Unnecessary Panic Over Coronavirus?

Unnecessary Panic Over Coronavirus?

My first thought was this was an Indonesian wet hijab contest.

But, no. They are spraying people so that the spray seeps into skins and into bodies to kill the home of the virus. Maybe. I hope. Or perhaps they are just panicking.

On Friday the Drudge headline was School District Closes For Two Days After 600 Students Call In Sick.

An entire school district in Ohio was shut down for two days this week after nearly 600 students called in sick, the district’s superintendent said…

Many of the students have the same symptoms, such as high fever, vomiting and body aches…

There’s nothing in the story about the new coronavirus, but the story was embedded in a series of such stories. Like how the USA is going to quarantine foreigners for two weeks at some (at the time) undisclosed location if they had traveled to the States from China’s Hubei’s province. Is that happening? Or was this only rumor?

Italy had barred all flights from China by Thursday night. They defined China as China, Macau, Hong Kong, and Taiwan. Taiwan? Ah, politics. The WHO lists Taiwan as part of China, and WHO’s on first. Singapore followed suit, but was more careful about their country definitions. Vietnam wasn’t as careful.

Lots of airlines have cut off new flights to China.

China themselves have quarantined several cities, leading to all sorts of difficulties. Like how to feed the quarantined.

Is this level of hyper-concern warranted?

Here are the Numbers!

There were, in the United States alone, in the week ending 25 January, over 19 million cases of disease. There were 180,000 hospitalizations. And—the big one—about 10,000 deaths!

That’s a lot, isn’t it? Worse, 68 of these deaths were in infants. The rate of infection for 65+ was 71.3 per 100,000, which is huge.

Quoting directly: “6.7% of the deaths occurring during the week ending January 18, 2020 (week 3) were due to P&I. This percentage is below the epidemic threshold of 7.2% for week 3.”

Quoting who? The CDC. A known authority.

About this year’s flu.

Which has not yet reached its peak, or is maybe at the peak, but in any case with several more weeks of flu season to go. That “P&I” is pneumonia and influenza.

This year’s flu, which sounds awful, and is as far as body count goes, is not as bad as it was two years ago. Indeed, this is a mediocre year, as this plot shows:

Two years ago was twice as bad as this year’s horrible numbers. But I don’t recall a panic then, and there isn’t one now, either. About the flu. Importantly, there weren’t any travel restrictions or extraordinary measures taken to contain the flu then or now, yet the flu each year, as it does, burned itself out for all the reasons you already know (it gets warmer, people go outside, etc.).

Corona

What about the coronavirus? Here are the numbers, as of 7 PM Sunday night EST (Monday morning in Asia).

According to one source, cases were 17,386 worldwide with deaths 362. Are these the true numbers? We hear all kinds of rumors out of China, and China being China some of these are probably true, or they are in the right direction. Perhaps the death counts are higher. I do not know.

However, conditional on these numbers, as all probability is conditional on the assumptions we make, I fit a naive R nls/SSlogis logistic curve to both data sets. You can see the predictions. Unfortunately, the nls method doesn’t have prediction intervals implemented yet, so I can’t show you the +/-. There are many other ways to fit this curve which will give them, and maybe we can do them together in a class.

That’s not the point of the picture though. I do not swear to the prediction (fit is lousy in the beginning), but I do caution against plotting raw exponential-only curves as I’m seeing elsewhere (e.g. this). It cannot be that the number of new cases and deaths will increase without limit exponentially. When the panic/concern started a week or so back, I saw some projections of 1,178,144 deaths by 21 February using these kinds of exponential models.

Most infections follow something like a logistic curve, like SARS, which might also with MERS (via a camel intermediary) have originated in bats. The naive curve above might not be catching the recent increase, but the idea is likely not far wrong. Yet there could be another strong upward kick, though its a good bet it settles down globally like a logistic curve. Maybe the middle prediction at this link is better: 60,000 total cases by the end, 2.2 times this naive fit, which would give about 1,355 deaths.

Here’s more numbers:

When epidemics start only the sickest go to hospital to get treated, hence the early high mortality rate. As publicity increases, more people who really didn’t need special treatment go to get checked, and the mortality rate decreases. A good indication we’re settling down is the flattening of the mortality rate. If these are the right numbers; again, I don’t know.

Publicity thus also drives cases. On the other hand, since the coronavirus is a cold virus which in robust people will seem like a cold, so many cases will go unreported. How many I don’t know. Obviously these unreported cases are not dying, though.

Breathless

Some of the panic seems to be settling down. Yet breathless is one word to describe how people react to each new report. Here, for example, is one Dr. Eric Feigl-Ding, who tweeted “Whoa- the rate of increase ***outside of China*** is steeper than inside of China or Wuhan! Figure 1A. From: @TheLancet ‘Nowcasting and forecasting the potential domestic and international spread of 2019-nCoV http://bit.ly/2GF6gZP’)”. I replied (including my typo), “Well of course it is. Being a novel virus to a new, uninfected area, and the rate of increase necessarily is higher than in an area where is it extant. The rate of increase on the price a new widget, previously non-existent, is infinite.” Make that bring not being.

I never did hear back from Fiegl-Ding (what a fun name!).

Am I wrong in sensing that some want this to be worse than it seems to be?

Control

It is obvious that all the control measures governments and people are taking will reduce the infection rate. Would the spread be worse had these measures not been taken? Well, to some extent, yes. But to what extent? That’s a counterfactual question you can’t answer by appealing to observations.

For example, it must be that a strict quarantine (true isolation) of a infected man keeps that man from spreading his disease. The quarantines in place appear to be rather leaky, though. And on the other hand, the far worse flu of two years ago burned itself out without extraordinary precautions, as it does every year. So maybe we’re fooling ourselves with our “solutions.” But then flu deaths are huge!

The global instant news cycle is driving some of the panic/concern. Officials, or some of them, must be reasoning that it’s better to do something just in case. If the something they do wasn’t needed, they’ll be able to point to all the other officials and say “Everybody’s doing it.” On the other hand, whatever deaths there are outside China will be blamed on those same officials.

As of this writing, and using the same data source, all the deaths save one were in China. The other was in the PI. The USA had 9 cases, no deaths.

Sure, the new coronavirus might bust out everywhere. Or again it might not. Taken together, this is a tautology that does not given any information about what to do.

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23 Comments

  1. Um, the coronavirus is *not* a cold virus. Those are rhinoviruses (upper respiratory tract) for which there are several hundred subtypes and none of these have been shown, to date, to be zoonotic. This is a zoonotic virus and is somewhat like the influenza virus, in that it is more of a lower respiratory virus and is a variant of the corona ARDS/SARS and MERS viruses. Many respiratory system viruses do spread in the ‘cold’ seasons, that is late autumn, winter and early spring.

  2. Gary

    New infection.
    No vaccine.
    Uncertainty about spread.
    At least it might make people more cautious when they get the sniffles and thereby slow the influenza as a threat.

  3. Sheri

    Remember when an epidemic was more than a tiny portion of the population and the death rate well over 50%. Seems we managed to wipe out all the big scary diseases, so now we have to exaggerate and wring hands over everything. A measles epidemic is less than 100 people in a country of 330 million. We are terrified of tiny insects, having defeated the giants.

  4. Ray

    I remember the SARS panic. IIRC, an estimated 8,000 people contracted the infection and about 800 died, mostly in China. Many people who got the virus died from treatable secondary infections. If the virus doesn’t kill you some opportunistic germ might.

  5. Thanks as always for a breath of statistical sanity in a sadly innumerate world, my friend, very well done.

    w.

  6. Karl

    How did you get the mortality rate? Newest data I could find is 362 dead and 530 recovered. This gives a mortality of about 40%.

    There about 17489 total cases. Those who are infected might die or recover. I don’t know and I don’t see a basis for including them in a calculation of a
    mortality rate.

    Data from China must be underreporting mild cases. A possibility to avoid this problem is to look at cases outside China. That gives 1 dead and 9 recovered. Not much for a statistic. 183 cases outside China will soon allow give a better basis.

    Please explain how a mortality rate of about 2% was calculated.

  7. Fredo

    What’s astonishing are the suppositions and conclusions people are jumping
    to online, Agenda 21, Bill Gates, UN, CDC, FDA, and the luciferians are all
    plotting to wipe out humankind. It’s ironclad logic ; this is how the 1%’s will
    replace the 99% with robots so they can tool around in space. LOL

    No doubt governments are monitoring and quantifying all public reactions
    to the vagary’s and unknowns of the current situation. There will be
    months and years of statistical assessment of the most obscure data
    imaginable. A bureaucratic wet dream come true with an endless parade of
    nebulous hypothesis to occupy acres of warehouses filled to the brim with
    filing cabinets. The sign over the door will read, ‘ALIENS WELCOME”.

  8. Hun

    The one death outside of China was a Chinese man from Wuhan, so it barely counts as a foreign death.

  9. Sander Van Der Wal

    To get an idea about the validity of the reported numbers, you can also look at other government actions regarding this new disease. For instance, would one build a brand new hospital in 10 days for a disease with the reported numbers?

  10. vince

    Vi “r” Us

    vide infra

    toyed with

  11. GamecockJerry

    About that hospital. Why does it have bars on the windows?

  12. Hun

    The hospital has bars on the windows because it’s a hospital, why else? Are you suggesting some weird conspiracy?
    We are supposed to doubt the numbers coming from China, but the official story about this hospital is 100% true.

  13. Uncle Mike

    Dear cdquarles,

    The corona virus is indeed a common cold virus. Check it out on Wiki.

    Viral respiratory infections can be fatal if the patient has a compromised immune system, but mostly colds don’t kill. The attribution of mortality to a cold virus is imprecise because there are always other factors.

    With a population of 1.4 billion people and a mortality rate of 7 to 10 deaths per thousand per year, China experiences ~300,000 deaths per day from all causes. According to the (highly questionable) reports, the corona virus is (allegedly) responsible for an additional 20-30 deaths per day.

    However this is no reason not to panic. Panic seems like an entirely rational thing to do. I suggest that you sell your portfolio and convert the cash to gold bullion and ammo, stash it in your bomb shelter, then get inside and lock the door. If somebody comes a knocking, don’t let them in. If nobody knocks for a year or so, stick your head out and scope the situation very carefully. Safety first!

  14. Fredo

    Dear Mike,
    Forget the gold go for the ammo. With ammo you can barter with
    conviction for gold or pretty much anything else you might want. No ones going
    to make change for an ounce of gold it won’t be worth a bushel of turnips.

  15. Uncle Mike

    Dear Fredo,

    I apologize for firing on the paranoid delusionals. It’s just that last week the Mass Mediocracy caused a corona panic, and the S&P dropped 3%. That cost me and rasped my a$$.

    But today the market came back as sanity triumphed over insanity, so I’m feeling better. I resolve to be kinder and gentler to the impaired twit wee todd alarmatroids, because they are God’s chillin, too, even if they are “on the spectrum.”

  16. Wiki’s wrong about that. Respiratory system virus yes. Cold viruses are rhinoviruses and only rhinoviruses.

  17. Joy

    One of the things I remember about Uncle Mike is that he tries to go nowhere near cities and busy airports etc. Meticulous! Don’t know why that image stuck.
    My advice,
    When using an excavator use the heel of your hand just for balance.
    don’t press buttons on lifts. use your knuckle or pisiform.
    Always let someone else open the door in the public loos or take dry tissue to open the door then drop in behind the door on your way ou.
    Always do these things. Your hand cleanliness is only as good as the last person who touched the thing.

    People don’t wash their hands when they know they should. They cough openly without putting their hand over.

    Don’t rub your eyes. Most olds are caught through rubbing your eyes after touching something nasty!
    Men, the elderly, the very young and otherwise immune compromised have a worse reaction. Men? because their inflammatory reaction is greater, marginally, I think. So man flu is worse, same for colds.

  18. Joy

    An excavator!! I meant an escalator. Never use an excavator without proper training.

  19. J Moore

    Based on what I am seeing from the epidemiologists (as opposed to the press), without significant control measures, the disease will kill a lot of people. This is based on an estimate, of course, of the reproduction number – which is at a level (>2) to create a rapid exponential increase in infections until the world’s population has developed enough immunity that R0 will go back down. Note, of course, that any epidemic/pandemic will have an exponential increase in infections until something slows it.

    In other words, if you are not in China, don’t panic. But, serious control measures must be taken.

    Now one can argue that the deaths will be less than from this year’s seasonal influenza, but the evidence so far suggest otherwise – if the disease is not checked.

    2019-nCov is quite dangerous, if the approximately 2% mortality rate holds up. It’s contagion is perhaps less than SARS, but SARS was very dangerous and we dodged a bullet by rapidly implementing containment methods.

    One may sneer at that rate, but are you willing to take a 1/50 chance of death from a disease than should be stopped and never threaten you? And, let’s say the mortality is overestimated by a factor of 10 – would you get on an aircraft with a record of fatal crashes of 1 in 500 flights?

    Of course, there are a lot of unknowns. For example. how many people are asymptomatic with the disease, which means they both are not discovered by the health system, and are spreading the disease. Also, the case fatality rate is tied to that same issue and others – so how deadly it is in the wild is not really known.

  20. Amateur Brain Surgeon

    ABS is just coming to full recovery from the Y2K virus and now this?

  21. Roy Case

    What do you have to say now?

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