nCov Cases In China Jump to 43,652 - 20,438 Confirmed 23,214 Suspect

[niman]

2788 severe cases with cumulative deaths 425 cases, 632 cases were cured and discharged

http://www.chinacdc.cn/jkzt/crb/zl/szkb_11803/jszl_11809/202002/t20200204_212199.html

[niman]

　At 04:00 on February 3, 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps reported 3235 newly confirmed cases (2345 in Hubei Province) and 492 severe cases (442 in Hubei Province). There were 64 death cases (64 cases in Hubei Province), 157 newly cured cases (101 cases in Hubei Province), and 5,072 suspected cases (3182 cases in Hubei Province).

　　As of 24:00 on February 3, the National Health and Health Commission has received a cumulative report of 20,438 confirmed cases (2 nuclear reductions in Heilongjiang Province ) in 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps . There are currently 2788 severe cases with cumulative deaths There were 425 cases, 632 cases were cured and discharged, and there were 23214 suspected cases.

　　At present, 221,015 close contacts have been tracked. 12,755 people were released from medical observation on the same day, and 171,329 people are currently receiving medical observation.

　　A total of 33 confirmed cases were reported in Hong Kong, Macao and Taiwan: 15 in the Hong Kong Special Administrative Region, 8 in the Macao Special Administrative Region, and 10 in Taiwan.

　　(Information comes from the official website of the National Health Commission)

[Jon Schultz]

Dr. Niman, What do you think of the idea that the case fatality rate may not be very high because there are likely many people who are infected but haven't gotten sick or very sick? Arguing against that is the incidence of sick people 1) being turned away by the hospitals and not being tested; 2) not going to the hospitals for one reason or another, such as fear their family will be quarantined; and/or 3) dying at home or in the hospitals without being counted an nCov fatality (i.e. if their test wasn't double-confirmed or they had an underlying condition which was exacerbated by the virus).

Actually 1) and 2) above don't directly affect the number of deaths outside of 3), but I'm not sure there's any evidence that there are a lot of people who are infected but haven't gotten sick or very sick. 

And then the CFR should go up, of course, in areas where hospital or medical care is no longer available.

Edited February 4, 2020 by Jon Schultz

[niman]

2 hours ago, Jon Schultz said:

Dr. Niman, What do you think of the idea that the case fatality rate may not be very high because there are likely many people who are infected but haven't gotten sick or very sick? Arguing against that is the incidence of sick people 1) being turned away by the hospitals and not being tested; 2) not going to the hospitals for one reason or another, such as fear their family will be quarantined; and/or 3) dying at home or in the hospitals without being counted an nCov fatality (i.e. if their test wasn't double-confirmed or they had an underlying condition which was exacerbated by the virus).

Actually 1) and 2) above don't directly affect the number of deaths outside of 3), but I'm not sure there's any evidence that there are a lot of people who are infected but haven't gotten sick or very sick. 

And then the CFR should go up, of course, in areas where hospital or medical care is no longer available.

The low CFR is low because they are using all who have been diagnosed in the denomination,so the calculation assumes all who are hospitalized and alive,will be discharged. At the early stages,a CFR should be calculated on OUTCOMES (as in died or discharged).  In tonight's update China is reporting 425 dead and 632 discharged,so the CFR based on OUTCOMES is currently at 40.4%.  The CFR for the first 34 outcomes at Wuhan was 17.6%, with 7 more still hospitalized,  Tonight's interview,which will be posted in the morning,discusses the CFR at length, including the two Lancet papers on the first 99 cases at Wuhan.

[Jon Schultz]

Yes, but in addition to calculating the CFR without regard for outcomes, some people are also saying that the real CFR is probably much less than 2% because there are probably many people who are infected but don't get sick. Is there any evidence for that or is it a likelihood in any viral outbreak? Thanks for responding and great interview.

[niman]

6 minutes ago, Jon Schultz said:

Yes, but in addition to calculating the CFR without regard for outcomes, some people are also saying that the real CFR is probably much less than 2% because there are probably many people who are infected but don't get sick. Is there any evidence for that or is it a likelihood in any viral outbreak? Thanks for responding and great interview.

The C in CFR stands for CASE and the case definition includes pneumonia. The new name for the illness is NCIP which stands for Novel Coronavirus Infected PNEUMONIA and like SARS (Sudden Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) these are severe hospitalized cases that involve pneumonia (asymptomatic or sub-clinical infections do not meet the CASE definition). They may be important for controlling the disease, but the CFR is calculated for hospitalized patients with pneumonia.

[Jon Schultz]

Thank you for the clarification. So when lay people talk about the case fatality rate of a virus, then, they could really be talking about one of three things: 1) the scientific definition you stated; 2) the percentage of people who die of all who have gotten at least somewhat ill; or 3) the percentage of people who die of all who will sooner or later test positive for antibodies. To avoid confusion I think maybe each of the three should have a different name, maybe something like case fatality rate, illness fatality rate, and infection fatality rate. I think it's important to know all three, as best possible. No?