Corona Virus in Chiang Mai

[samuttodd]

This just in... H5N8 in Saudi arabia... New topic started in General section  https://forum.thaivisa.com/topic/1146794-now-there-is-an-outbreak-of-h5n8-in-saudi-arabia/

Edited February 5, 2020 by samuttodd

[Thailand]

Some info and "live" report links on WuFlu.cn

Edited February 5, 2020 by Thailand

[stephenterry]

6 minutes ago, WaveHunter said:

REGARDING DEATH RATE for nCoV:  A lot of misinformation is going around about "death rate" figures.  Again for those who keep harping on a specific death rate figure for nCoV, there is no valid number right now since it requires comparing actual deaths against the number of confirmed cases, and that is not possible to do in an ongoing outbreak involving incubation lag time.

 

However, it is possible to correlate Serious Complication cases (i.e.: those with pneumonia and/or ARDS) with deaths.  The most valid study to date is this one (published on Lancet):

 

Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

 

Again, the death rate discussed here is NOT the mortality rate of those infected; it is the fatality rate of those who have gone to to develop serious complications, which in the case of nCoV appears to be about 20% of those confirmed to be infected.

 

This cohort study of 99 patients with pneumonia and with the Wuhan Corona Virus had a death rate of 11%, whereas the previous 41 case study (alos published in Lancet) showed 15%.  This new paper is much more granular due to the higher number of cases in the study.

 

The clinical features that predict mortality are discussed and this scoring system has been assigned (MuLBSTA Score).  Each clinical feature is given a score and the combined total score gave a prediction of mortality rate. 

 

The clinical features and assigned scores were:

• Both lungs involved - 5 points
• Lymphocytes < 0.8 - 4 points
• Bacterial co-infection - 4 points
• Acute Smoker (active smoker) - 3 points
• Quit Smoker (former smoker) - 2 points
• Hypertension - 2 points
• Age > 60 - 2 points

Total Score and Mortality Rate:

• A score of 0 indicates chance of mortality at 0.47%
• A score of 6 was 2.9%
• A score of 12 was 15%
• A score  22 points was greater than 69% mortality rate

The one stat that always frustrates me is the 'one cap fits all' used against Age. Is it just an age issue or a lack of diet, exercise, stress, etc etc? And no leeway is given for physically healthy age groups as opposed to those less healthy.   

 

Hence I consider an age stat to be skewed and, if included in any study (random or otherwise), to be treated as variable not finite, as would be the results and conclusions.

 

Hence the above is merely a guideline, not scientifically proven.

[Mapguy]

Appears to be  couple of intelligent posts of a general nature just above.  But useful to post ELSEWHERE not on a thread about the situation in Chiang Mai. Plenty of appropriate threads on ThaiVisa to go to if general discussion of the virus is your goal.

[samuttodd]

To calculate the kill rate,   we would take the total number of dead,  and the total number of recovered and add them together.   Then we'd figure out the % of that # that was dead.

 

We can not count those that are still battling the illness in the above,  because they have neither succombed to the illness nor have they recovered.

 

 

That is how we'll have to run the numbers while the virus is in play...

 

Once it is all over,   we can take the total number of dead and add the total number recovered.  And figure out the % of the dead in that #.

 

 

Go ahead and do the math.

493 dead

907 recovered

Those add up to 1400 souls

 

493 is 35.21% of 1400    That is the current ratio.   The virus currently kills 35% of those it infects based on the current numbers being reported.   Those numbers will change obviously.

Edited February 5, 2020 by samuttodd

[EricTh]

4 hours ago, Mapguy said:

Would appreciate posters remarking on the Corona virus IN CHIANG MAI as this thread was intended. There are any number of other places to discuss the  topic of the virus more generally. There is barely anything here specific to Chiang Mai.

 

So how many infected people are reported and being treated in Chiang Mai so far?

 

I don't want to read every page in this thread to get the answer.

 

As of now, the total case in whole of Thailand is 25.

[stephenterry]

5 hours ago, Mapguy said:

Would appreciate posters remarking on the Corona virus IN CHIANG MAI as this thread was intended. There are any number of other places to discuss the  topic of the virus more generally. There is barely anything here specific to Chiang Mai.

I live in CM, focused me towards this topic, and this discussion is very useful to me because if an outbreak occurs here, I'll be well informed as to how it's being treated at out local government and private hospitals.

 

I would like to think we're all sensible enough to pick and choose what relative topic takes out interest - and in reality this one should be transferred to a more general one, because there's nothing happening in CM to warrant a topic is there? 

 

The main issue is of course, too many Corona topics being posted independently of one another. As was the case with Brexit. 

[WaveHunter]

2 hours ago, EricTh said:

 

So how many infected people are reported and being treated in Chiang Mai so far?

 

I don't want to read every page in this thread to get the answer.

 

As of now, the total case in whole of Thailand is 25.

I agree with you that finding info specific to Chiang Mai is getting more difficult in this thread but it is the most popular thread right now concerning nCoV on the forum, and understanding the general natur of this outbreak may be more pertinent to those of us living in Chiang Mai should the numbers start to rise locally (and hopefully they do not).  Nonetheless, I agree with you.  Perhaps the title of the thread should be changed to one of a more general nature, and a new thread started specifically for the situation in Chiang Mai.

 

In the meantime though, for what it's worth, since the search engine on the forum sucks, a much better way to search a growing thread like this is to use Google Search instead.  It is actually much more adept.  Just search "your query" "thaivisa" in the search box.  It is amazing how much effective it is...very powerful at finding the most speific detail you may be looking for!

 

Edited February 5, 2020 by WaveHunter

[WaveHunter]

1 hour ago, stephenterry said:

...I would like to think we're all sensible enough to pick and choose what relative topic takes out interest - and in reality this one should be transferred to a more general one, because there's nothing happening in CM to warrant a topic is there? 

Nothing happening in CM is the best news there could be!  If anything does actually happen of significance here, I'm sure there will be no difficulty in finding it in this thread.

[Tayaout]

1 hour ago, WaveHunter said:

I agree with you that finding info specific to Chiang Mai is getting more difficult in this thread but it is the most popular thread right now concerning nCoV on the forum, and understanding the general natur of this outbreak may be more pertinent to those of us living in Chiang Mai should the numbers start to rise locally (and hopefully they do not).  Nonetheless, I agree with you.  Perhaps the title of the thread should be changed to one of a more general nature, and a new thread started specifically for the situation in Chiang Mai.

 

In the meantime though, for what it's worth, since the search engine on the forum sucks, a much better way to search a growing thread like this is to use Google Search instead.  It is actually much more adept.  Just search "your query" "thaivisa" in the search box.  It is amazing how much effective it is...very powerful at finding the most speific detail you may be looking for!

 

Even better use "site:thaivisa.com" or "site:forum.thaivisa.com" for only forum posts. 

[Mapguy]

3 hours ago, EricTh said:

 

So how many infected people are reported and being treated in Chiang Mai so far?

 

I don't want to read every page in this thread to get the answer.

 

As of now, the total case in whole of Thailand is 25.

One reported. The airport continues to serve a few cities in China.   Don't know about passenger loads in and out of town.

 

Edited February 5, 2020 by Mapguy

[saengd]

4 hours ago, samuttodd said:

To calculate the kill rate,   we would take the total number of dead,  and the total number of recovered and add them together.   Then we'd figure out the % of that # that was dead.

 

We can not count those that are still battling the illness in the above,  because they have neither succombed to the illness nor have they recovered.

 

 

That is how we'll have to run the numbers while the virus is in play...

 

Once it is all over,   we can take the total number of dead and add the total number recovered.  And figure out the % of the dead in that #.

 

 

Go ahead and do the math.

493 dead

907 recovered

Those add up to 1400 souls

 

493 is 35.21% of 1400    That is the current ratio.   The virus currently kills 35% of those it infects based on the current numbers being reported.   Those numbers will change obviously.

Do the math you say..... you've included the dead and the recovered but you've omitted the patients that are neither, those that are still sick, around 20,000 cases as I recall!  Don't give up your day job cos math aint for you!

Edited February 5, 2020 by saengd

[samuttodd]

You can not include the them in the calculation because they fit neither the dead nor the recovered set.   They are 2 different sets.   

That is why you  remove them  from the equation.

 

The tabulation is of two sets,   not 2 sets and a subset.   In order to calculate the subset, you would need to have information that does not currently exist, or be a mystic or Wizard or just a fortune teller.    I suspect you are none of the above.

 

I can do arithmetic and mathematics just fine,  it is your reading comprehension and understanding of how to work with health statistics that is in question.  

 

That is why the original post has as a closing "That is the current ratio.   The virus currently kills 35% of those it infects based on the current numbers being reported.   Those numbers will change obviously."

Edited February 5, 2020 by samuttodd

[saengd]

5 minutes ago, samuttodd said:

You can not include the them in the calculation because they fit neither the dead nor the recovered set.   They are 2 different sets.   

That is why you will not be able to get a true tabulation until they are removed from the equation.

 

The tabulation is of two sets,   not 2 sets and a subset.   In order to calculate the subset, you would need to have information that does not currently exist, or be a mystic or Wizard or just a fortune teller.    I suspect you are none of the above.

 

I can do arithmetic and mathematics just fine,  it is your reading comprehension and understanding of how to work with health statistics that is in question.  

You think you can accurately calculate the mortality rate based solely on number of deaths versus the number recovered, at this early stage in the cycle!!! You realise that by using that entirely unique calculation the mortality rate at some point, for a fraction, was probably 100% and will almost never stabilize! 

[samuttodd]

I do?   

That was the point of the exercise.   To show that it is not possible to get the calculation when the program is still going on.   

In order to get the true numbers,  you need to know how many lived and how many died.

 

That is in the future.   It is not in the now.    Nobody knows.

 

Is that easier to grasp?

Edited February 5, 2020 by samuttodd

[Mapguy]

Whether or not this happens to be the "most popular" site on ThaiVsa at present, I still wish that this thread be dedicated to Chiang Mai rather than to a general discussion of the virus.  For those who need a quick fix I offer the following:

 

https://www.worldometers.info/coronavirus/#age

[saengd]

8 minutes ago, samuttodd said:

I do?   

That was the point of the exercise.   To show that it is not possible to get the calculation when the program is still going on.   

In order to get the true numbers,  you need to know how many lived and how many died.

 

That is in the future.   It is not in the now.    Nobody knows.

 

Is that easier to grasp?

Respectfully, that's a meaningless fleeting number.

[EricTh]

2 hours ago, WaveHunter said:

I agree with you that finding info specific to Chiang Mai is getting more difficult in this thread but it is the most popular thread right now concerning nCoV on the forum, and understanding the general natur of this outbreak may be more pertinent to those of us living in Chiang Mai should the numbers start to rise locally (and hopefully they do not).  Nonetheless, I agree with you.  Perhaps the title of the thread should be changed to one of a more general nature, and a new thread started specifically for the situation in Chiang Mai.

 

In the meantime though, for what it's worth, since the search engine on the forum sucks, a much better way to search a growing thread like this is to use Google Search instead.  It is actually much more adept.  Just search "your query" "thaivisa" in the search box.  It is amazing how much effective it is...very powerful at finding the most speific detail you may be looking for!

 

According to Mapguy, there is only one guy who is infected in Chiang Mai. Hardly worth a separate thread.

 

People are being too paranoid. I think most of the other cases are in Bangkok. Correct me if I am wrong.

 

If we do get infected which is one in a million chance, which hospital is best equipped to handle the virus in Chiang Mai?

 

Edited February 5, 2020 by EricTh

[samuttodd]

4 minutes ago, EricTh said:

 

I ain't saying you are wrong.   I will say that nobody knows.    Nobody will know until the virus has come and gone.     Perhaps the Thai Ministry of Health would have some information re the different regions?   It may take a while.   Other than visiting the staff at the Hospitals in the area and hoping that they will be forthcomingwith the information,   it'd be pretty hard to get a real answer.   They might be willing to give some information.

 

Edited February 5, 2020 by samuttodd

[EricTh]

19 minutes ago, Mapguy said:

Whether or not this happens to be the "most popular" site on ThaiVsa at present, I still wish that this thread be dedicated to Chiang Mai rather than to a general discussion of the virus.  For those who need a quick fix I offer the following:

 

https://www.worldometers.info/coronavirus/#age

If there is only one person who got infected in CM so far out of 25, wouldn't it be paranoid just to have a special thread?

 

Anyway, which hospital in CM is the best to deal with this virus just in case....

 

Edited February 5, 2020 by EricTh

[WaveHunter]

5 hours ago, samuttodd said:

To calculate the kill rate,   we would take the total number of dead,  and the total number of recovered and add them together.   Then we'd figure out the % of that # that was dead.

 

We can not count those that are still battling the illness in the above,  because they have neither succombed to the illness nor have they recovered.

 

 

That is how we'll have to run the numbers while the virus is in play...

 

Once it is all over,   we can take the total number of dead and add the total number recovered.  And figure out the % of the dead in that #.

 

 

Go ahead and do the math.

493 dead

907 recovered

Those add up to 1400 souls

 

493 is 35.21% of 1400    That is the current ratio.   The virus currently kills 35% of those it infects based on the current numbers being reported.   Those numbers will change obviously.

That doesn't really work too well because you are ignoring the number of confirmed infections that have neither recovered or died.  It is simply an invalid mathematical statement.

 

The only valid death rate at this stage of the outbreak is in comparing the total number of "serious complication" cases (those already requiring ICU care) to the total confirmed deaths of a cohort group.  A report in Lancet described a cohort group of 99 "serious complication" cases and the death rate was calculated at 11%.

 

Again, keep in mind this is NOT the overall mortality rate for those confirmed to be infected, only those who are under ICU care.

 

Even this death rate of 11% doesn't really tell a convincing story about the long range aspects of the outbreak because the number of infected, but not yet confirmed cases will quickly become confirmed as more of them come into hospital.  Remember, there are probably around 75,000 people infected but not yet confirmed in Wuhan (according to epidemiological computer modeling which is considered pretty accurate.)  Also when sufficient number of test kits are finally available to hospitals, more "suspected cases" will be tested and confirmed positive.

 

What's going to happen is the larger and larger number of confirmed cases are going to convert to more and more "Serious Complication" cases since n-CoV has a "Serious Complication Rate (SCR) of about 20%.  As these cases rapidly grown, they will very quickly exceed the medical system's ability to handle them (not enough ICU beds for the number of ICU cases). 

 

That is when then the death rate really will climb much higher than it is now.

 

Edited February 5, 2020 by WaveHunter

[samuttodd]

19 minutes ago, saengd said:

Respectfully, that's a meaningless fleeting number.

Something that could give you a more accurate number would be to determine the average length of time the virus takes from first onset until the survivor gets a "clean bill of health" or dies.

 

Once you are able to detmine that length of time,  you could then backdate the statistical death/survived/infected #'s by that length of time and figure the ratio with the numbers that were current far enough back to get a more accurate calculation.    You will only be able to do that once the avg illness result time interval is found.

 

The problem is:   everybody is looking at the rearview mirror to try and see STRAIGHT AHEAD through  the windshield.   It is not possible.

Edited February 5, 2020 by samuttodd

[WaveHunter]

8 minutes ago, samuttodd said:

Something that could give you a more accurate number would be to determine the average length of time the virus takes from first onset until the survivor gets a "clean bill of health" or dies.

 

Once you are able to detmine that length of time,  you could then backdate the statistical death/survived #'s by that length of time and figure the ratio with the numbers that were current far enough back to get a more accurate calculation.    You will only be able to do that once the avg illness result time interval is found.

The thing is, at this stage of the outbreak, any sort of death rate other than the one described in the Lancet article concerning death rate of those in ICU is of minimal predictive value.  There are just too many variables to consider.

Edited February 5, 2020 by WaveHunter

[samuttodd]

One concern is that at least in the US,  Hospitals are already operating at capacity in many places in the areas where these very sick will need to be treated.

 

The emergency medical response will be unable to deal with the deluge of very sick people,  which is going to mean that many folks will not be able to get well.    They simply don't have the staff or the space to serve everyone.

 

 

I would propose that a very large cruise ships or naval vessels be set up to do emergency and quarrantine off shore near large costal metro areas (LA, San Fransisco, Seattle, nyc, miami...)   They could essentially be MASH units to handle the excess patients.    The military and reserves could be used to help.   

 

 

Edited February 5, 2020 by samuttodd

[WaveHunter]

13 minutes ago, samuttodd said:

One concern is that at least in the US,  Hospitals are already operating at capacity in many places in the areas where these very sick will need to be treated.

 

The emergency medical response will be unable to deal with the deluge of very sick people,  which is going to mean that many folks will not be able to get well.    They simply don't have the staff or the space to serve everyone.

 

 

I would propose that a very large cruiseline or naval vessel be set up to do emergency and quarrantine off shore near large costal metro areas (LA, San Fransisco, Seattle, nyc, miami...)

Yes, exactly.  That is what the real worry should be.  In China, even with the highly publicized construction of two new hospitals in Wuhan that will hardly be enough ICU beds to deal with the crisis if the exponential rise of newly confirmed cases continues, not when 20% of them will end up requiring ICU care. 

 

Consider that in the entire USA, there are only around 100,000 ICU beds and, as you mention, many of those are nearly always occupied to near capacity.  That is a very small number of ICU beds when you consider the potential of this virus to spread. 

 

That's why I think mortality rate should not even be on people's minds at this point in the outbreak.  The real concern should be in the number of confirmed cases because you can accurately predict how many of those will go on to be "serious complication" cases and when there are no longer any ICU beds and new ICU cases can not even be treated...that's when things get real bad. 

Edited February 5, 2020 by WaveHunter

[samuttodd]

California couple have contracted it too.    The man went to china and got home and self quarrantined.    His wife (did not go to china)  and she got it too.     No info on their age/race/   but now they've taken a turn for the worse and are in the hospital.

[samuttodd]

I think they need to start training groups in the nat'l guard etc in disease protocol and quarantine protocol.    Each of these offshore quarrantine vessels could have experts and MD's directing and have the newly trained guardsmen/women carrying out much of the grunt work that normally hospital staff do.   It would take a massive effort from a lot of people.   But it may be one way of helping all of the people that wouldn't otherwise be able to get help at the overflowing hospitals.

 

They've helped in other disasters/ hurricanes / wildfires/ etc.

 

It'd also keep all of the healthcare workers and front line folks isolated as well as the patients (out of the rest of the population)

 

Edited February 5, 2020 by samuttodd

[tifino]

4 minutes ago, WaveHunter said:

in the entire USA, there are only around 100,000 ICU beds

I'll bet they quickly magically become vacated by the incumbents,

when it is revealed that NovelCV is 'somewhere in the house'...

[samuttodd]

Get a load of this... What a Surprise!

 

[link to www.taiwannews.com.tw (secure)]

On late Saturday evening (Feb. 1), Tencent, on its webpage titled "Epidemic Situation Tracker", showed confirmed cases of novel coronavirus (2019nCoV) in China as standing at 154,023, 10 times the official figure at the time. It listed the number of suspected cases as 79,808, four times the official figure.

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.

Moments later, Tencent updated the numbers to reflect the government's "official" numbers that day. Netizens noticed that Tencent has on at least three occasions posted extremely high numbers, only to quickly lower them to government-approved statistics.

[saengd]

5 minutes ago, samuttodd said:

Get a load of this... What a Surprise!

 

[link to www.taiwannews.com.tw (secure)]

On late Saturday evening (Feb. 1), Tencent, on its webpage titled "Epidemic Situation Tracker", showed confirmed cases of novel coronavirus (2019nCoV) in China as standing at 154,023, 10 times the official figure at the time. It listed the number of suspected cases as 79,808, four times the official figure.

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.

Moments later, Tencent updated the numbers to reflect the government's "official" numbers that day. Netizens noticed that Tencent has on at least three occasions posted extremely high numbers, only to quickly lower them to government-approved statistics.

Even though all of this is taking place in China there are still many avenues for information to flow out of the country, accurate information. If in fact the number of deaths was almost 25, 000 I'm pretty sure the rest of the world would have got sight of that either through foreign embassies in the country, business people or locals who have traveled or spoken with others overseas. The West has come to accept a certain level of inaccuracy regarding Chinese statistics but not to the level you have stated which I personally think is rumor mongering and irresponsible, given the circumstances today.