Outline - Read & annotate without distractions
Fatality rate for acute patients is 4%-5%; 3 weeks determine life and death
Caixin: Based on your clinical experience, what’s the disease progression of the new coronavirus?
Peng: Lately I’ve been spending the daytime seeing patients in the ICU, then doing some research in the evenings. I just wrote a thesis. I drew on data from 138 cases that South Central Hospital had from Jan. 7-28 and attempted to summarize some patterns of the novel coronavirus.
A lot of viruses will die off on their own after a certain amount of time. We call these self-limited diseases. I’ve observed that the breakout period of the novel coronavirus tends to be three weeks, from the onset of symptoms to developing difficulties breathing. Basically going from mild to severe symptoms takes about a week. There are all sorts of mild symptoms: feebleness, shortness of breath, some people have fevers, some don’t. Based on studies of our 138 cases, the most common symptoms in the first stage are fever (98.6% of cases), feebleness (69.6%), cough (59.4%), muscle pains (34.8%), difficulties breathing (31.2%), while less common symptoms include headaches, dizziness, stomach pain, diarrhea, nausea, vomiting.
But some patients who enter the second week will suddenly get worse. At this stage, people should go to the hospital. Elderly with underlying conditions may develop complications; some may need machine-assisted respiration. When the body’s other organs start to fail, that’s when it becomes severe, while those with strong immune systems see their symptoms decrease in severity at this stage and gradually recover. So the second week is what determines whether the illness becomes critical.
The third week determines whether critical illness leads to death. Some in critical condition who receive treatment can raise their lymphocyte, a type of white blood cell, and see an improvement in their immune systems, and have been brought back, so to speak. But those whose lymphocyte numbers continue to decline, those whose immune systems are destroyed in the end, experience multiple organ failure and die.
For most, the illness is over in two weeks, whereas for those for whom the illness becomes severe, if they can survive three weeks they’re good. Those that can’t will die in three weeks.
Interesting. I've been basing my numbers off a 10-day lag time for death, but maybe it should be 21?
To base this off the China reported confirmed cases, I would guess the majority of them are not tested & confirmed on day 1. Lets give it 3 days between initial symptoms and confirmation. That would give it a 18-day lag time. I am not sure if this includes the asymptomatic time as well. I'm going to round this down to 16-day lead time,
Lets re-run the numbers based on a 16-day lead time, see full numbers below, I am going to copypasta this each day to try and keep it updated. I am sure there is a better way, but whatever.
So originally 27 people came down with this on 12/30/2019. First person died (officially) on 1/10/2020. That's a 11'ish day time period to die. The first 7 people were released as "recovered" on 1/15/2020. So it took 16 days for people to get over it enough to be declared recovered. The early days of this were all full of misinformation, misdiagnosis, etc, so these #s are taken with a BIG grain of salt, but it's all we have to work with right now.
Only a sprinkling of deaths here and there until 1/22/2020, when there were 8 deaths (17 total). If we use the 16-day death period on this, 16 days back would have had been 1/6/2020. We only know of 27 cases officially sick on 1/6/2020, so if by that date 17 had died. That's a whopping 65% mortality rate. WTF! I would guess there were MORE infected prior to this and not diagnosed properly, but it's a scary start. If you took the total # of confirmed cases on 1/22/2020 (131 and divided it by the number of dead, 17, you still get a 13% mortality rate.)
So moving along, we know they changed some things internally around 1/18/2020 which caused a spike in reported cases.
16-day lag time, picked a few days for sampling, everything in January doesn't make sense, because more people were dying than were brought in 16-days earlier.
2/3: 64 deaths, 59 reported cases (16-day lag, 1/28 (16DL) = 100%+ mortality), a 10-day lag (10DL) would have a 1/24 date, with 457 cases reported, 14% mortality. 5-day lag (5DL), 1/29, 1737 cases, 3.7% mortality.
TOTAL case mortality, as of 2/3, (425 deaths / 20438 cases = 2% mortality). So, either everyone is already dead, or maybe 2% die. That is unhelpful. If you go off their 3-week time table (21 days!) it gets even more unreliable.
Oh well, let's run some more dates
2/4: 65 deaths, 16DL=84%, 10DL=9.4%, 5DL=3.2%, TM=2%
2/5: 71 deaths, 16DL=76%, 10DL=9.2%, 5DL=3.3%, TM=1.9%
Predicted?
2/6: 16DL=104 Deaths (70%), 10DL=159 Deaths (9%), 5DL=77 Deaths (3%)
2/7: 16DL=91.7, 10DL=131, 5DL=85
2/8: 16DL=181, 10DL=156, 5DL=97
2/9: 16DL=319, 10DL=178, 5DL=114
2/10: 16DL=481, 10DL=188, 5DL=109
So.. yeah, no idea. Have to wait and see which model it starts to follow I guess. The 16-day lag model gets monstrous as the cases get larger. Could you imagine a total mortality of 70% over the course of the virus? Yeah, me either. The fact that we have just about double the # of recovered cases vs deaths, means we should at MAX be looking at a 50% death rate, and even that is on the "Crazy wacky conspiracy story"-level.
I full expect this to fall somewhere between 3%-10% mortality at the high end, at least for Hubei. The rest of China & the World SEEMS to be doing much better with this, though depending on the LAG time we may just not be seeing it yet.
Stats reported by China below for reference:
Total Cases (Worldwide through 2/5): 28,364
12/30: 27
No cases reported between 12/31 & 1/10
1/10: 14
No cases reported between 1/11 & 1/15
1/16: 4
1/17: 17
1/18: 59
1/19: 77
1/20: 93
1/21: 149
1/22: 131
1/23: 259
1/24: 457
1/25: 688
1/26: 769
1/27: 1771
1/28: 1459
1/29: 1737
1/30: 1981
1/31: 2099
2/1: 2589
2/2: 2825
2/3: 3235
2/4: 3831
2/5: 3647
Deaths, since the 1st (Worldwide through 2/5): 566
1/10: 1
1/15: 1
1/16: 0
1/17: 0
1/18: 0
1/19: 1
1/20: 3
1/21: 3
1/22: 8
1/23: 8
1/24: 16
1/25: 15
1/26: 24
1/27: 26
1/28: 26
1/29: 38
1/30: 43
1/31: 46
2/1: 45
2/2: 57
2/3: 64
2/4: 65
2/5: 71
Released total: 1,153
1/15: 7
1/16: 5
1/17: 3
1/18: 4
1/19: 6
1/20: 0
1/21: 0
1/22: 0
1/23: 9
1/24: 4
1/25: 11
1/26: 2
1/27: 9
1/28: 43
1/29: 21
1/30: 47
1/31: 72
2/1: 85
2/2: 232
2/3: 157
2/4: 183
2/5: 100
