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Medicine Science

Experts Envision Two Scenarios if the New Coronavirus Isn't Contained (statnews.com) 194

With the new coronavirus coronavirus spreading from person to person (possibly including from people without symptoms), reaching four continents, and traveling faster than SARS, driving it out of existence is looking increasingly unlikely. From a report: It's still possible that quarantines and travel bans will first halt the outbreak and then eradicate the microbe, and the world will never see 2019-nCoV again, as epidemiologist Dr. Mike Ryan, head of health emergencies at the World Health Organization, told STAT on Saturday. That's what happened with SARS in 2003. Many experts, however, view that happy outcome as increasingly unlikely. "Independent self-sustaining outbreaks [of 2019-nCoV] in major cities globally could become inevitable because of substantial exportation of pre-symptomatic cases," scientists at the University of Hong Kong concluded in a paper published in The Lancet last week. Researchers are therefore asking what seems like a defeatist question but whose answer has huge implications for public policy: What will a world with endemic 2019-nCoV -- circulating permanently in the human population -- be like?
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Experts Envision Two Scenarios if the New Coronavirus Isn't Contained

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  • by Mal-2 ( 675116 ) on Wednesday February 05, 2020 @04:28PM (#59694584) Homepage Journal

    It will just become another flu variant you have to get a jab for. The only reason it's hitting so hard now is because nobody had time to prepare and whip up a vaccine for it. Give six months of lead time, and this problem goes away.

    • It will just become another flu variant you have to get a jab for. The only reason it's hitting so hard now is because nobody had time to prepare and whip up a vaccine for it. Give six months of lead time, and this problem goes away.

      Quite an optimistic view, however:
      - FDA approval for a new vaccination takes much longer than 6 months (we're talking about a new virus here)
      - this new virus mortality is at the moment at about 2%, whilst influenza is at about 0.1% (200 x more)
      - this virus seems more contagious (reported cases of infecting through eyes)
      - there are also more severe cases than for influenza, which combining with all the above might result in shortages of medications and hospital places, thus more deaths

      In short, it's not

      • ... sorry for the math error - 20 times higher mortality
      • by Mal-2 ( 675116 ) on Wednesday February 05, 2020 @05:13PM (#59694784) Homepage Journal

        Influenza mortality can sometimes be in the 0.3-0.4% range, and I have seen estimates that 75-90% of all coronavirus cases are asymptomatic. That means for every one you see, there are three to nine that you don't. If I take a low number here (say, 4 unseen for every 1 seen) then the actual mortality rate needs to be divided by 5, which brings it in line with flu viruses.

        • by samkass ( 174571 )

          But unlike influenza, which can cause deaths in otherwise healthy young people, nCoV seems to cause severe symptoms or death mostly in older or already sick people. It's quite possible that in developed countries, if nCoV becomes endemic it'll become like the Chicken Pox of old, where parents intentionally expose a children and have them go through a week of hell to get lifelong immunity.

          • by EvilSS ( 557649 ) on Wednesday February 05, 2020 @06:34PM (#59695182)

            But unlike influenza, which can cause deaths in otherwise healthy young people, nCoV seems to cause severe symptoms or death mostly in older or already sick people. It's quite possible that in developed countries, if nCoV becomes endemic it'll become like the Chicken Pox of old, where parents intentionally expose a children and have them go through a week of hell to get lifelong immunity.

            Actually, in most cases flu deaths are in the elderly and otherwise compromised individuals. Far more than in younger populations, about two orders of magnitude when you compare 0-49 years of age to those 65+ (50-64 it's about 1 order of magnitude higher). In the 2017-2018 season in the US, there were a total of 61,099 deaths attributed to the flu, 50,903 were 65+ in age. There have been exceptions (Spanish flu) but those are outliers.

            As for immunity, viruses that attack the respiratory system don't grant the patient lifelong immunity. Secretory IgA antibodies only persist for 1-2 years, and they are the first-line defense against things like coronaviruses and other rhinoviruses. This is why you can catch a cold from the same virus multiple times throughout your lifetime. Your blood borne antibodies, like IgE that can persist much longer, may give you a foot up on future infections, but you can't guarantee they would prevent serious illness from a future reinfection.

            Also, as was pointed out, you don't get immunity from Chicken Pox. You get a persistent infection that can flare up later in life.

            • It is much ado about very little.

              But much like the war on drugs, war on terror, it generates much media hype and feeds into institutions that then want to promote themselves.

              The measures taken here in Australia are out of all proportion to the risks. But risks involve numbers, and numbers are not news.

      • There are two teams working on a vaccine and as I understood it they were each able to basically use existing strategies for a SARS vaccine and get a "head start" on the vaccine development process. I forget the details, but I think at least one of them was because they're both coronavirus.

        I think they had some optimism that they could be in human trials in about six months, way faster than some novel non-coronavirus.

        But even if they pull that off and have a vaccine for the public in 9 months (which makes

      • by bobbied ( 2522392 ) on Wednesday February 05, 2020 @06:07PM (#59695020)

        The mortality rate observed is in China, where the healthcare services are sub-par compared to the rest of the industrialized world. Here in the USA, I doubt we will see it as deadly.

        However, I suspect this will still be serious. It has already spread far enough that it will be really hard to stop, but I also don't expect that 2% is even close to the mortality rate here in the USA. Also, I seriously doubt that the FDA takes 6 months to approve a vaccine, but will be putting this on the fast track to approval. I also don't think it will take all that long to develop and approve the vaccine. However, what WILL take a long time is the manufacturing of it in sufficient volume to vaccinate enough folks to make much of a dent. We will have a vaccine soon, just not enough of it to treat everybody.

        Finally, I also suspect that we will see the spread of the virus slow considerably as spring gets underway in about a month. If we can slow the virus down a bit, get the vaccine into production to spot treat outbreaks, we might make it into late spring before it really gets going, and hopefully keep the mortality rate low.

        IMHO - I suspect that the press is blowing this way out of proportion in it's ever growing quest for generating click bait headlines for profit. I seriously doubt the problem is anywhere near as serious as it's being reported. I'm being cautious and keeping an eye out just in case, but so far, I'm at about zero risk, being a middle aged healthy person, in reasonable shape without any deficiencies in my diet.

        • by EvilSS ( 557649 )
          Even in China, outside of Hubei province (where Wuhan is), the death rate has only been around 0.1-0.4%. 97% of deaths, 71% of recorded cases, and 56% of the reported recoveries are from Hubei. Wuhan's hospitals are far, far over capacity right now, and there are only so many ICU beds, ventilators, and other advanced support equipment to go around.
        • I don't want to reply offtopic or troll bait but as a side note :
          but historically reading news ( my hobby is the study on information movement from
          anywhere to the USA after 1852 and world wide prior to that )

          a very similar line was issued in the press in the 1918-1919 while the spanish flu was
          striking ie : "The mortality rate observed is in Spain, where the healthcare services are
          sub-par compared to the rest of the industrialized world." and
          during the NYC aids crisis of the 80's, " the africans have xyz ...

      • by HiThere ( 15173 )

        I don't think you're right. From what I read a lot of the cases aren't sick enough to go to the hospital, so they don't get counted. This means that severe reactions are a lot less frequent, on a percentage basis, than the official records indicate.

        OTOH, it also means it's a lot less likely to be contained. Whoops!

        Also, apparently most young children who are infected have a very mild case. Will this yield permanent immunity? Well, possibly not, since this is a rapidly mutating virus. But perhaps, if t

    • Re: (Score:3, Interesting)

      by Rei ( 128717 )

      And so far, there's no real sign that it's actually breaking out outside of Hubei (Wuhan). It's certainly spreading heavily within Hubei (almost all of the new cases you see reported are there), but in terms of new cases elsewhere, no other province in China - let alone outside of China - seems to show problematic rates of spread. Indeed, things seem to be (slowly) headed back towards normalcy outside of Hubei. For example, most factories - which were shuttered for an extra week due to the virus, past the

      • by Rei ( 128717 ) on Wednesday February 05, 2020 @05:21PM (#59694820) Homepage

        In terms of the disease... mortality rates appear to be settling in around 2%. 80% of the fatalities have been people over 60, and 75% in people with preexisting conditions. So it's like a bad flu. The earlier rates of R0 unsurprisingly appear to have been too low (1,4-3); it appears to be 3-4. A typical flu is 2-3. On the upper end, measles is 12-18.

        It's possible that this will become a worse disease. Certainly, it's evolved to spread effectively from person to person. It certainly could become more dangerous disease, as it's still early in its evolution as a human-hosted disease. However, humans are practicing artificial selection in the opposite manner. The worst cases cause people to get medically examined, diagnosed, and those people get quarantined, and everyone who they came into contact with quarantined. It's the minor cases however that are more likely to spread. Indeed, it's these sort of selective factors in normal colds / flus (mildly sick people go to school/work, really sick people stay home) that's selected for variants that don't kill their hosts. The infamous Spanish Flu was different; as it was during World War I, people who got mildly sick stayed in their trenches, while those who got seriously ill were packed into trains and sent to overcrowded, poorly sanitized hospitals on the outskirts of cities; humans selected for the worst strains of the disease to spread.

        • However, humans are practicing artificial selection in the opposite manner.

          Evolutionary selection doesn't work on those too old or too sick to breed. Since most of the deaths are of the elderly and the sick, not much selection of fit or "unfit" genes is going on. The virus is simply hastening the natural process of death. Maybe that's why we've never evolved much of an immunity against flu-like viruses. The overwhelming majority of the breeding population survive the infections and so would continue to s

      • Quarantine work, but using the example of the pandemic in world of warcraft, we might have to really lock up communities.

    • The flu is estimated to have killed 80,000 people in the US alone last winter. People keep saying, "why worry, it's no worse than the flu?" The flu is bad. 80,000 dead is a lot. Would you like to have the flu twice as often? And face twice the chance of dying from it (or something like it) when you get old?
      • here is what's interesting:
        50 million people in the USA are over 65 (male 22,678,235/female 28,376,817) 2017 ( 16% )
        if the flu is 20x stronger than the normal flu then we are looking at a death count of about
        1.6 million. Of which 600k-800K would be in the above group ( the virus target's very young
        and very old ) again, this is not so bad, unless it's your child or grandma.
        I'm ok with casualty rates in the 15 million or less range in the USA. most likely I will be one
        due to my health, but that's fine anyway.

    • It will just become another flu variant you have to get a jab for. The only reason it's hitting so hard now is because nobody had time to prepare and whip up a vaccine for it. Give six months of lead time, and this problem goes away.

      And if we're lucky, the antivaxers will eschew that jab, die off, and leave the rest of us alone.

      • from your lip's to god's ears if you are that sort.
        but yes, getting rid of the anti-vaxxers and flat earthers is a great start to a cleansing.

        darwin will remove the rest.

  • https://github.com/feraliscatu... [github.com]

    It may or may not be super effective, but if you know your HLA type, you can synthesize some of the viral peptides that your immune system would present via the MHCI and MHC II system. Of course it may have risks, zero guarantees, and you better be well qualified in immunology and lab protocols first.

    • by xleeko ( 551231 )

      Thanks for that. I get annoyed by the lack of flying cars, but occasionally something like this reminds me that we really *are* living in the future.

  • by 89cents ( 589228 ) on Wednesday February 05, 2020 @04:38PM (#59694644)
    I hope I am not understanding this correctly or received misinformation, but SARS had an incubation period of just a day or more and would not be contagious until days after the symtoms began to show, allowing people to be quarantined.

    Coronavirus symptoms take up to 2 weeks to appear but can spread to others before they appear. That is a HUGE difference and worries me.

    • Coronavirus symptoms take up to 2 weeks to appear but can spread to others before they appear. That is a HUGE difference and worries me.

      All the more reason not to leave the basement^H^H^H^H^H^H^H^H command bunker for the next few months.

      • If the virus becomes a permanent thing circulating among the global human population like the article suggests, staying in a basement for a few months will not help. You'll be exposed to it when you eventually come out. You have to wait down there until vaccination for this virus becomes as routine as flu shots, and that may take a year.

    • The paper claiming people without symptoms could still spread it turned out to be wrong [arstechnica.com]. They were rushing to get the paper out, and didn't manage to get in touch with the woman who was the source to ask her. The co-workers who got it from her said she didn't seem to be sick. Once they got in touch with her though, she said she'd had flu like symptoms and took medicine for them.

  • by gurps_npc ( 621217 ) on Wednesday February 05, 2020 @04:42PM (#59694664) Homepage

    Basically, the reasons why people are scared of this virus are:

    1) You are infectious before you show symptoms, like the flu.
    2) Estimates for contagious vary, from medium contagious (like the flu), to VERY contagious (like polio)
    3) The numbers in China appear to make it very deadly, some say as high as 8% death rate (assuming it is only as contagious as the flu). But other estimates make it no deadlier than the flu at all (that would require it to be very contagious (like Polio)

    If something was as contagious as polio and also 8% deadly, THAT would be very scary, particularly with the infectious before symptoms.

    But the numbers do not support that. If tens of thousands are infected, then the hundreds dead mean a high death rate, but a low infectious rate.

    If hundreds of thousands are infected, than the hundreds dead mean a LOW death rate and a high infectious rate.

    The number dead do not support a high infectious with a high death rate.

    • What's going to happen if it spreads to India (beyond the 3 or 4 reported cases)?

      It can be spread by fecal matter apparently, and India does NOT have the same capabilities for locking down metro areas with tens of millions of people, nor the ability to construct hospitals from scratch in 2 or 3 days to quarantine suspected cases.

    • by guruevi ( 827432 )

      You also have to take into account that China is a 3rd world communist dictatorship. The numbers could be way off which makes any statistical analysis moot until you get to a country where data can be sourced reliably. The death rate for those people could be really high compared to places like the US that have adequate health care.

      At this point, none of the data suggests this is any worse than a flu virus. The scary bit is where China refuses to answer questions which means they're hiding something, either

    • > The number dead do not support a high infectious with a high death rate.

      Tencent accidentally published non-political numbers. They were rapidly revised.

      The least-smart thing to do would be to trust CCP numbers.

    • by hey! ( 33014 )

      I'm not sure I follow your reasoning. This thing was a local bug in December and it just blew up in January. It appears to have legs.

      As you say, estimates for R0 are all over the place, but nobody thinks it's less than 1. Most estimates place the number of people a newly infected person will in turn infect to be between 2 and 3, so we're talking about an exponential growth phase if nothing is done.

      The thing is R0 is an empirical figure; the virus's contagiousness is only one factor that determines that

    • What I'd like to know is how it affects different age groups. Is this like the Spanish flu, where healthy young people die? Like the flu, where it's mostly older people and immune compromised people? I'm hearing that people are dying, but WHO? What's the risk to the general population? Who should preemptively quarantine themselves?

      Do I worry about my Mother, or me, or my younger sister, or my friends' kids? All of the above?

    • And 4,5,6,7) The virus comes from China. Everything that starts in China is especially scary.

  • Jail / prisons become the doctor of the poor or the ER is forced to cover this even if you can't pay. USA ONLY GOP PLAN

  • We are going to create a safe and effective vaccine against the coronavirus, and then no one's going to get it because it's not a big deal, autism, etc.

    • Well, with a hint of luck something good will eventually come out of this and the virus wipes out at least a sizable portion of the gullible fools that believe any crap they read on the internet, reducing their number to a less obnoxious critical mass.

  • This morning on NPR China (predictably) objected to the travel bans that are being put in place against China - specifically speaking about the US ban.

    This is in China's self-interest, so I get it.

    What didn't help was that they were also talking to some UN talking head (head of WHO?) who *also* asserted that travel bans were somehow going to make dealing with this crisis worse.

    I find it hard to believe that a UN spokesperson in *any* role would be so beholden to China that they'd parrot an obvious untruth.

  • Pretty much the same as it is now, it is not an existential threat to humanity, it is just one of many ways to die.

    Death through violent crime out ranks deaths through terrorism, death through this will be vastly outnumbered by deaths through traffic accidents or common killer diseases.

  • ...and millions of people will refuse to take allowing the virus to survive many decades longer than it should have.

  • What will a world with endemic 2019-nCoV -- circulating permanently in the human population -- be like?

    Well all of those annoying germophobes will have all their irrational fears confirmed which will be super annoying.

  • We survived that, well 80% of us did.

  • The nCoV virus is more infectious than SARS.
    Even the numbers released by China show that it has, by far, surpassed what SARS infections were at the same time.

    See the graphs here [www.cbc.ca].

    However, the deaths per infection figures are far less than SARS. True, you can't trust the numbers from China, but although that many countries reported cases, only 2 persons died outside China (one in the Philippines, and another in Hong Kong).

    It is even less deadly than the annual flu seasonal epidemic, per the WHO's numbers (see

  • If the 10-15% death rates hold then this'll be like Spanish Flu. Short term it's quite an economic and humanitarian disaster, but the survivors will be resistant, problem solved.

    And we've got almost 8 billion humans swarming over the planet like roaches, bumping that briefly back down to 7 would be a decent respite for lots of reasons.

  • Seriously, why not make your own personalized vaccine? Just qualify yourself in immunology courses and get experience in some lab techniques.

    Here is an example of how you can get started in designing the vaccine if you know your own HLA-type:
    https://github.com/feraliscatu... [github.com]

  • The bubonic plague killed approximately 1/3 to 1/2 of the population in Europe in medieval times. I guess we can agree that even the worst scenario is not even close to that.

    And while those outbreaks had some serious impact on societies, humanity survived.

    So please, stop worrying. Yes, it might kill you but don't worry, this planet isn't going to get rid of us that easily.

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