Covid-19 — Navigating the Uncharted (from New England Journal)

[TBoneTX 45,966]

From the New England Journal of Medicine; links to other articles are within.  Comments?

Quote

Covid-19 — Navigating the Uncharted

Anthony S. Fauci, M.D., H. Clifford Lane, M.D., and Robert R. Redfield, M.D.

 

https://www.nejm.org/doi/full/10.1056/NEJMe2002387?query=RP

 

[90DayFinancier 910]

59 minutes ago, TBoneTX said:

From the New England Journal of Medicine; links to other articles are within.  Comments?

These guys are super smart. I hope the administration is listening. It is too late to close the borders.

 

 

 

"However, given the efficiency of transmission as indicated in the current report, we should be prepared for Covid-19 to gain a foothold throughout the world, including in the United States. Community spread in the United States could require a shift from containment to mitigation strategies such as social distancing in order to reduce transmission. Such strategies could include isolating ill persons (including voluntary isolation at home), school closures, and telecommuting where possible.^9"

[Nature Boy 2.0 8,378]

Imagine if we took care of the flu 

[Voice of Reason 10,298]

1 hour ago, Nature Boy 2.0 said:

Imagine if we took care of the flu 

There are FAR too many impeachable offenses out there to worry about a little thing like the flu. 

Edited March 1, 2020 by Voice of Reason

[Dashinka 24,744]

5 hours ago, 90DayFinancier said:

These guys are super smart. I hope the administration is listening. It is too late to close the borders.

 

 

 

"However, given the efficiency of transmission as indicated in the current report, we should be prepared for Covid-19 to gain a foothold throughout the world, including in the United States. Community spread in the United States could require a shift from containment to mitigation strategies such as social distancing in order to reduce transmission. Such strategies could include isolating ill persons (including voluntary isolation at home), school closures, and telecommuting where possible.^9"

These guys are super smart, and I agree, folks of all stripes should listen to them.

 

On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%.⁴ In another article in the Journal, Guan et al.⁵ report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.²

[Neonred 3,632]

8 minutes ago, Bill & Katya said:

These guys are super smart, and I agree, folks of all stripes should listen to them.

 

On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%.⁴ In another article in the Journal, Guan et al.⁵ report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.²

Spanish flu of 1918 had a fatality rate of over 2.5% and killed of at least 1.7% of the worlds population. 

 

[90DayFinancier 910]

49 minutes ago, Neonred said:

Spanish flu of 1918 had a fatality rate of over 2.5% and killed of at least 1.7% of the worlds population. 

 

Is the covid-19 motto, "at least we're not the Spanish flu"?

[Voice of Reason 10,298]

1 hour ago, 90DayFinancier said:

Is the covid-19 motto, "at least we're not the Spanish flu"?

Yeah.  Because all diseases have mottos. 

[Ban Hammer 13,491]

46 minutes ago, Voice of Reason said:

Yeah.  Because all diseases have mottos. 

it's the kung flu

[Steeleballz 7,550]

3 hours ago, Bill & Katya said:

These guys are super smart, and I agree, folks of all stripes should listen to them.

 

On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported case fatality rate is approximately 2%.⁴ In another article in the Journal, Guan et al.⁵ report mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity. If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.²

 

 

    I have said a few times that the mortality rate is likely lower than reported because of the number of people with mild symptoms who don't even need to seek treatment. The only thing we don't know is how much lower. That's why I listed the example of H1N1 going from being reported as 7% mortality rate at first to ~0.1% by the time they had did an analysis of all the people who did not have severe symptoms.

 

  It's not always the case that rates go down though. I think the mortality rate with SARS kept increasing until the end of the outbreak.

[Steeleballz 7,550]

7 minutes ago, Ban Hammer said:

it's the kung flu

 

  Thanks TBone.

[Voice of Reason 10,298]

1 hour ago, Steeleballz said:

 

 

    I have said a few times that the mortality rate is likely lower than reported because of the number of people with mild symptoms who don't even need to seek treatment. The only thing we don't know is how much lower. That's why I listed the example of H1N1 going from being reported as 7% mortality rate at first to ~0.1% by the time they had did an analysis of all the people who did not have severe symptoms.

 

  It's not always the case that rates go down though. I think the mortality rate with SARS kept increasing until the end of the outbreak.

Same think with the Spanish flu.  Estimates are all over the place, as might be expected for that era.  30 million died.  50 million died.  Up to 100 million died.  No one will ever really know.  Thankfully, our modern day reporting is quite a bit better, minus countries that try to cover it up.

[Steeleballz 7,550]

1 minute ago, Voice of Reason said:

Same think with the Spanish flu.  Estimates are all over the place, as might be expected for that era.  30 million died.  50 million died.  Up to 100 million died.  No one will ever really know.  Thankfully, our modern day reporting is quite a bit better, minus countries that try to cover it up.

 

   For the early 1900's, it's a rough estimate at best. I don't even think deaths had to be recorded back then. Even nowadays for flu, adult statistics are still a best estimate. It's probably a pretty close estimate, but only childhood deaths are required to be reported to the CDC.

[Neonred 3,632]

Just for a little perspective

This Is How Many People Die From the Flu Each Year, According to the CDC  

https://www.health.com/condition/cold-flu-sinus/how-many-people-die-of-the-flu-every-year

Flu season is hitting its stride right now in the US. So far, the CDC has estimated (based on weekly influenza surveillance data) that at least 12,000 people have died from influenza between Oct. 1, 2019 through Feb. 1, 2020, and the number of deaths may be as high as 30,000. 

 

Overall, the CDC estimates that 12,000 and 61,000 deaths annually since 2010 can be blamed on the flu. Globally, the World Health Organization (WHO) estimates that the flu kills 290,000 to 650,000 people per year. 

[Ban Hammer 13,491]

20 hours ago, Steeleballz said:

 

  Thanks TBone.

everyone was kung flu dying....

they were dropping like they were hit by lightning....