outbreak in late 2002 and early 2003, infecting more than 8,000 people around the globe and killing nearly 800 before it was contained. MERS has never caused a sustain global outbreak, though a number of large hospital-based outbreaks — including one in South Korea sparked by a businessman who contracted the virus in the Middle East — have been recorded.

    One of the luckiest breaks the world got with the SARS outbreak was the fact that the virus did not transmit before people developed symptoms.

    With some diseases, like influenza and measles, people who are infected but who are not yet feeling sick — people who are still going to work or school, taking public transit, shopping in malls, or going to movies — can pass the viruses to others.

    Tools like quarantine and isolation — which were key to controlling SARS — are unlikely stop spread of a virus that can transmit during the period from infection to symptoms, experts say.

    Dr. Nancy Messonnier, director of National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention, said the agency knows transmission of the virus within the United States may be on the horizon.

    “We’re leaning far forward. And we have been every step of the way with an aggressive stance to everything we can do in the U.S.,” she told STAT. “And yet those of us who have been around long enough know that everything we do might not be enough to stop this from spreading in the U.S.”

    To date, at least 14 countries and territories outside of mainland China have reported nearly 60 cases. There have been no reports yet of unchecked spreading from those imported cases to others.

    “In hours where I’m feeling optimistic I think about the fact that none of the other countries, including the U.S., have seen significant sustained chains of transmission,” Messonnier said. “But that doesn’t mean that it’s not coming.”

    It also appears that the incubation time — the time from infection to the development of symptoms — may be a bit shorter than that of SARS, McGeer said, citing a paper published Friday that described transmission within a family in Hong Kong. With SARS, most people developed symptoms about four or five days after infection, she said.

    A short incubation period gives health authorities less time to track down and quarantine people who have been exposed to the virus and who are en route to becoming infectious.

    Scientists who have been studying the genetic sequences of viruses from China and a few other of the countries that have recorded cases have calculated what is known as the reproductive rate of this outbreak — the number of people, on average, that each case will infect.

    An outbreak with a reproductive number of below 1 will peter out. But a number of groups have calculated a reproductive rate for this current outbreak — known by the term R-naught or R0 — in the range of 2 to 3 or beyond.

    Trevor Bedford, a computational biologist at the Fred Hutchinson Cancer Research Center in Seattle, suggested the estimates are sobering and point to continued spread.

    “If it’s not contained shortly, I think we are looking at a pandemic,” Bedford said, though he cautioned that it’s impossible to know at this point how severe that type of event would be.

    Dr. Tom Inglesby, director of the Center for Health Security at Johns Hopkins School of Public Health, urged countries to start planning to deal with global spread of the new virus. Such plans need to include far more aggressive efforts to develop a vaccine than have already been announced, he suggested.

    “I’m not making a prediction that it’s going to happen,” Inglesby said, though he noted the mathematical modeling, the statements from Chinese authorities, and the sharply rising infection numbers make a case for this possible outcome. “I think just based on those pieces of limited information, it’s important for us to begin some planning around the possibility that this won’t be contained.”
    Last edited by Chris, 27th January 2020 at 22:30.

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    Senior Member NotAPretender's Avatar
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    If you didn't wish to alarm anyone Chris, you failed...
    "A large infusion of cash will cure most forms of fanatacism" - Thumbnail Biographies

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    I recall the SARS scare when my son was a child.

    There will be more, possibly worse viral scares as glaciers melt and release microbes unknown to our biology.

    Grab your seats and get ready.

    And wash your hands while your at it.

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    If it bleeds, we can kill it.

    In all seriousness though, I feel that this is one of those scaremongering campaigns again. Don't believe the hype.

    Even if the worst happened, what can we really do about it besides than lose our sleep? It's not worth it.

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    Quote Originally posted by Wind View Post
    If it bleeds, we can kill it.

    In all seriousness though, I feel that this is one of those scaremongering campaigns again. Don't believe the hype.

    Even if the worst happened, what can we really do about it besides than lose our sleep? It's not worth it.
    Normally I would agree, but that R0 number is scary, as is the response of the Chinese Government. They must know that this is dead serious, if they reacted that way and two countries have already completely sealed their borders with China, nobody goes in and out. The last time such drastic measures were necessary was during the middle ages, when during the black plague, Poland completely sealed its borders with all of it neighbours, as a result escaping the brunt of it.

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    Cheers Chris, will swing with Wind on this one, calm swing

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    I should also add that I have seen credible reports, that the real number of those infected could already be in the hundreds of thousands. Also, it is too early to establish the death rate with any sort of accuracy, but similar SARS had a death rate of roughly ten percent, whereas the even scarier MERS has a staggering death rate of 34 percent, so one in three people that get it die. That is worse btw, than the death rate of the fictional coronavirus in the movie Contagion, which was put at 25 percent or one in four.

    So, we shall see, but whereas I ignored the media hoopla in the beginning, I'm certainly paying attention now...

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    Calmly swings.

    To feel into IF, to touch WHY, Once fear

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    Your concerns are well-founded, Chris. The numbers are serious. The symptoms factor is a big one.

    Here's a humorous take.

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    This Harvard doctor does an excellent job of breaking down what that above 3 R0 number actually means in practice. Not particularly reassuring.

    https://twitter.com/DrEricDing/statu...19589623803905

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    Markets are already reacting. They will continue to, I imagine.

    Trade wars, disease, ahh the law of unintended consequences. We have no idea what they will be.

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    Quote Originally posted by Dreamtimer View Post
    Markets are already reacting. They will continue to, I imagine.

    Trade wars, disease, ahh the law of unintended consequences. We have no idea what they will be.
    The more I look into it, the less I like it. I have dear friends, who live in Beijing and this thing is spreading quickly.

    I mean, there is still a chance, however slim, that this whole thing will blow over, but the reaction of the Chinese government and the facts on the ground tell me otherwise. BTW, as of now, four neighbouring countries have sealed their borders with China and the US and UK governments advise against all but non-essential travel to the whole of China, which is a continent-sized country, even larger than the US.

    Officially, only a few thousand people have gotten sick, but if that were true, why are they building brand new hospitals with record speed in Wuhan? From local reports, it would seem that Wuhan alone has tens, maybe hundreds of thousands of cases already. Pretty soon there will be millions and it has already spread beyond the borders of China. The silver lining seems to be that the death rate is not too bad so far perhaps 2-3 percent, although it must be said, the Spanish Influenza had roughly the same death rate, but a significantly lower R0 number, at around 1,8, so this outbreak is actually more serious. I have seen projections from serious publications that estimate around 20 percent of the global population will get it if current trends continue. That means around 1,5 billion well get sick and 30-40 million might die, all within the next year or so. I am also concerned about serious reports, not from whackjobs, but reputable sources, that the original source of the outbreak may have been the Wuhan biodefence lab, where they were experimenting with coronavirus strains collected from batcaves in the nearby area. Who knows if we'll ever find out the truth.

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    This is a video from the twitter thread linked above.


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    Quote Originally posted by Chris View Post
    I am also concerned about serious reports, not from whackjobs, but reputable sources, that the original source of the outbreak may have been the Wuhan biodefence lab, where they were experimenting with coronavirus strains collected from batcaves in the nearby area. Who knows if we'll ever find out the truth.
    Hearing truth from the government? Never.

    The situation is a bit concerning now, I must admit. It's worrisome what governments can potentially do with their biological weapons.

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    British Airways has now suspended all flights to China, until at least the end of February. We can now say that China is in lockdown and will soon be quarantined by the entire world. Not reassuring.

    https://www.independent.co.uk/travel...-a9307246.html

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