Thread by @balajis

What actually happens when someone gets #nCoV2019?

The Lancet has a study of 99 patients with the condition recruited from Jan 1-Jan 20. Most had fever and cough at time of admission.

As of Jan 25
57 remained hospitalized
31 were discharged
11 have died
thelancet.com/journals/lance…

As the article notes, 7 of the 11 who died were 60+ years old. Still, that's a high death rate if it holds up.

On a reassuring note, the NEJM has another paper today on asymptomatic transmission. It notes that the four Munich cases seen have been mild.
nejm.org/doi/full/10.10…

The largest study I've seen is the sample of 425 in NEJM, but it's more focused on epidemiology (how it spreads) than clinical features (how it presents).

A key point again here is that people are getting the disease without knowing anyone with symptoms. nejm.org/doi/full/10.10…

Good piece on the case for uncertainty.

On the one hand, only folks who felt sick enough to be admitted are seen in the Lancet stats. And there are many mild cases.

On the other hand, there is *something* on the ground that has the Chinese very worried.
statnews.com/2020/01/30/lim…

As a hypothesis, it could simultaneously be true that:

- the virus is very contagious
- most have mild symptoms
- but some are badly hit
- and the sheer scale is overwhelming

Even if “only” a few percent die, if it infects millions that is an enormous toll on the system.