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Coronavirus — early rates of severe cases in Hong kong and Singapore are over 10%

Posted By Jo Nova On February 14, 2020 @ 5:20 pm In Health,Microbiology | Comments Disabled

Global Markets were shaken by the sudden rise in numbers out of China yesterday. But the increase was not a surprise for anyone who has been watching social media and the measures being taken in China. That China is now allowing the WHO in may be an admission that they really do need help.  The explanation for the jump is that China changed the definitions.  They are also admitting that there may be many cases of people with low grade infections, but also unattributed deaths as well. For days the ratio of cases to deaths was suspiciously 2.1%, 2.1%, 2.1% …  Now perhaps it’s a tiny bit closer to the truth.

The tally outside China continues to rise: there now 587 cases, with 3 deaths (1 new one in Japan) and 24 people classified as “serious critical”.  These are the key figures to watch. We expected the number of cases that were severe to rise as the five to eight day lag unfolds from the first symptoms to the onset of breathing trouble. So at the moment 4% of cases outside China are headed for hospital intervention, perhaps ICU (does anyone know the definition of “Serious Critical”?). That will keep rising. We need to see that leveling off so we know what kind of load to plan for with ICU units. The early days rates of serious cases in Hong Kong (11%), Singapore (14%) and Japan (2%) are a concern. Unless there is a genetic factor or other localized risk the current low levels elsewhere will presumably trend up to match. I’ll write more on that soon, but “hoping” those rates will be lower is not much of a strategy, though if we are lucky, rates may be lower.

Germany has 16 cases, none of which has progressed to severe. The first five cases were all diagnosed by Jan 28th, but how many cases were there in Germany on 4th Feb? The lag in case progression means only these early cases would be expected to have become “severe”. Oh for more data…  Also bearing in mind about 32,000 in Germany – are currently suffering from flu.

Let’s stress these rates of severe cases are very early and small caseloads and the numbers are highly variable. It’s still possible that Covid 19 is widely spread and with a low grade infection, and all the rates are therefore overestimates among the population as a whole. We hope.

About 14% of patients have recovered but it can take a month so there is a long lag there too.

First lock down outside China occurs

At this point, even to limit the load to a manageable level we ought be stopping more flights from at risk countries. Vietnam has only 15 cases but has locked down a small village  of 10,000 in the north.It’s only 40km from Hanoi.

The locking down of Son Loi, about 40 kilometres from Hanoi, is the first mass quarantine outside of China since the virus emerged from a central Chinese city late last year. “As of February 13, 2020, we will urgently implement the task of isolation and quarantine of the epidemic area in Son Loi commune,” said a health ministry statement. “The timeline… is for 20 days”. The health ministry previously said five people in Son Loi had been infected with the virus, and on Thursday reported a sixth case.

The hunt is on for the single case source in Singapore that has not yet been identified. This story is worth reading if you want to understand the burden of tracking cases to limit infections. That single case source may well be fine now, and not shedding, but what are the odds that they didn’t unknowingly infect just one other person who is now “at loose”?

Three weeks later, global health authorities are still scrambling to work out who carried the disease into the mundane meeting of a firm selling gas meters, which then spread to five countries from South Korea to Spain, infecting more than a dozen people.

The firm said it immediately adopted “extensive measures” to contain the virus and protect employees and the wider community. Those included self-isolation for all 109 attendees, of whom 94 were from overseas and had left Singapore.

But the virus kept spreading.

Two South Korean delegates fell sick after sharing a buffet meal with the Malaysian, who also passed the infection to his sister and mother-in-law. Three of the firm’s Singapore attendees also tested positive.

Then cases started appearing in Europe.

 While quarantine is very expensive, if these numbers are correct and the virus is easily spread with many low grade infections it is still probably cheaper to limit and contain now, rather than have to close schools and factories in a months time. With winter coming in three months in Australia it would be a huge advantage to stop the virus getting hold before the weather turns cooler.

Added up from the Worldometer page with an extra column from me to the right and below:

Country, Total Cases Change Total Change Total Serious, % “severe”
Territory (cases) Deaths (deaths) Recovered Critical
China 64,658 4,854 1,488 123 7,014 10,584
Japan 252 50 1 1 10 5 2%
Singapore 58 8 15 8 14%
Hong Kong 53 3 1 1 6 11%
Thailand 33 12 1 3%
S. Korea 28 7
Malaysia 19 1 3
Taiwan 18 1
Vietnam 16 1 7
Germany 16 1
Australia 15 8
USA 15 2 3
France 11 2 1 9%
Macao 10 3
U.K. 9 1
U.A.E. 8 1 1 13%
Canada 7 1
India 5 2 1
Philippines 3 1 2
Italy 3 2 67%
Russia 2 2
Spain 2
Sweden 1
Nepal 1 1
Sri Lanka 1 1
Finland 1 1
Cambodia 1 1
Belgium 1
Total outside China 588 67 3 85 24 4%
% 1% 14% 4%
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