> Doctors there were running "naked" as they knew they were set to be infected given the shortage of protective gear. They still worked there nonetheless.
That is so rough, especially since some healthcare workers are now among the dead: specifically, I saw that Li Wenliang had died.
> "Doctors there were running "naked" as they knew they were set to be infected given the shortage of protective gear. They still worked there nonetheless."
The absolute definition of heroes. It blows my mind to imagine ever having that sort of selfless dedication to helping others. For all the crappy things in the world these days, it's stuff like this that gives me hope for humanity.
> Doctors there were running "naked" as they knew they were set to be infected given the shortage of protective gear. They still worked there nonetheless.
This was one of the most tragic things in that article.
The doctors, nurses, and health workers are the front line soldiers in this fight against the virus. And they don’t have the protective gear that they need to stay safe, and to keep the population safe, as well as the rest of the world.
I hope they can fight the infection, and survive, and live to fight another day. We need them!
According to a medical professional in my family who have close friends that have worked on the front line of epidemics, the high grade protective gears are like space suits, it takes close to an hour just to put them on and make sure they’re airtight, and taking them off takes even longer due to the significant risk of inflection (compared to when you put on a clean set) if you don’t take extreme care. Then there’s shower and stuff. You can’t eat or drink anything during the entire process, including the four to six hour shift in between putting on and taking off, and not surprisingly it’s extra taxing to work in the suits. Therefore, even if there are enough protective gear, fully equipping them basically cuts the available labor force by half, which is already heavily strained.
You are probably thinking of hazmat suits and it's not the most common type.
Medical staff in Wuhan wear disposable protective overalls that are made of a thin layer of polypropylene (as intended so it would be light and cheap) and easily torn. Thus it's necessary to avoid taking them on and off between shifts because the act will probably rip it beyond repair. Some also took the additional step of strapping plastic bags to their feet and forearm to protect against rupture. None of this would have been necessary if they had enough to go around.
They may be thinking of Bio-Safety Level (BSL) 4 Personal Protective Equipment (PPE). The CDC has suggested nCOV-2019 be investigated/treated with BSL 2 PPE. Links to the CDC guidelines and a doc outlines what constitutes BSL 2 are below.
I’ve asked for clarifications and was told that yes, the outer layer is indeed disposable, but medical staff need to wear multiple layers of protection, and the dressing and removal processes do take an hour or more each.
I would like to discuss the definition of heroism (which might easily be culture-specific); however, I suspect that it is a highly sensitive subject in this context, so let's leave it at that.
Suggesting that soldiers cannot be heroes while on duty?
It's rather common to see our cultures honor fallen soldiers and regard them as the archetypal case of heroes. Being on duty has never been considered a limitation.
In the 2019 television series, they were miners conscripted into service on the disaster. And in the show they actually did work literally naked due to the heat.
My wife is mainland Chinese, and she has been saying that it a worse than what the government is saying. Also, since Li Wenliang died, well, frankly a lot of people are pissed at the CCP.
Anyway, I feel like it’ll be an epidemic ( it already is, I believe ) in China, and be much better controlled outside of China.
Unfortunately my wife is also stuck in Chongqing; Taiwan is essentially closing up its borders and we don’t know if she’ll be able to move here to Taiwan to live with me. At least not until things blow over ( I assume summer time ).
I live in Taiwan and they’ve been very good at containing this, afaik. Just this morning they released a map of Taiwan with nav-points where all the cruise ship people were at in Taiwan before they went on the ship, and released information on what to do if you experience certain symptoms. 13 people have been diagnosed and quarantined.
I don’t understand what it is that the Chinese authorities are supposedly misreporting?
The mortality rate of 2% is consistent with the number of cases and deaths reported by other countries.
Is it that there are a large number of undiagnosed cases? That is kind of a given and is probably also the case in other countries.
The timespan between first case and until it gets reported to who and quarantines start is less than a month. To me that seems very fast (but I am just a layperson).
My wife, when she went to the hospital to be diagnosed, said that they had a separate room for those that were diagnosed with having the Wuhan virus, and a separate room for those that did not.
She saw several people in that room, and yet over the next few days, only one new case was reported from that hospital.
I don’t know if this is due to unconfirmed or bad diagnosis, but this is just yet another red flag in a country full of red flags.
As for my wife, she only had a respiratory infection and got medicine for it. She’s better now, but now her mother is sick -.-
Good luck to you and yours. My grandparents are worried and they're on the other side of the planet. I can only imagine what the atmosphere is in your region.
Presumably they could be under-reporting the number of infections and the number of deaths, to keep the mortality rate consistent.
I don't know why they would do that, but they are accused of doing this kind of thing frequently.
If they sat on the news of the virus for an extended period they might have known the mortality rate they needed to align with long before the rest us.
If Chinese authorities are under reporting both, death and infections, inorder to drive "true" mortality up that would mean there more unreported people dying in relation to people being infected compared to the reported numbers. And yet every real expert out there is telling us the opposite is more likely because only the more severe cases tend to be reported. And mortality is expected to be lower if the unreported cases are considered. Not sure why laypeople prefer to believe the contrary of what experts are telling us.
Every expert is not saying that the infection rate is much higher than the official numbers, but the death rate is reliable. They’re both unreliable and we just don’t know the true numbers. China’s reaction is not comforting though.
No, you misunderstood the parent, as well as the facts: experts are saying that the widely parroted “2%” number is an overestimate, and that the real infection rate is lower.
Deaths are easy to count. Minor cases of the virus are likely the most common sort, and never show up in a hospital at all.
No, I didn’t misunderstand anything. The “real experts” are saying that the denominator (number of infected) is likely much higher than official numbers. But they are not saying that the numerator (deaths) is accurately represented by official figures. Deaths are easy to count if you only count deaths of confirmed infected people. There’s plenty of evidence that people are dying outside of the medical system, and that China is not accurately reporting all deaths from within the medical system as being caused by the virus.
In short, we have no idea, and it’s very dishonest to claim that either number is remotely reliable at this point.
Now the interesting question is which number is greater, unreported cases or unreported deaths. I'd say the number of unreported cases tends to be way higher than unreported deaths. Fits apparently epidemics in general. Also it is kind of logic. Severe cases have a bias to end up in hospitals, and to reported when they end deadly, only leaving the measuring error due to reporting issues.
Less severe cases on the other hand have a tendency to end up unreported, not in the hospital. Neither deadly. Still leaves a number of never reported cases. All in all, unreported cases are likely to be higher than unreported deaths. As a result, qualitatively speaking, mortality should be lower.
I'd say the number of unreported cases tends to be way higher than unreported deaths.
Of course, but that doesn’t mean that mortality will be lower. A much smaller number of unreported deaths can shift the rate upward. At a 2% mortality rate, you only need one unreported death for every 50 unreported infected to maintain the same rate. That might be laughably high or laughably low. We just don’t know.
But the people in the best position to know, the Chinese government, seem to be taking this pretty damn seriously.
The main reason now is that the confirmation method of infection is still under debate and improvement. The current method is nucleic acid detection, which only has about 50% accuracy, so obviously a huge number of people out there cannot be diagnosed, and they won't be added to the official number.
And there are also rumors out there saying the lack of medical resources. Sick people couldn't get proper medical treatment and dying at home or somewhere. Because they didn't get diagnosed before they die, so the number won't be added to the official number. Don't know if it's true or how many people are dying there, but sure it's terrifying.
About misreporting, they did do it back in January, mainly because they want to control the panic as they always do, (and probably they didn't know it's gonna be this bad), but it should be much better now (I hope).
Just as an aside: "accuracy" is a pointless measure if you don't also know the ratio of true cases to false cases. The metrics you really want is the True/False Positive rates - without that you can't gauge the quality of a test like this.
The data I got is that among the people who really got the virus, positive rate of the test is only 30% - 50%. So false negative rate is as high as 50-70%.
Yeah. It's not that bad outside Wuhan, people who infected will get top level treatment, there will be best experts doing the diagnostics. But for Wuhan, where medical resources are extremely in short, we can only pray for the people there. Hope it's gonna be better.
Chinese authorities at some level -- it's not clear that this was CCP or local Wuhan decisionmakers -- clearly tried to shut down initial reports of the outbreak, as evidenced by Dr. Li Wenliang's detention and citation.
As a new disease, with the first cases possibly being acquired as early as late November 2019, it wasn't until mid to late January 2020 that city and national authorities appeared to start taking the outbreak seriously.
I'm not aware of other novel outbreaks outside of China and how quickly those have attracted notice, though there's the case of the 1976 initial outbreak of Legionaire's Disease, reported within a week of first outbreak (though the disease was both fast-acting and rapidly lethal for many victims). However epidemiologists also realised that there had been previous, unrecognised outbreaks, dating to the 1950s. See:
The case of HIV/AIDS in the US and elsehwere would be a case of a disease with ascribed social and moral assocations, for which early responses were very much delayed, on of several examples of stigma associated with the disease:
https://en.wikipedia.org/wiki/Discrimination_against_people_...
(The fact that SARS, MERS, and 2019-nCoV all appear to have emerged during November may be significant.)
Point being:
- China are slow to detect, report, and respond to new contagious epidemics. Notably so in the case of SARS, and less so, but still, with 2019-nCoV.
- Other countries, including the US, have had similar failures.
- Early unofficial public disclosure of 2019-nCoV was prosecuted by Chinese authorities, though at what direction is unclear.
- Trust between the people and the government is somewhat frayed.
- There are also numerous actors with incentives to make the most of any missteps of the government, or to inflate distrust.
Several of those groups have legitimate gripes against the Chinese government, and I've seen reports associated with Falun Gong, Hong Kong, and Taiwan specifically. I've not seen any associated with Tibet or Uygher populations. And there are various rabble-rousing actors elsewhere, doomers, and conspiracists (generally of the nutcake variety).
This ... clouds information. Many of the criticisms are legimate, some are not, and sorting fact from fiction (both between and within reports) is challenging. China are in the position where both locked-down and unfettered communications are potentially harmful -- the first for preventing accurate information from being available to both public and government, the latter for allowing agents provacateurs to rumourmonger, exaggerate bad news, and spread active disinforation. This is strong shades of attacks the West has seen over the past several years (within the US, UK, EU, and elsewhere), some of it from China itself.
> The fact that SARS, MERS, and 2019-nCoV all appear to have emerged during November may be significant.
From [1]: The “seasonal” reflects the fact that viruses can’t tolerate high heat and humidity, preferring the cool and dry conditions of winter and spring, Webby said. That’s why flu, as well as the four coronaviruses, are less prevalent in warm, humid months.
Also less prevalent in warm and humid regions (though spread in Singapore and Thailand is ... interesting).
This is among the reasons my concerns' been on a breakout in North Korea, which has both a meterological and political/epidemiological climate that seems highly favourable to outbreak of a disease such as 2019-nCoV.
Though it's politically viable to order a near-complete shutdown of transportation and travel, the likelihood of this being effective (particularly against high-level party members breaking quarantine), or pragmatically possible to sustain (what exists of the PRK economy likely requires people in close contact), limiting epidemiological effectiveness.
Thank you so much for this comment. I feel it quite balanced and Lola at the topic from multiple angles.
However I would like to inquire why you see Dr.Li's detention as evidence of "shutting down initial reports of the outbreak"?
First of all we do not have any kind of real insight on what Dr.Li was actually saying, and what was the severity of his reprimandation.
When something is on the lose that has the potential to kill millions, you need to be quick and purposeful in controlling the message. Wrong information can make people underprepare, but it can also make people overprepare.
The BBC is the UK's national broadcaster. SCMP is owned by the Alibaba group, a major mainland China corporation. Each clearly labels Dr. Li as a whistleblower. SCMP's story includes a highlighted summary "China’s health authorities and the public have offered their condolences over the death of the doctor, whom police tried to silence in the early days of the outbreak".
Both articles focus on Li's acts in breaking the nCoV story -- without really wanting or intending to -- the initial negative response of Wuhan police, and the narrative now, from authorities such as Zeng Guang, chief epidemiologist at the Chinese Centre for Disease Control and Prevention (reported in the SCMP story) that "that the eight people punished by the police should be held in 'high regard'", again, quoting the SCMP directly.
As for ongoing suppression of discussion adjacent to the nCoV outbreak, messages of support for Li and criticism of the Chinese government continue to be censored:
The top two trending hashtags on the website were "Wuhan government owes Dr Li Wenliang and apology" and "We want freedom of speech".
Both hashtags were quickly censored. When the BBC searched Weibo on Friday morning, hundreds of thousands of comments had already been wiped.
As a reminder, don't mix this rate with case fatality (or lethality) rate, which is counted on ended cases and is about 30%. This is your real chance when you're infected.
There’s lots of people who aren’t going to hospitals and aren’t tracked. If it’s really a 30% fatality rate, we’re going to lose a billion people to this before it over.
Take a hypothetical disease A that started spreading on Jan 1st. It takes a patient 1 month to recover from A, while it only takes 7 days for A to kill. We perform a calculation on Feb 9th to determine A's case fatality rate.
The correct way to calculate A's case fatality rate would be to select a cohort, Group B, for example: everyone infected in the first week. And calculate:
(deaths in Group B by Feb 9th) / (deaths in Group B by Feb 9th + recovered in Group B by Feb 9th)
An incorrect way to calculate A's case fatality rate would be:
(deaths by Feb 9th) / (deaths by Feb 9th + recovered by Feb 9th)
This is incorrect because "deaths by Feb 9th" includes all deaths from people infected between Jan 1st and Feb 2nd, while "recovered by Feb 9th" only counts the recovered patients who were infected between Jan 1st and Jan 9th. The above equation basically expands to:
(deaths in Group C by Feb 9th) / (deaths in Group C by Feb 9th + recovered in Group D by Feb 9th)
Where:
Group C: infected between Jan 1st and Feb 2nd
Group D: infected between Jan 1st and Jan 9th
Since disease A is spreading exponentially, it's clear that Group C is a few orders of magnitude larger than Group D.
Official mortality rate is 2.1%. Deaths per confirmed infections. And yes, the WHO isn't that stupid to count cases that aren't decided yet. And yes, they are smart enough to take the appr. three weeks it usually takes until death into account.
No idea where you got that 30% from. Even in Wuhan, with its medical infrastructure close to the breaking point, we are talking about 4.9%.
According to https://coronavirus.app/ we have 34955 infected, 726 dead, 2287 recovered as of now. Total resolved cases are dead + recovered, which is 3013. Fatality rate is 726 / 3013 = 24.1%. At the time of my original post it was 30%.
That's exactly what I don't understand. Logically, wouldn't deaths typically lag diagnosis by some amount? If so, we would expect the death rate to be higher than current deaths/cases because we need to use the confirmed cases from some number of days ago. That number of days being the average time between someone being diagnosed and dying.
Another stat is that there are roughly 700 deaths and 2400 recoveries, which would indicate a mortality rate of 23%. Of course, this suffers from the same delay issue as the 2% calculation (T_death < T_recovery). But the possible range is 2% < M_rate < 23%
There's a standard paper on this topic the authors I forget atm but all estimates will be biased. The best estimates are sort of unintuitive and account for estimated time-to-death and the time since diagnosis.
The question I'm still not sure is: of those who were infected, how many have been discharged from the hospital already? What was their mean recovery time?
Just over 2300 have been discharged based on a 10-day absence of viral RNA in throat swabs.
There has been some discussion about changing the guidelines to discharge patients after 3 days without viral titre but I'm not sure if this has been adopted. Any comment about recovery time would have to be made after the dust settles.
Which, from what I read so far, should drive mortality down. Reason is that unreported cases trend towards less severe cases with an overall lower mortality rate. And nobody is disputing that kind of underreporting in any way. So I'm not sure why everybody is making such a fuss about that.
If you underreporting deaths without underreporting infections doesn't work. You can underreport deaths, sure. But you have to consider the underreporting of cases as well. And all these cases have bias towards being less severe. Also, the underreporting of infections is kind of systematic. So in order to increase mortality by underreporting both, infections and deaths, the mortality rate of unreported cases has to be higher than the rate for reported cases. Which is unlikely, severe cases have a tendency to show up at hospitals.
So unless you believe authorities are getting with hiding hundreds of deaths at hospitals being under international scrutiny, while simultaneously hiding the fact that dead people pile up at their homes, this theory seems kind of unlikely. Especially since international numbers outside of mainland China are more or less in line.
I dunno if you’ve seen any of the undercover videos from the hospitals? It’s entirely possible there are hundreds of deaths that haven’t been recorded. Many deaths are being recorded with viral pneumonia as death as they don’t have enough test kits to verify and are therefore not attributed to this coronavirus.
Undercover videos. Played to much Plague Inc. lately? As long as numbers from the epicenter in Wuhan don't deviate to much from international WHO numbers I will not go by "it is possible that...". I don't argue the situation in Wuhan is horrible. But taking some individual cases from area hit worst and build some BS theories out of that, going against every expert opinion out there, is just conspiracy theory shit. And spreading panic.
So all the youtubers arw able to counter proof them with videos people in other countries, without any relevant medical expertise, are analysing. Great. Now tell me, how exactly are the youtubers and people on Twitter getting the "true" numbers if China is censoring everything? And why do you refuse to accept that the Chinese figures do align pretty well with numbers from other countries? Or do the Chinese and the WHO conspire with all other governments as well to keep the "truth" hidden?
I'm not taking either side, only saying its a possibility. Given how egregious figures and "facts" from the CCP have been previously I trust them less than most. They made their reputation so they have to live with it.
But hey, you want to panic, go for it. But do it for yourself. Because now the "independent" media, the "propaganda" and the WHO numbers are more or less the same.
> Also, since Li Wenliang died, well, frankly a lot of people are pissed at the CCP.
This is a pretty irrational reaction if you ask me, the CCP is actually the more open, quasi-democratic side of Chinese government and politics. There are loose 'factions' as part of the CCP that are cautiously pushing for more openness, and the Chinese should be aware of them and be supportive. Frustration and anger are not helpful.
If they screw up other measures, like hygiene for the sick and food delivery to 50 million people they can multiply the death rate.
Modern theory of Spanish flu[1] is that the flu itself was not that deadly. Combination of influenza with bacteria in the lungs caused most of the deaths. It was the World War I with lots of wounded in the same place, bad hygiene conditions, many with scarred lungs from poison gas and civilians suffering from malnutrition.
> However, it is possible that — as in 1918 — a similar pattern of viral damage followed by bacterial invasion could unfold, say the authors. Preparations for diagnosing, treating and preventing bacterial pneumonia should be among highest priorities in influenza pandemic planning, they write. "We are encouraged by the fact that pandemic planners are already considering and implementing some of these actions," says Dr. Fauci.
Spanish flu killed very many people in regions that did not directly participate in WWI, so civilians (as opposed to recruits sent overseas) should not be affected by the war; e.g. India, Indonesia, etc.
The half a million people who died of the Spanish flu in USA did not die because lots of wounded in the same place and scarred lungs from poison gas.
In the US roughly half present of the population died. It killed roughly ~5% of the world's population.
btw. I did not say WWII was the single cause for high mortality. Hygiene, malnutrition etc. contributed. And the virus itself had higher mortality rate than usual, but not as much as previously thought.
>Whatever is taken as estimation of the American pandemic death burden, it is well below the European estimations we provide and others have provided. A possible explanation is that, at the end of WW1, Europe was characterised by massive civilian and army movements, a health care system put at its minimum and frail populations. This has very likely heavily impacted the European death toll.
There are very little details on how the bodies are being disposed of. Does the virus become dormant at a certain temperature ranges? How does it fare with irradiation? These are the kinds of experiments that need to be run.
Honestly if there is truth to this article it is reassuring. I've been scouring the darker corners of the internet obsessively for every seemingly reputable bit of data under the assumption that virtually anything official out of China could not be trusted.
This doctor is working on the absolute worst of cases and even they, it seems, have a high overall probability of survival. Also good to see some figures on the progression of the virus - 5-10 days of incubation, 1 week before symptoms either improve or worsen, then one more week before severe cases recover or die.
Regardless, we should all be paying attention to the quarantined cruise ships. In a few weeks or so we'll have much a more accurate mortality rate. I feel for those people but perhaps there is some comfort in knowing that their losses will not be without value.
We had a SARS outbreak in Taiwan since we trusted the statement from Chinese government back then. This time we assume coronavirus can do person to person transmission and blocked travel to WuHan back when CCP and WHO were downplaying its ability to spread. That's how we have less cases than Japan, Korea and Hong Kong now.
Recently Taiwanese people in WuHan asked for evacuation. CCP denied our request at first, then they allowed but the plane had to be operated by them. We requested to fly children, elderly and people with medical condition first, instead they flew wealthy businessmen with good connection to CCP and their China spouses. Three people on that plane exhibit symptoms at customs and one of them is confirmed infected with coronavirus. Now we have to quarantine all 200+ people boarded.
> That's how we have less cases than Japan, Korea and Hong Kong now.
There could be other reasons for this, no? I mean, specifically in Japan's case, a huge cluster of that is from cruise ships. That seems more like a [bad] luck thing rather than the result of proactive action.
Also, I think we should make the distinction between "cases" and "confirmed cases". I'm in Singapore and one of the reasons given why Singapore has so many confirmed cases (3rd most) is that the Government is relentless about tracking infections.
Maybe that's just a positive spin. Either way, I think there's a lot of reasons to take these early numbers with a grain of salt.
Before the cruise ship, Japan already got domestic transmission case which is a bus driver driving tour groups from WuHan. It is confirmed on 1/28. (Later the Japanese local tour guide on that bus is also confirmed infected) They barred foreign nationals who visited China's Hubei Province on 2/1
Taiwan blocked tour groups from Hubei on 1/24 and ordered to evict existing groups. There are two confirmed cases whom are WuHan tourists entered before 1/24. Fortunately they did not caused domestic transmission.
The case I referred on that evacuation plane is a confirmed case and there is still a chance there might be more cases from that plane since the on-plane protection is reported to be sloppy.
> We requested to fly children, elderly and people with medical condition first, instead they flew wealthy businessmen with good connection to CCP and their China spouses.
> I've been scouring the darker corners of the internet obsessively for every seemingly reputable bit of data under the assumption that virtually anything official out of China could not be trusted.
I do the same. If you can read Chinese, I strongly recommend you read Sina Weibo, a micro-blogging social media in China, or Toutiao. Read them quickly before posts are inevitably deleted by the censors. There are some truly harrowing stories of ordinary people being refused treatment and left to die at home.
Caixin does excellent reporting even on major scandals. As the name (财新) indicates, they specialize in financial news. That means they're not widely read except by businesspeople, which is likely how they can get away with their riskier stories. Also, you need to distinguish between embarrassing the party leadership in Beijing vs. some local cadre who thinks that gagging the local media is enough to keep his dirty laundry under wraps.
It’s an account from a 23 year old healthy male who contracted the virus late December. He was hospitalized with fever and developed pneumonia. Within a week he was in critical condition with near fatally low blood oxygen (claimed 60%) and digestive issues. He would have died without medical treatment.
There are several stories like this shared on Chinese media but they’re not shared with the rest of the world.
And all these cases are anecdotal data. Reporting or not reporting them doesn't change anything regarding the Corona virus and the overall number. Quite the contrary, these stories are totally in line with official reports and thesis / papers by doctors, virologists and so forth. Because is disputing that the severe cases are ugly and, well, severe.
I disagree. Stories and anecdotes are a much more effective way to communicate the situation to the public than guidelines, facts, and figures.
I've had people try to tell me "You don't need to worry, the virus only affects elderly people, younger people who get it will be fine." (paraphrasing)
I respond with this datapoint to let people know the virus can be severe, requiring hospitalization, even for young people.
Well, isn't that the very definition of anecdotal data? Not saying these cases didn't happen. But to use them to build a model of the Corona virus epidemic doesn't fly, IMHO. I for my part stick to WHO data.
One general point so. That WHO has now a te dedicated to counter false rumours and theories on the internet is telling. And HN would be best served if we, educated, critical thinking people, would stick in that with the experts. Who are the WHO.
I mentioned this in another thread as well but I recommend watching MedCram's video series on nCov. They have been doing daily videos since late January, [0] really good no nonsense information.
In particular, if this gets really out of hand in the west, we may not have enough oxygen facilities to support patients anywhere. Most hospitals are not equipped to provide high volume oxygen to thousands of people at a time.
Regarding sources, I came across this article in the Sinocism newsletter from Bill Bishop. I only subscribe to the free version, but during the coronavirus crisis he's been making the full version free. It's a pretty broad survey of both Chinese and English language sources, usually with an economic and political focus. It's at sinocism.com.
You're right, and this could very well be a propaganda piece, but it somehow comes off as genuine. There are activists in China who recognize the severity, understand the grasp of the party, and still desperately attempt to reach out - including the selfless doctor who died yesterday, and a number of activists who have already been disappeared. No doubt the number of such people has been increasing exponentially and the only antidote to authoritarian control is numbers. It's plausible that enough Chinese sympathetic to dissemination of such critical information have gathered such that an article like this may be genuine.
Moreover, while many terrible rumors ostensibly from educated and/or directly witnessing sources from the dregs of the web have turned out to be true, these sources are even less reliable than the CCP, given the propensity of netizens for exaggerating and/or deliberately spreading falsehoods. Which is to say reports out of China may not be that much less reliable than much of what is floating around and at this point, as ridiculous as I know it sounds, I'm almost willing to relax my suspicion and cling to slivers of hope.
The undesputed facts so far are grim. 80-90% of the Chinese GDP has been shut down, we still don't know with certainty just how contagious or dangerous the virus actually is, but it is obviously more virulent than any of the previous viruses from the Corona family, and if for whatever reason containment fails for an extended period of time in a region, you can expect severe social hardship. How long can China continue to operate at 10% capacity?
It is only prudent in my opinion to make at least minimal preparations now with 1-2 months of food and water before panic potentially sets in and stores are emptied. There is still a high probability that the virus will be sufficiently contained and minimally deadly, but this also is shaping up to possibly be the biggest threat faced by civilization in centuries, exceeding the Spanish Flu of the early 1900s. I'm about halfway through Gallaher's report linked in these comments (very thankful for it) and I hope I'm wrong, but even his numbers are understandably prefaced with uncertainty.
Even though this is true, Caixin has been allowed some leniency, especially in reporting this outbreak. Some reports have been very distinct from the official reporting, although it appears that some articles have also been retracted.
In times of a crisis like this, some signal will get through.
Caixin is the best Chinese news source in normal times, and at this time all Chinese news is more free to report on the virus. As someone very critical of the CCP, I'd say Caixin's reporting here is as authoritative as anywhere.
Specifically in the category of news media companies.
There are many stories that they simply can not publish, being based out of Beijing. These stories, at best, will be published to social media by individuals in the thick of it.
AFAIK the WHO always acknowledges that there is a large number if unreported cases and truly reliable numbers are only available after the fact. They also state that during the outbreak, the longer it takes and the more cases are reported numbers trend towards the true numbers. It is rather improbable that that the death ratio for the unreported cases should be higher than for the reported ones. Unless you believe in conspiracy theories, which I think the HN crowd should be above believing.
I believe it goes further than this. WHO and China are both trying to downplay the severity of the pandemic because they know if they publish more accurate estimates, it will cause mass panic. Panic is not helpful in any situation, and leads to an unstable society, hoarding, and destructive behaviors.
> WHO and China are both trying to downplay the severity of the pandemic because they know if they publish more accurate estimates, it will cause mass panic.
I'm making an interactive map showing the progression of the virus, from various sources. https://coronaprogress.com/
I don't believe anymore that they are trying to downplay it, or they are being really bad at it. We shall be approaching a hundred thousand confirmed cases within 10 days.
And what makes you believe that to be true? Have any WHO numbers been proven wrong in the past for, say, ebola? SARS? Or any other epidemic or disease? Or is it because it is China that a lots of people prefer to not believe them? Because that is how you spread panic if you ask me.
It's widely reported that the confirmed case count published by China is far below the actual case count. This is due to several factors, including:
* A high percentage of asymptomatic carriers (WHO est. 82%), who have mild symptoms and no need to go to the hospital. These victims are still able to transmit the virus to others.
Read that China and WHO are not "wrong" about the reported case numbers. They do not reflect how widespread the virus is. I've read reports that the true case count is 5-10x higher.
That was a good read. This is what should be shared.
The entire world is going into a freaking panic over this. And they’re spewing out nonsense that the China government is lying, and their numbers cannot be trusted. Which doesn’t really help the situation, and it clouds the scientific understanding of this incident.
Then the 2 moronic scientific papers that were published whipped everyone up into a frenzy.
(1) The German paper said that people can transmit it asymptomatically, which means this is some kind of Frankenstein virus that can transmit over 14 days, and infect others when not showing any symptoms.
(2) The Indian paper that suggested that this virus was man-made, and thus fueled the conspiracy theories about it being a bio weapon. And this fed more fuel to the fire for #1.
Two scientific papers that were both terribly wrong!
And what was the result? It created mass panic.
So there you have it. Fake news that created real mass panic in the real world.
Some good highlights from this transcription were:
* This is like SARS, but less deadly. Yes, it is infectious and contagious, but it is also less deadly than SARS.
* The virus will likely burn out in May, because it doesn’t do well in warm and humid weathers. So Australia with its hot wildfires will be spared. Go take a vacation in the hot and dry outback of Australia everyone. You’ll be fine out there.
* The 2.2 reproductive R0 number is a perfect theoretical scenario, but it will likely not happen in this case, since China mandated the quarantine. And the entire country is a ghost town, with people wearing face masks in public, and avoiding any outdoor activities. This should help to slow the spread, and kill off the virus, like how SARS mysteriously disappeared.
So, governments around the world, need to be vigilant, and do what they can to contain the spread of the virus, but we should be ok. There is no need to panic right now. The fear is worse than the disease.
The leaders of the world needs to step forward and make regular public health announcements about this. And to calm the public down, and stick to known scientific facts and evidence.
Unfortunately, we have morons as our elected leaders.
He's the expert, and I'm not. But I can do math. Influenza this year in the US: 19M infected and 10K fatalities. If you posit 1% mortality rate for coronavirus like he argues, that's 20 times more deadly. And it's twice that in China, it's unclear if that's a statistical anomaly or a structural feature of some difference in how things are tested/reported in China.
So I'm not going to just shrug and say it's no big deal. It could be. I'm a programmer, I know powers of 2 intimately. We're at 2^15 and doubling every 5 days. If that keeps up for a month we'll be at 1M infected and 16K dead. From there it's another 50 days to 1B infected and 1-2M dead. I'm keeping an eye on that, if it doesn't slow down before 2^20 (1M) then I've already planned to bug out with my loved ones to the mountains of Panama for a couple months until this blows over.
I think it won't come to that, but I'm keeping an eye on the progression and doubling rate. The thing with exponential growth is it always ends. The question here is does it end in time?
You can only do the math right if you get counter and denominator right. The number of unreported cases is probably very high.
I found this in the article posted above:
”So the 20,000 cases in China is probably only the severe cases; the folks that actually went to the hospital and got tested. The Chinese healthcare system is very overwhelmed with all the tests going through. So my thinking is this is actually not as severe a disease as is being suggested. The fatality rate is probably only 0.8%-1%. There’s a vast underreporting of cases in China. Compared to Sars and Mers we are talking about a coronavirus that has a mortality rate of 8 to 10 times less deadly to Sars to Mers. So a correct comparison is not Sars or Mers but a severe cold. Basically this is a severe form of the cold.”
I also assumed that the death rate was lower due to under-diagnosis of mild cases -- until a few hours ago when I asked a few questions to someone with connections to Wuhan.
The response indicated that the deaths were likely significantly under-reported, as in: not counting the people dying while waiting to get into the hospital, or who never make it there. Plausible since there is both no incentive to report higher rates than confirmed, and not a lot of spare bandwidth to test cases already lost.
The real question now is which is more under-reported, cases or deaths. Either way, reading here details of the mechanism of death, it is far too virulent and deadly for complacency.
Looks like the prevailing approach is a very healthy Normalcy Bias.
Wuhan's Healthcare system could not handle a widespread cold break out either.
Much of the rest of the world has sufficient capacity to hospitalize patients to prevent an outbreak. China being China is behind both due to recent industrialization and also an authoritarian state which lied about the dangers.
Take it how you want, but this is a severe flu which would not have survived in more industrialized nations.
Saying that it's an order of magnitude less deadly than SARS doesn't exactly allay any concerns when it's still at least an order of magnitude more deadly than the flu, and probably twice as communicable. "A severe form of the cold" is the understatement of the century.
I agree, It's viral pneumonia for those over 60 and heavy smokers. China has 240M people who are 60 or older. Assuming a 2% mortality in that population and the fact that many of the younger infected have mild symptoms, 1/4 to 1/2 of these folks may be infected in the next 3-6 months. That's 1-2M fatalities.
Statistics I saw indicated that 2% of women smoke and 60% of men. This may account for a gender-linked differential between more serious outcomes for men, it could be a selection for smokers. I agree that the air pollution may push even non-smokers into the risk category for smokers in other countries and push smokers into a deeper level of risk.
I'm using his mortality rate of 1%. That's 20x the mortality rate of influenza in the US. If it's 2% like the media reports then it's 40x. It doesn't really matter to me, either way is too deadly for my liking.
That's part of the problem though. Mortality rate outside of Wuhan reflects the mortality rate under ideal conditions (enough ICU beds, enough ventilators and ECMO, etc.) Mortality rate within Wuhan reflects the mortality rate under pandemic conditions.
If the rest of China looks like Hubei in a few weeks, we will be in pandemic conditions throughout all of China. If other countries start to look like China in a month or two, we will be in pandemic conditions throughout the world.
Some of the "repatriates" flown to Travis AFB in California, near SF, have been admitted to the hospital now, showing symptoms... This is being reported in local news as of this evening.
Several weeks already. How long does this super highly infectious disease take to spread outside of China? You have to wonder the claims made on transmission at this stage.
The disease takes about 2-3 weeks to run its course through each patient. It’s slow burning and mildly yet unpredictably lethal. That sounds innocuous but it is a recipe for disaster.
The Chinese government’s senior medical adviser has said the disease is hitting a peak in China and may be over by April. He said he was basing the forecast on mathematical modelling, recent events and government action.
Dale Fisher, chair of the Global Outbreak Alert & Response Network that is coordinated by the World Health Organization, said that predicted “time course” may well be true if the virus is allowed to run free in Wuhan.
The flu-like virus has killed more than 1,100 people and infected nearly 45,000, predominantly in China and mostly in Wuhan.
Singapore has reported 50 coronavirus cases, one of the highest tallies outside China, including mounting evidence of local transmission.
[...]
Asked why there were so many cases in Singapore, he said there were comparatively more tests being conducted on the island.
“We have a very low index of suspicion for testing people so...we do have higher ascertainment,” he said, but added that there was a lot about transmission of the virus yet to be understood.
You sound a lot like the Wuhan government circa late December/early January.
I'm not sure what to tell you. Unless you think that this virus somehow only targets people living in China, it's only a matter of time before it takes hold in other countries. This is not one that you can simply quarantine and isolate away like SARS. This one seems to be communicable at the earliest onset of symptoms, or even perhaps before.
Its been several weeks already people are infected in several countries. Yet no sign of pandemic outside of China. I dont know what other facts you need.
Fast quarantine for example is one big difference. People with symptoms that could be Corona related going to hospitals is another big difference. Tests being developed. Hospitals being on alert. But believe whatever you want.
That certainly helped with SARS. But nCov appears to be transmissible at the time symptoms appear or even earlier. That is a big difference from SARS and makes self-isolation and quarantine significantly less effective.
So we went from "no difference at all" to "the differences won't matter". If want to panic, do it. But please don't spread it, online or offline. Already too many people are doing just that.
While there may be some other protective factors, the status of the infection in North America is similar to what it was in China in early December (the likely start of the outbreak).
> We're at 2^15 and doubling every 5 days. If that keeps up for a month we'll be at 1M infected and 16K dead. From there it's another 50 days to 1B infected and 1-2M dead.
You may be a programmer, but certainly not a virologist. That’s not how that works.
I stated as much in my comment. You can't just take an exponential trendline and plot it out and make predictions from it. But at what point does it start to slow down? Before a million infected - not a virologist, probably, but by how much?
Before a billion infected, well obviously. Flu infects about 9-45 million people a year, so there's a ballpark model. If we take 45M and 2% mortality as the worst case scenario - and really, it could be worse than that even. It's still a million deaths. That hasn't been seen since the Spanish flu at the end of World War I.
So you are programmer and no epidemiologist. I would believe the true experts get their models and math right. And I believe them to have correct data base, plus the experience to read and interpret the data they get from the ground.
The fact that you are already planning to bug out, despite being on a different continent is also a little bit telling.
I said I'm watching it and have planned for a worst-case eventuality. That's telling of what? My paranoia? Or just that I like plan things more than you do? I wouldn't read too much into that, it's not charitable. I'm probably a couple standard deviations smarter than you would guess, maybe smarter than you. Don't be dismissive.
Now it seems healthcare workers are readily getting infected.
"A study has found that 40 health-care workers were infected with the novel coronavirus by patients at a single Wuhan hospital in January, underscoring the risks to those at the frontlines of the growing epidemic."
>...South Central Hospital. The deputy director went there to help in their ICU. He found that two-thirds of the medical staff in the ICU were already infected.
I was thinking maybe they should get low risk health workers (young fit) to deliberately get the virus under holiday conditions and then return to run the hospitals when immune.
yeah, in the early days, before mid of January, health care workers did not know what it was so a significant number got infected. And in the early days the local hospitals were overwhelmed with patients and the supplies were running short, some got infected. Now there are a lot of medical staff coming from other regions, and staff is pretty well protected. Hopefully we do not hear anymore medical staff infected.
I have been telling everyone to relax, these mass media panics about some virus happen every few years like clockwork. We are primed as a society to fear China right now so a panic like this is right on schedule.
Do you think it is a mass media panic within China? Because if you look at what is going on, it doesn’t look like the response to a yearly flu. It looks like a gravely serious event.
The big difference between this and flu is that there is no effective drug and vaccine. Some people react mildly to the virus, some people's immune system seems to compromised by the virus quickly. It also seems to have long incubation periods and high infection rate. In a city as dense as China, it would spread quick from person to person. So the only effective way to reduce infection is to quarantine people. Not allow them to gather around. Flu is actually affects a lot of people too. It just not a "massive event" because we dont try to contain it. It would take a similar measure to try to contain flu if there is no flu vaccine
OPs article does have merit, as far as giving a first-person account of treating the virus and quarantine procedures, but you'll learn a lot more about the virus itself if you follow the research.
“ nCoV2019 has a furin-sensitive motif at the traditional S1/S2 border fo the spike protein, i.e. RRAR, that was lacking in SARS (which depends on cathepsin cleavage a few amino acids downstream). nCoV2019 lacks the secondary minimal furin cleavage site, i.e. RNTR, that is found in SARS. Therefore, the endoproteolytic cleavage pattern is expected to be different between nCoV2019 and SARS.
Prediction of O-glycosylation sites reveals a cluster of Serine residues, just before and after the RRAR cleavage site, with a high propensity to form a “mini-mucin” patch at that site. It is positioned to protect the putative fusion peptide region in the native or pre-fusion Swiss-Model projection of the probable nCoV2019 structure.”
Not sure how to ‘follow the research’ when the first page has 12 proper nouns/terms I’ve never encountered...
So this is a discussion of the differences in how these viruses uses their respective spike proteins to trigger endoproteolytic cleavage in the host cell. Specifically, what the impact of different positionings of their amino acids is.
For example, the idea "Furin-sensitive motif" means that there is a section of the spike protein which contains the amino acids described (RRAR), which is sensitive to the protein Furin in host cells.
1) In complex problems outside your domain, trust the experts.
2) These experts should go out and sell the truth in way laypeople understand them. Which is incredibly hard as everyone prefers dooms day scenarios it seems.
Just kind of sad even HN doesn't get that as this thread clearly shows.
I've noticed the English language media has been big on facts and events, but generally provide little context besides the usual unhelpful short quotes.
Great article all around, worth reading as it's one of the only I've seen that are actually talking about disease progression and timeline. Some key info from the article:
----
Caixin: Based on your clinical experience, what's the disease progression of the new coronavirus?
Peng: Lately I've been spending the daytime seeing patients in the ICU, then doing some research in the evenings. I just wrote a thesis. I drew on data from 138 cases that South Central Hospital had from Jan 7 to Jan 28 and attempted to summarise some patterns of the novel coronavirus.
A lot of viruses will die off on their own after a certain amount of time. We call these self-limited diseases.
I've observed that the breakout period of the novel coronavirus tends to be three weeks, from the onset of symptoms to developing difficulties breathing. Basically going from mild to severe symptoms takes about a week. There are all sorts of mild symptoms: feebleness, shortness of breath, some people have fevers, some don't. Based on studies of our 138 cases, the most common symptoms in the first stage are fever (98.6 per cent of cases), feebleness (69.6 per cent), cough (59.4 per cent), muscle pains (34.8 per cent), difficulties breathing (31.2%), while less common symptoms include headaches, dizziness, stomach pain, diarrhea, nausea, vomiting.
But some patients who enter the second week will suddenly get worse. At this stage, people should go to the hospital. The elderly with underlying conditions may develop complications; some may need machine-assisted respiration. When the body's other organs start to fail, that's when it becomes severe, while those with strong immune systems see their symptoms decrease in severity at this stage and gradually recover. So the second week is what determines whether the illness becomes critical.
The third week determines whether critical illness leads to death. Some in critical condition who receive treatment can raise their level of lymphocytes, a type of white blood cell, and see an improvement in their immune systems, and have been brought back, so to speak. But those whose lymphocyte numbers continue to decline, those whose immune systems are destroyed in the end, experience multiple organ failure and die.
For most, the illness is over in two weeks, whereas for those for whom the illness becomes severe, if they can survive three weeks, they're good. Those that can't will die in three weeks.
The cases that the interview alluded to have already been published in JAMA: Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China https://jamanetwork.com/journals/jama/fullarticle/2761044
Note Dr. Peng in the interview is one of the authors of the JAMA article.
Should add their discussion of cytokine storms in healthy people, which appears to have a more rapid timeline
> Some experts argue that the virus triggers a cytokine storm, which ravages the stronger immune system of young adults
> Based on my observations, a third of patients exhibited inflammation in their whole body. It was not necessarily limited to young adults. The mechanism of a cytokine storm is about whole-body inflammation, which leads to a failure of multiple organs and quickly evolves into the terminal stage. In some fast-progressing cases, it took two to three days to progress from whole-body inflammation to the life-threatening stage.
the 1918 flu pandemic caused a cytokine storm, which is hypothesized to have caused so many otherwise healthy people to die. if there's cytokine activity that's another parallel to the Spanish flu.
I find it so strange that even people who should know better say yeah there is 30k cases and 600 deaths so only 2% die. They should look at the clinical progression of the disease, if it takes 2 weeks from hospitalization to death - how many cases where there 2 weeks ago: those were the people that died.
Yeah, and people who know better say anything different than that? Or what exactly don't you like about official WHO numbers based on global data that pretty much alines with Chinese ones?
EDIT: What makes you think highly educated people just doing epidemics didn't have that ideas alrwady and didn't base their numbers on that?
Beyond the actual mortality rate or possible sequelae (which seemed to occur in post-SARS survivors), the real danger lies in what the actual percentage of cases requiring hospitalization due to severity of pneumonia is (serious + critical condition). Some believe it to be a much higher percentage of the total # of cases than something like the flu, meaning if the infection spreads as much as the normal flu, we may see a shortage of ICU beds and respirators.
The corollary of this is that you don't even have to be infected with the coronavirus to die because of it. This coronavirus acts as figurative denial of service attack against hospitals. Anybody with a medical emergency is going to have an incresed risk of mortality if hospitals are swamped with an epidemic.
It’s effectively a distributed denial of service attack (DDOS) on the medical system.
There are a lot of old people in Wuhan and the province, that those that gets a heart attack or an old age ailment, where they normally would have been saved, will now die. This is a terribly tragic secondary effect.
I wonder if it would be better to get infected now (on purpose), while hospitals are not under heavy load yet. You probably have higher chance of survival now, comparing to many weeks from now.
Also the virus might mutate and become more deadly, so having antibodies now would also help down the line.
Probably not, you'd still run a small risk of death, even if you are young and healthy and getting excellent treatment in a first world hospital -- not to mention exposing your loved ones (particularly elders) to infection.
The best approach is certainly self-isolation with sufficient food, then you have zero chance of becoming infected.
I'm not at that point yet in Europe. But if I lived in Singapore or Hong Kong I might start considering it.
> is it obvious from the symptoms whether they have novel coronavirus, or just the regular flu?
There are test kits but China has very few of them compared to the mass of patients who have flu-like symptoms. So... from what I heard we dont really know.
From what I read, the coronavirus reduces lymphocytes and that is what ultimately causes the serious symptoms. For people who can keep their white counts up, they don’t get so sick.
Edit: my thought is that maybe they could use blood counts to separate it from the flu
If one is to run tests, it would much easier to use the actual nCoV diagnostic panel. The question was whether differential diagnosis for nCoV based on (early-stage) symptoms exists, which to my knowledge it doesn’t yet.
People that talk this way about the flu most likely have not had the flu, or at least not a “full flu”. I came down with it in a year when the flu shot was particularly ineffective and that was enough to end any deliberation with the flu shot for me ever again.
Interesting. I has heard the link between GBS and the flu vaccination before (since all the flu vaccine questionnaires mention it), but that article suggests there's evidence that the flu is more likely to cause it than the vaccination, which is supported by this article:
That was always my impression of the flu, until this year. My husband, infant daughter, and myself all came down with the flu within 3 days of each other. The infant had been vaccinated, while my husband and I were not. The infant and husband were confirmed via a nose swab to have the flu, while we just inferred that I got it since we all had classic flu symptoms.
Despite not being vaccinated, my husband was feeling 80% better within three days and fully recovered within four days. He was miserable for the first two days, but still not the level of ‘got hit by a truck’ that I remember from previous cases. I took five days to recover and also had relatively mild symptoms - it was undeniably different from a common cold (muscle soreness, chills and night sweats, fatigue) but I wouldn’t have thought it was the flu if the rest of my family wasn’t infected. My daughter seemed to be recovered within 48 hours, though she later contracted pneumonia. Even that was managed within 24 hours of starting amoxicillin and a nebulizer.
This post has gotten pretty long, but my point is that, for whatever reason, we came down with a flu that wasn’t nearly as bad as the norm. Even the doctors were skeptical until the test results came back.
My anecdata from a few influenza events is that it is truly awful. A week of slowly worsening fever. I got close to admitting myself to hospital before my fever broke and I recovered. Symptoms dissapear very quickly once it's over, but it took me months to recover my fitness.
I agree with the others, but I think we should note that these sorts of illness are not divided neatly into two categories, cold and flu. Besides the many different viruses grouped under "the common cold", there is a whole spectrum of bacterial infections whose symptoms look similar to, and interpolate between, the cold and flu. So there are other things someone could get that are like less severe version of the flu, but are worse than a common cold, and it's hard to distinguish without a formal test.
I believe pneumonia can be caused by a number of bacteria. These used to be very deadly before the advance of antibiotics, much worse than the flu or cold.
The overwhelming majority of deaths are elderly people though. Then most of the rest are above middle aged. Only a tiny percentage of young healthy people die from the flu. One thing that's very different about some of these strains.
EDIT: not to minimize the flu though. Comparing a flu to a cold is like comparing a migraine to a tension headache.
I don’t think it’s correct that most do. I think most people have mild symptoms. I’ve seen statistics that up to half of the people that end up in the hospital die, though.
This was the most valuable piece of info for me, which I shared among my social circle:
Doctor observed that three weeks seemed to determine the difference between life and death.
- Patients with stronger immune systems would start to recover in a couple of weeks
- Second week, some cases would take a turn for the worse.
- In the third week, keeping some of these acute patients alive might require extraordinary intervention. For this group, the death rate seems to be 4 per cent to 5 per cent.
Nothing much. If the infection breaks out near you, avoid crowds, wash your hands frequently, and don't touch your face (especially nose) with said hands. SARS and it's ilk kill the old and sick, not the young, so avoid your grandparents or elderly parents.
If there's little or no infection near you, I wouldn't do anything yet.
That's the principle mechanism of public health to epidemiological outbreaks: reduce the likelyhood and rate of transmission between people.
This is why the appropriate response is to curtail transport, especially long-distance modes which occur faster than onset of symptoms (e.g., air flights from known epidemic zones). It's why locking down cities within epidemic zones, restricting mobility between cities where outbreaks have occurred, wearing barrier protection to prevent both contracting and transmitting particles, disinfecting infected surfaces, and limiting social and business contact, are all primary responses.
Get a flu shot, if you haven't already. Not because it'll keep you from getting 2019-nCoV, but because you don't want to be confusing having the flu with having nCoV, and you don't want to have to be out getting treated for flu whilst nCoV's circulating. And having all others treating you like Typhoid Mary to boot.
Wash your hands.
Carry (and use) alcohol-based hand sanitiser. (Antibiotic is useless against virus.)
Wash the doorknobs, light switches, taps, knobs/pulls, and bannisters in your home, regularly. Keep visitors and guests to a minimum. Don't touch your hands to your face, eyes, nose, or ears.
Look for indications of breakout in your area on news or online. Realise that if there's a breakout, the disease has likely already been circulating for several weeks, e.g., the risk is high. Currently, outside of China, there are very few places at risk -- Singapore, Hong Kong, Japan, Korea, Japan, Thailand, and South Korea are the major additional locations.
Transmission seems to require several hours of fairly close contact.
Stocking up on cleaning supplies generally makes more sense than masks, which are of limited use or efficacy.
Some somewhat nonobvious practices (salt-infused masks, apparently, others may exist) seem to reduce transmission or viral capability profoundly.
For now, the containment trends are strongly positive, outbreaks outside China are quite limited, and it looks as if measures are effective. It'll be another few weeks before this is certain, things could still go quite badly, but signs are encouraging.
Most notably, the new cases and deaths trends are dropping well below their initial exponential trajectory:
Comments I made yesterday on Diaspora regarding this, and pointer to a now 10-day-old post based on the then exponential growth, in which I'd suggested we should see containment working on new cases by early February, and deaths by mid-February (we're actually trending well ahead of that):
Unproven and likely wrong but I saw a speculation that MMR vaccine and rubella boosters may provide partial protection explaining why so few children and young women are amongst the casualties. (from https://foreignpolicy.com/2020/01/26/2019-ncov-china-epidemi...)
> That was why ICU medical staff were almost all sickened.
This is a brilliant strategy for spreading the virus to any patients who might've come in with regular cold or flu and hadn't been infected with coronavirus yet.
This is like a commercial for why we need to build medical telepresence robots.
There's an understandably big focus on mortality/non-mortality. It seems that people are classified recovered and sent home after 3 to 14 days of tests are clear (depending on the hospital) but I haven't seen estimates for full recovery from symptoms and fatigue afterwards.
Many companies run very lean... Is it likely 2 weeks off work per person after hospital discharge? 4?
Those graphs depict Total Cases and Total Deaths. (This presentation of data is sometimes used by startups trying to show their amazing growth off to potential investors.)
If you look at the daily change in amounts of deaths from this data series, it is more of a wobbly straight line:
I did a linear projection of this data series to see how long it would take for a 1000 a day to be perishing if this trend and I came up with 8/8. Can anyone else replicate this?
I would hope containment would slow these numbers, but it is possible it could go another way. If the data itself is underreported then it could also be worse.
Even in Communist China, people are turned away from hospitals due to inability to pay for treatment...that’s the worst irony I have ever heard.
This disease is virulent and unpredictable. A 34 year old doctor died. 12 hospitals are being built at breakneck speed. This will become endemic at this rate. Either we create a vaccine or we each roll the dice on acquired immunity and too many people die in the process. It is time to be concerned.
"The most regretful thing to me was a pregnant woman from Huanggang. She was in very serious condition. Nearly 200,000 yuan (S$39,505) was spent after more than a week in the ICU. She was from the countryside, and the money for hospitalisation was borrowed from her relatives and friends. Her condition was improving after the use of Ecmo, and she was likely to survive. But her husband decided to give up. He cried for his decision. I wept too because I felt there was hope for her to be saved. The woman died after we gave up. And exactly the next day, the government announced a new policy that offers free treatment for all coronavirus-infected patients. I feel so sorry for that pregnant woman."
I had the unchecked belief that China claiming to be a communist country would be covering medical costs.
Above reminded me of this: "'He cannot speak or look after himself': A 17-year-old with cerebral palsy died after being left alone for 6 days while Chinese authorities quarantined his father over coronavirus fears" - https://www.businessinsider.com/teenager-cerebral-palsy-dies...
Edit: I really can't understand why anyone would downvote this comment - the downvotes are making me laugh.
> And exactly the next day, the government announced a new policy that offers free treatment for all coronavirus-infected patients.
According to some Twitter videos I saw from Wuhan that is not actually the case, as in supposedly the local hospitals still ask people for money. There are also cases like this one [1] of people not being let in even though their relatives have paid some money.
This latter link might also be interesting for the HN crowd as the lady from the video can be heard shouting at a hospital security guard that het older mother wasn't able to pay the money through any phone apps (supposedly because of her age and her not knowing to use this modern stuff), which made me think again about how eliminating cash and person-to-person transactions is really detrimental for large swaths of the population (in this case older and sick people).
"The boy's aunt told Damihexiaomi that she fed Cheng three times and changed his clothes twice during the six days that he was alone. Her own poor health prevented her from doing more. When she stopped by to take care of Cheng on Tuesday, his condition was already on the decline, the Post reported. "
The medical system there is far more similar to the US system than the European system. It fails some of its citizens the same way the US system fails some of its citizens. Yet it is also similar to the US system is that it is fostering more medical innovation than socialized systems as well. Basically it is similar in both good and bad ways.
China has made more gains in medical R&D than pretty much any other country besides the US and a lot of that has to do with the fact that it allows firms to profit like the US does. It's the second biggest drug market after the United States and I believe it's also the second biggest market for clinical trials after the US.
I'm curious what the exact costs (financial and otherwise) are for these gains in medical R&D.
Canada's system likewise has pros and cons to it, and I believe once democracy and freedom is stabilized via adequate distribution of resources sharing the technological gains of this century, then society must first focus on analyzing, conversing about, our health systems in depth. The conversation for too long has been primarily held, lead, by industrial complexes and specialized professionals in funnels that are more indoctrinated, non-interdisciplinary, than is healthy.
The official claim is that China is a socialist country with Chinese characteristics. It's not really true but that's the official claim. And yes, the Chinese government started to cover medical costs for coronavirus-infected patients a few days ago, which was also mentioned in the interview. I think the real problem is that with some many patients, there is simply not enough resource. I can only hope that things will get better soon.
Please stop taking HN threads on generic ideological tangents. It's tedious, explicitly not what this site is for, and we've already had to ask you this repeatedly.
Yes, that's why capitalists drive on private roads only, and go to private courts when they get in trouble with private police forces. They also honk to honor their private armies and thank them for their service. The private fire service is of course a pillar of most capitalist communities as well.
...And we're writing about this on an internet that was developed by privately funded defense researchers and private universities. You can use this internet to get driving directions via privately funded geolocation satellites.
No, the internet originally was funded almost exclusively by public money (US military and CERN being some of the biggest contributors), and there is basically no such thing as "privately funded defense researchers" - almost by definition, defense research is funded by public money, or at least by private investors looking to get their money back by selling to the state. Universities also tend to do research funded by outside grants, which in the early days of computer technology were, again, almost exclusively public US military budgets.
GPS is a public utility, as are GLONASS and Galileo, so I'm not even sure what "privately funded geolocation satellites" you are talking about.
Regardless, your claim was a universal (the state is worse at providing ALL services) so showing some services which the state is much better at providing is enough to prove you were wrong.
Meanwhile ... the news on the Lieber story[0], which first appeared 5 weeks ago, has gone silent. Interesting coincidence. Of course, on Reddit it's been combined with Epstein. BTW, in case you run across it, here's what 'BSL-4' means.[1]
This whole thing has brought out my conspiratorial side...I don’t know what to believe anymore but I feel like we’re in a tip of the iceberg situation here. Hope I’m wrong.
I think we are dealing with black swan event. It's new disease, higly contagious and with 200 more deathly rate than flu. Since we don't know much about that disease and how much that virus can mutate being extra cautious is best
strategy.
Some say the mortality rate is 10-20% because the 1-2% numbers being passed around are comparing current deaths against current population who have the disease. Current deaths should be compared to the population that had the disease at the time they contracted it which was 1-2 weeks ago. The epidemic began only two weeks ago.
While the epidemic is still in an exponential growth phase, not very useful, because death and recovery may not take the same average time from initial symptoms. Even a small difference in time will result in a huge bias in the death/recovery ratio, which right now is about 1:3, using the official statistics.
The number of people dying each day from this corona virus is increasing and these are official numbers so might be under reported. 29-30th Jan around 40 people were dying a day now it has reached 80-90. When you take into account the number of infected is still increasing and no real way to control the spread or treat the virus this is going to be way worse in the next few weeks.
https://voice.baidu.com/act/newpneumonia/newpneumonia
As the share of the population that is infected grows, the death rate for complications will increase dramatically. It is already extreme, and it is expected to grow exponentially into April (at least in Hubei).
Up to the limits of medical facilities, your odds will be good, but it takes a lot of resources to keep patients alive when they are experiencing complications, and those resources are inherently limited.
That is so rough, especially since some healthcare workers are now among the dead: specifically, I saw that Li Wenliang had died.
https://www.straitstimes.com/asia/east-asia/chinese-doctor-w...