Thread by @ferrisjabr

The viral thread quoted below is missing essential context and contains numerous errors. It does not reflect the latest evidence. #2019nCoV

Here is a new thread with the facts:

The basic reproduction number (R0) is the average number of secondary infections generated by one infected person in a totally susceptible population #2019nCoV

The claim that the new coronavirus has an R0 of 3.8 is based on this paper medrxiv.org/content/10.110…

The authors of that paper emphasize the high degree of uncertainty and have already downgraded their estimate to an R0 of 2.5

The claim that "we are now faced with the most virulent virus epidemic the world has ever seen" and that the new coronavirus is 8x as infectious as SARS is completely untrue. Even if the R0 were 3.8 that would be nowhere near a record.

Here is some context w/ a range of R0s:

Moreover, R0 is not the only statistic that matters. Some diseases are extremely infectious but not very lethal; others are the inverse.

Infectiousness can change dramatically depending on the population in question and circumstances. #2019nCoV

It's estimated, for example, that control measures reduced the R0 of SARS from ~2.9 to 0.4. (This might be the source of the erroneously cited "modest" 0.49 "viral attack rate" for SARS in the viral thread)

Reference: who.int/csr/sars/en/WH…

None of this is to belittle what is happening. The outbreak in China is a genuine public health emergency.

But the essential data are still being collected and assessed. Sweeping and alarmist claims about unprecedented global threat are neither warranted nor helpful.

#2019nCoV

Following numerous critiques, the most inaccurate tweet in the original viral thread disappeared/was probably deleted without explanation or follow-up correction. For transparency and posterity, this is what it looked like.

The info in the pictured tweet is unequivocally wrong

Some people have asked why they should believe me rather than a Harvard epidemiologist.

This is not a matter of belief, nor pedigree. This is about facts, evidence, due diligence.

I have presented the facts and their sources so you can examine them for yourself.

I'd like to thank everyone who has been sharing my thread. You are helping to combat misinformation and alarmism. Some people think it is futile to try, but you are proving them wrong.

Critical thinking is a skill—a muscle. We have a collective responsibility to exercise it.

Here is one of the latest analyses of the new coronavirus, with an estimated R0 of 2.6

Remember, though: R0 is just one factor. It's still early, data are still coming in, and all the statistics are likely to keep changing
imperial.ac.uk/mrc-global-inf…

Some of the latest numbers according to People's Daily, China

This is a great resource: an interactive map of confirmed novel coronavirus infections and deaths around the world, frequently updated.

Created by the Center for Systems Science and Engineering, John Hopkins University. Last update: 10PM EST Jan 25

gisanddata.maps.arcgis.com/apps/opsdashbo…

A lot of people sharing this study, which estimates an R0 of 3.3 - 5.47 for the new coronavirus

This study was published on Jan 24. It doesn't use data beyond Jan 22. And it hasn't been peer-reviewed. It does not represent a definitive consensus
biorxiv.org/content/10.110…

Remember: the estimated R0 for SARS ranged from 2 to 5 depending on the context (who.int/csr/sars/en/WH…). It's entirely possible the R0 for the new coronavirus will fall within or close to that range (they are related viruses).

But R0 is not the only factor to consider

Incoming reports suggest the new coronavirus has a variable incubation period (1 to 14 days) & may be contagious pre-symptoms. That could potentially make it harder to contain than SARS.

But we simply don't yet have enough data to accurately pin down the R0 or fatality rate.

Here are some especially good recent reports:

1) Reuters reuters.com/article/us-chi…

2) Washington Post washingtonpost.com/world/asia_pac…

3) STAT News statnews.com/2020/01/26/con…

4) Foreign Policy foreignpolicy.com/2020/01/25/how…

New analysis, published Jan 26, reports avg incubation of 4.8 days and R0 of 2.9, which is consistent with earlier estimates of 2.6. Dr. @mugecevik says this is "the first detailed epidemic curve." Still working with early data, though

biorxiv.org/content/10.110…

@mugecevik From same study: "2019-nCoV may have higher pandemic risk than SARS...implemented public-health efforts have significantly decreased pandemic risk....However, more rigorous control and prevention strategies and measures [needed] to contain further spread" biorxiv.org/content/10.110…

@mugecevik Here are two important examples of the many data collection and communication challenges that arise in the early stages of a crisis, why it's so important to have reliable information before making dramatic pronouncements, and why context and level of uncertainty are crucial:

@mugecevik Health minister Ma Xiaowei said the new coronavirus is contagious pre-symptoms; didn't explain further. This 1 piece of info could make a huge diff in planning & outcomes. But the CDC's Nancy Messonnier & other experts point out that direct evidence is lacking. Not yet certain.

@mugecevik Similarly, the confirmed number of cases globally is about 3,000 right now (vast majority in China). Expert estimates of additional cases in China range from an extra 1,000 to *hundreds of thousands*

For ex see: theguardian.com/science/2020/j… &

@mugecevik Be advised: Social media has been flooded with misinformation about the coronavirus, including old, unrelated, & possibly fake videos. Many opportunists are capitalizing on this crisis for financial & political gain. Always investigate credibility:
buzzfeednews.com/article/janely…

@mugecevik I've started a Public List of accounts to follow for updates on the new coronavirus: a mix of scientists, journalists, non-profits, and government agencies. I'll update as the situation develops. You can find it under my profile or subscribe via this link twitter.com/i/lists/122149…

@mugecevik Key passage from @DavidQuammen's recent NYT Op-Ed on the new coronavirus nytimes.com/2020/01/28/opi…

@mugecevik @DavidQuammen The recent Twitter discourse about R0, science communication, and viral outbreaks—in multiple senses of the phrase—has inspired two new pieces in The Atlantic:

1) @edyong209 offers a useful crash course on what R0 does and does not mean theatlantic.com/science/archiv…

@mugecevik @DavidQuammen @edyong209 2) @alexismadrigal examines how misinformation spreads, "the scope and speed by which social-media platforms enable this to happen—and the strangeness of the information networks that are formed in crisis" theatlantic.com/technology/arc…

@mugecevik @DavidQuammen @edyong209 @alexismadrigal New preliminary analysis finds an R0 of 2.24 - 3.58 for the new coronavirus, consistent with the majority of estimates so far biorxiv.org/content/10.110…

@mugecevik @DavidQuammen @edyong209 @alexismadrigal A thread of #nCoV2019 #coronavirus updates rolling in from @HelenBranswell:
-China's response to outbreak "massive"
-Transmission outside Hubei less intense so far
-Tomorrow, WHO will reconsider declaring a Public Health Emergency of International Concern

@mugecevik @DavidQuammen @edyong209 @alexismadrigal @HelenBranswell Interesting comment from @DrTedros via @HelenBranswell: "The current situation on PHEICS is Yes or No — "Green or Red." He thinks there should be a yellow status — a warning, but not yet a PHEIC — should be added"

@mugecevik @DavidQuammen @edyong209 @alexismadrigal @HelenBranswell @DrTedros Today's Updates Part I:

-Nearly 10,000 cases worldwide (vast majority in China); more than 200 deaths (all in China)
-WHO declares global health emergency (note: not synonymous with global pandemic)
-U.S. State Department advises against travel to China

#nCoV2019 #coronavirus

@mugecevik @DavidQuammen @edyong209 @alexismadrigal @HelenBranswell @DrTedros Today's Updates Part II:

-Illinois reports first case of human-human transmission in U.S.
-Increasing evidence of asymptomatic transmission, but not definitive
-Latest R0 estimates between 2 - 4, consistent w/ most estimates so far & comparable to SARS

#nCoV2019 #coronavirus

@mugecevik @DavidQuammen @edyong209 @alexismadrigal @HelenBranswell @DrTedros Updates:

-Close to 21,000 cases globally (of which 20,000+ are in China)

-427 deaths (425 in China, 1 in Hong Kong, 1 in Philippines)

-So far no sustained outbreaks outside of China

Latest summary table from WHO: who.int/emergencies/di…

#nCoV2019 #coronavirus

@mugecevik @DavidQuammen @edyong209 @alexismadrigal @HelenBranswell @DrTedros Nice thread here on the growth of case numbers and fatality rate. Note that we won't know the true numbers and trajectories for quite a while, but such graphs are useful for now

@mugecevik @DavidQuammen @edyong209 @alexismadrigal @HelenBranswell @DrTedros If the outbreak in China is not contained, will that mean "unprecedented global threat"?

No. More likely the new coronavirus will become another "mundane" cause of the common cold, or a seasonally recurring infection similar to the flu in severity

statnews.com/2020/02/04/two…

@mugecevik @DavidQuammen @edyong209 @alexismadrigal @HelenBranswell @DrTedros