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On 1/25/2020 at 8:22 PM, Gilles said:

Je voulais me faire des vacances en Asie dans pas longtemps, ça m'arrange pas non plus, d'ailleurs.

 

Tu auras peut-être des billets moins chers.

 

Perso, la meilleure promo pour un sejour de vacances dont j'ai profité, c'était en Tunisie deux semaines après les attentats de juin 2019

Et puisqu'on parle de pandémie, pendant la grippe aviaire, le prix du poulet était à -25% parce que les consommateurs se méfiaient de la volaille (sans fondement : seule la volaille vivante pouvait porter le virus)

Dès qu'il y a un mouvement de foule un peu irrationnel, il ya des opportunités qui se crééent.

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Il y a 6 heures, Rübezahl a dit :

Je présume soit des infos supplémentaires entre les 2 itws, soit une reprise de sang-froid, ou les 2.

Troisième hypothèse : son niveau d'anxiété a peu évolué dans l'absolu (éventuellement un peu à la baisse suite à de nouvelles informations, comme dans ta première hypothèse) ; ce qui a changé, c'est l'ambiance générale, qu'il jugeait sans doute un peu insouciante lors de la première interview, mais qu'il trouve complètement délirante lors de la seconde. 

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Le CDC recommande désormais d'éviter les voyages en Chine :
 

 

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Citation

Fife doctor spearheading drive to develop vaccine for deadly coronavirus

 

Coronavirus-620x332.jpg

 

Dr Kate Broderick, from Dunfermline, is senior vice president of research and development at Inovio Pharmaceuticals in the United States, which has just received a $9 million grant towards creating a vaccine to tackle the deadly strain which originated in China.

 

The 45-year-old former St Columba’s High pupil is spearheading a team which designed a vaccine after receiving the sequence of the virus from the Chinese authorities, and is now working on manufacturing it so it can be tested in animals before going to clinical trials.

 

“Those $9 million will allow us to push that research and development into the clinic and allow us to give help to those patients in the outbreak region,” said Dr Broderick.

 

“We’re working day and night to make this happen,” she said on Fox News.

 

Dr Broderick – who studied at the University of Glasgow before moving to San Diego 20 years ago – revealed how computer technology allowed Inovio to design a vaccine within just hours of reviewing the genetic sequencing earlier this month — far quicker than the traditional approach of growing proteins in eggs.

 

Such is the pace of development, Dr Broderick said Inovio’s hope was to have a vaccine ready for human testing by the summer.

 

“The first case was reported to the WHO on December 31 and it didn’t seem super worrying. It was like a new strain of pneumonia but nothing crazy,” the molecular genetics specialist told The Courier.

 

“We quickly found out it was serious and within a week, the Chinese government had sent us a sequence of the virus to allow us to design a vaccine, which will be ready for testing in a few months.

 

“We’ve taken the DNA sequence of the virus to design a DNA medicine which works much faster than the vaccines we get as children.

 

“We’re hoping to have it tested by early summer and rolled out to where it’s needed. It might need to be scaled up to millions of doses, though.

 

“I have done something similar before when I was involved in treating the Zika virus around three years ago. The vaccine for that was developed and tested in seven months, which was the quickest ever, but we want to be faster again this time.

 

“We have a lot of experience with infectious diseases such as Ebola and Zika, so we’re really confident. The major hurdle is going to be scaling it up.”

 

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Il y a 5 heures, Freezbee a dit :

 

Taleb a d'ailleurs fait un post la dessus. 

 

Son point est de dire que R0 vaut que dalle parce que fat tails (surprenant n'est-ce pas) mais c'est pas si con. En gros, il dit que les stats de transmissions ne valent pas grand chose parce qu'il suffit d'un seul super vecteur pour infecter beaucoup de gens et ça colle avec ce que j'ai lu sur les épidémies dans The Tipping Point ou sur le SIda

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41 minutes ago, NoName said:

Taleb a d'ailleurs fait un post la dessus. 

 

Son poitbe St de dire que R0 vaut que dalle parce que fat tails (surprenant n'est-ce pas) mais c'est pas si con. En gros, il dit que les stats de transmissions ne valent pas grand chose parce qu'il suffit d'un seul super vecteur pour infecter beaucoup de gens et ça olé avec ce que j'ai lu sur els épidémies dans The Tipping Point ou sur le SIda

 

So ?

 

A la fin , 1000 malades infectent 2000 personnes. Je ne vois pas l'influence des fat tails ici.

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il y a 2 minutes, Lameador a dit :

 

So ?

 

A la fin , 1000 malades infectent 2000 personnes. Je ne vois pas l'influence des fat tails ici.

Que faire des prédictions et des modèles en partant du principe que le taux de transmission est stable n'est pas très intéressant et qu'il suffit sur de petits nombres comme on traite là de quelques cygnes noirs qui s'enchaînent  pour crever le plafond. 

 

Exemple: un pilote porteur sans symptômes infecte une dizaine d'hôtesse de l'air et de personnel d'aéroport qui auront un contact avec des dizaines de voyageurs qui iront dans le monde entier. 

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C'est paresseux de juste dire "fat tail lol". Il n'utilise pas au moins un peu de théorie des graphes ?

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il y a 9 minutes, NoName a dit :

Exemple: un pilote porteur sans symptômes infecte une dizaine d'hôtesse de l'air et de personnel d'aéroport qui auront un contact avec des dizaines de voyageurs qui iront dans le monde entier. 

 

C'est ce qu'on appelle un gros porteur. Ce n'est pas nouveau :

 

le-design-souriant-beluga-xl-nouveau-gro

 

Les épidémiologistes n'ont pas attendu Taleb : https://en.wikipedia.org/wiki/Super-spreader

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Ben tiens d'ailleurs justement

 

 

 

 

Il a aussi écrit un papier Btw

 

 

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3 minutes ago, NoName said:

Ben tiens d'ailleurs justement

Bon au moins là c'est exprimé en termes de graphes.

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il y a 47 minutes, Lancelot a dit :

Bon au moins là c'est exprimé en termes de graphes.

 

C'était posté plus haut, je dis ça je dis rien...

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2 minutes ago, Freezbee said:

C'était posté plus haut, je dis ça je dis rien...

Je n'étais pas allé regarder (parce que ça me semble complètement trivial) donc je n'avais pas vu la figure :jesaispo:

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Citation

Un quatrième cas de coronavirus avéré en France, annonce le directeur général de la Santé Jérôme Solomon

 

C'est un touriste chinois âgé qui se trouve dans un « état clinique sévère ». Hospitalisé à Paris, cet homme vient de la province de Hubei, la plus touchée de Chine, et se trouve actuellement en réanimation, a précisé le directeur général de la Santé, Jérôme Salomon, lors d’une conférence de presse.

 

Source : https://www.20minutes.fr/monde/2705247-20200128-coronavirus-direct-premier-rapatriement-francais-depuis-chine-prevu-jeudi

 

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Retranscription d'un thread assez intéressant...

 

 

Citation

Each day we learn more about the #nCOV2019 outbreak. Here is a #tweetorial on 5 key questions and terminology in infectious disease epidemiology to help make sense of all of this information.

 

#1. R0: what does it mean, and what does it tell us?

 

R[subscript]0 -- pronounced R-nought or R-zero, and called the basic reproductive “rate” or number, is the value that summarizes how contagious a pathogen is.

 

R0 is the average # of people one case will infect if it is introduced into an entirely susceptible population. If R0 >1 each infected person will transmit to >1 person, creating epidemic potential.

 

R0 does not give us any information on the total number of people who are currently infected. It is also not a measure of disease severity - it only tells us on average how many people each person will infect, not how severe those infections will be.

 

R0 does not have to be constant for a given disease, and may depend on factors such as population density and contact patterns. Despite this, it seems to be relatively similar for a given disease across populations.

 

There are several ways to estimate R0.  At an epidemic’s start, reported cases grow exponentially, and R0= (approximately) 1+growth rate*serial interval. The serial interval is the time between one infection and the next in a transmission chain. 

 

For more details on the math and the exact version see: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1766383/. Using this approach, Guangdong CDC reported estimates of the R0 for nCoV of 2.9: https://www.biorxiv.org/content/10.1101/2020.01.25.919787v1 

 

Challenges for this approach are:

 

a) unreliable reporting (missing cases) -can lead to biased estimates of R0 (up or down) if there are changes in proportion of cases detected or in delays in reporting

b) uncertain serial interval (time step over which to calculate the rate).

 

In simple mathematical models, we can estimate R0 as the probability of infection given contact with infectious person (b) x contact rate (k) x infectious duration (d). At the beginning of an outbreak, these parameters are challenging to estimate, given the limited data.

 

The # of contacts (k) is particularly hard to estimate. Heterogeneity in k can lead to “bursts” of cases from superspreading events (when one individual infects a large # of people) leading to heterogeneity in R0. Superspreaders played important roles in SARS and MERS outbreaks.

 

For the Wuhan nCoV there are several estimates of R0 using different approaches. A list is https://docs.google.com/spreadsheets/d/1QP5vM62ctnMRYdkQ4J5IqaOmB3hISGvYqCvnB8rBmNY/edit#gid=0. Not every approach is equally valid.

 

E.g., using the growth rate in cases by date of symptom onset is preferable to using the growth rate by date of report, because reporting can be delayed, come in “chunks” of many cases reported at once, and otherwise be confusing. Even date of onset has issues, but is better.

 

Also, the growth rate by date of symptom onset will seem to decline near the present, because recent cases won’t all have been reported. If not accounted for this can look like transmission is slowing. From 2009 flu: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1750-2659.2009.00106.x

 

 

#2. How do we know the # of cases?

 

Reports from health facilities and government agencies are key sources of information. But at the beginning of an outbreak, even if diagnostics are available quickly (like for nCoV), the total number of cases will be uncertain.

 

If we assume many cases are missed in the outbreak’s epicenter (here, Wuhan), but detection is near 100% in int’l travelers, case incidence in travelers combined w/ daily probability of travel and mean detection time can be used to estimate total # of cases at the epicenter.

 

This approach was used for the nCov outbreak: https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/news--wuhan-coronavirus/. Similar methods were used during the 2009 H1N1 epidemic. For the algebra behind it: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0006895 

 

HKU released results of their real-time nowcast and forecast, using number of confirmed cases and daily travel estimates: https://sph.hku.hk/images/news/press-releases2020/Wuhan-20200127.pdf 

 

This analysis combined an approach using outbound traveler volume from Wuhan and exported case numbers to estimate cases in Wuhan, then again used outbound travel volume to estimate cases exported to other Chinese cities. https://files.sph.hku.hk/download/wuhan_exportation_preprint.pdf 

 

Active surveillance, which involves testing an (ideally representative) sample of the population exhibiting symptoms, can also be used to estimate total # cases:   https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61377-5/

 

 

#3. How and when did the outbreak start?

 

Rapid genomic sequencing can help identify when a virus was introduced, how many times, and where imported infections originated. Viruses mutate, so if two people are infected with viruses that are similar, this suggests the two people’s infections are connected.

 

Combining analysis of genomes of viruses from those infected with estimates of how fast viruses are mutating and the total number of cases, we can estimate when the virus was introduced into a population.

 

Analyses of nCoV viruses suggest it was introduced in Nov or Dec 2019. The similarities in the viruses suggest only one or a small number of introductions from animals.

 

http://virological.org/t/phylodynamic-analysis-of-ncov-2019-genomes-27-jan-2020/353

https://nextstrain.org

 

Combined with data on people’s travel history and exposure, genomic data can help distinguish between imported cases and local transmission. Most cases outside of China have been imported, but local transmission is beginning to be reported. Global cases: https://systems.jhu.edu/

 

 

#4. How do we contain an outbreak? What makes containment harder or easier? 

 

R[subscript]e (effective reproductive number) is the # of people infected by a single case when the population isn’t entirely susceptible, and/or control measures are in place. Re=R0*(1-effect of control)*(proportion of pop susceptible). To stop an epidemic, Re must be <1.

 

Vaccines are some of our best tools for bringing Re <1, by reducing the proportion of the population that is susceptible. Like a forest fire, if susceptibles (trees) run out, the epidemic will burn out.

 

Vaccine development for #nCOV2019 is underway: https://cepi.net/news_cepi/cepi-to-fund-three-programmes-to-develop-vaccines-against-the-novel-coronavirus-ncov-2019/ 

 

Treatment can also reduce Re by decreasing the duration of infectiousness. Until vaccines and treatment are available, we must rely on nonpharmaceutical interventions. These include measures to decrease contacts, such as symptom monitoring/isolation and quarantine.

 

The relative effectiveness of these case-based interventions (which require knowing who is infected) depends on two key factors: 1) the relationship b/w timing of infectiousness and symptoms, 2) the proportion of presymptomatic and asymptomatic infections: https://www.pnas.org/content/101/16/6146

 

qMeColGs1a9LYpFX2GDqcUPLW7wCa_C20z-p5eEaOGc3mh-3W6eXYeE27jtVSBHVNYXrWvn1V2NJi7thD5MN92oXzY22ce74zDXPewyKaPySJW3y13sk0bxQvkD8Dch-EUj3lyoT

 

Infectiousness before or w/o symptoms makes control harder b/c cases may not be identified before transmission, or may be missed completely yet may transmit.

 

Quarantine of contacts can reduce these effects but has feasibility and social liberty costs. https://www.pnas.org/content/pnas/114/15/4023

 

0W254ShEp9743nWXi1Ek0NL9d2jIlut6CyRUR_y7gB2Tx42Tw6Bi60JJnFolydWgRNRDvZkHBqIbTKtpCT4h8aBQBqf0KgfJX5VG5vsSRJ5vhaCgTlw2e9fc5WMJElkuKhEaJiin

 

The substantial concern raised by reports of a presymptomatic transmission (https://www.bbc.com/news/world-asia-china-51254523) reflects that if it is common, control by isolation will be much harder. There isn’t any data yet on whether presymptomatic transmission is common in nCoV.

 

Screening of travelers at ports of entry for symptoms is another way to control outbreaks. Presymptomatic and asymptomatic transmission make this approach less effective.

 

 

#5. Severity - a double edged sword.

 

Understanding the clinical spectrum of a novel infectious pathogen is relevant for public health response to an outbreak.

 

Severe cases, while leading to hospitalization and potential death, are more likely to be detected and reported. Infected individuals with no or few symptoms are more likely to remain unnoticed. If these individuals contribute to transmission, the outbreak is harder to control.

 

On the other hand, if mild or asymptomatic cases are common and do NOT contribute much to transmission, then they will aid control because fewer individuals will need care, and their infections will likely give them immunity to reinfection, at least for some time.

 

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c'est juste moi ou le fait de rapatrier ses ressortissants vivant en Chine en France (ou ailleurs parce que 'il semble que chaque pays veut récupérer ses ressortissants hors de Chine) ça favorise la propagation du virus quoiqu'on en dise?

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il y a 33 minutes, biwi a dit :

c'est juste moi ou le fait de rapatrier ses ressortissants vivant en Chine en France (ou ailleurs parce que 'il semble que chaque pays veut récupérer ses ressortissants hors de Chine) ça favorise la propagation du virus quoiqu'on en dise?

ça me semble également techniquement totalement irrationnel.

Mais hélas pour nous, l'état vit beaucoup plus dans les symboles que dans la rationalité.

 

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il y a 28 minutes, Rübezahl a dit :

ça me semble également techniquement totalement irrationnel.

 

Si un Français pense que sa vie est en danger il pourrait décider de se rapatrier tout seul. Ce n'est pas une guerre et les voies d'accès ne sont pas bloquées ni attaquées. EDIT : Ah si en fait la Chine semble cloisonner des zones contaminées OK ça se tient.

 

Ces rapatriements sont révélateurs d'un certain état d'esprit. Le gouvernement français voit toujours le reste du monde comme un monde hostile à coloniser.

 

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il y a 4 minutes, L'affreux a dit :

Ces rapatriements sont révélateurs d'un certain état d'esprit. Le gouvernement français voit toujours le reste du monde comme un monde hostile à coloniser.

Moi je vois surtout ça comme l'état qui enfile bien ostensiblement sa belle cape de Zorro

pour sauver le pauvre individu isolé malade et tout seulet qui serait mourru sans Superman pour le sauver des griffes de la vilaine morquitue extérieure

et le ramener dans le nid douillet de sa communauté fronçaise ousque la sécu que le monde entier nouzenvie prendra le relais.

 

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Il y a 4 heures, biwi a dit :

c'est juste moi ou le fait de rapatrier ses ressortissants vivant en Chine en France (ou ailleurs parce que 'il semble que chaque pays veut récupérer ses ressortissants hors de Chine) ça favorise la propagation du virus quoiqu'on en dise?


Ça crée de l’aléa moral. Après les gens ne s’assurent pas quand ils partent en voyage. 

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Je me demande quelles seront les conséquences économiques de cette épidémie... C'est du jamais vu :

 

 

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3 minutes ago, Freezbee said:

Je me demande quelles seront les conséquences économiques de cette épidémie... C'est du jamais vu :

 

 

 

Techniquement, un cordon bien plus hermétique a été en place autour de la Chine entre 1960 et 1970

 

Et pour arriver à se sortir de cette zone sanitaire sinistrée, il faudra arriver à pied par la Chine.

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il y a 1 minute, Lameador a dit :

Techniquement, un cordon bien plus hermétique a été en place autour de la Chine entre 1960 et 1970

 

Oui enfin, quelle était la place de l'économie chinoise dans le monde à cette époque ?

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83258105_1662536850555245_4451764066507030528_o.jpg?_nc_cat=100&_nc_ohc=_uRVbzTuxdgAX9Qq-Ex&_nc_ht=scontent-ber1-1.xx&oh=3c519114eba30c77abcf9c739734110c&oe=5E8E5A35

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Quitte à faire mon mouton de Panurge collapsolocatastrophiste, je trouve cette affaire inquiétante. Pas au point de ma cacher sous mon lit, mais l'influenza de 1918 peut parfaitement revenir.

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A priori le lavage des mains n'est pas une pratique répandue en Chine, encore moins avec du savon. Conjugué à une défiance/ignorance sur la médecine "occidentale", ça n'aide pas du tout.

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