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Mitigating #COVID19 @TheLancet, the difficult decisions, is superb thelancet.com/pb-assets/Lanc…
by Roy Anderson, @DeirdreHoll and colleagues
"Best estimates suggest a CFR for COVID-19 of about 0·3–1%, which is higher than the order of 0·1% CFR for a moderate influenza A season"
"Personal, rather than government action, in western democracies might be the most important issue. Early self-isolation, seeking medical advice remotely unless symptoms are severe, and social distancing are key."
from the appendices, very useful adds
This exceptional paper articulated the difficult decision between the economy & social distancing. Now that the market (although ≠ economy) is tanking, it's time to get serious on pulling out all the stops for the latter. Stop "business as usual"—we are in unusual times.
This #COVID19 paper was prescient. It laid out the choice for countries: #FlattentheCurve vs preserving their economy. Unfortunately, many countries are only now making the former their priority.
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#COVID19 #FlattentheCurve

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Eric Topol
@EricTopol
The 1st #COVID19 case in the US was diagnosed Jan 21.
It has since taken 53 days to do ~20,000 tests.
That's how many South Korea does in 1 day now.
That broad testing in South Korea (now >270,000 tests) was mounted early along with social distancing, closing of schools, tracing contacts. Total cases now 8162, curve flattened to lowest number of cases (76) since Feb 22; 75 deaths (0.9%).
The broad testing of people w/exposure, no symptoms, picked up on the key asymptomatic group, now understood to be a major driver of spread, especially among the young (unlike Italy/US testing)
—cnn.com/2020/03/14/hea… by @elizcohencnn
—medium.com/@andreasbackha… by @andreasshrugged
Read 6 tweets
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Eric Topol
@EricTopol
A new @jclinicalinvest commentary suggesting the use of serum from people who have recovered from #COVID19 as a potential prevention/treatment jci.org/articles/view/…
by @ACasadevall1 @JohnsHopkinsSPH and Liise-Anne Pirofski @EinsteinMed
They make a very strong case and review all the prior experience, ending w/:
"Hence, as we are in the midst of a worldwide pandemic, we recommend that institutions consider the emergency use of convalescent sera and begin preparations as soon as possible. Time is of the essence."
The #COVID19 convalescent transfusion concept was also advanced @TheLancet 2 weeks ago
thelancet.com/action/showPdf… via @tmprowell @matthewherper
@TheLancetInfDis
Read 3 tweets
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Eric Topol
@EricTopol
The dire #COVID19 situation in Italy where ~20% (350) of health professionals have been infected, some deaths, and projections for hospital bed and resource shortage
In today's @TheLancet
thelancet.com/action/showPdf…
by @AndreaRemuzzi and @gremuzzi1
Note that is in the Lombardy region which has been profoundly hit
@JAMALive has an extensive report from Italy today
Of the 13,882 patients in Lombardy region w/ #COVID19, 1,186 (8%) are #healthcare professionals (#JAMALive) A very useful interview w/ @howardbauchner w/ @DeMCecconi
accompanying @JAMA_Current paper jamanetwork.com/journals/jama/…
by @DrMCecconi, Giacomo Grasselli, @pesenti_antonio
Read 4 tweets

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BankofVol 🦠¹⁰⁰⁰
@BankofVol
Some extracts from the Lancet article on #COVID19:

1/Governments will not be able to minimise both deaths from coronavirus disease 2019 (COVID-19) and the economic impact of viral spread. Keeping mortality as low as possible will be the highest priority for individuals;
2/hence governments must put in place measures to ameliorate the inevitable economic downturn. In our view, COVID-19 has developed into a pandemic, with small chains of transmission in many countries and large chains resulting in extensive spread
3/in a few countries, such as Italy, Iran, South Korea, and Japan.1 Most countries are likely to have spread of COVID-19, at least in the early stages, before any mitigation measures have an impact.
Read 27 tweets
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David States
@statesdj
Good discussion of the COVID19 epidemic and the imporance of hygiene and social distancing. Actually may be even more important than they suggest. Let me explain: 1/
thelancet.com/pb-assets/Lanc…
2/ The spread of virus stops when enough people have acquired immunity. If R0 is fixed, this happens when the fraction of the population infected is 1-1/R0. In the case of SARSCOV2, R0 is ~2.5 which means about 60% of the population gets infected before viral spread ends
3/ 60% of the population is REALLY BAD NEWS. If that happens, we are talking about overwhelmed ICUs and hospitals and millions of deaths, especially in the elderly (OK Boomers and older, this is you we're talking about)
Read 14 tweets
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The Lancet
@TheLancet
Just published: Two new studies on the novel coronavirus. All Lancet #coronavirus content is fully and freely available at our 2019-nCoV Resource Centre thelancet.com/coronavirus
Paper 1: A new genetic analysis of 10 genome sequences of novel #coronavirus (2019-nCoV) from 9 patients in Wuhan finds that the virus is most closely related to two bat-derived SARS-like coronaviruses thelancet.com/pb-assets/Lanc…
The study reports epidemiological data of 9 patients diagnosed with viral pneumonia of unidentified cause. The authors took samples from patients’ lungs to harvest samples of 2019-nCoV virus, which they analysed to determine virus origin & how it enters human cells
Read 11 tweets
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Dr. Maia Majumder
@maiamajumder
We've updated our transmissibility assessment for #nCoV2019! R_0 estimates (based off of publicly reported confirmed cases through 1/26/20 & subject to change) remain ~stable, now ranging from 2.0 to 3.1.

Pre-print will be updated soon: ssrn.com/abstract=35246…

See thread below.
On January 24, this study [thelancet.com/pb-assets/Lanc…] provided onset data for the first 41 cases & back-dated the start of the outbreak to December 1 (instead of December 8, as we'd thought before due to the WHO [who.int/csr/don/12-jan…]). Our estimates now include these data.
Because of the ~1 day delay in reporting, we were able to incorporate these new data starting with our estimates on January 23 onward. There was an initial dip (though still within initial bounds) in our R_0 range, likely due to back-dating, on January 23. It's since stabilized.
Read 8 tweets
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dr muge cevik
@mugecevik
THREAD
As the #nCoV2019 outbreak continues, a lot of data emerging in real-time & being rapidly disseminated.

I compiled the available data (in no particular order) to have a better understanding of #nCoV2019 & will update the list as more info become available.
#IDTwitter
Clinical features of the first 41 pts suggest that #nCoV2019 has an insidious onset with fever, cough, and myalgia +/- shortness of breath. Radiological findings of bilateral ground-glass opacities. Some with mild, but >60y with severe disease #IDTwitter

thelancet.com/journals/lance…
The majority of patients requiring ICU care are those who presented with low blood pressure and dyspnea, high neutrophil count and LDH, and more likely to have AKI, secondary infection and shock. #nCoV2019 #IDTwitter

thelancet.com/journals/lance…
Read 49 tweets
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The Lancet
@TheLancet
Today, we publish the first clinical data from individuals confirmed to be infected with 2019-nCov from Wuhan, China. As for all public health emergencies, we will be making all related #Coronavirus Lancet content fully and freely available thelancet.com/coronavirus
Paper 1 outlines the first 41 cases. The severity of illness is concerning: almost a third of patients developed acute respiratory distress syndrome requiring intensive care: 6 patients died; 5 had acute cardiac injury; and 4 required ventilation thelancet.com/pb-assets/Lanc…
China has quickly isolated and sequenced the virus and shared these data internationally. The lessons from the SARS epidemic…have been successfully learned.

Comment from Chen Wang, Peter W Horby, Frederick G Hayden & George F Gao thelancet.com/pb-assets/Lanc…
Read 7 tweets

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