
Clinical features of patients infected with 2019 novel coronavirus - SQL2219
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext
======
pbourke
It’s interesting to watch the response to this crisis ricochet around the
world. Results come from China, the CDC sequences the virus from the Chicago
and Seattle patients and releases them, researchers in Seattle process the
merged data through their open source tool[0]. Researchers in China then
translate these results to Chinese [1]

The internet is our immune system.

[0]
[https://twitter.com/nextstrain/status/1221181133884256256?s=...](https://twitter.com/nextstrain/status/1221181133884256256?s=20)

[1]
[https://mobile.twitter.com/nextstrain/status/122154827481917...](https://mobile.twitter.com/nextstrain/status/1221548274819178499)

------
rdtsc
> 27 (66%) patients had direct exposure to Huanan seafood market (figure 1B
> [https://www.thelancet.com/journals/lancet/article/PIIS0140-6...](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(20\)30183-5/fulltext#fig1)).
> Market exposure was similar between the patients with ICU care (nine [69%])
> and those with non-ICU care (18 [64%]). The symptom onset date of the first
> patient identified was Dec 1, 2019. None of his family members developed
> fever or any respiratory symptoms. No epidemiological link was found between
> the first patient and later cases.

The idea I think was that the strain originated at the market, from people
handling and possibly consuming bats. But, the description above and figure 1B
indicates the currently known patient 0 was not exposed to the market.

Also, what is the chance that a random person in the area has exposure to that
market in say a week's time. If it is a central place in the city, and
depending on the layout and public transportation, 60% weekly exposure to it
might not be unusual for an average citizen there.

It maybe be conspiracy at this point but I find it highly suspicious that out
of all the markets in the country, this epidemic started just around the
corner from China's first (and only?) biosafety level 4 laboratory
[https://wwwnc.cdc.gov/eid/article/25/5/18-0220_article](https://wwwnc.cdc.gov/eid/article/25/5/18-0220_article),
which just happened to have been built in response to the 2003 SARS epidemic,
and so presumably has been working with those kind of viruses since.

~~~
sanxiyn
Chinese CDC collected environmental samples from the market and some of them
tested positive. So it's a little more than "the market happened to be there",
although your point about the first patient identified is valid.

[http://www.xinhuanet.com/english/2020-01/27/c_138735677.htm](http://www.xinhuanet.com/english/2020-01/27/c_138735677.htm)

~~~
rdtsc
> Thirty-three of the 585 environmental samples collected from the Wuhan's
> Huanan Seafood Wholesale Market were found

But what’s the chance that sick people would have gone to the market when they
were infectious and handled animals, produce, raw meat etc.

Having watched footage of some of the wet market I have no doubt it would be
place for germs to spread efficiently. But it is still useful to figure out
how the whole thing originated.

~~~
emayljames
The onset of symptoms can take upto 8 days.

~~~
rdtsc
Yeah. And the virus is transmittable before that. I think it's part of what
makes it insidious. There is a time when people don't feel sick so they travel
around and spread it.

------
azalemeth
> "Suspected patients were isolated using airborne precautions in the
> designated hospital, Jin Yin-tan Hospital (Wuhan, China), and fit-tested N95
> masks and airborne precautions for aerosol-generating procedures were taken.

> This study was approved by the National Health Commission of China and
> Ethics Commission of Jin Yin-tan Hospital (KY-2020-01.01).

> Written informed consent was waived by the Ethics Commission of the
> designated hospital for emerging infectious diseases."

In other words, data from every patient they had is reported in this paper,
with or without their consent. That includes radiographic imaging, blood and
respiratory specimens, including nasal and pharyngeal swabs, bronchoalveolar
lavage fluid, sputum, and/or bronchial aspirates.

In a western country, one of the tenants of medical ethics is that, if you
have capacity to consent, you can always refuse to give it. In my country, I
would be personally liable for assault if I (invasively) collected these
samples from patients _without_ their explicit consent.

It must be a terrifying situation to be in: sick, in respiratory distress, and
isolated from your family and friends in a large hospital, surrounded only by
presumably somewhat scared looking medical professionals wearing tightly
fitting face masks. I just hope that patients were _verbally_ asked if they
consented to the collection of bronchoscopy-obtained samples for research and
hopefully their diagnosis and management: it is an unpleasant procedure that,
like many things in medicine, carries a small but non-zero risk of serious
injury or death.

~~~
danieltillett
Serious this sort of thinking is what will kill hundreds of millions of
people. We are not dealing with a couple of stubbed toes or hurt feelings
here, but a novel deadly virus that is out of control. This is a war
situation.

~~~
raxxorrax
Nothing about this is a war situation. This just reads like reactionary fear
mongering.

~~~
danieltillett
...and exactly how do you know this?

~~~
raxxorrax
I don't know, Coronaviridae have neither oil nor WMD?

There might be cause for some concern like for any form of disease, but
calling it a war is ridiculous and inappropiate to describe the situation.
Even a well intentioned reading of the statement leaves much to wish for.

The common cold kills more than 50,000 people a year. 90% of media reports are
intentionally worded to dramatize the situation, so I don't think anything
warrants this classification with respect to the people deceased.

This reaction is precisely the reason why some might think about restricting
information about infections or simliar health hazards to the public.

~~~
danieltillett
So you think the Chinese government has put 50 million people into lockdown
just to dramatise the situation for some sort of media beat up?

If we are lucky the problem is not as bad as it appears, but so far nothing I
have seen suggests this is anything other than very, very serious.

------
peter303
I am impressed how fast Chinese scientists developed a genetic test
distinguish 2019-coronavirus from other kinds of pneumonia. I am old enough to
remember biologists flailing around for 4 years to identify the HIV virus and
two years more for slow (two week) test.

~~~
chrisco255
I'm not surprised. The Wuhan virology center was studying viruses just like
this and probably found this virus years ago.

~~~
caycep
Granted - this is a Hong Kong U paper...

------
caseyf7
Of the initial 41 patients, 13 were admitted to ICU and 6 died(15%). This is
the data the news has been missing and shows why China is taking this so
seriously.

~~~
mysterypie
A 15% mortality rate is huge, but considering that this is a newly identified
disease, the actual mortaility rate might be much less. Inventing some
numbers, let's say that 3000 people were already infected when the initial 41
patients were identified -- those 41 being the sickest. The other 2959 people
either didn't have symptoms or were assumed to have a cold or flu, and they
all recovered. Had there been a reliable way to identify the hypothetical 3000
infected people, the mortaility rate would be only 0.2% if 6 had died.

------
angled
My wife just pointed out what might be a spurious anecdote: no Caucasians died
during the SARS epidemic in 2003, and none have died so far in response to
this novel virus. Is there any data to back this up?

(She was in Beijing during 2003, and saw SARS first hand)

~~~
yegle
This is just one of the populor rumors during the 2003 SARS epidemic, that
because no Caucasian died from the virus, the whole epidemic is a well
organized biological war against China.

Like the other comments has pointed out, Dr. Carlo Urbarni is a doctor who
died from SARS. He's the one who warned the WHO about the new desease.

~~~
angled
Thanks for clarifying!

------
nnq
It would be interesting to see less accurate statistics on the _total CURRENT
number of cases_ rather than this OLD NEWS. Cool for whoever published that,
but we need more focus on speed of information dissemination, even
prioritising it over accurracy, we're moving at pre-Internet pace here or
someone is actively hindering the flow of info...

~~~
Geee
There's realtime statistics of non-accurate reports (most cases aren't even
diagnosed)
[https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...](https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6)

------
aaron695
We have 2700 confirmed cases, 80 dead. Some also in the West and we are still
talking about these initial 41?

Are we a pre or post internet civilisation?

Honestly 4chan is doing better than this. Reading through their noise is
better than the clean data coming out of the officials. For example they have
people in pools of blood on the street with people in the bio suits China are
using.

Maybe it's obvious people will throw up blood with this new SARS, but the
officials aren't mentioning it. Sperm may contain the virus for months. Again
obvious, not seeing it on official feeds.

~~~
malandrew
Where are you getting the 2700 and 80 numbers from? I couldn’t find a reliable
up to date counter. Even the CDC only lists countries.

~~~
sanxiyn
WHO is now publishing daily situation reports:
[https://www.who.int/emergencies/diseases/novel-
coronavirus-2...](https://www.who.int/emergencies/diseases/novel-
coronavirus-2019/situation-reports/)

~~~
adrianmonk
Their "Situation Report - 7" link is broken (points to something, but the
wrong document).

I managed to guess the correct URL:

[https://www.who.int/docs/default-
source/coronaviruse/situati...](https://www.who.int/docs/default-
source/coronaviruse/situation-reports/20200127-sitrep-7-2019--ncov.pdf)

This says 2741 confirmed cases in China and 2798 globally.

