
U.S. Identifies First Coronavirus Case Without Outbreak Ties - siftrics
https://www.bloomberg.com/news/articles/2020-02-27/u-s-identifies-first-coronavirus-case-without-ties-to-outbreak
======
kenneth
As someone living in Hong Kong, it kind of blows my mind how little attention
Americans have given this situation. All but a few Americans have their head
in the sand on this, and the markets have not at all priced in the all but
certain long term impact of this.

I've personally broken my long-time rule of no trading public markets and
opened a Robinhood account to hedge against this. So far this week I'm up 5x
on those hedges. Markets are starting to realize, but I don't think we're even
close to having fully priced in the impact of this.

Everybody remembers the 2008 recession. A subset of people during that
recession made a killing. The Big Short was a great book (and movie) about
this. This is probably the first new opportunity to be a "big shorter."

~~~
lettergram
I think it's because the death rate is hard to track and while "high" does not
seem nearly as bad as the spanish flu. In part, the damage appears to be
China's methods of trying to contain the virus that are making it worse...

For instance, the death rates appear to have a distribution mostly impacting
the elderly (incidentally those who are also most likely to have a weaker
immune system, but also believe in less conventional medicine:

80+ years old 14.8%

70-79 years old 8.0%

60-69 years old 3.6%

50-59 years old 1.3%

40-49 years old 0.4%

30-39 years old 0.2%

20-29 years old 0.2%

10-19 years old 0.2%

0-9 years old no fatalities

[https://www.worldometers.info/coronavirus/coronavirus-age-
se...](https://www.worldometers.info/coronavirus/coronavirus-age-sex-
demographics/)

Not saying this isn't bad, the current stats are showing something around a
0.7% mortality rate[2][3]. The real scare here, is like the spanish flu,
there's a chance it can evolve into a more deadly strain (such as SARS) the
more people who contract it. If that's the case, we could be seeing 10%
fatality rates across the board.

If you're interested in the history of the spanish flu, there's a great series
here:
[https://www.youtube.com/watch?v=XQ9WX4qVxEo&list=PLhyKYa0YJ_...](https://www.youtube.com/watch?v=XQ9WX4qVxEo&list=PLhyKYa0YJ_5BZ3gQleTk-
PJqIejFf4Rh2)

In any case, general point, people American's aren't super worried about it
because we have a great healthcare system, and it's spread is limited thus
far. I do think a panic will set in as every major city likely now has
infected individuals. So it's a good time to pull out of the market.

[2] [https://www.statnews.com/2020/02/25/new-data-from-china-
butt...](https://www.statnews.com/2020/02/25/new-data-from-china-buttress-
fears-about-high-coronavirus-fatality-rate-who-expert-says/)

[3] [https://www.marketwatch.com/story/coronavirus-
update-79339-c...](https://www.marketwatch.com/story/coronavirus-
update-79339-cases-2169-deaths-clusters-emerge-in-iran-and-italy-2020-02-24)

~~~
kenneth
Extra history is fantastic, thanks for sharing.

The problem here isn't with the mortality per se, it's with the strain on
healthcare resources. We just don't have the capacity to deal with an influx
of cases requiring hospitalization. Currently about 10%+ of COVID-19 require
that. We don't have the beds, the oxygen support, the ventilators, and
generally the ability to keep these people from infecting others. That leads
to scenes like in Wuhan where people get turned away from hospitals, where
they end up dying at home, where bodies require mass cremation, etc. This
could happen anywhere. The US healthcare system is not prepared for this. (I
don't believe for a second in the assertion that it's the best in the world.
Perhaps quality of care is good, but the system that pays for it is a joke.
But it's also hugely variable, with some great hospitals attached to
university research centers, and a ton of terrible underfunded ones.)

~~~
joering2
There was article yesterday that one of cruise passenger coming back to USA
felt weak and had fewer, but Miami Hospital told him it will cost $3,700 to
test his blood. He went home without testing and 3 days later came back with
positive result for cornv-19. so much for “best healthcare” if you can’t
afford it.

~~~
extradego
What a joke. Sometimes I am just amazed America still exists.

------
prepend
> It took four days for the patient to be tested for the coronavirus by the
> CDC, according to the letter, because the patient didn’t fit the initial
> criteria of a likely patient. The CDC confirmed the diagnosis on Wednesday,
> according to the report.

This is what’s scary to me as that means the patient probably wasn’t isolated
with daily healthcare.

Does this mean everyone who came in contact with them during that time is self
monitoring for symptoms for some large number of days?

~~~
csomar
My guess is that the world didn't really understand what and why China did
take such draconian measures (Shutting down whole cities, locking people in
their homes, stopping transportation, building hospitals in record time,
etc...). From the graph it looks like China successfully contained the
disease. China has around 78,500 cases; around 65,000 of those are in Hubei
which has 50 million people.

If we were to extrapolate these numbers to the rest of the world (ex. China),
that would be around 8.19 million cases and around 350k deaths. But this
assumes that the cities of the rest of the world could implement the strict
curfews that China implemented.

It's also important to remember that Hubei had a big support network of
neighboring cities which could provide resources. Countries where all cities
will break out at the same time will have a hard time copping.

~~~
jmnicolas
I'm not sure I can trust China's numbers. Judging by their reaction I expect
the real numbers to be much worse than 70k cases.

~~~
SirLotsaLocks
remember what the USSR did with chernobyl? They constantly downplayed the
numbers to save face. I suspect that's what they're doing here. No 100%
guarantee but considering the CCP's record of doing everything they can to
maintain their pride and not showing weakness this would make sense.

~~~
Balgair
The 1918 flu killed ~0.01% of Philadelphia in one winter.

The Liberty Loan Parade on September 28th was a major event in the pandemic.
Health officials knew that the flu was in Philadelphia and had warned City
Officials about it in very clear terms. The parade continued on and 3 days
later, people started showing up to hospitals, just as predicted. The morgue
was rated for 36 bodies. _Hundreds_ came in every day that winter. They had
priests operating backhoes to bury the dead, as the workers were too sick to
do so. The entire city was quarantined.

Still, newspapers published day after day that everything was fine, despite
the obituaries becoming an ever thickening section. People knew and it wasn't
hard to guess.

The Soviets did it with Chernobyl, the Chinese are doing it right now, and the
US did it nearly 100 years ago.

These are _human_ things, not specific to any country.

------
sciinfo
Here are estimates from MRC Centre for Global Infectious Disease Analysis at
Imperial College:

=> Estimated fatality ratio for infections 1% (including those who with mild
cases and don't go to see doctors)

=> Estimated Case Fatality Rate (CFR) for travellers outside mainland China
(mix severe & milder cases) 1%-5%

=> Estimated CFR for detected cases in Hubei (severe cases) 18%

The last line (18%) applies when the outbreak becomes prevalent in an area and
overwhelm hospital capacity.

No country has sufficient ventilators, ECMO machines, and medical staff if
infections become widespread since about 20% of infections requires
hospitalization. People who need medical care from other causes would suffer
from resource shortages as well. _If not contained, dozens of cities around
the world may become Hubei!_

Marc Lipsitch, Professor of Epidemiology at Harvard, believes that it might
infect 40-70% of population (excl. kids) without effective control measures.
His articles here:
[https://twitter.com/mlipsitch/status/1232504457377861632](https://twitter.com/mlipsitch/status/1232504457377861632)

\--

Reference: Report 4 here: [https://www.imperial.ac.uk/mrc-global-infectious-
disease-ana...](https://www.imperial.ac.uk/mrc-global-infectious-disease-
analysis/news--wuhan-coronavirus/)

From Report 6: "we estimated that about two thirds of COVID-19 cases exported
from mainland China have remained undetected worldwide, potentially resulting
in multiple chains of as yet undetected human-to-human transmission outside
mainland China."

For concise interviews with experts and other info: Follow their Twitter at
@MRC_Outbreak
[https://twitter.com/MRC_Outbreak](https://twitter.com/MRC_Outbreak)

~~~
sciinfo
For people thinking it is just like SARS, MERS, or Swine Flu, check out these
graphs: [https://ncov.r6.no/](https://ncov.r6.no/)

~~~
bamboozled
According to one of those graphs it has a 50% fatality rate? Seems a little
surprising.

~~~
tree3
No, the graphs that have both solid and dashed lines have two separate
vertical axis on the left and right.

~~~
bamboozled
Sorry, that was unclear to me. You're right.

------
testfoobar
Reading the Washington Post article:

[https://www.washingtonpost.com/health/northern-
californian-t...](https://www.washingtonpost.com/health/northern-californian-
tests-positive-for-coronavirus-in-first-us-case-with-no-link-to-foreign-
travel/2020/02/26/b2088840-58fb-11ea-9000-f3cffee23036_story.html)

"There are indications that other hospitals could be involved in the case.
Kris Concepcion, fire chief and acting public information officer in
Vacaville, Calif., said county officials had issued a directive not to
transport any new patients to two local hospitals — NorthBay VacaValley
Hospital in Vacaville and NorthBay Medical Center in nearby Fairfield.
Concepcion declined to say why those orders had been given."

Are these hospitals open now?

------
nullc
I'm confused about the Coronavirus mortality figures. The published numbers
appear to be computed as deaths/cases. But cases is growing exponentially and
deaths take time.

If you use deaths/(deaths+recoveries) you get a much higher figure, but
presumably recoveries take longer than deaths.

~~~
axaxs
This absolutely isn't accurate. The website promoting this garbage is
dangerous. Nobody knows the total infected, nor the real fatality rate. But
pay attention to how many on the cruise liners have died. 14% is a joke. My
completely off the cuff, uneducated guess would be closer to 3%.

~~~
javitury
3% fatality rate with appropriate (if not the best available) medical
attention and resources

------
nl
The big problem when Covid19 hits the US won't be the number of deaths
(although of course there will tragically be many).

It will be the number of medical bankruptcies.

Also it'll be interesting to see how much more contagious it will be in a
country where people avoid hospitals because of the cost.

~~~
AnthonyMouse
Why would you expect medical bankruptcies for something without any existing
treatment? There is nothing to pay for.

The bigger problem is people who keep going to work when they're sick instead
of staying home.

~~~
nl
Even the test is thousands of dollars.

[https://www.google.com/amp/s/amp.miamiherald.com/news/health...](https://www.google.com/amp/s/amp.miamiherald.com/news/health-
care/article240476806.html)

And treatment for at least some cases involves hospital stays similar to
pneumonia.

~~~
AnthonyMouse
Everything is thousands of dollars in a hospital emergency room. They charge
hundreds of dollars for a band aid. It's not the place to go for a routine
diagnostic test if you care at all about the price.

~~~
nl
I don't think coronavirus is a routine diagnosis. CDC missed the one this
story bid about for example.

~~~
AnthonyMouse
The test that cost thousands of dollars in your article was the routine
diagnostic test for the flu. It didn't cost thousands of dollars because it
was for the coronavirus, it cost thousands of dollars because it was done in
an emergency room.

~~~
nl
Sure, but the CDC is referring travellers with flu-like symptoms to hospital.
It's not an outrageous thing to have done.

 _As of February 23, 11 travelers were referred to a hospital and tested for
infection; one tested positive and was isolated and managed medically._

[https://www.cdc.gov/mmwr/volumes/69/wr/mm6908e1.htm](https://www.cdc.gov/mmwr/volumes/69/wr/mm6908e1.htm)

------
SubiculumCode
Having this patient at my place of work does not worry me at all. Not one bit.

Time to use some of my vacation days.

Note: I'm not a medical practitioner, I am a research scientist and can do my
work remotely. I admire and applaud the doctors and nurse who are there, and
UC Davis has some of the best.

------
deniscepko2
I kinda foresee this spreading in US the worst, people who work in low paid
jobs like McDonalds (which requires lots of people contact) rarely take sick
days there as far as i remember.

------
neonate
[https://archive.md/LI2XJ](https://archive.md/LI2XJ)

~~~
briandear
Why do you always post archive links? Isn’t that a copyright violation?

~~~
DecoPerson
Telling someone where to find drugs is not illegal (in the US — unless you’re
compensated).

I imagine it’s the same for copyrighted material?

