Note: This thread is related to #COVID19.

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Eric Feigl-Ding
+ Your AuthorsArchive @DrEricDing Epidemiologist & Health Economist. Health Justice & Policy. Senior Fellow, FAS. Former 16 yrs @Harvard. @JohnsHopkins & @HarvardEPI alum. COVID updates Jan’20- Jan. 25, 2020 3 min read

HOLY MOTHER OF GOD - the new coronavirus is a 3.8!!! How bad is that reproductive R0 value? It is thermonuclear pandemic level bad - never seen an actual virality coefficient outside of Twitter in my entire career. I’m not exaggerating... #WuhanCoronovirus #CoronavirusOutbreak

2/ “We estimate the basic reproduction number of the infection (R_0) to be 3.8 (95% confidence interval, 3.6-4.0), indicating that 72-75% of transmissions must be prevented by control measures for infections to stop increasing...

3/ ... We estimate that only 5.1% (95%CI, 4.8-5.5) of infections in Wuhan are identified, and by 21 January a total of 11,341 people (prediction interval, 9,217-14,245) had been infected in Wuhan since the start of the year. Should the epidemic continue unabated in Wuhan....

4/ we predict the epidemic in Wuhan will be substantially larger by 4 February (191,529 infections; prediction interval, 132,751-273,649), infection will be established in other Chinese cities, and importations to other countries will be more frequent. Our model suggests that..

5/ travel restrictions from and to Wuhan city are unlikely to be effective in halting transmission across China; with a 99% effective reduction in travel, the size of the epidemic outside of Wuhan may only be reduced by 24.9% on 4 February. Our findings are...

6/ ...critically dependent on the assumptions underpinning our model, and the timing and reporting of confirmed cases, and there is considerable uncertainty associated with the outbreak at this early stage. With these caveats in mind, our work suggests that...

7/ a basic reproductive number for this 2019-nCoV outbreak is higher compared to other emergent coronaviruses, suggesting that containment or control of this pathogen may be substantially more difficult.”!!!! #wuhanvirus #CoronavirusOutbreak #ChinaCoronaVirus ...

8/ ... SUMMARY: so what does this mean for the world??? We are now faced with the most virulent virus 🦠 epidemic the world has ever seen. An R0=3.8 means that it exceeds SARS’s modest 0.49 viral attack rate by 7.75x — almost 8 fold! A virus that spreads 8 faster than SARS...

9/ ...cannot be stopped by containment alone. A 99% quarantine lockdown containment of Wuhan will not even reduce the epidemic’s spread by even 1/3rd in the next 2 weeks. Thus, I really hate to be the epidemiologist who has to admit this, but we are potentially faced with...

10\ ... possibly an unchecked pandemic that the world has not seen since the 1918 Spanish Influenza. Let’s hope it doesn’t reach that level but we now live in the modern world 🌎 with faster ✈️+ 🚞 than 1918. @WHO and @CDCgov needs to declare public health emergency ASAP!

11/ REFERENCE for the R0 attack rate (reproductive coefficient) of 3.8 and the 99% containment models come from this paper: 

12/ What is the typical R0 attack rate for the seasonal flu in most years? It’s around an R0=1.28. The 2009 flu pandemic? R0=1.48. The 1918 Spanish Flu? 1.80. This new #WuhanCoronavirus reproductive value again? R0=3.8. (Flu reference: )

13/ ...and it gets even worse, the Lancet now reports that the coronavirus is contagious even when *no symptoms*: specifically: “crucial to isolate patients... quarantine contacts as early as possible because asymptomatic infection appears possible”! 

14/ Let’s pretend the 3.8 estimate is too high (there’s unpublished estimates of 2.5). even if this virus’s R0=2.5, that’s still 2x higher than seasonal flu’s 1.28 (ref above), and higher than 1918 Spanish Flu pandemic of 1.80 that killed millions. So 2.8 is still super bad folks

You can follow @DrEricDing.


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