The Official CORONAVIRUS oh *&^! thread. Time to start stocking up on food?

[Marinejiujitsu]

I have 2 confirmed cases in isolation at a rural hospital I am currently working. I want to go in and start taking deep breaths to get 3 weeks off.

Sent from my SM-N975U using Tapatalk

[GetMeOuttaThisMess]

Son of a gun if the Chinese didn't get that two story hospital, or so it appears, built.  It did take two weeks instead of one I believe.

Edit:  I stand corrected.  It was TEN days from start to completion apparently.

Edited February 3, 2020 by GetMeOuttaThisMess

[Marinejiujitsu]

Son of a gun if the Chinese didn't get that two story hospital, or so it appears, built.  It did take two weeks instead of one I believe.

Yeah, they started showing signs in 2 weeks. Husband and wife.

Sent from my SM-N975U using Tapatalk

[Cideous]

Wish these people in the hot zone would stop getting on planes....

[Marinejiujitsu]

Wish these people in the hot zone would stop getting on planes....

Supposedly these 2 quarantined themselves per request of cards they received coming off the plane.

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[surgblumm]

Facts that are reliable.  

 

https://www.politifact.com/article/2020/jan/30/readers-guide-misinformation-about-coronavirus/?fbclid=IwAR0-3awn9BmJ4kKHwE3hGKV9ByfJ69X-t6Pq8_eWesshEVRY318nlL3l_mk

[MediMike]

This may have been voiced earlier in this thread but...we've got 10,000+ dead from influenza this season alone.  600 dead worldwide? This thing is a cheap knock-off of the good 'ol 'Merican flu.

[Cideous]

3 hours ago, MediMike said:

This may have been voiced earlier in this thread but...we've got 10,000+ dead from influenza this season alone.  600 dead worldwide? This thing is a cheap knock-off of the good 'ol 'Merican flu.

Tell that to the young and healthy whistleblower doc in China who first warned people about the virus.  After treating patients he got it....and died today.

This thing is just getting started.

[rev ronin]

4 hours ago, MediMike said:

This may have been voiced earlier in this thread but...we've got 10,000+ dead from influenza this season alone.  600 dead worldwide? This thing is a cheap knock-off of the good 'ol 'Merican flu.

It'll be 30,000 from Influenza and related complications in the U.S. by the end of the flu season, but we know the R0 and case fatality rate for non-pandemic influenza.  Wuhan coronavirus has both numbers higher, and there's no vaccine for people to ignore.  An R0 is an exponent, not a multiplier, so if influenza is 1.3 and Wuhan coronavirus is 2.2 that's WAY more than twice as bad.

Again, the speed of this spread is far slower than the computer worms I studied way before PA school, but the curve looks terrible.

Today's numbers? 31,500 confirmed infected, 640 dead, 1600 recovered. The case fatality rate is clearly at least 2%, assuming that the current numbers are accurate, but 93% or so of those diagnosed with the illness are still Schroedinger's patients: neither cured nor killed, still awaiting a final outcome.  Seasonal, and even pandemic, influenza has a case fatality rate of 0.1% or less.  This is, at minimum, 20x deadlier.

Daily case counts are rising in non-PRC Asian countries like Japan, Thailand, and Singapore.  While the West may have done a great job of identification, isolation, and tracking, we live in a connected world that cannot economically tolerate the entire lack of human interaction across affected national boundaries. What happens when a country reaches the point where it cannot adequately isolate its own contagious folk?

If you're not scared, you either don't understand the medicine, or you don't understand the math.
 

 

Edited February 7, 2020 by rev ronin
+epidemiology video

[MediMike]

13 hours ago, rev ronin said:

It'll be 30,000 from Influenza and related complications in the U.S. by the end of the flu season, but we know the R0 and case fatality rate for non-pandemic influenza.  Wuhan coronavirus has both numbers higher, and there's no vaccine for people to ignore.  An R0 is an exponent, not a multiplier, so if influenza is 1.3 and Wuhan coronavirus is 2.2 that's WAY more than twice as bad.

Again, the speed of this spread is far slower than the computer worms I studied way before PA school, but the curve looks terrible.

Today's numbers? 31,500 confirmed infected, 640 dead, 1600 recovered. The case fatality rate is clearly at least 2%, assuming that the current numbers are accurate, but 93% or so of those diagnosed with the illness are still Schroedinger's patients: neither cured nor killed, still awaiting a final outcome.  Seasonal, and even pandemic, influenza has a case fatality rate of 0.1% or less.  This is, at minimum, 20x deadlier.

Daily case counts are rising in non-PRC Asian countries like Japan, Thailand, and Singapore.  While the West may have done a great job of identification, isolation, and tracking, we live in a connected world that cannot economically tolerate the entire lack of human interaction across affected national boundaries. What happens when a country reaches the point where it cannot adequately isolate its own contagious folk?

If you're not scared, you either don't understand the medicine, or you don't understand the math.
 

 

Whoa there Poindexter. Way too many numbers and syllables for a simple country pulmonary PA here, you know, one who doesn't understand math or medicine?

What a ridiculous assumption that if someone isn't scared that they are ignorant. Should I assume that you are some form of sheep following the prompts of the mainstream media, whipping up hysteria as they are prone to do? 

Nah. Because I'm apparently a more respectful person than you.

The deaths are almost exclusively in China, a region notorious for lack of detailed reporting. How many individuals do you think are symptomatic and haven't come forward? Bet enough that it will throw off your mortality numbers. The deaths are happening in a medically overwhelmed region without the support, infrastructure and supplies to manage the mobs of people quarantined.

So yeah, I stand by my statement that for me, my community and my practice I am much more concerned about influenza. This hasn't proven to be SARS with a R of what, 2-5 depending on who you look at? Or MERS with a mortality rate of 35%.

I'll end this post with an appeal for you to act like the medical professional you claim to be and not assert ignorance and stupidity in others for not falling prey to the same fears as you. 

[MediMike]

15 hours ago, Cideous said:

Tell that to the young and healthy whistleblower doc in China who first warned people about the virus.  After treating patients he got it....and died today.

This thing is just getting started.

Tell it to the parents of the 15 kids who died from influenza last week. 78 so far this year.

[rev ronin]

4 hours ago, MediMike said:

Tell it to the parents of the 15 kids who died from influenza last week. 78 so far this year.

If we get enough people scared enough about Wuhan Coronavirus, maybe they'll actually wash hands well enough to cut down on the influenza transmission rate.

[EMEDPA]

I went with a friend to her son's pediatrician's office the other day for evaluation of fever in her young son. The doc asked when it all started and I said "right after we got off the plane from Wuhan". He did a double take then said "well played my friend". 

[Cideous]

25 minutes ago, EMEDPA said:

I went with a friend to her son's pediatrician's office the other day for evaluation of fever in her young son. The doc asked when it all started and I said "right after we got off the plane from Wuhan". He did a double take then said "well played my friend". 

ROFL Nice.

[rev ronin]

9 hours ago, MediMike said:

Whoa there Poindexter. Way too many numbers and syllables for a simple country pulmonary PA here, you know, one who doesn't understand math or medicine?

What a ridiculous assumption that if someone isn't scared that they are ignorant. Should I assume that you are some form of sheep following the prompts of the mainstream media, whipping up hysteria as they are prone to do? 

Nah. Because I'm apparently a more respectful person than you.

The deaths are almost exclusively in China, a region notorious for lack of detailed reporting. How many individuals do you think are symptomatic and haven't come forward? Bet enough that it will throw off your mortality numbers. The deaths are happening in a medically overwhelmed region without the support, infrastructure and supplies to manage the mobs of people quarantined.

So yeah, I stand by my statement that for me, my community and my practice I am much more concerned about influenza. This hasn't proven to be SARS with a R of what, 2-5 depending on who you look at? Or MERS with a mortality rate of 35%.

I'll end this post with an appeal for you to act like the medical professional you claim to be and not assert ignorance and stupidity in others for not falling prey to the same fears as you. 

Sigh.

Yes, there are, in fact, other options than you not understanding the math or the medicine, but I intentionally left them out to highlight the fact that I don't think you understand the math. This is a site where we're all (or want to be) medical practitioners; the comment was intended to be thought-provoking, rather than insulting, but the risks of readers misconstruing provocative statements is unfortunately unavoidable.

Influenza is bad.  But influenza is KNOWN bad; even in this season of poor seasonal influenza vaccine/strain match, we don't have to worry that it will kill 10x the average annualized death rate.  We know it's not going to go significantly above 0.1% case fatality rate.  Influenza has an R0 of 1.28  for seasonal, 1.80 for 1918, and 1.46 for 2009 H1N1 swine flu (https://www.ncbi.nlm.nih.gov/m/pubmed/25186370/), meaning that all of them will spread throughout a vulnerable population, per incubation period, to a number of people more than the currently infectious persons, but less than twice the currently infectious persons.

While Wikipedia lists SARS as having an R0 of 2-5, that's a ridiculously wide range, although The Atlantic (https://www.theatlantic.com/science/archive/2020/01/how-fast-and-far-will-new-coronavirus-spread/605632/) appears to also be using the same range with respect to SARS, such numbers are from 2004, not later analyses.  (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558759/) estimates SARS R0 at 2-3 prior to countermeasures, which were of various effect. See Table 2 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3323341/), which separates R0 by non-China area of spread; not surprisingly, Canada fared significantly better than Hong Kong or Singapore, which each had an R0 above 1 for the time under consideration. One of the challenges of nCoV vs. SARS or MERS is that in both cases new infections were symptomatic, quite evident, and became rapidly severe, such that people would not go around inadvertently spreading them.  It's also clear that the case fatality rate is lower than either, but more on that below.

Note that, as of now (https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6) lists Singapore and Hong Kong as the two biggest rates of non-PRC infection. Both have huge international airports, of course, and are highly connected destinations. As of today, Singapore has apparent community spread (https://www.scmp.com/week-asia/health-environment/article/3049539/coronavirus-singapore-raises-pandemic-alert-level), and there are allegations that Hong Kong has the same (https://www.scmp.com/news/hong-kong/health-environment/article/3049297/coronavirus-community-outbreak-declared-hong-kong)  While we're rapidly building a Maginot line against travel direct from China, the virus is spreading in adjacent, highly connected destinations--likely including Thailand as well, although probably not literal Belgium.

The R0 of nCoV is variously estimated as between 1.4 and 3.9, and the numerical consensus seems to be somewhere in the mid 2's (2.2-2.6) absent any controls.  It is almost certainly falling in areas in which commerce, schooling, and essentially normal life has ground to a standstill.  If we can get to 1.3 (seasonal flu) level spread by destroying normal life, there's still the expectation that it will spread through essentially an entire vulnerable population.

And indeed, as the thread has progressed, we have had ongoing, perhaps inexorable, concurrent progress in disease spread.  Every day is a new milestone. First U.S. case.  First U.S. transmission.  Now, first U.S. citizen to die.  More deaths that SARS total, and climbing. 

Bottom line #1: There's no reason to suspect that nCoV will be restricted to the current countries in which it is currently spreading in the community.

The severity/case fatality rate is indeed up in the air. Also earlier today, WHO's breakdown (https://www.pscp.tv/w/1jMKgQbpRPMJL, 18:15 into the video) listed 82% mild, 15% severe, 3% critical. Right at 2% of people confirmed with nCoV have died, and the ratio of died:recovered is improving, and is now 1 dead per 3 recovered, when just a few days ago it was more like 2:3.  However, to get current data to map to the fatality of seasonal influenza, we would have to have 10x the number of undetected cases out there... which would instead mean a far more wide spread!  If we assume that PRC is a special case, let's look just at the non-PRC cases, which we can expect to be reasonably new in the run of the disease: 319 non-PRC cases, among them 2 deaths and 14 recovered: 0.6% fatal so far, with a probable upper limit of fatality of 12.5%--raw numbers, without much in the way of projections or interpretation.

I'm speculating, but the flip side of what you note about the PRC's woeful medical infrastructure is that each non-PRC case is having the entire medical community of its country thrown at it.  Like Ebola, fatality may be near-certain in the jungle, but a coin toss--or better!--if a few patients are cared for by the pinnacle of western medicine.  PRC is past that tipping point. They have movement restrictions on 400 million people (https://twitter.com/jenniferatntd/status/1225755932904304641) in geographically separate areas (https://www.washingtonpost.com/world/asia_pacific/hundreds-of-miles-from-hubei-another-30-million-chinese-are-in-coronavirus-lockdown/2020/02/07/03a08282-48b9-11ea-8a1f-de1597be6cbc_story.html).

Which brings me to the rest of the damning math: Supply chain, just-in-time, and capacity planning.  If you watched today's WHO briefing through, mask demand has surged by 100x, and prices are already 20x what they were last month. You can't get more surgical masks; neither can I.  Does your practice need them? Your community? My EMS system sure does.  We use them routinely for influenza season, but what we have in the county is likely to be all we will be able to get for months.

What about vents?  Pretty hard to add an ICU bed for a potentially-fatal respiratory illness without a ventilator.  Want to bet that wait times and prices have already gone up for them? Does your practice, your community, need ICU beds?

What about everything else that's made in China?  What are the 2nd order effects of the various quarantines in PRC on the world's manufacturing capacity? When the supply chain starts to break, what will your community run out of?  I sure hope it's nothing health-related.  Remember all the drug shortages attributed to Puerto Rico's travails?  How much bigger of a problem, both for the global economy and for the production of goods essential to public health and welfare, is it going to be if China has to take a month or six off for sick leave?
https://www.washingtonpost.com/health/2020/02/07/biggest-questions-about-new-coronavirus-what-we-know-so-far/

[rev ronin]

Gaah, that got unweildily long, but I'm not done musing.

PRC is probably the worst case scenario on planet earth: There is no place more connected and crowded.  I've not been to China since 2005, but I really doubt it's changed significantly: people, people, everywhere.  Mass transit.  High rise apartment buildings as far as the eye can see. I think it's entirely likely that the total death toll in the PRC itself will be in the five figure range, and in a worst-case scenario (1918 Influenza-level spread/fatality) tens of millions.

The timing was also the worst possible, with lunar new year prompting tons of travel all over Asia.

I'm concerned about the hospital-based transmission of nCoV.  Maybe PRC medical staff are just sloppy, but why on earth should anyone working in a hospital get infected with anything that just spreads via droplet?  Patient-to-Patient transmission is an unfortunate reality... but the number of healthcare professionals who are bearing the brunt of known, diagnosed infections is bothersome.  Sure, they may have better access to testing than the general populace, but I am concerned what this might mean for US-based healthcare workers' safety if these cases start showing up outside of known recent travelers. (https://jamanetwork.com/journals/jama/fullarticle/2761044)

I probably didn't emphasize enough in my previous post why I think Hong Kong, Singapore, and UAE (5 so far...) are such bad places to see nCoV spread: network dynamics.  Those are each highly connected hubs, with connections all over the world. You can think of it just in terms of an air travel flight map, but those are misleading, because all the lines are the same thickness: Hubs are not just connected to more other places, but they have relatively more individuals traveling through them.  I think the U.S.'s initial move to restrict points of entry to a few known airports was a wise move... So far, the U.S. looks fine.  We'll see, week by week, if that continues to be the case.

[MediMike]

48 minutes ago, rev ronin said:

Sigh.Yes, there are, in fact, other options than you not understanding the math or the medicine, but I intentionally left them out to highlight the fact that I don't think you understand the math. This is a site where we're all (or want to be) medical practitioners; the comment was intended to be thought-provoking, rather than insulting, but the risks of readers misconstruing provocative statements is unfortunately unavoidable.

Sigh.

Don't be an ass is all I'm saying. Nice research. Work on your delivery and you should do fine.

Edited February 8, 2020 by MediMike
Tired thumbs

[rev ronin]

"The latest patients include five British nationals staying in the same chalet at a ski village in Haute-Savoie in the Alps, health officials said, raising fears of further infections at a busy period in the ski season.

"The five, including a child, had been lodged in the same chalet with a person who had been in Singapore. They were not in a serious condition, the officials said."

https://www.yahoo.com/news/wrapup-1-death-toll-coronavirus-033743192.html

The stupid news headlines are all about "first American to die" today. That's not the big news; THIS is.  If this report is accurate, this indicates second-order International spread.  If we see this one, we're likely going to have any number of others, and because it's cold season and the symptoms can be so mild initially in healthy adults, we're going to be playing the Kevin Bacon game to see who might be able to connect their illness to Wuhan in December.   The testing will likely not be able to keep up.

ETA: Oh, also UAE was at 3 confirmed nCoV cases last night.  It's 7 now.

Edited February 8, 2020 by rev ronin
add

[FiremedicMike]

On 2/2/2020 at 10:59 PM, GetMeOuttaThisMess said:

Son of a gun if the Chinese didn't get that two story hospital, or so it appears, built.  It did take two weeks instead of one I believe.

Edit:  I stand corrected.  It was TEN days from start to completion apparently.

I had the opportunity to watch extreme home makeover in person..  They aren’t lying, they demo and rebuild a home in 7 days..

with enough manpower, it IS possible to build complete structures in much less time than you’d think.

[EMSGuy1982]

I think the interesting thing is that the total of infected that is being reported daily out of mainland China is jumping 2-3k+ daily while the number of deaths has also been climbing. I wonder how many patients have died prior to even testing. Also, let’s not forget that China was not exactly forthcoming about the true number of infection during the SARS outbreak in 2003... I figure the numbers are likely much higher than reported. Sure influenza kills more but at least there is a vaccination for influenza unlike this new, never been seen before virus that has killed over 900 people (reported) in about a month and a half. The Spanish flu of 1918 killed about 50 million and that was before    convenient and fast air travel. Albeit our healthcare system is much more robust now than in 1918. 
 

 

just a few thoughts from a lowly urgent care PA. 

[rev ronin]

2 hours ago, EMSGuy1982 said:

Albeit our healthcare system is much more robust now than in 1918.

Is it really more robust?  Looks like a lot of ingredients to a lot of pharmaceuticals are made in China, and with a just-in-time supply chain, we're likely to see drug shortages... goodness knows how much single use medical equipment is made in China.

We definitely have a medical system that can provide awesome pinnacle care to the very acutely ill... but how many hospitals are ALREADY struggling with having enough ICU beds?  If you got 1000 per million patients needing a vent all at once, could your metro area handle it?  How about 100 per million? Oh, keep in mind that if this is pandemic, the surrounding cities are going to have roughly the same requirement for their own resources...

So yeah, we can do some awesome stuff... but overwhelm us and disrupt our supply chains, and we're going back to supportive care we did a century ago.

BTW, the total worldwide death toll from the 1918 influenza pandemic has been estimated as high as 200 million.

[EMSGuy1982]

5 minutes ago, rev ronin said:

Is it really more robust?  Looks like a lot of ingredients to a lot of pharmaceuticals are made in China, and with a just-in-time supply chain, we're likely to see drug shortages... goodness knows how much single use medical equipment is made in China.

We definitely have a medical system that can provide awesome pinnacle care to the very acutely ill... but how many hospitals are ALREADY struggling with having enough ICU beds?  If you got 1000 per million patients needing a vent all at once, could your metro area handle it?  How about 100 per million? Oh, keep in mind that if this is pandemic, the surrounding cities are going to have roughly the same requirement for their own resources...

So yeah, we can do some awesome stuff... but overwhelm us and disrupt our supply chains, and we're going back to supportive care we did a century ago.

BTW, the total worldwide death toll from the 1918 influenza pandemic has been estimated as high as 200 million.

I agree. The disruption financially worldwide could be catastrophic seems how pretty much everything comes from China. Last time I was in a “Made in the USA” store I sure didn’t see anything really life sustaining in that place . Honestly I think the powers that be are more concerned about the financial aspect and hoping the markets don’t crash because then we would really be in trouble. It’s all about the Benjamin's. definitely agree about our healthcare infrastructure  and I recently read an article that was written by a EM MD who highlighted what you said above about a stressed healthcare system. Especially during cold and flu season. Cold/flu season + Coronavirus would be disastrous. I have concerns about the screening tool that was sent out by the state DOH (if I remember correctly your in WA as well)    . It seemed that unless you just got into town from China or have hung out with someone who has tested positive, it really shouldn’t be on my differential. Have they not heard that it’s spread to how many other countries? Or the fact that there has been human-human transmission in countries in patients that have had no travel history? 
 

Just another two cents. 

[chaitea]

 

Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

Dawei Wang, MD¹; Bo Hu, MD¹; Chang Hu, MD¹; et alFangfang Zhu, MD¹; Xing Liu, MD¹; Jing Zhang, MD¹; Binbin Wang, MD¹; Hui Xiang, MD¹; Zhenshun Cheng, MD²; Yong Xiong, MD³; Yan Zhao, MD⁴; Yirong Li, MD⁵; Xinghuan Wang, MD⁶; Zhiyong Peng, MD¹

Author Affiliations Article Information

JAMA. Published online February 7, 2020. doi:10.1001/jama.2020.1585

Coronavirus Resource Center

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Related

Articles

 

Key Points

Question  What are the clinical characteristics of hospitalized patients with 2019 novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) in Wuhan, China?

Findings  In this single-center case series involving 138 patients with NCIP, 26% of patients required admission to the intensive care unit and 4.3% died. Presumed human-to-human hospital-associated transmission of 2019-nCoV was suspected in 41% of patients.

Meaning  In this case series in Wuhan, China, NCIP was frequently associated with presumed hospital-related transmission, 26% of patients required intensive care unit treatment, and mortality was 4.3%.

Abstract

Importance  In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.

Objective  To describe the epidemiological and clinical characteristics of NCIP.

Design, Setting, and Participants  Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020.

Exposures  Documented NCIP.

Main Outcomes and Measures  Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked.

Results  Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 10⁹/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89 [64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy (62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0).

Presumed Hospital-Related Transmission and Infection

Of the 138 patients, 57 (41.3%) were presumed to have been infected in hospital, including 17 patients (12.3%) who were already hospitalized for other reasons and 40 health care workers (29%). Of the hospitalized patients, 7 patients were from the surgical department, 5 were from internal medicine, and 5 were from the oncology department. Of the infected health care workers, 31 (77.5%) worked on general wards, 7 (17.5%) in the emergency department, and 2 (5%) in the ICU. One patient in the current study presented with abdominal symptoms and was admitted to the surgical department. More than 10 health care workers in this department were presumed to have been infected by this patient. Patient-to-patient transmission also was presumed to have occurred, and at least 4 hospitalized patients in the same ward were infected, and all presented with atypical abdominal symptoms. One of the 4 patients had fever and was diagnosed as having nCoV infection during hospitalization. Then, the patient was isolated. Subsequently, the other 3 patients in the same ward had fever, presented with abdominal symptoms, and were diagnosed as having nCoV infection.

This report, to our knowledge, is the largest case series to date of hospitalized patients with NCIP. As of February 3, 2020, of the 138 patients included in this study, 26% required ICU care, 34.1% were discharged, 6 died (4.3%), and 61.6% remain hospitalized. 

Conclusions and Relevance  In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%.

 

 

[Cideous]

One patient in the current study presented with abdominal symptoms and was admitted to the surgical department. More than 10 health care workers in this department were presumed to have been infected by this patient. Patient-to-patient transmission also was presumed to have occurred, and at least 4 hospitalized patients in the same ward were infected, and all presented with atypical abdominal symptoms.

 

Get use to working in head to toe hazmat suits once it gets here in mass.  No joke.

[chaitea]

 

9 minutes ago, Cideous said:

One patient in the current study presented with abdominal symptoms and was admitted to the surgical department. More than 10 health care workers in this department were presumed to have been infected by this patient. Patient-to-patient transmission also was presumed to have occurred, and at least 4 hospitalized patients in the same ward were infected, and all presented with atypical abdominal symptoms.

 

Get use to working in head to toe hazmat suits once it gets here in mass.  No joke.

My thoughts exactly.  Anyone hear that a CDC worker has contracted it in the US?  I have a reliable inside source inside that says it is the case.  We are not being told the full truth.  Let's keep each other informed as much as possible.