Coronavirus Super-Spreader Infects 57 in Hospital

Mish

One of the coronavirus fears was the possibility of super-spreaders. That possible fear is now reality,

Disturbing Details

A New Report on 138 Coronavirus Cases Reveals Disturbing Details including the emergence of a super-spreader.

One patient, admitted to a hospital in Wuhan, China, infected at least 10 health care workers and four other patients [actual suspect total is 57 see study below].

The patient who infected so many health workers had been placed in a surgical ward because of abdominal symptoms, and the coronavirus was not initially suspected. Four other patients in that ward also contracted the disease, presumably from the first patient.

The incident was a chilling reminder of the “super-spreaders” in outbreaks of other coronavirus diseases, SARS and MERS — patients who infected huge numbers of other people, sometimes dozens. The phenomenon is poorly understood and unpredictable, an epidemiologist’s nightmare. Super-spreaders led to considerable transmission of MERS and SARS inside hospitals.

Super-Spreader Infects 40 Health Care Workers

The JAMA Report, published on Friday, is among the most comprehensive articles to date about people infected with the newly identified virus.

Of the 138 patients, 57 (41.3%) were presumed to have been infected in hospital, including 17 patients (12.3%) who were already hospitalized for other reasons and 40 health care workers (29%). Of the hospitalized patients, 7 patients were from the surgical department, 5 were from internal medicine, and 5 were from the oncology department. Of the infected health care workers, 31 (77.5%) worked on general wards, 7 (17.5%) in the emergency department, and 2 (5%) in the ICU. One patient in the current study presented with abdominal symptoms and was admitted to the surgical department. More than 10 health care workers in this department were presumed to have been infected by this patient. Patient-to-patient transmission also was presumed to have occurred, and at least 4 hospitalized patients in the same ward were infected, and all presented with atypical abdominal symptoms. One of the 4 patients had fever and was diagnosed as having nCoV infection during hospitalization. Then, the patient was isolated. Subsequently, the other 3 patients in the same ward had fever, presented with abdominal symptoms, and were diagnosed as having nCoV infection.

The data in this study suggest rapid person-to-person transmission of 2019-nCoV may have occurred. The main reason is derived from the estimation of the basic reproductive number (R0) based on a previous study.

In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%.

JAMA Video

"Fatality rate in a normal Flu is about 0.1%. When you get into the pandemics, of 1957 and 1968, it goes up to 0.8% to 1.2%. The 1918 pandemic, the famous Spanish Flu, you go up to as much as 2.0%. ... I think I can say we don't know everything about this virus, but it is evolving in a way that it looks like it is adapting itself to infecting much better but we are going to start seeing a diminution in the overall death rate. ... The r0 of this one is supposedly somewhere around 2.0, 2.5, 3.0 depending upon how you model it. Which means that it is a virus that is quite good at transmitting from one person to another."

First US and Japanese Deaths

Massaged Numbers?

Or Not Enough Test Kits?

Terminal 3 in Copenhagen Closed

Shanghai Empty

Downtown of Shanghai, a city with 24 million people and it is totally empty!

Cruise Ship Update

China ignores offers of help from the C.D.C. and W.H.O.

China probably wants and needs US assistance, but it absolutely does not want US reporting or any investigation into the alleged number of deaths.

The streets in Shanghai, population 24 million, are empty.

60 million people are quarantined not even able to leave their houses. That is equivalent to no one in California, Illinois, and Wisconsin being locked in, unable to go to work. The economic hit will be enormous.

I just cannot believe this would happen over the reported 700 dead.

In case you missed it, please see 50,000 New Coronavirus Infections Per Day in China.

Mike "Mish" Shedlock

Comments (64)
No. 1-14
eths
eths

Calculating the fatality rate by dividing the number of deaths by the number of current cases seems anyway to be a good way to minimize things, especially when the number of cases is exponential.

FloydVanPeter
FloydVanPeter

Adding on @eths point: Dividing total reported death over total reported cases is a poor approximation. The reported figures are suspect. The formula is wrong. And, none-flat rates of infection and death as pointed by @eths.

The correct computation is to extrapolate based on some sort of weighted summation of patient death by daily cohort.

One can attempt approximating this idea with daily stats and modeled distribution representing days to recovery/death.

FloydVanPeter
FloydVanPeter

Any suggestions about the no-news (good news) from Africa, South America and the Middle East?

Is that merely a function of lesser flying traffic bw the PRC and those regions?

abend237-04
abend237-04

I'm curious if they have video of the super-spreader. I think personal carelessness can have major impact on transmission rates. A few years back, just as my wife and I were seated at a restaurant table in Vegas, a woman at the next table coughed open-mouthed directly at my wife. When it happened a second time, less than a minute later, I started looking for our waiter, intending to ask for a different table. Before he arrived, they got their check and left. Two days later, my wife began having problems. Two days after that, I took her to emergency, over her objections, and she was diagnosed with pneumonia. I'm convinced that, given free rein, the woman could have infected the entire Strip overnight.

cindylouwho
cindylouwho

The Coronavirus is just another consequence of an overpopulated world. It is a natural consequence of poor controls, poor sanitation, and poor people. And even after it has finally been contained, something else will be right around the next corner.

The world is suffering from overpopulation. There are simply too many people for the planet to sustain. We are witnessing the consequences of this overpopulation:

Global Warming> Climate Change> Consequences

Deforestation>Desertification>Consequences

Pollution>Poor Sanitation>Unsafe water>Consequences

Overpopulated Cities>Consequences

The Consequences include health issues such as the Coronavirus. But there are hundreds more. Chief among them will be our food supply and our supply of usable water. We are already seeing the disappearance of pollinators, such as bees. Floods, droughts, extreme weather, insects, blights, wildfires, etc are all beginning to have an impact on food production. For the developed world, this will mostly be an inconvenience; higher food prices; perhaps shortages of certain food types. For the poor in the world it will mean malnutrition and starvation.

I imagine, that as these catastrophes continue, we will slowly get better at dealing with them, and perhaps even preventing some of them. But the costs are going to be high. Sadly, this is nature’s way of solving the overpopulation problem.

Curious-Cat
Curious-Cat

I was just looking at the Johns Hopkins map of global cases and note that there have been no cases reported on the continents of Africa and South America. How can this possibly be correct? China has abundant economic interactions on both continents. More likely this is a failure in either diagnosis or reporting. If so, this has enormous implications for the rest of the world. Neither continent has the governmental structure or the medical infrastructure to deal effectively with an outbreak.

edk38
edk38

The correct math is death divided by death + recovered...the outcome of those infected is still unknown. As the data from the epicenter is skewing any analysis and the most unreliable it should be excluded...the mortality rate approximates 2.22% (26 deaths/1173 recovered, excludes Hubei). That's the best number we have today. The data to track is deaths and recoveries outside of China, however, the sample size is too small as of today.

jeco
jeco

Indonesia with 300+ million dirt poor people also has no REPORTED cases. Java island (Jakarta) is most crowded place in the world. Impossible all these places have no cvirus , it's an issue of testing and reportsing

Carl_R
Carl_R

I don't get the fascination with the "2.1%" argument. That's just a way for people to demonstrate their lack of understanding of mathematics. Given that each day a small number of new cases and new deaths are added into a large pool, of course the total percentage for the pool isn't going to move very far. Duh. Look at the daily totals, though, and the days move around quite a bit. The last few days have been, using the data from the tweet above:
64 deaths, 3970 cases, 1.6%
71 deaths, 4164 cases, 1.7%
160 deaths, 6072 cases, 2.6%

None of these are 2.1%, yet none are large enough to shift the average for the much larger pool.

Edit - I am going to switch to my numbers, rather than the numbers in the twitter post above. Now that the number of new cases is declining each day, but deaths continue to rise from the older infections, we can expect to see a significant increase in the useless ratio of (deaths from old infections/newly reported infections). Starting about a week ago:
58 deaths/2779 new cases, ratio 2.1%
65 deaths/3269 new cases, ratio 2.0%
67 deaths/3968 new cases, ratio 1.7% <== peak # of new cases
71 deaths/3694 new cases, ratio 1.9%
73 deaths/3077 new cases, ratio 2.4%
86 deaths/3407 new cases, ratio 2.5%
89 deaths/2627 new cases, ratio 3.4%
97 deaths/2964 new cases, ratio 3.3%

With 4 days in a row over 2.1%, the cumulative ratio has now risen to 2.2%. If you look at just Hubei, the cumulative ratio is 2.9%, and the last few days have been:
70 deaths/2987 new cases, 2.3%
69 deaths/2447 new cases, 2.8%
81 deaths/2841 new cases, 2.9%
81 deaths/2147 new cases, 3.8%
91 deaths/2531 new cases, 3.6%

If new cases continue to decline in the typical bell curve shape, deaths will eventually plateau and fall as well, but the ratio should stay over 2.1% for the rest of Wave 1 of the infection.

The question remains open whether the Cornavirus will escape to the wild in other parts of the world, initiating a second wave of infection, and also whether, if China relaxes the nationwide shutdown, there will be a second wave in China. Both seem possible, even likely.

FloydVanPeter
FloydVanPeter

D/J, where D is number of deaths and J number of infected is a poor model.
D(t)/J(t) representing the ratio of deaths to infected given infection time t (let's say in days granularity) seems rather good calculation, but dependent on good data and future results (when t is near past, so not all infections concluded). Then, we can average the D(t) sequence. A running average seems right to me (with a two week windows - let's say).

Carl_R
Carl_R

Now that we have firm evidence of just how fast it can spread, let's go back to January. Back in January, just when nCov19 was starting to spread, Wuhan hosted a massive buffet. I heard they were trying to break the Guinness World Record for the most people at a buffet, but I don't know if that is true. I also heard there were between 50,000 and 100,000 people at the buffet. How many people could just a single infected person have infected? Suppose there were 20 infected people there?

Carl_R
Carl_R

Here are more calculations from the official data. If you take the average growth rate in the number of cases over the last three days, cases are now growing at the following rate:
Hubei - 10.7%, down from 20.6% the three days before that
Rest of China - 5.6%, down from 9.9% the three prior days
Rest of World - 10.7%, down from 12.3% the three days prior
All numbers are even lower tonight:
Hubei up 9% avg last two days
Rest of China +4.6% avg last two days
Rest of World +8.7% avg last two days

Casual_Observer
Casual_Observer

Who really believes the numbers ? There is major underreporting going on.

EntrrUsername
EntrrUsername

You do realize the tweet you used in the "Massaged Numbers?" section isn't accurate right? The guy even admitted it himself. And he wants to claim that China is faking the numbers lmao


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