Disease modelers: the future of coronavirus doesn’t look good

Infectious-disease models have been approximating reality better and better in recent years.

Based on cutting-edge modeling, researchers predict 300,000 coronavirus cases by next week.

Working backwards from confirmed infections in countries other than mainland China, researchers at Imperial College London, who advise the World Health Organization, estimated that Wuhan had 1,000 to 9,700 symptomatic cases as of Jan. 18. Three days later, all of mainland China had officially reported 440 cases. This supports concerns of global health officials that China is undercounting.

In a more recent model run, Jonathan Read of England’s University of Lancaster and his colleagues estimated “that only about 1 in 20 infections were being detected.”

via StatNews

https://seekingalpha.com/news/3542438-disease-modelers-future-of-coronavirus-doesnt-look-good

HCA in the headlines — 12 latest stories

Here are 12 updates on Nashville, Tenn.-based HCA Healthcare’s financial performance, acquisitions, executive recruitment and lawsuits reported by Becker’s Hospital Review since Jan. 1.
1. HCA hiring 10 execs for Orlando teaching hospital
HCA Healthcare and the University of Central Florida in Orlando are hiring executives to lead services like quality, emergency services and patient safety at their new 64-bed facility in Orlando.
2. ‘Critically understaffed’: Lawmakers, patients and staff blast HCA’s takeover of Mission Health
Patients, staff and elected officials are raising concerns about HCA Healthcare’s management of Mission Health one year after the for-profit company acquired the Asheville, N.C.-based health system.
3. HCA to issue $1B in new notes
HCA Healthcare announced Feb. 11 that it will offer $1 billion of senior notes due in 2030.
4. HCA wins bid to dismiss ER ‘cover charge’ suit
A federal judge dismissed a proposed class-action lawsuit alleging HCA Healthcare billed emergency room patients for an undisclosed “cover charge.”
5. HCA has acquisitions in the pipeline, plans to expand nursing school
HCA Healthcare grew to 185 hospitals when it completed the $1.5 billion acquisition of Asheville, N.C.-based Mission Health last year. Now, the for-profit hospital operator is looking to expand again.
6. New Hampshire won’t block HCA, Frisbie hospital merger
The state won’t seek to block Frisbie Memorial Hospital in Rochester, N.H., from joining HCA Healthcare.
7. HCA’s profit tops $1B in Q4
HCA Healthcare said its revenue and profit were up year over year in the fourth quarter of last year.
8. HCA’s West Florida Division gets new chief nurse executive
Leanne Salazar, APRN, DNP, BSN, was promoted to chief nurse executive of HCA’s West Florida division.
9. HCA Houston Healthcare opens air ambulance service in Texas
HCA Houston Healthcare established a hospital-based air ambulance program that will service parts of Texas. The emergency helicopter service is called AirLife Ambulance Service.
10. HCA Gulf Coast Division appoints CMO
The HCA Gulf Coast Division selected Mujtaba Ali-Khan, DO, to serve as CMO.
11. HCA acquires tech company: 4 things to know
HCA Healthcare acquired Valify, a Frisco, Texas-based company that offers a web-based platform to help healthcare organizations identify opportunities to cut costs.
12. HCA buys majority stake in multistate nursing school
HCA Healthcare acquired a majority stake in the Galen College of Nursing, a multistate nursing school.
https://www.beckershospitalreview.com/finance/hca-in-the-headlines-12-latest-stories.html

Coronavirus outbreak: Countries that have tested negative

The novel coronavirus-affected countries as of 16 February stand at 27 including China, following the outbreak in Wuhan in December 2019. While a number of countries have announced suspected cases of the Covid-19, some of them felt a sigh of relief when the test for coronavirus came up negative.
Below is a list of countries where all suspected cases of the novel coronavirus have been tested negative resulting in no confirmed spread of the virus.

Ecuador

Ecuador was one of the first countries outside Mainland China to have reported a coronavirus suspected case on 26 January. The 49-year-old Chinese citizen arrived from Hong Kong and displayed symptoms of the infection. On 05 February, the Ecuador Ministry of Health announced the suspected coronavirus case tested negative.

Botswana

A total of five suspected cases of coronavirus infection were reported in Bostwana. All the cases have tested negative for the infection as reported by the government of Bostwana on 05 February.
The first suspected coronavirus case in Botswana was registered on 30 January, announced the Ministry of Health and Wellness on 31st January.
The suspect arrived in an Ethiopian Airways flight from China and is isolated and being investigated.

Czech Republic

Until the end of 04 February, Czech Republic screened a total of 48 individuals for the novel coronavirus and all of them tested negative, reported the Czech Ministry of Health.
Respilon Group, a nanofibre technology company based in Czech Republic, announced that it developed a new face mask that could limit the coronavirus spread.

Namibia

A 30-year-old woman with symptoms similar to those of coronavirus is being observed in a hospital Swakopmund, Namibia, on 01 February, reported Namibia Broadcasting Corporation (NBC). The woman had visited Sydney, Australia and arrived at the Hosea Kutako International Airport. She noted that her return flight included Chinese passengers who were wearing masks and coughing. The Namibia Health Ministry confirmed the news about the suspected case, added NBC.
On 03 February, the Namibian Health minister announced that the suspected case has tested negative.

Peru

The Peruvian Ministry of Health confirmed in its latest update on 03 February that no confirmed coronavirus cases exist in the country. Earlier on 31 January, the Ministry announced that all the four suspected to have coronavirus tested negative.

Maldives: Suspected cases test negative

Maldives, which is already working hard to control a measles outbreak, witnessed the first suspected coronavirus case on 30 January in a male who arrived from Xiamen, China. Subsequently, six other cases were reported of Malvidians who travelled to China. The Maldives Ministry of Health announced that all cases tested negative for the virus on 03 February.

Myanmar: Novel coronavirus suspected cases

The first suspected coronavirus case of a Chinese visitor in Myanmar was reported on 31 January. The visitor arrived in Yangon on a China Southern Airlines flight, from Guangzhou. Out of the remaining 78 passengers the flight carried, only two were allowed to disembark the plane, while the rest 76 were not, reported Anadolu Agency.
Myanmar, however, announced that the suspected case tested negative for the virus.

Angola

The first suspected coronavirus case in Angola was reported on 29 January. The suspected is a Chinese citizen currently under observation in a clinic in Luanda. His samples have tested negative for the virus.

Ivory Coast (Côte d’Ivoire)

One suspected case of coronavirus infection was reported in the Ivory Coast on 26 January 2020. The patient, a 34-year old female student, arrived from Beijing to Abidjan in the Ivory Coast. She was placed under isolation and remained stable during the observation period.
Her samples tested negative for coronavirus, announced officials.

Ethiopia

Four people that were suspected to have contracted the coronavirus infection and hence placed under isolation in Addis Ababa were announced to have tested negative for the infection.
Three of them are students studying in universities in the Wuhan city.

Kenya

Kenya reported on 30 January 2020 that the first suspected case of coronavirus infection has tested negative.
The case, first reported on 28 January 2020, was a traveller from Guangzhou who displayed symptoms of the disease. He was first placed in isloation at the Jomo Kenyatta
International Airport upon arrival and later placed in isolation at the Infectious Disease Unit of the Kenyatta National Hospital. Coronavirus test results showed that the person was suffering was common cold, but not the coronavirus infection.

Austria

A total of seven Austrians who arrived from China and placed under quarantine at the Hygiene Centre Vienna tested negative for coronavirus infection on 04 February. The seven people arrived in Austria on 02 February and isloated as a precautionary measure.

Mexico

Mexico reported seven suspected cases of the coronavirus infection, all of which tested negative on 27 January. The suspected cases included a 42-year-old man who recently visited Wuhan, and a 37-year-old woman and a two-year-old girl who came in contact with the man. They are currently receiving medical treatment for other respiratory illnesses. Another three cases were reported in Jalisco 20 January.

New Zealand

The first suspected case announced on 31 January in New Zealand tested negative. the test results were announced on 1 February by Dr Ashley Bloomfield, the Director General of Health.
The person was suspected of contracting the disease and held in isolation at the Auckland City Hospital.

Cyprus

A man from China who was suspected of contracting the coronavirus infection tested negative on 02 February 2020, according to Cyprus News Agency.
The man was placed under quarantine at the Nicosia General Hospital on 31 January after he showed symptoms of the disease.

Croatia

A man held in isolation at the Split KBC hospital for showing symptoms of coronavirus infection tested negative on 03 February, according to Total Croatia News. He was suspected of having contracted the infection on 2 February after having recently visiting China.

Suspected coronavirus in Switzerland

Two suspected cases of coronavirus infection tested negative on 28 January, according to SWI. The two cases were first reported on 27 January and placed in isolation at the Triemli hospital in Zurich. The persons had recently visited China and returned with symptoms of the infection.

Greece

A sixty-year old man suspected of contracting the coronavirus infection has tested negative for the disease, reported the Greek City Times. The man was placed under quarantine at the AHEPA University General Hospital.

Denmark

Denmark has announced that all those tested of suspected coronavirus have turned out to be negative as of 04 February.
The most recent tests were on those that arrived at Roskilde Airport from Wuhan. Earlier, a Danish that returned from Wuhan with symptoms of infection was isolated and tested at Aarhus University Hospital. The test was confirmed to be negative.

Ireland

Ireland suspected a person that came from Wuhan to have coronavirus infection and admitted him to the Royal Victoria Hospital, but the tests were confirmed to be negative by the Department of Health, reported the BBC on 25 January.
As of 11 February, a total of 15 suspected coronavirus cases have been tested, all of which came up negative.

Coronavirus outbreak: Countries that have tested negative

Hong Kong warns of coronavirus-related ‘economic winter’

“The actual impact of this [coronavirus] epidemic on Hong Kong’s economy is quite large, and may be higher than the impact of SARS on the economy in 2003,” Financial Secretary Paul Chan wrote in a blog post.

“In addition to the epidemic, the local situation has not completely escaped the haze of last year’s social events. It is necessary to maintain a cautious attitude towards the short-term economic outlook.”

“Such “tsunami-like” shocks may cause the unemployment rate to deteriorate rapidly. Indeed, the projected fiscal deficit for the new fiscal year (2020/21), in terms of amount, may be the highest ever.”

“The affected areas are no longer confined to retail, catering or tourism-related industries… I hope we can survive this economic winter that may not be a half-moment.”

https://seekingalpha.com/news/3542435-hong-kong-warns-of-coronavirus-related-economic-winter

Yum China gives gloomy outlook for China-heavy businesses

From Yum China’s (NYSE:YUMC) Q4 earnings call:

“The recent coronavirus outbreaks have caused significant interruptions to our business. The impact comes from temporary closure of our restaurants, as well as a substantial decline in sales to the restaurants that remain open. We started closing some of our restaurants right before the Chinese New Year.

“In recent days, more than 30% of our restaurants were closed. The traffic at the restaurants that remained open were impacted by travel restriction, suspended facilities and shortened operating hours as people avoid going out. For the restaurants that remained open, same-store sales since the Chinese New Year declined by 40% to 50% year-over-year after adjusting for the timing of the Chinese New Year holiday.

“While dining traffic was hard hit, as people avoided public gatherings, delivery is holding up well. To better serve our customer and to protect our employees, we rolled out contactless delivery, which is very well received by our customers. In addition, we also rolled out order online pick up and in-store contactless services and saw some encouraging early results as well.

“However, at this time, we cannot forecast when, nor at what rate the closed restaurant will be reopened and the traffic will be restored. Furthermore, we may be required or otherwise decide to close additional stores or modify our operation in response to the outbreak. The situation is rapidly evolving. While we cannot yet fully ascertain the expected impact. We may experience operating losses for the first quarter of 2020 and if the sales trend continues for the full year of 2020. Future operations, cash flow, and financial position may be materially and adversely influenced by the further development related to the outbreak including potential additional announcements and action from the central and local authorities or other reasons.”

In the words of Up-and-to-the-Right Capital Management: “Does $YUMC really seem like a stock price that’s baked in the health crisis in China? Amazing how everybody is able to keep such a long-term perspective on these things.”

https://seekingalpha.com/news/3542437-yum-china-gives-gloomy-outlook-for-china-heavy-businesses-due-to-coronavirus-impact

Jana cuts stake in Zimmer, ups Wright Medical shares

Jana Partners 13F portfolio value stood at $1.2B this quarter, down 3.2% from the last quarter.

Jana Partners trimmed its stake in Callaway Golf (NYSE:ELY), Bloomin Brands (NASDAQ:BLMN), while halved its position in Axalta Coating (NYSE:AXTA) and Zimmer Biomet (NYSE:ZBH).

Added Wright Medical Group (NASDAQ:WMGI) to its portfolio.

https://seekingalpha.com/news/3542436-jana-partners-halves-stake-in-axalta-coating-zimmer-biomet

Global Chronic Kidney Disease Mortality Up More Than 40%

The global burden of chronic kidney disease (CKD) has increased substantially since the 1990s, but in many countries people can still not afford adequate care, researchers reported.
An analysis of data from 195 countries found that 1.23 million people died worldwide from CKD in 2017, an increase of 41.5% since 1990, reported Theo Vos, MD, PhD, of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine in Seattle, and colleagues.
In addition, according to the analysis online in The Lancet, there were 697.5 million cases of CKD worldwide in 2017, for a global prevalence of 9.1%. That was a 29% increase from 1990. However, the age-standardized prevalence and mortality rates for CKD have remained relatively stable since 1990, indicating that the increases are driven by an aging population, the researchers said.
Approximately one-third of CKD patients lived in just two countries: China (132 million cases) and India (115 million). Countries with more than 10 million cases included the U.S., Indonesia, Russia, Japan, Brazil, Pakistan, Mexico, Nigeria, Bangladesh, and Vietnam. In total, 79 of the countries in the analysis had more than one million cases of CKD. The analysis was part of the Global Burden of Disease (GBD) study coordinated by IHME.
“The number of individuals with all stages of prevalent CKD reached almost 700 million in 2017, a number larger than that of diabetes, osteoarthritis, chronic obstructive pulmonary disease (COPD), asthma, or depressive disorders,” Vos and co-authors wrote. “GBD ranks CKD as the 12th leading cause of death out of 133 conditions. Globally in 2017, CKD resulted in more deaths than tuberculosis or HIV and was almost equal to the number of deaths due to road injuries.”
“We have not seen the same degree of progress in prevention of CKD mortality as we have for many other important non-communicable disease,” the researchers added. “From 1990 to 2017, the global age-standardized mortality rate declined by 30.4% for cardiovascular disease (CVD), 14.9% for cancer, and 41.3% for COPD, but a similar decline was not seen for CKD.”
The study also assessed the global burden of CKD in terms of disability-adjusted life-years (DALYs). In 2017, CKD resulted in 7.3 million years lived with disability and 28.5 million years of life lost, for a total of 35.8 million DALYs.
Poorer countries bore the brunt of this burden. El Salvador, the Marshall Islands, Mauritius, Micronesia, and American Samoa had the highest estimated rates of age-standardized DALYs, with more than 1,500 per 100,000 population. Slovenia, Finland, Iceland, and Andorra experienced the lowest burden, with less than 120 age-standardized DALYs per 100,000.
Disparities in CKD burden highlight the disparities in treatment access, the study authors said. “For instance, in sub-Saharan Africa, even if individuals requiring renal replacement therapy initiate treatment, retention is low due to inability to pay for ongoing dialysis, and up to 85% of the incident patients are forced to withdraw from this life-saving treatment.”
In an accompanying press release, Vos said, “Chronic kidney disease is a global killer hidden in plain sight. The evidence is clear: Many nations’ health systems cannot keep pace with the dialysis demand. Cases far exceed and are well beyond the ability of those systems to handle. The consequences, literally, are deadly.”
The researchers complied data on CKD epidemiology through systematic literature reviews in PubMed and EMBASE, using search queries combining “chronic kidney disease” and “prevalence.” Data on dialysis and kidney transplant were obtained from medical registries. The investigators calculated disease burden estimates using a Cause of Death Ensemble model (CODEm) and Bayesian meta-regression analyses.
An important limitation of the research, the team said, was lack of quality, population-based studies on the incidence or prevalence of CKD for many countries, especially those in Central and Latin America. As such, the GBD study had to rely on statistical methods and predictive covariate values to estimate the CKD burden in those regions.
In addition, many of the studies included in the analysis were cross-sectional and performed only one laboratory measurement to determine CKD. “Studies suggest that the use of a single decreased eGFR [estimated glomerular filtration rate] determination to characterize CKD may overestimate prevalence by anywhere from 25% to 50%,” the researchers wrote. “It is therefore possible that the results of our analysis represent an overestimate of CKD prevalence.”
However, “kidney disease has a major impact on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for CVD,” Vos and co-authors continued. “Chronic kidney disease is largely preventable and treatable and deserves greater attention in global health policy decision-making, especially in low and middle socio-demographic index geographies.”

Disclosures

The study was supported by the Bill & Melinda Gates Foundation.
Vos disclosed no conflicts of interest; one co-author reported receiving a grant from the European Union’s Horizon 2020 research and innovation program.

Primary Source

The Lancet

Source Reference: GBD Chronic Kidney Disease Collaboration “Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017” The Lancet 2020; DOI: 10.1016/S0140-6736(19)32977-0.

https://www.medpagetoday.com/nephrology/generalnephrology/84879