I also assumed that the death rate was lower due to under-diagnosis of mild cases -- until a few hours ago when I asked a few questions to someone with connections to Wuhan.

The response indicated that the deaths were likely significantly under-reported, as in: not counting the people dying while waiting to get into the hospital, or who never make it there. Plausible since there is both no incentive to report higher rates than confirmed, and not a lot of spare bandwidth to test cases already lost.

The real question now is which is more under-reported, cases or deaths. Either way, reading here details of the mechanism of death, it is far too virulent and deadly for complacency.

Looks like the prevailing approach is a very healthy Normalcy Bias.

Why are they building 12 hospitals at breakneck speed for a severe cold? Do you honestly believe that?

Wuhan's Healthcare system could not handle a widespread cold break out either.

Much of the rest of the world has sufficient capacity to hospitalize patients to prevent an outbreak. China being China is behind both due to recent industrialization and also an authoritarian state which lied about the dangers.

Take it how you want, but this is a severe flu which would not have survived in more industrialized nations.

Saying that it's an order of magnitude less deadly than SARS doesn't exactly allay any concerns when it's still at least an order of magnitude more deadly than the flu, and probably twice as communicable. "A severe form of the cold" is the understatement of the century.

I agree, It's viral pneumonia for those over 60 and heavy smokers. China has 240M people who are 60 or older. Assuming a 2% mortality in that population and the fact that many of the younger infected have mild symptoms, 1/4 to 1/2 of these folks may be infected in the next 3-6 months. That's 1-2M fatalities.

Everyone is a heavy smoker in China; air pollution levels and all that. So that stacks the odds against them already.

Statistics I saw indicated that 2% of women smoke and 60% of men. This may account for a gender-linked differential between more serious outcomes for men, it could be a selection for smokers. I agree that the air pollution may push even non-smokers into the risk category for smokers in other countries and push smokers into a deeper level of risk.

I'm using his mortality rate of 1%. That's 20x the mortality rate of influenza in the US. If it's 2% like the media reports then it's 40x. It doesn't really matter to me, either way is too deadly for my liking.

You have to remember that when a virus is new and spreads quickly, resources and medical care around the area are strained.

Look at the mortality rate outside of Wuhan to see what the real mortality under a controlled environment look like.

That's part of the problem though. Mortality rate outside of Wuhan reflects the mortality rate under ideal conditions (enough ICU beds, enough ventilators and ECMO, etc.) Mortality rate within Wuhan reflects the mortality rate under pandemic conditions.

If the rest of China looks like Hubei in a few weeks, we will be in pandemic conditions throughout all of China. If other countries start to look like China in a month or two, we will be in pandemic conditions throughout the world.

> If other countries start to look like China in a month or two, we will be in pandemic conditions throughout the world.

Your "if" is completely unfounded. Outside of China infections are not following any exponential trend at all.

Many under 60 exhibit mild symptoms. Surveillance in Thailand and Malaysia may not be catching many of the infected.

Some of the "repatriates" flown to Travis AFB in California, near SF, have been admitted to the hospital now, showing symptoms... This is being reported in local news as of this evening.

No hospital has been overrun by patients outside of China yet despite high awareness of symptoms.

Good point. I hope that continues to be true.

Yet.

Several weeks already. How long does this super highly infectious disease take to spread outside of China? You have to wonder the claims made on transmission at this stage.

The disease takes about 2-3 weeks to run its course through each patient. It’s slow burning and mildly yet unpredictably lethal. That sounds innocuous but it is a recipe for disaster.

Transmission seems clearly far less bad than initially thought. If it were exponential we should be at millions infected right now.

China only has capacity to test a few thousand patients per day...

From "Coronavirus outbreak 'just beginning' outside China, says expert" (Feb 12 2020) https://www.reuters.com/article/us-china-health-singapore-in...

The Chinese government’s senior medical adviser has said the disease is hitting a peak in China and may be over by April. He said he was basing the forecast on mathematical modelling, recent events and government action.

Dale Fisher, chair of the Global Outbreak Alert & Response Network that is coordinated by the World Health Organization, said that predicted “time course” may well be true if the virus is allowed to run free in Wuhan.

The flu-like virus has killed more than 1,100 people and infected nearly 45,000, predominantly in China and mostly in Wuhan.

Singapore has reported 50 coronavirus cases, one of the highest tallies outside China, including mounting evidence of local transmission.

[...]

Asked why there were so many cases in Singapore, he said there were comparatively more tests being conducted on the island.

“We have a very low index of suspicion for testing people so...we do have higher ascertainment,” he said, but added that there was a lot about transmission of the virus yet to be understood.

You sound a lot like the Wuhan government circa late December/early January.

I'm not sure what to tell you. Unless you think that this virus somehow only targets people living in China, it's only a matter of time before it takes hold in other countries. This is not one that you can simply quarantine and isolate away like SARS. This one seems to be communicable at the earliest onset of symptoms, or even perhaps before.

Its been several weeks already people are infected in several countries. Yet no sign of pandemic outside of China. I dont know what other facts you need.

First recorded patient in Wuhan was December 8. It’s been 2 months since then. Even exponential growth takes some time.

Don’t you think there is a difference when no one is aware (back in December) and the way it is now?

Not too much, no. But we will know who is right in just a few weeks, so we’ll see.

Fast quarantine for example is one big difference. People with symptoms that could be Corona related going to hospitals is another big difference. Tests being developed. Hospitals being on alert. But believe whatever you want.

That certainly helped with SARS. But nCov appears to be transmissible at the time symptoms appear or even earlier. That is a big difference from SARS and makes self-isolation and quarantine significantly less effective.

So we went from "no difference at all" to "the differences won't matter". If want to panic, do it. But please don't spread it, online or offline. Already too many people are doing just that.

While there may be some other protective factors, the status of the infection in North America is similar to what it was in China in early December (the likely start of the outbreak).

It’s going to become endemic and seasonal. We will need to build up a resistance. Too many will die.