3) Control measures could be extremely effective in locations that have had time to prepare. Maybe in a few, but seems unlikely that is the case in all, especially countries with stretched health systems.
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4) Seasonal factors could be much more powerful at reducing transmission than we currently expect. That doesn't help the Southern hemisphere, and is not consistent with behavior in China (preprint in queue from
@MauSantillana et al.)4 Antworten 33 Retweets 147 Gefällt mirDiesen Thread anzeigen -
So that's my reasoning. It is as tight as I can make it and is an effort to use the science as we have it to make our best estimate about the future. Predictions can be wrong and I very much hope this is, but better to be prepared.
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Next question is what to do. While we have countable numbers of cases outside China, tracing, counting, trying to stop onward transmission one case at a time will help to buy time for those populations and on the hope that mitigating factors above hold, could maybe buy a lot
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Buying time matters in order to get supplies, test treatments, progress on vaccine development, and learn from the experiences of those who are currently battling this virus. This may include travel restrictons and efforts to make sure returnees don't transmit
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which must be done in a manner that is humane and safe for those individuals and their dependents. Equally important, as
@CDCDirector has implied https://www.cnn.com/2020/02/13/health/coronavirus-cdc-robert-redfield-gupta-intv/index.html … and PM of Singapore has stated, it may get beyond the stage of individual cases https://www.facebook.com/ChannelNewsAsia/videos/pm-lee-urges-singapore-to-take-courage-amid-coronavirus-outbreak/4547645628666527/ …2 Antworten 59 Retweets 159 Gefällt mirDiesen Thread anzeigen -
at which point will have to shift to mitigation rather than containment, and we must make sure that restrictions on travel, quarantine, and the like do not outlast their usefulness -- they are costly to individuals, families and economies and shd only be used as long as justified
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If there is widespread community transmission driven importantly by mild or asymptomatic cases -- still a big if -- then it will be like flu and control measures targeting cases should be relaxed in favor of general social distancing to reduce contacts in general.
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The pace of new information is overwhelming, and some of the claims in this thread have shifted from speculative to factual or very nearly so. Other points need to be modified in light of new data. See article with
@BillHanage on these categorieshttps://blogs.scientificamerican.com/observations/how-to-report-on-the-covid-19-outbreak-responsibly/ …1 Antwort 33 Retweets 99 Gefällt mirDiesen Thread anzeigen -
Increased confidence in claims: Since I wrote this, large numbers of cases have appeared in new countries (Iran, Italy) or increased dramatically (S. Korea), increasing the evidence that this will become or already is a pandemic.
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Hi Marc, i was wondering if you could tell us something about the amount of exported cases from Iran. If we look at all the exported cases from Iran, do you think Iran is underreporting/underdetecting? Thanks in advance.
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Antwort an @2019nCoVwatcher @mlipsitch und
Dr Rob Whitehurst hat Isaac Bogoch retweetet
Preprint from
@BogochIsaac looks at this. He finds evidence for very large outbreak, and this is without factoring in the very large number of exports detected in the Middle East today, so probably largest outbreak outside Hubei.https://twitter.com/BogochIsaac/status/1221787025361309697 …Dr Rob Whitehurst hat hinzugefügt,
Isaac Bogoch @BogochIsaac1. Here is our new analysis for the potential international dissemination of the novel coronavirus from China, via commercial air travel. East and Southeast Asian cities are still the highest risk, but also centres in Europe and North America. https://tinyurl.com/rc6yv4t#coronavirusDiesen Thread anzeigen1 Antwort 0 Retweets 0 Gefällt mir -
Antwort an @OYCar @2019nCoVwatcher und
That was the China reference, the Iran one ishttps://bit.ly/2VlgpDB
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