Wuhan virus (coronavirus) arrives in the USA

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What’s the “alarming” significance of the Dr above commenting that he “does not think there’s a significant iceberg of un(der) reported mild cases”?

It would mean the death rate is really high—-anywhere from 2% to 20% depending on what data set you are looking at. And that means containment is really important—buy is nearly impossible on a country that is not authoritarian especially where the virus transmit before symptoms appear.

1-2% is plenty high enough to be alarming.

Overall no one is saying anything like 20% CFR. You cannot go by initial results in outbreaks as if they haven't been testing for it, the first cases they know about will be the severe ones.

If 10% of the cases are "severe" and medical attention is not available, then the CFR might be higher in those areas.

But I think a lot of people were hoping there was much mild, undetected spread which would bring the CFR of this virus down to 0.1 % like seasonal flu.

Why the emphasis on using a denominator (CFR) that includes unresolved cases? If you look at closed cases (ended in recovery or death), the current death rate = 8%. : https://www.worldometers.info/coronavirus/

That's not a good way to estimate case fatality rates at the start of an epidemic. For example, if you have 100 sick people and 1 dead person with 0 recovered then you have a 100% fatality rate by your method. Not a good way to estimate. The real problem is that the number of critical patients that need ventilator support will have huge fatality rates if there is not enough medical support and that's what everyone's worried about.

[Anonymous]

Iran has thrown up it's hands and stomped out like a toddler. They're not even going to try. It's impossible to stop the spread when you have a country with that large of a population doing this. Our best hope still remains to delay delay delay until vaccine.

https://twitter.com/ragipsoylu/status/1232586823832088583?s=19

Iranian President Rouhani says there will be no quarantine imposed on any city or place in the country, and the people should not care about the rumors.

[Anonymous]

This is a good article that points out there is basically no way the US could do what China is doing with quarantines.

https://www.wired.com/story/could-the-us-contain-a-coronavirus-outbreak/

[Anonymous]

Anonymous wrote:This is a good article that points out there is basically no way the US could do what China is doing with quarantines.

https://www.wired.com/story/could-the-us-contain-a-coronavirus-outbreak/

US doesn't have tests. A doctor in NYC came back from Venice with a fever and when he called health department they didn't have tests. CDC promises to supply tests in mid March. We're screwed.

[Anonymous]

Why are all these other countries testing and not us? Can someone help us understand the problem?

[Anonymous]

Anonymous wrote:Why are all these other countries testing and not us? Can someone help us understand the problem?

Don't know. In 2018, the Trump administration fired the government’s entire pandemic response chain of command, including the White House management infrastructure.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why are all these other countries testing and not us? Can someone help us understand the problem?

Don't know. In 2018, the Trump administration fired the government’s entire pandemic response chain of command, including the White House management infrastructure.

I guess he can hire them all back as contractors at 10 times the pay. That's what Republicans like to do right?

[Anonymous]

Anonymous wrote:Why are all these other countries testing and not us? Can someone help us understand the problem?

While I do feel that we could be testing more, I'm not sure where you would draw the line at this point. The symptoms are not so unique from many other illnesses currently going around, that I guess the CDC just decided unless you came from Hubei directly, it doesn't make sense. Because the alternative would probably turn into testing WAY too many people, running out of tests, etc. which would just drain the system too much.

Of course I'm not 100% sure if this is true, but I definitely don't think the answer is simply mass testing willy nilly.

[Anonymous]

As soon as people in U.S. communities start testing positive, the whole country will freak out and the government is probably trying to avoid that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why are all these other countries testing and not us? Can someone help us understand the problem?

While I do feel that we could be testing more, I'm not sure where you would draw the line at this point. The symptoms are not so unique from many other illnesses currently going around, that I guess the CDC just decided unless you came from Hubei directly, it doesn't make sense. Because the alternative would probably turn into testing WAY too many people, running out of tests, etc. which would just drain the system too much.

Of course I'm not 100% sure if this is true, but I definitely don't think the answer is simply mass testing willy nilly.

My understanding is that other countries are doing RNA testing, which is faster to develop and cheaper, while CDC decided to pursue more of a gold standard DNA test, which has the benefit of fewer false negatives but for which test kits are more complex and more expensive. So there have been delays in distributing test kits and only three cities can test on-site without having to send the blood samples into the CDC.

The Public Health Laboratories Association (note to a previous poster on this--these are governmental, not for-profit entities) have asked for the ability to develop their own test kits, presumably using the RNA approach other countries are using. Blood test have to be approved by the FDA so they are essentially asking for an emergency exemption so they can begin testing on their own.

Right now states are dependent on a laborious CDC process--they have to send them to Atlanta, preventing them from conducting tests they think are justified. As far as I know, the CDC guidelines still only allow for testing people from Wuhan or those who are known contacts of infected people. But obviously there are few known infected people because so few tests are being run.

CDC also has made the choice of updating its website only three times a week and discloses no information in between. Public information fail. (Have already complained here about how uninformative their website is.)

[Anonymous]

Anonymous wrote:Why are all these other countries testing and not us? Can someone help us understand the problem?

Because they know it can't be contained and it would be a waste of resources to test anyone with symptoms because most people will be fine without medical intervention.

This is not to say that this virus isn't going to be problematic for some people because it certainly will. But you can't go around testing every person who develops minor cold symptoms. Allergy season is gearing up now - there are going to be a ton of people with minor cold symptoms.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why are all these other countries testing and not us? Can someone help us understand the problem?

While I do feel that we could be testing more, I'm not sure where you would draw the line at this point. The symptoms are not so unique from many other illnesses currently going around, that I guess the CDC just decided unless you came from Hubei directly, it doesn't make sense. Because the alternative would probably turn into testing WAY too many people, running out of tests, etc. which would just drain the system too much.

Of course I'm not 100% sure if this is true, but I definitely don't think the answer is simply mass testing willy nilly.

This is why.

https://www.washingtonpost.com/health/2020/02/25/cdc-coronavirus-test/

Problems with a government-created coronavirus test have limited the United States’ capacity to rapidly increase testing, just as the outbreak has entered a worrisome new phase in countries worldwide. Experts are increasingly concerned that the small number of U.S. cases may be a reflection of limited testing, not of the virus’s spread.

The nation’s public health laboratories, exasperated by the malfunctioning tests in the face of a global public health emergency, have taken the unusual step of appealing to the Food and Drug Administration for permission to develop and use their own tests. In Hawaii, authorities are so alarmed about the lack of testing ability that they requested permission from the CDC to use tests from Japan. A medical director at a hospital laboratory in Boston is developing an in-house test, but is frustrated that his laboratory won’t be able to use it without going through an onerous and time-consuming review process, even if demand surges.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why are all these other countries testing and not us? Can someone help us understand the problem?

While I do feel that we could be testing more, I'm not sure where you would draw the line at this point. The symptoms are not so unique from many other illnesses currently going around, that I guess the CDC just decided unless you came from Hubei directly, it doesn't make sense. Because the alternative would probably turn into testing WAY too many people, running out of tests, etc. which would just drain the system too much.

Of course I'm not 100% sure if this is true, but I definitely don't think the answer is simply mass testing willy nilly.

This is why.

https://www.washingtonpost.com/health/2020/02/25/cdc-coronavirus-test/

Problems with a government-created coronavirus test have limited the United States’ capacity to rapidly increase testing, just as the outbreak has entered a worrisome new phase in countries worldwide. Experts are increasingly concerned that the small number of U.S. cases may be a reflection of limited testing, not of the virus’s spread.

The nation’s public health laboratories, exasperated by the malfunctioning tests in the face of a global public health emergency, have taken the unusual step of appealing to the Food and Drug Administration for permission to develop and use their own tests. In Hawaii, authorities are so alarmed about the lack of testing ability that they requested permission from the CDC to use tests from Japan. A medical director at a hospital laboratory in Boston is developing an in-house test, but is frustrated that his laboratory won’t be able to use it without going through an onerous and time-consuming review process, even if demand surges.

More details:

One of the three reagents upon which the test hinges produced inconclusive results during a quality check, Kelly Wroblewski, director of infectious diseases at the American Association of Public Health Laboratories, told Politico.

https://thehill.com/policy/healthcare/483980-issues-with-cdc-coronavirus-test-pose-challenges-for-expanded-screening

[Anonymous]

Re; Test kits in the US, article from Government Executive:

"CDC is working with the Food and Drug Administration to rush out the door new test kits to enable state and local facilities to diagnose COVID-19, the disease that results from the new coronavirus. The agency has encountered problems with the kits, Messonnier said, and only 12 jurisdictions can currently conduct tests on their own. Even in those cases, positive tests must be sent to CDC for verification."

https://www.govexec.com/management/2020/02/trump-administration-prepares-rapid-growth-us-coronavirus-cases/163330/

[Anonymous]

Breaking news from BNO: Pakistan reports its first case.

No further details available. A good guess is that it was imported from Iran, likely from the Shi'ite holy city of Qom. Shi'ites are a minority in Pakistan, but there are 16 million of them.