New York/Minneapolis: As signs emerge that China’s coronavirus outbreak may be moderating, a morbid reminder of the disease’s toll is expected to persist, or even rise, in the days to come.
While new cases reported in China appeared to decline after a Feb. 4 peak, the number of dead has grown to around a hundred a day — double the daily count of just a few weeks ago.
But those deaths aren’t a sign the virus is getting more deadly, according to experts.
“Deaths are a lagging indicator,” said Marc Lipsitch, an epidemiologist at Harvard University, who is modeling the outbreak. Once people are infected, “it takes around three weeks on average for someone to die.”
On Thursday, the Hubei province where the outbreak is centered issued a revised count of cases and deaths, using a new methodology. The new method adds 13,332 new cases and 135 deaths to the total in the province — infections that were diagnosed using medical imaging but not a lab test.
Across China, more than 1,300 people have died from the virus and more than 59,000 have been infected, according to authorities. Outside experts have said the number of cases is likely far higher, and Hubei’s announcement that it was counting thousands of new cases in its total will likely add to that analysis.
As of Wednesday, there were 8,204 patients classified as severe cases, according to numbers released by Chinese officials. New confirmed cases have fallen to about 2,000 a day, down from a peak more than 3,500 daily cases last week.
“If cases only plateaued a week ago, we might expect numbers of new deaths to continue to rise for some time yet,” said Steven Riley, professor of infectious disease dynamics at Imperial College London’s MRC Centre for Global Infectious Disease Analysis.
The chaotic nature of the outbreak combined with limited access by international experts to Hubei province, where it began, has made it hard to know the full extent of the epidemic. Bloomberg and other news outlets have reported on a health-care system overwhelmed by the disease, with some severe patients turned away and sent home — making a final count of deaths far more difficult.
“It may be by far that the vast majority of people are those who died at home,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota’s medical school. “We may never know how many people have died from this disease in China. I don’t think we ever will.”
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Health experts have been working to estimate the deadliness of the disease. A crude analysis done by dividing the number of deaths by the number of confirmed cases yields a mortality rate of about 2%. Other estimates that attempt to account for undiagnosed, milder cases have put it closer to 1%.
“It’s dropping every day as the number of tested patients is going up,” Soumya Swaminathan, chief scientist of the World Health Organization, said in an interview.
Making matters more confusing, the crude mortality rate mixes together a wide variety of disparate populations.
“We are seeing the tip of the iceberg, and it is a very large iceberg,” said Harvard’s Lipsitch.
Confounding Numbers
There are people who were hospitalized for other conditions in Wuhan and who then acquired the infection from coronavirus patients in the same facility. The numbers also include severe cases in Hubei province and other parts of China who were diagnosed early, precisely because of the gravity of their illness. And there is a large swath of healthier patients with mild cases, who are more likely to recover but less likely to ever be diagnosed.
“You are seeing case fatality rates in different populations being glommed together,” said David Fisman, an infectious disease doctor at the University of Toronto. The coronavirus death rate in vulnerable patients may not be relevant to healthy people who get the virus through everyday contact, he said.
While many people want to compare the outbreak to SARS, a coronavirus outbreak from 2002 and 2003 that infected more than 8,000 people and killed almost 800, a better comparison is seasonal influenza, said Anthony Fauci, head of the NIH’s National Institute of Allergy and Infectious Diseases.
Seasonal flu kills about 0.1% of those infected, while pandemics in 1957 and 1968 had mortality rates closer to 1%. The catastrophic 1918 contagion, known as the Spanish flu, had a 2% mortality rate, similar to what’s seen now in Chinese hospitals, Fauci said.
“It’s very different from influenza, but it would be acting like a really bad influenza season,” he said.
The uncertainly about how nasty the virus will turn out to be is a problem for public health officials trying to prepare for its potential spread around the world.
The death rate “is a number that we really can’t nail down at the moment,” said Ian Mackay, a virologist at the University of Queensland in Australia. “It is hard because we need that number to know how much to prepare.” – Bloomberg
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World Health Organization was not in a position on 15 February 2020 to predict the direction the epidemic Coronavirus may take. This opinion was expressed by the Director General of Health Services in the said Organization. That may hold good in the light of facts and details available with the W.H.O. But this Vedic astrology writer has already in the mid-January 2020 predicted the direction the epidemic of Coronavirus has strong potential to take. And the developments after have so far suggested accuracy. Here are details of the direction indicated by this Vedic astrology writer in mid-January and after :-
Coronavirus , now named as COVID-19 , is learnt to have appeared in Wuhan city of China sometime towards late of December 2019. It attracted attention when it assumed striking power and W.H.O. announced its worrisome existence on 14 January 2020. At this stage , this Vedic astrology writer had responded by saying that the ailment was likely to grow more worrisome in days to come and stay longer. It was added that a period of three months from April to June in 2020 looked to be major worrisome in that regard with attendant woes like economic and other chaos across the globe. If appropriate and sufficient endeavors were made to deal with the ailment , some sort of medicine or way out can spring up in July to September 2020. It may be capable of containing the epidemic but may stop short of substantially stamping it out. The likelihood of the ailment regaining striking power during October to December 2020 cannot be ruled out unless appropriate and sufficient endeavor is continued. And the ailment can have tendency to linger on , in one form or the other , until about December 2021.
Coming to the present as on 18 February 2020 , the ailment is reported to have assumed huge worrisome upsurge on 12 February and after in 2020 . A record number of 242 deaths and 14840 new cases were reported on a single day on 12 February while the figure as on 17 February is reported to be over 1770 death toll and infections exceed 70, 000 in China and across the world. W.H.O. seems to have been seriously concerned by this sudden huge upsurge asking the Chinese authorities details of the upsurge , whether the count is due to a recent change in the method of counting. Whatever , the fact remains that a huge upsurge in the ailment is suggested after 11 February 2020, the cut date in this writer’s predictive alert as follows here. In this context , it may be apt to refer the readers to the following message in an email of 3rd February 2020 this Vedic astrology writer had sent to a friend CEO of a company in Asia:-
“ Feb 3 , 2020 :
I may share with you that the ailment is likely to enormously aggravate after 11 February 2020 while three months period from April to June 2020 looks to be one of major worrisome”.