nCoV_info

Deaths and severe cases doubling period roughly 3 days during the early, exponential phase.

I think this gives us a good, rather unbiased proxy of actual epidemic doubling time.

After all, when assessing doubling periods it does not matter if there is systemtic under-counting of cases (i.e. if cases are off by a certain fixed factor) the doubling time will be the same.

Also consistent with latest research.

Former research (Leung et. al) used to rely on case doubling estimates of 7 days.

Many people have difficulty understanding nature of exponential growth.

Case doubling of 3 days, means: epidemic is one thousnad times larger after just 4 weeks and one million times larger after 8 weeks.

Sorry, I did not clearly express myself.
What I wanted to say is not that the virus itself necessarily mutated to a milder form, but that the early media reporting, case and death counting etc. was very much biased.

The reason for this was that, most probably, that they completely overlooked the mass of many very mild/asymptomatic cases.
In the end it came apparent that mild infections were not only 10x under reported, but more than 100x.

I still hope that this is playing out similarly with COVID19.

What if virus prevalence in Wuhan is not 1% but already 10% of population with most of them only a little headache and runny nose ?

This would also explain the slowing of the spread in Wuhan due to increasing herd immunity.

So we now know that deaths have actually been under counted by about factor 2 (now about 200+ daily increase vs. 100+ yesterday)

But infections probably even (much) more  under counted than deaths.

So final CFR may turn out quite low.  (my estimate: less than 1% BUT only in non-overwhelmed health system)

money is always a problem , but you said "cheap"

It could be worth it in some countries.

The problem is people are infective before having symptoms and maybe
also before symptoms can be detected.

I think it must be made illegal to infect others carelessly or to not report
a risk-level and isolate/protect if required.
See China.

I generally avoid drawing conclusions from official china numbers from Wuhan/Hubei (I have some more trust in the chinese numbers outside Hubei). This is not to say, the official lie intentionally, rather I think it is simply a problem of capacity and chaos in an near-overwhelmed health system)

Fortunately there are many studies now, that model the spread and severity of the epidemic using only non-china data and air travel models.

The other point we all should keep in mind is that you cannot simply mix numbers from before Jan 23 (i.e. before the drastic isolation measures) with the numbers after the shutdown.

Before the shutdown we probably had real exponential community transmission with case doubling of 3 days. (You can even use the official numbers to see that because for case doubling estimation it does not matter whether the numbers are off by a factor of ten)

Now, after the sutdown (plus one incubation period) i.e. roughly after February 1, we see about linear growth which means that the isolation measures work in so far as exponential spread is stopped (R_effective <= 1)
Unfortunately there is still no sign that the isolation measures are enough to not only slow down but actually END the epidemic (R_effective << 1)

This is crucial, because isolation cannot be maintained forever.










 

did they well because they were better preparing or just because they were
not being overwhelmed ?

They were not overwhelmed because they were prepared.

It was wise to immediately close schools, workplaces, public transport etc. even at a time when they had only imported cases from Wuhan.

Its my concern that gouvernments outside of china are now in the same position resp. "import from china" than the other chinese Provinces were with respect to "import from Wuhan."
 
We must not miss this window of opportunity. But here in Germany, for example, the only thing they do is distributing flyers at the airports 

why do you think it's likely mild

I have to admit it is partly due to wishful thinking. But the other reason is my experience with how the 2009 H1N1 swine flu pandemics played out.

I vividly remember the reports from Mexico at the time with CFR estimates of 10% then 1-5%the media full with comparions to 1918 spanish flu,  and the reports of healthy young patients all over the world on ventilators with severe pneumonia.

As the pandemic unfolded, two things became more and more clear: 1. it was hopeless to try to contain it and 2. somehow the proportion of very mild cases  increased dramatically until in the end it was even less serious than the seasonal flu.

Transmission through the eye has been established fact for other respiratory viruses:

https://www.ncbi.nlm.nih.gov/pubmed/17050596

"Viral infection of the lungs through the eye."

"These results establish the eye as a major gateway of respiratory infection and a respiratory virus as a bona fide eye pathogen"

So its not surprising that goggles are recommended as PPE when dealing with viruses like SARS/MERS/2019nCoV