You know how we look back at the state of medical knowledge from a couple hundred years ago, and it all seems so primitive? Contagion was explained by miasma rather than germs, leeches and trepans were best practices, and even basic surgical sanitation was an uphill battle. From our point of view, they didn't even understand the basics! Easily cured diseases were just left to run their course!
Events like this are a reminder that there is still so much that is beyond the abilities of current medicine. As a prominent doctor, he almost certainly got the best care that is currently available, and yet he still died from a simple virus. Our ability to treat viruses today is where our ability to treat bacterial infections was 100 years ago. We knew that germs existed, but penicillin was still a decade away. The standard of care was to keep the patient well hydrated and hope that they don't die.
Similarly, we know today that viruses exist, but in most cases the best care we can offer is to keep the patient hydrated and hope that they don't die. With sufficient luck, in a hundred years we'll have progressed to the point that people look at us and marvel: "They didn't even know the basics! When people contracted a virus, there was nothing they could do but let the disease run its course!"
...and yet, we are still so much further ahead than we were even only 20 years ago.
This virus was caught by the early detection mechanisms setup after SARS, and it was DNA sequenced from samples taken from some of the first victims within a couple of weeks - pointing to a near match with a sample collected in 2014 in a cave from bat poop as part of a "preparatory program" also setup after SARS.
New sequencing tech has allowed the global distribution of test kits, allowing us to have thousands of confirmed cases shown to us in real time - globally.
Vaccines are already in development and the FDA is prepared to fast-track their testing under procedures, you guessed it, updated after SARS.
...and yet, this turned into a global outbreak that we're desperately trying to stop from becoming a global pandemic. Sadly, Chinese prosperity has meant prolific Chinese tourist industries which helped spread the disease robustly throughout South-east Asia. And so there's a very real possibility that, unlike SARS, this new Coronavirus will become endemic and return each year like the seasonal flu, possibly causing hundreds of thousands of dead per year until a vaccine is deployed. Based on projected numbers, it seems like it has spread far beyond our ability to contain it.
So while it certainly could have been worse, had we not been as prepared - I like to think that when this happens again 20 years from now, we'll be far better prepared. I'll have to learn to use those three sea shells.
First, condolences to Dr. Li’s family. As we speak of epidemiology and statistics, let’s not forget that every single “case” is an individual with family and friends, and behind each individual are doctors, nurses, and caretakers who risk their own health to help another.
Second, as noted by nkurz the contrast between bacterial and viral treatments is striking. Whereas we expect bacterial infections to be treatable and are alarmed when they aren’t (MRSA), we expect viral infections to simply run their course except for the few instances where they’re treatable (HIV, influenza) or even (gasp!) curable (HCV). We explain away the sad state of antivirals by pointing to the inherent biochemical challenges of fighting viruses [1] but maybe what we really need is a breakthrough — perhaps a miraculous fortuitous “penicillin” moment — so 100 years from now antivirals will also be a matter of course.
I'm concerned about this virus. Most people I talk to (in the UK) think it's being over-hyped but I can't help but think it's being under-played.
The virus seems, in my completely inexpert assessment, to occupy a sort of sweet spot in a terms of virulence, mortality and incubation period, for wreaking maximum damage.
Based on its current trajectory I can't see any reason to believe the whole of the world won't be affected on the same scale as Wuhan at some point this year.
Am I right to be concerned, and if so what should I be doing about it?
The biggest concern is health care capacities being overwhelmed. He died in a place under severe resource constraints, basically a warzone. Fatality inside Wuhan is 5%, the rest of china 0.17% and even lower outside the country. Regardless of how correct the numbers are at this point - available ICU capacity is probably the largest factor for fatality rates for the disease at this point.
Just like the flu, this virus causes number of very serious cases that require intensive care but care capacities in most countries are barely able to cope with a bad flu season before bed appear on hallways - and this year had a particularly bad flu season still ongoing. There are only so many ventilators and artificial lungs available in hospitals and there is limited capacity in the world to deal with a new, highly infectious pathogen hitting a population without any preexisting immunities and people requiring weeks care to recover and become non infectious
China has, for better or worse, sacrificed Wuhan to buy the rest of the country and the world time to shore up capacities and enact procedures to stagger the load that will hit healthcare systems if the virus becomes broadly entrenched. I don't think there is any healthcare system on the planet that won't severely strain if hit by the sudden load of a new, highly infectious virus with long, invisible incubation period.
I think the biggest concern is it seems quite capable of killing people that tend to be in the generally healthy age range.
Diseases that do that often do so by causing (even if indirectly) the person's own immune system to overreact or otherwise go haywire.
I belive SARS had a similar impact.
My son had a situation where his immune system overreacted. We had folks from the local university on call for updates every few hours and etc. Doctors have very few things at their disposal that they can do when that happens and they get really nervous.
My son pulled through but it was an enlightening / scary moment to see doctors that concerned / with few options.
31 year old doctor died from it. That raises some alarms for me when media is saying it is like the flu. Do a lot of 31 year old doctors die from the flu?
There is currently no vaccine to prevent 2019-nCoV infection. The best way to prevent infection is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory viruses, including:
Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
Avoid touching your eyes, nose, and mouth with unwashed hands.
Avoid close contact with people who are sick.
Stay home when you are sick.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
I completely agree. I fail to see any plausible scenario where this doesn’t become a global pandemic in 2020. It seems like the best case is that it either becomes much less lethal as it spreads, and / or we slow it down enough to develop a vaccine. Failing that, I’m unclear on why any rational person thinks this is no big deal.
There’s no way China goes from 27k infected and it growing 15% per day to zero infections. It’s beyond containment at this point, they can’t stay on lockdown forever. And while it has barely spread beyond China, are we just going to wall off 1.4 billion people from the rest of humanity for the foreseeable future? Unlikely, probably impossible. So it seems like just a matter of time until it spreads globally, just like the flu, but much more deadly. And likely to overwhelm our medical infrastructure for the people who don’t die, many of which end up in critical condition.
I’m not panicking, but I’m concerned. Please, someone smart and well-informed, make the case for why this isn’t that big of a deal. (Hint: if you start by comparing it to total flu deaths instead of flu mortality rate, you’ve disqualified yourself).
> Most people I talk to (in the UK) think it's being over-hyped
Not to be too snarky, but most of people in UK though Brexit was a good move.
I am too a bit concerned about corona, but its hard to judge how dangerous it is as long as all info goes through Chinese filter (Chinese gov prevents any outside help so they can have as much control over the PR as they can).
The cases in other countries are still too small to get a definitive answer, if this is something scary or not. All we can do is wait and see.
I think what triggers an enormous amount of panic are the stories from Chinese social media - contradicting official Chinese reports. I cannot tell what's true and what's hyperbole... The government numbers don't seem so bad - but then some of the quarantine measures seem oddly harsh if the numbers were true.
Stories of Tencent "accidentally" leaking numbers online that are 10x what the government is reporting - stories of crematoriums being inundated with corpses - pictures of death certificates omitting the cause - the banning of funerals - videos of women being pulled off the street to be forcibly transported to a quarantine center (that one was particularly concerning) - etc...
The numbers from China are suspect of course - it's statistically hard to imagine such a global contagion last week with the small number of confirmed cases the Chinese gov't was publishing.
I don't want to overreact... but I also don't want to underreact.
The Tencent thing is definitely erroneous. The numbers “leaked” were just a transposition of the number of known cases transposed as “dead”.
I absolutely hate that China’s powers that be decided to hush up the outbreak. Shame on them. But this specific case is just an error magnified by social media (which very fairly doesn’t believe the official party line either).
I'm not really seeing the "global" aspect to this. A huge majority of the numbers are in Wuhan or Hubei, and then much of the rest is just elsewhere in mainland China. Cases abroad are almost a rounding error by comparison. It's quite weird actually, it's like there's some factor we don't quite understand that has been limiting the virus's spread even before protective measures were taken.
The fact that the hospital lied about Dr. Li Wenliang dying goes to show you how absolutely dystopian China is. How afraid (or corrupt) do you have to be to continue to claim someone who died was alive?
>The announcement capped several chaotic hours in which Chinese media first reported Li’s death, only for the hospital to respond that Li was alive, though in critical condition.
>Li Wenliang has died, Wuhan Central Hospital confirmed early Friday morning, hours after it initially denied reports of his death.
Where here do you see clear evidence or even indication of deceit?
If someone is in critical condition, that does not mean they are dead. Announcing someone dead just hours after saying someone is in critical condition is, actually, super super logical.
I fear your comment might be quite guided by your unfamiliarity with China and xenophobic touch. Please do take some more time to reflect before posting similar comments again. Thank you.
The coronavirus is devastating for the Chinese Communist Party.
Basically, the deal with the populace was people gave up their freedom in exchange for competent government and economic growth. In the last several decades, this was seen as a good deal, by a lot of people both inside and outside China. China had massive economic growth and modernization.
Now, however, the handling of coronavirus was a huge blow to the perception of competency of the government, and is likely to have big economic implications as well, thereby threatening the foundations of this deal.
I'm not so sure. Could a western country initiate entire city-wide quarantines at the drop of a hat? Could a western country pull sick people off the streets and forcibly put them into quarantine centers? Unilaterally shut down schools, factories, and transportation at a whim?
Maybe. ...but, to be honest, despite their clear dishonestly about the number of infected/dying, they are also clearly taking some definitive actions to contain this.
I don't know that the populace has ever perceived the government as particularly competent. Powerful and dangerous if you cross them, sure--but competent?
It's remarkable that humanity can globally track such things.
He was only a few years older than me.
How does the coronavirus kill? I tried searching, but the first five results were all paywalled. I'm curious about what specifically makes the coronavirus deadly compared to the flu.
Studies from patients who died from SARS coronavirus showed the virus caused damage to not only the lungs, but also other organs in the body. Early research suggests the Wuhan coronavirus can also damage other organs, including the kidneys.
The Wuhan coronavirus appears to cause pneumonia in two ways: when the virus takes hold in the lungs, and through secondary bacterial infections, however, the first way appears to be more common.
Although it can be difficult to determine whether organ damage from the Wuhan coronavirus is a result of direct viral infection or indirect “collateral damage” from the immune system, initial reports suggested around 11% of people severely ill with the Wuhan coronavirus experienced sepsis with multi-organ failure.
I am not a medical practitioner nor researcher and have no understanding of the virus. I make no representation as to the veracity of this source lacking the means to independently verify it.
The numbers are ridiculous. What gives it away, is that if you plot them onto a graph, they almost exactly match what an algorithm would predict, unchanging regardless of quarantines, blockades, etc. that have been enacted.
The further kicker is that the model it aligns to is quadratic where an actual virus spread is exponential. So, the Chinese are not only making up numbers and following an ideal model exactly but can't even figure out to use a valid ideal model to generate those fake numbers from.
"The number of cured cases was only 269, well below the official number that day of 300. Most ominously, the death toll listed was 24,589, vastly higher than the 300 officially listed that day." -- https://www.taiwannews.com.tw/en/news/3871594
The source is Taiwan News so probably not impartial.
It directly infects the lungs, it's essentially a viral pneumonia. It can kill by reducing lung function or enabling sepsis or other opportunistic infections that can enter through damaged lung tissue.
For more information the most recent dozen or so videos by John Campbell at https://www.youtube.com/channel/UCF9IOB2TExg3QIBupFtBDxg will take you through material published in peer reviewed medical journals that explain transmission models and an in depth review of some early cases.
Interestingly and rarely, instead of covering up or Force deleting the posts, this time the Central government treat this seriously with several investigation announced and official mourning. This news does go viral among Chinese internet and triggered huge criticism of the government so it might be impractical to censor it. All in all, it could be a good thing to CCP since they showed iron hand in the right way this time
Yeah, it’s just more contagious than the flu, possibly has a mortality rate of 1-3% (20x - 50x higher than the flu), lands another 10-20% in the ICU, has infected tens of thousands of people already (likely many more), has overwhelmed medical infrastructure, and has prompted China to place 100 million people on lockdown and force their economy to grind to a halt to try and stop a global pandemic.
We don't know the mortality rate yet. Most of the confirmed cases are too recent for the illness to have killed the patients, so expressing the mortality rate as (deaths / confirmed cases) is incorrect.
We are also not sure how many people are dying as a result of complications caused by this illness. The current reported death rate is based on people killed as a direct result of the illness.
[+] [-] nkurz|6 years ago|reply
Events like this are a reminder that there is still so much that is beyond the abilities of current medicine. As a prominent doctor, he almost certainly got the best care that is currently available, and yet he still died from a simple virus. Our ability to treat viruses today is where our ability to treat bacterial infections was 100 years ago. We knew that germs existed, but penicillin was still a decade away. The standard of care was to keep the patient well hydrated and hope that they don't die.
Similarly, we know today that viruses exist, but in most cases the best care we can offer is to keep the patient hydrated and hope that they don't die. With sufficient luck, in a hundred years we'll have progressed to the point that people look at us and marvel: "They didn't even know the basics! When people contracted a virus, there was nothing they could do but let the disease run its course!"
[+] [-] koheripbal|6 years ago|reply
This virus was caught by the early detection mechanisms setup after SARS, and it was DNA sequenced from samples taken from some of the first victims within a couple of weeks - pointing to a near match with a sample collected in 2014 in a cave from bat poop as part of a "preparatory program" also setup after SARS.
New sequencing tech has allowed the global distribution of test kits, allowing us to have thousands of confirmed cases shown to us in real time - globally.
Vaccines are already in development and the FDA is prepared to fast-track their testing under procedures, you guessed it, updated after SARS.
...and yet, this turned into a global outbreak that we're desperately trying to stop from becoming a global pandemic. Sadly, Chinese prosperity has meant prolific Chinese tourist industries which helped spread the disease robustly throughout South-east Asia. And so there's a very real possibility that, unlike SARS, this new Coronavirus will become endemic and return each year like the seasonal flu, possibly causing hundreds of thousands of dead per year until a vaccine is deployed. Based on projected numbers, it seems like it has spread far beyond our ability to contain it.
So while it certainly could have been worse, had we not been as prepared - I like to think that when this happens again 20 years from now, we'll be far better prepared. I'll have to learn to use those three sea shells.
[+] [-] himinlomax|6 years ago|reply
Is it a problem of with current medicine, or a problem with censorious communist dictatorships and cultures obsessed with face-saving?
[+] [-] divbzero|6 years ago|reply
Second, as noted by nkurz the contrast between bacterial and viral treatments is striking. Whereas we expect bacterial infections to be treatable and are alarmed when they aren’t (MRSA), we expect viral infections to simply run their course except for the few instances where they’re treatable (HIV, influenza) or even (gasp!) curable (HCV). We explain away the sad state of antivirals by pointing to the inherent biochemical challenges of fighting viruses [1] but maybe what we really need is a breakthrough — perhaps a miraculous fortuitous “penicillin” moment — so 100 years from now antivirals will also be a matter of course.
[1]: https://en.wikipedia.org/wiki/Antiviral_drug#Approaches_by_l...
[+] [-] hanoz|6 years ago|reply
The virus seems, in my completely inexpert assessment, to occupy a sort of sweet spot in a terms of virulence, mortality and incubation period, for wreaking maximum damage.
Based on its current trajectory I can't see any reason to believe the whole of the world won't be affected on the same scale as Wuhan at some point this year.
Am I right to be concerned, and if so what should I be doing about it?
[+] [-] hatenberg|6 years ago|reply
Just like the flu, this virus causes number of very serious cases that require intensive care but care capacities in most countries are barely able to cope with a bad flu season before bed appear on hallways - and this year had a particularly bad flu season still ongoing. There are only so many ventilators and artificial lungs available in hospitals and there is limited capacity in the world to deal with a new, highly infectious pathogen hitting a population without any preexisting immunities and people requiring weeks care to recover and become non infectious
China has, for better or worse, sacrificed Wuhan to buy the rest of the country and the world time to shore up capacities and enact procedures to stagger the load that will hit healthcare systems if the virus becomes broadly entrenched. I don't think there is any healthcare system on the planet that won't severely strain if hit by the sudden load of a new, highly infectious virus with long, invisible incubation period.
[+] [-] duxup|6 years ago|reply
Diseases that do that often do so by causing (even if indirectly) the person's own immune system to overreact or otherwise go haywire.
I belive SARS had a similar impact.
My son had a situation where his immune system overreacted. We had folks from the local university on call for updates every few hours and etc. Doctors have very few things at their disposal that they can do when that happens and they get really nervous.
My son pulled through but it was an enlightening / scary moment to see doctors that concerned / with few options.
[+] [-] electriclove|6 years ago|reply
I seriously hope China can contain this.
[+] [-] keanzu|6 years ago|reply
There is currently no vaccine to prevent 2019-nCoV infection. The best way to prevent infection is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory viruses, including:
https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-t...[+] [-] ryanwaggoner|6 years ago|reply
There’s no way China goes from 27k infected and it growing 15% per day to zero infections. It’s beyond containment at this point, they can’t stay on lockdown forever. And while it has barely spread beyond China, are we just going to wall off 1.4 billion people from the rest of humanity for the foreseeable future? Unlikely, probably impossible. So it seems like just a matter of time until it spreads globally, just like the flu, but much more deadly. And likely to overwhelm our medical infrastructure for the people who don’t die, many of which end up in critical condition.
I’m not panicking, but I’m concerned. Please, someone smart and well-informed, make the case for why this isn’t that big of a deal. (Hint: if you start by comparing it to total flu deaths instead of flu mortality rate, you’ve disqualified yourself).
[+] [-] me_me_me|6 years ago|reply
Not to be too snarky, but most of people in UK though Brexit was a good move.
I am too a bit concerned about corona, but its hard to judge how dangerous it is as long as all info goes through Chinese filter (Chinese gov prevents any outside help so they can have as much control over the PR as they can).
The cases in other countries are still too small to get a definitive answer, if this is something scary or not. All we can do is wait and see.
[+] [-] koheripbal|6 years ago|reply
Stories of Tencent "accidentally" leaking numbers online that are 10x what the government is reporting - stories of crematoriums being inundated with corpses - pictures of death certificates omitting the cause - the banning of funerals - videos of women being pulled off the street to be forcibly transported to a quarantine center (that one was particularly concerning) - etc...
The numbers from China are suspect of course - it's statistically hard to imagine such a global contagion last week with the small number of confirmed cases the Chinese gov't was publishing.
I don't want to overreact... but I also don't want to underreact.
[+] [-] alasdair_|6 years ago|reply
I absolutely hate that China’s powers that be decided to hush up the outbreak. Shame on them. But this specific case is just an error magnified by social media (which very fairly doesn’t believe the official party line either).
[+] [-] zozbot234|6 years ago|reply
[+] [-] keanzu|6 years ago|reply
Banning of large public gatherings of people potentially exposed to the virus. Sounds like a reasonable precaution.
[+] [-] himinlomax|6 years ago|reply
[+] [-] ashwinaj|6 years ago|reply
How about going out to protest? Oh wait, you can't...bravo for your virtue signalling.
[+] [-] anonytrary|6 years ago|reply
[+] [-] Jommi|6 years ago|reply
>The announcement capped several chaotic hours in which Chinese media first reported Li’s death, only for the hospital to respond that Li was alive, though in critical condition.
>Li Wenliang has died, Wuhan Central Hospital confirmed early Friday morning, hours after it initially denied reports of his death.
Where here do you see clear evidence or even indication of deceit?
If someone is in critical condition, that does not mean they are dead. Announcing someone dead just hours after saying someone is in critical condition is, actually, super super logical.
I fear your comment might be quite guided by your unfamiliarity with China and xenophobic touch. Please do take some more time to reflect before posting similar comments again. Thank you.
[+] [-] unknown|6 years ago|reply
[deleted]
[+] [-] RcouF1uZ4gsC|6 years ago|reply
Basically, the deal with the populace was people gave up their freedom in exchange for competent government and economic growth. In the last several decades, this was seen as a good deal, by a lot of people both inside and outside China. China had massive economic growth and modernization.
Now, however, the handling of coronavirus was a huge blow to the perception of competency of the government, and is likely to have big economic implications as well, thereby threatening the foundations of this deal.
[+] [-] koheripbal|6 years ago|reply
Maybe. ...but, to be honest, despite their clear dishonestly about the number of infected/dying, they are also clearly taking some definitive actions to contain this.
[+] [-] tvanantwerp|6 years ago|reply
[+] [-] unknown|6 years ago|reply
[deleted]
[+] [-] sillysaurusx|6 years ago|reply
It's remarkable that humanity can globally track such things.
He was only a few years older than me.
How does the coronavirus kill? I tried searching, but the first five results were all paywalled. I'm curious about what specifically makes the coronavirus deadly compared to the flu.
[+] [-] keanzu|6 years ago|reply
The Wuhan coronavirus appears to cause pneumonia in two ways: when the virus takes hold in the lungs, and through secondary bacterial infections, however, the first way appears to be more common.
Although it can be difficult to determine whether organ damage from the Wuhan coronavirus is a result of direct viral infection or indirect “collateral damage” from the immune system, initial reports suggested around 11% of people severely ill with the Wuhan coronavirus experienced sepsis with multi-organ failure.
https://theconversation.com/how-does-the-wuhan-coronavirus-c...
I am not a medical practitioner nor researcher and have no understanding of the virus. I make no representation as to the veracity of this source lacking the means to independently verify it.
[+] [-] topmonk|6 years ago|reply
The further kicker is that the model it aligns to is quadratic where an actual virus spread is exponential. So, the Chinese are not only making up numbers and following an ideal model exactly but can't even figure out to use a valid ideal model to generate those fake numbers from.
See more here:
https://m.youtube.com/watch?v=jbvibANxARg
[+] [-] avtar|6 years ago|reply
The source is Taiwan News so probably not impartial.
[+] [-] aaomidi|6 years ago|reply
Once your immune system detects it, you're going to get the standard flu/cold symptoms (fever, runny nose, etc).
During this period your body is actively losing its protection due to putting so much resources into fighting the viral infection in your body.
Other deadlier diseases can now enter your body and essentially hide behind the fact that your immune system can't respond to everything at once.
So you get more complications as you're sick for longer.
The viral infection itself does have an impact on organs, specifically the lungs, but it's usually secondary complications that kill.
[+] [-] skmurphy|6 years ago|reply
For more information the most recent dozen or so videos by John Campbell at https://www.youtube.com/channel/UCF9IOB2TExg3QIBupFtBDxg will take you through material published in peer reviewed medical journals that explain transmission models and an in depth review of some early cases.
[+] [-] s_y_n_t_a_x|6 years ago|reply
[+] [-] TwoNineA|6 years ago|reply
[deleted]
[+] [-] whoevercares|6 years ago|reply
[+] [-] monadic2|6 years ago|reply
[+] [-] ryanwaggoner|6 years ago|reply
Yeah, it’s clearly nothing. What’s the big deal?
[+] [-] keanzu|6 years ago|reply
https://www.worldometers.info/coronavirus/coronavirus-death-...
What would you consider a high mortality rate? 2% lethality in healthy patients is significant and it is "so far". We don't know the true rate yet.
[+] [-] danso|6 years ago|reply
[+] [-] robjan|6 years ago|reply
We are also not sure how many people are dying as a result of complications caused by this illness. The current reported death rate is based on people killed as a direct result of the illness.
[+] [-] unknown|6 years ago|reply
[deleted]
[+] [-] asdz|6 years ago|reply