Tweets of the Day: Iran's VP Infected, Japan Closes All Schools

Mish

Millions of school kids are hit with school closures in Japan. Iran's "Screaming Mary" is infected. Surprise Fed cut?

Community Spread in the US

Trump Admin Incompetence

Iran's "Screaming Mary" Infected

How Many Iranians are Really Infected?

Japan to Close All Schools

Let's Get Those Exports to China Humming

Trump wants to exports masks to China. Hey why not?

Bianco's Latest Charts

Clorox Doing Well

Cruise Ships and Casinos Not Doing Well

ECB Complacency

Too Soon For a Rate Cut?

How About a Surprise Rate Cut?

Twice in the past week I mentioned the possibility of a surprise rate cut.

If it happens, I won't be surprised.

All News Must Funnel Through VP Pence

US Censorship Already

What's Happening?

  1. Feb 19: Fed Minutes Highlight Coronavirus Concerns and Uncertainty 8 Times
  2. Feb 24: Bond Yields Crash and Gold Soars on Pandemic Threat
  3. Feb 25: CDC Admits Spread of Coronavirus in the US Appears Inevitable
  4. Feb 25: Lie of the Day: This is Not a Pandemic
  5. Feb 25: Nearly 50% Odds of "At Least" 3 Rate Cuts by December
  6. Feb 26: Trump says We are "Very, Very Ready for the Coronavirus, for Anything"
  7. Feb 27: Useless Act: California Monitors 8,400 People for Coronavirus; 33 Test Positive
  8. Feb 27: Containment Fails: Coronavirus Tweets of the Day

Rate cuts odds started rising before coronavirus threat materialized on news Largest Global Shipping Decline Since 2009.

In regards to point 6 and Trump's comment that we are "very, very, ready", excuse me for pointing out that California is monitoring 8,400 people and has 200 test kits.

And monitoring people in and of itself is useless. By the time anyone show symptoms, they have been a carrier for as long as 19 days.

Mike "Mish" Shedlock

Comments (79)
Latkes
Latkes

infection fatality ratio (IFR) 0.07% and time-delay adjusted IFR 0.23%

31 Replies

LB412
LB412

"The power of our approach lies in the ability to infer epidemiological parameters with quantified uncertainty from partial observations collected by surveillance systems." This is not what @who found when they were on the ground in Hubei province.

Latkes
Latkes

Link?

Anda
Anda

They modelled China epidemiology on returnee Japanese cases, and they admit that there might be bias due to different transmission rate amongst different social groups.

Then they admit more or less that it is as high for China as represented by official figures :

"These findings indicate that the death risk in Wuhan is estimated to be much higher than those in other areas, which is likely explained by hospital-based transmissions."

So their sum is higher transmissibility than previously estimated, but lower CFR (and IFR) due to comorbidity in hospital transmission accounting for many fatalities in China, which would not occur outside of China.

Well it's an idea I suppose, but I'm going to wait till we have fuller figures in the west before I draw any sort of conclusion.

Latkes
Latkes

They are saying exactly what I am saying all the time - a lot of undocumented cases and a much lower fatality rate.

It's funny, yet again, that you are "going to wait till we have fuller figures", which is what many people are saying about any kind of positive news and by itself is a reasonable thing to say... however, people don't show this kind of restraint when they spread panic and predictions of doom based on this same data and general hysteria.

Ironically, I found this study posted elsewhere with the title "980,000 infections in Wuhan!" and no mention of the low mortality rate. It's like people wish for this to be as bad as possible.

Anda
Anda

I am saying that because we don't have a workable set of reliable figures, and that is why that study knowingly goes deep into hypothetical extrapolations.

Some accept China data, others try to disprove it, I cannot work with it. It does indicate that there is high transmission and fatality, and it will take a clear study using valid real data for me to reject that basic assumption.

Latkes
Latkes

OK, reasonable.

The next time someone makes the claim that this is just like or worse than the Spanish Flu or if someone extrapolates an outlier into a general pattern (like people freaking out about an alleged 24 or 27 day incubation period as if that was the norm), I hope to see you having a reasonable response to that.

Mish
Mish

Editor

Death rate in Wuhan is likely higher due to lack of supplies, putting sick people together in close proximity in beds next to each other.

Mish
Mish

Editor

"(like people freaking out about an alleged 24 or 27 day incubation period as if that was the norm),"

You are now on very thin ice.

No one is "freaking out" about an alleged incubation period - except YOU.

YOU are the one ignoring evidence and scientific opinions.

I never once said it was the "norm". Nor did anyone else. It is possible and you have to be a fool to not see it.

I will not tolerate you putting words in my mouth that I never said.

Latkes
Latkes

I did not say it was you. If it were you, I would have mentioned your name. There are a lot of people commenting here too.

YOU are the one ignoring evidence and scientific opinions.

Any evidence or scientific opinion I provided (like the study above) is dismissed. Talk about ignoring.

I will not tolerate you putting words in my mouth that I never said.

I am fine with that, since I have not done such thing.

This virus certainly brings out the "interesting" in people.

Anda
Anda

We're guessing though really, opposite arguments have been made, but am not going to tie myself in knots arguing because whatever reasonable set of figures are used the picture is not a happy one.

Anda
Anda

Chinese study via scmp says 1% are over 14 days, 24 days was 0.1%. There is one case said at 40 days, though hard to prove not infected later. There are asymptomatic carriers that transmit, people who transmit after being cleared, people who reinfect by themselves and by others, the testing system is dubious also.

Median incubation is taken at around 5 days btw by most, time between symptoms and seeking attention is very variable. In the west median is a couple of days for those who know they might be exposed, but it can be a week or more or never if symptoms are mild. R0 is high, probably well over 5 in normal circumstance, decreasing depending on quarantine level.

Enough please, we are in an unknown circumstance, fatalities are occuring with people of various age groups, some of them known healthy. Let people prepare or be alerted to possible danger, even many governments are taking strong actions they would not if they could help it, if they thought there was little danger or even if they thought they could excuse inaction.

Latkes
Latkes

Thanks, hopefully @Mish reads this too.

I would say there is a good chance that the 24 day cases are also hard to prove not infected later.

A link would be nice too. I linked the Chinese study with N over 1000 that set the median incubation period at 3 days.

LB412
LB412

She is a great source of information.

LB412
LB412

I can't post the link. Visit @HelenBranswell on Twitter. 8:01 AM on Feb 25th

Latkes
Latkes

Thanks, here is the study that mentions 3 days median: https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1

Anyway, 3 days or 4.5 days, both still support the basic argument about the statistical outliers.

Anda
Anda

40 days questionable

The asymptomatic transmissions and mild transmitters are well documented. The 38yr old athlete in Italy is critical, a 21 yr old athlete was fatality in Iran. Milan hospital is out if beds, Spain doctors are short of basic masks, the test kit failures I linked previously, lack of coordination, incoherent protocol everywhere - it just says to me we are not prepared for a serious pandemic. People, people can barely comprehend what a serious pandemic would mean.

Like most people, I truly hope it is all exaggerated.

Anda
Anda

Statistical outliers , point is for example they set the parameters of if quarantine will work or not, so in those terms those with 14 days or less incubation are the outliers (they don't count).

Anda
Anda

Both opinions in the article by Helen Branswell work for or are associated with WHO . It isn't WHO denying Aylward , and the take home as I read it is that missed cases might be between 0.5% to a multiple of that. Even if it were 10 % it won't dilute CFR much ( say 4 in 100 vs 4 in 110), it will increase RO, and it will mean unsourced transmission or unnoticed reservoir of virus will increase.

Latkes
Latkes

Sure, but a) that is not what was written in Mish's article (not going to any more into that) and b) practical considerations have to be taken into account - where do you stop - for example would 42 day long quarantine for thousands of people on a ship or in a hotel, locked in their rooms be reasonable?

Stuki
Stuki

"...Of 320,000 tests performed, just under 0.5% were positive for the virus at the peak of transmission there, he said.."

Not sure what tests Guangdong fever clinics performed, but I really hope, for the sake of "we are prepared" Trump and Newsom, that these 320,000 tests, aren't the same ones the entire state of California only has 200 of........

Also, 0.5% of 320,000 is 1600. With the 320,000 seemingly self selected from a population conditioned to worry about viruses, post SARS. If anyone half paranoid could show up at a "fever clinic" and get tested in Cali, wonder how many would turn up positive.... (Unless tests ran out after the first 200 were tested, of course...)

In general, until tests themselves are more standardized, less suspect and more vetted, I wouldn't extrapolate too far based on them. While no doubt still useful from the POV of deciding on treatment, quarantines etc. on a patient by patient basis, basing large scale, speculative, global outbreak models on them, seems a bit risky.

Data from Wuhan/Hubei itself seems more settled, as they have more corroborating observation than just various versions of initial tests of varying quality. But at the same time, I'm not sure how representative the Wuhan/Hubei outbreak really was, as a model for possible outbreaks further out.

Indicating that we should probably wait for more conclusive data from Iran, Japan, South Korea and Italy, before getting too married to any theories, models or conclusions about how things will unfold elsewhere.

Latkes
Latkes

Both opinions in the article by Helen Branswell work for or are associated with WHO .

Yes, I know. I thought it was obvious from the context.

and the take home as I read it is that missed cases might be between 0.5% to a multiple of that.

Where did Kobinger say that?

Anda
Anda

Kobinger didn't. Aylward's report was 0.5%, Kobinger said much higher. You don't like 20X higher, OK. Continue guessing, but don't make out to me you have anything specific to contribute.

Latkes
Latkes

Kobinger didn't.

So I was right. Not sure what is the problem then.

Read the context again, LB412 pointed out that WHO said something and gave me a reference to the article. I read the article and pointed out that another WHO expert countered the claim (in that same article!). An educated guess was provided in the study that started this thread. You disagree with that, fine.

Anda
Anda

a) I didn't read any obvious implication, it came across as a fact (as far as is known) to take into consideration.

b) The possible maximum incubation time is a practical consideration to be taken into account, to whatever degree depending on model or real world ability.

Anda
Anda

No, she didn't mention WHO, you did saying WHO discredited the info she linked to.

I don't find reason to validate the info in the study that you started the thread with, it is a proposition.

JimmyScot
JimmyScot

Not sure if all of those commenting bothered to watch the Aylward interview in full.

"They are out of medical supplies"
Not supported by his comments. Not only do they have more ECMO machines in one hospital than we have in the whole UK, but it was very plainly stated by Aylward that all of the provinces directed medical supplies and personnel (many of whom apparently well motivated volunteers) into Wuhan. And when they arrived they took over entire wards, effectively just overlaying their expertise, PPE, supplies, shift rotas and interpersonal relationships onto a different ward than normal. Hence, they hit the ground running.

"Their tests aren't good enough"
People turn up at a fever clinic, if they have a fever they get a CT scan, if the CT scan shows pneumonia, they get admitted, if it doesn't, they don't.

Aylward made a very telling comment toward the end of that session. He said that people in the west were making a dangerous assumption - that China was screwing this up. In fact, he said they were heavily invested in making people better, that they'd diverted the entire machinery of state to that goal, and that they were super efficient at it. He said they'd avoided 100s of thousands of infections.

Compare and contrast:
Every doctor they spoke to in every hospital was operating to a clinical standard updated just 24 hours before.
In Italy, people weren't using protective gear when treating patients. In the UK, two chinese people who rocked up with flu like symptoms were made to wait 4 hours in a room full of people (fortunately they were negative). Department of health telling schools with suspected cases to reopen.

What if the fatality rate in Wuhan is the lower bound of what can be achieved with a super efficient, technology driven health initiative?

KidHorn
KidHorn

It's impossible to determine the fatality rate until the number of cases reaches a steady state. Otherwise you have a numerator that lags a denominator.

Carl_R
Carl_R

I think China, with their draconian controls, is a lower bound on the infection rate at the least. We shall see if the free world can control it now.

JimmyScot
JimmyScot

If we can't we are going to look very stupid, so expect lots of anti-China propaganda - and probably allegations that those pesky Russians are spreading misinformationa gain.

No. 1-13
sangell
sangell

I tuned into CNBC at the close to see how they would handle it. Someone had found a way to get on their studio voice lines. AS the 'B' team was assembled and Mohammed El Arian was, somehow, persuaded to to a telephone interview the screams started. El Arian could talk uninterrupted, but as soon as a CNBC clown tried to the 'screams' began again. No 'big shot' will appear in person live. It is hilarious.

Herkie
Herkie

Northern Ireland now has it, a traveler came from Italy where they were infected and flew to Dublin then on to NI. So it is in Ireland also.

Mish
Mish

Editor

Chinese health officials previously estimated that the incubation period for the virus ranged from one to 14 days, but recent research suggests it could be as long as 24 days.

Doctors concluded that the woman's incubation period – the time during which she was infectious – was 19 days.

5 cases over 14 days

Latkes can apologize any time

FloydVanPeter
FloydVanPeter

Japan shutting down schools is first time officials attempt to get ahead of the curve rather than respond weeks late after infections already took place.

Sechel
Sechel

the iran v.p. tweet may be misunderstood. Iran has 12 vice presidents. sounds more like a minister with a portfolio, like our secretary of education

Zardoz
Zardoz

Pence has swung into action! Even now, he's got a hand on the president's fat shoulder, eyes squinched up communicating directly with God through His Sacred Orange Antenna that smells of Hamburders. God listens to Pence.... the righteous will be saved, and the heathens shall drown in their own snot! Rejoice! The time fo judgement is at hand!

mkestrel
mkestrel

I do not see how lower interest will help this situation but perhaps others can share their thoughts?

nothingbutblueskies
nothingbutblueskies

I don't know who wrote the story on Japan, (Athit Perawongmetha?) but I can say that most families still have the mother staying home with the children all day. This won't be chaos for working parents. It's a pretty ethnocentric position.

MiTurn
MiTurn

Both BNO News and Worldometer report that Nigeria has gotten its first case. I cannot find any other news links. NOW do we have a pandemic?

Roadrunner12
Roadrunner12

"Professor Mackay said if that was the case, “at some point in the coming months or years we’re all going to get infected because we’ve all been infected by these other endemic viruses”.

“We know that they just spread among us,” he said.

The government’s emergency response plan will give sweeping powers to federal and state ­governments to contain the virus if outbreaks occur, similar to those in Iran, Italy, Japan and South Korea."

JMOD46
JMOD46

I see that Latkes apparently doesn't understand the concept of "if it bleeds, it leads". Poor man. He should be more like Mish and run around with his hair on fire. That's the only way to be popular here.


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