• Coronavirus death toll rises to 56
• Nearly 2,000 infected
• Drastic travel restrictions expanded in Chinahttps://t.co/cQL6TLkJ40 | #CoronavirusOutbreak pic.twitter.com/J5HI50y9Z7— Al Jazeera English (@AJEnglish) January 26, 2020
National Health Commission to hold daily briefings from Monday. Local health officials in affected areas to do the same. (#China criticized for lack of transparency. More briefings better but when asked about possible underreporting, NHC chief talked # cases but didn’t answer.?)
— Eunice Yoon (@onlyyoontv) January 26, 2020
Mandatory reminder: What I’m posting here is what catches my eye, mostly from twitter. There’s (predictably) a ton of paranoid / xenophobic conspiracy theories (sample here from the NYPost, reposting from the Daily Mail, two major Western media outlets with established histories of hyping Fear, Uncertainty, Doubt).
AFP's reporters ON THE GROUND in Wuhan haven't seen any dead bodies in the streets of the city.
But Twitter is here for the rumors of the zombie apocalypse. https://t.co/BtNshOusV7
— Laurent Thomet 卢鸿 (@LThometAFP) January 25, 2020
I worry about two things: viral infection through crowded hospitals and undertrained/exhausted/underequipped health workers, and excess deaths from treatable conditions as the system struggles to cope and transport links are broken.
— James Palmer (@BeijingPalmer) January 24, 2020
Totally. There can be both a massive coverup/China is lying about the numbers AND no need for global panic. The two can coexist.
— Melissa Chan (@melissakchan) January 24, 2020
Corona virus epidemic online live map curated by Johns Hopkins Center for Systems Science and Engineeringhttps://t.co/8E8oRhQC5W pic.twitter.com/QOdnQHC346
— Ektropos (@Ektropos) January 26, 2020
It’s being reported that the State Department will evacuate some U.S. citizens, but only the paywalled Wall Street Journal seems to have much detail so far.
Interested U.S. citizens in possession of valid passports should contact [email protected] “If there is insufficient ability to transport everyone who expresses interest, priority will be given to individuals at greater risk from coronavirus.” https://t.co/PDV5SPq7Cw
— Eunice Yoon (@onlyyoontv) January 26, 2020
China MOFA confirms the US proposal. “In accordance with international practice and relevant Chinese epidemic prevention regulations, China has made corresponding arrangements to provide necessary assistance and convenience.” #WuhanCoronavirus https://t.co/0k82b7MaOI
— Olivia Qi Zhang (@zhang_qiii) January 26, 2020
Not a good time for tourist visits:
The decision applies to travel agencies and online platforms like Trip $TCOM. Lack of clarity about refunds, etc. Says “tourists and agencies can negotiate a solution according to their contracts.” Those who have already departed are allowed to finish their trips. #China
— Eunice Yoon (@onlyyoontv) January 25, 2020
The customs of the country:
#China imposes restrictions for travel to Beijing. Capital to suspend all inter-provincial road passenger transport from Sunday to curb spread of #Wuhanvirus, state media quote city authorities. (Means buses only -not private cars or trains. All transport within city allowed.)
— Eunice Yoon (@onlyyoontv) January 25, 2020
when Chinese get sick, they often make trip to a big city for care because health care system is lacking esp. in provinces. Beijing hospitals have best reputation. So #China likely trying to prevent flood of #coronavirus patients from showing up (which would be common practice.)
— Eunice Yoon (@onlyyoontv) January 25, 2020
Good news, bad news:
A potential vaccine to prevent the spreading coronavirus could move into early-stage human testing in the next three months, the NIH's infectious disease chief said. https://t.co/1A6SmmaVpe
— Bloomberg Law (@BLaw) January 26, 2020
Unlike #SARS, the coronavirus can infect people even if its carrier shows little or no symptom: Ma Xiaowei, head of the National Health Commission #WuhanCoronavirus https://t.co/Cx2zH1KXuW
— Global Times (@globaltimesnews) January 26, 2020
BE AFRAID BE… reasonably sensible, okay?
BREAKING: The OC Health Care Agency’s Communicable Disease Control Division has received confirmation from the CDC that a traveler to Orange County from China has tested positive for the novel coronavirus. https://t.co/F7TDnKJAEz
— CBS Los Angeles (@CBSLA) January 26, 2020
At the best of times, the Chinese government is considered less than transparent, not least by its own citizens…
This is a cry for help when the government and the system has failed the citizens of Wuhan miserably. #CoronaOutbreak #coronavirus #WuhanCoronavirus pic.twitter.com/JvYhrpLpcO
— ash (@ashtually) January 26, 2020
You’re probably not going to get the coronavirus. But there have been a bunch of these lately, and it’s not great. https://t.co/hxTihiGYDO
— Slate (@Slate) January 26, 2020
grammypat
Anne Laurie, You have email
phdesmond
thanks for all that information.
JPL
I sure hope that trump and team are honest about the possible pandemic.
Barbara
The fear stems from the fact that it is the same type of virus as SARS, and because it is new, no one can say how it compares to SARS or the flu virus in terms of mortality rate.
PST
My wife and I just came home from a week in Spain brushing shoulders with other tourists from around the world in planes, trains, automobiles, museums, restaurants, hotel lobbies, etc., and I feel like we picked up every virus there is other than Wuhan and influenza. I noticed face masks on many of the travelers from Asian countries.
Ascap_scab
Clearly SuperCriminals in Ukraine are responsible. By using old Soviet bio labs, they have been developing new superbugs to eradicate humans leaving only the Shape-Shifting Reptilian Overlords like Hillary Clinton to rule the world. #JadeHelm15 #PaulIsDead #ReptilianTerraForming #InfoWars #MelaniaIsARobot
(Is this snark? Is it?)
Matt McIrvin
It looks like we got out of Singapore just a day or two before the people with the country’s first confirmed cases of Wuhan coronavirus arrived there. They flew in directly from Wuhan and went to the same places we visited, because they’re popular tourist destinations. Which likely means there was no mass transmission of the coronavirus going on while we were there, but with the incubation period who knows; I guess there could have been asymptomatic carriers running around. We definitely did pick up some kind of cold virus while we were there, but it seems pretty minor.
debbie
NPR is reporting a third case in California.
Starfish
@PST: Travelers from Asian countries always wear face masks when they are sick. The population density in some of those countries is much higher than anything we have here.
Starfish
If you are going to write on this topic, I want you to follow people who would be good on this topic. Here is Tara Smith. She is an epidemiologist somewhere in the middle of the country who studies diseases in pigs. What she is retweeting about this particular epidemic is probably more grounded in reality than most.
We have election-year epidemic panic to spread the fear of foreigners that has to be taken with a large grain of salt. This happened last time too
Remember how awful people were to Kaci Hickox?
VOR
I went through Canadian Customs last night in Vancouver, arriving from the US. There was a question on the (electronic) customs declaration form asking whether you had visited Wuhan, China in the last xx days. Many, but not all, of the customs agents were wearing masks and gloves. Canada seems to be taking this seriously.
debbie
Took a while, but I think I now know what “RO” means:
Elliottg
Many, many people will get the virus and either not know they have it or pass it off as a cold or the flu.
Frankensteinbeck
@debbie:
The CDC says that no matter what you read, there is no R0 for this coronavirus because they have no even remotely trustworthy data.
laura
I flew back from Fort Lauderdale to SFO on Thursday and ride the sky train through the international terminal to car rentals. A dozen or so travelers got on with about half wearing masks. The irrationality of thinking about risk of exposure is “A Thing” I admit is running in the background of my devious mind.
Obvious Russian Troll
@Starfish: It’s not uncommon to see people with masks here in Toronto, either (and I’m sure Vancouver as well). We have a large population born in east Asia.
A couple of years ago, I ran into a person with light brown skin wearing all black with a black mask over their face on a Sunday. They were out walking like I was. I am reasonably sure that someone saw this person on Monday–resulting in a six hour lockdown on the U of T campus. No suspect or gun was found.
debbie
@Frankensteinbeck:
Understood, and wasn’t implying there was.
Another Scott
Thanks for this, AL.
I mentioned before that I went to a conference in Nara Japan last summer. I saw a bunch (maybe a handful of percent) of people out in public wearing surgical masks, but figured they had personal reasons to do so. A couple of days before I came home, I started feeling poorly, but figured it was just a cold.
By the time I flew home, I was coughing and feeling miserable. I tried to suppress my cough when in public, and especially on checking in at the airport… Fortunately, on the last big flight I was in a window seat in the last row so I was able to minimize contact with others.
Long story short, when I got back I went to a clinic, got tested, and I had the flu. I had it too long to get Tamiflu, so I had to tough it out. It took another week for me to get back to work.
It was quite surprising to me because 1) I’d gotten the vaccine the previous winter, b) it was summer!, iii) I didn’t notice anyone else was obviously sick. But it made me appreciate how quickly and easily these things can spread these days.
Reuters from the 22nd:
I hope China doesn’t make it worse.
And I hope that Donnie and the Teabaggers don’t try to turn this into some sort of political weapon (to restrict international travel, gin up fear) for the fall… Grrr….
Cheers,
Scott.
randal m sexton
My .02 $ from this twitter thread: https://twitter.com/DrEricDing/status/1220919589623803905
1/ So a few simple things to know: R0 factor is the transmission rate, so an R0 of 3.8 means each infected person will infect 3.8 other people.
2/ Spanish flu, which is the scariest recent flu had an R0 of 1.4 to 2.8 (Spanish flu in 1918, killed 50 million people)
/3 The mortality rate of the Spanish flu estimated between 10 to 20% . Pretty bad. Maybe if the Spanish flu happened today it would not be so high because of more modern treatment methods.
/4 As long as our treatment facilities are not being overwhelmed. The corona virus ( Wuhan Virus) maybe has a mortality rate of 3% (this is not known very well yet) ? So not as deadly as Spanish Flu. But again, that could be due to better treatment.
/5 Incubation period: Spanish Flu: 2 to 7 days, Corona Virus: 14 days. I guess this is a BIG factor in creating the higher R0 factor. So, in two weeks, if the R0 factor is that high, this will be a MUCH bigger deal.
/6 This R0 factor maybe isn’t hammered down yet ? Skewed by incidence of people who are much more contagious than other people ( Super Spreader ) ?
7 From infection, when do you become contagious? How long is a person contagious while infected and sick ? Doesn’t appear to be known yet, Both factors would determine how quarantining would work.
Personally, I ride caltrain up and down the SF peninsula every work day, and then ride by bike in the city, lunching in north beach, china town, ect. I am considering wearing a surgical mask, maybe n95 on the train, carrying hand sanitizer and using it a lot. If there start being large infections number reported here in the US I will take other measures.
Maybe we will find out if Alex Azar is a typical trump appointee, or can manage something.
Starfish
@Obvious Russian Troll: Yes! Toronto has people from everywhere.
I have seen some Asian people in bigger cities just wearing masks on public transit.
Where I live, it is not common, but the doctors’ offices do have masks and ask you to wear them if you are coughing, sneezing, and not feeling well so you do not get everyone else there sick.
Starfish
@randal m sexton: I have seen knowledgable people being super critical of this tweet thread and the irresponsibility of it.
1) We don’t know the exact R0.
2) Creating a panic before the data is in is irresponsible.
Fair Economist
Your chance of dying from flu next week are vastly higher than your chance of dying from 2019-nCoV but your chances of dying this year are probably higher for 2019-nCoV because its mortality rate is at least an order of magnitude higher and it now has a very respectable chance of becoming endemic like its relatives, the 4 human common cold coronaviruses.
The solution is not panic but careful and thorough hygeine measures – cover coughs and sneezes, minimize travel and public gatherings, wash hands frequently, use gloves, masks, and goggles, etc. A good goal is to catch no colds whatsoever this year – not because a cold is that bad, but because if you can you are likely to also avoid 2019-nCoV if it becomes endemic.
Panic and mass quarantines will damage trust and the economy and make useful containment measures harder.
Ked
So, a moderately technical but very practical question I haven’t seen a simple answer to:
(edit – but the three posts while I was typing it up all touched on it, of course)
How lethal is this bug?
On the one hand, yes, it’s still early to be giving a hard percentage. On the other hand with 2000+ documented infections to track we should be getting a pretty good feel for the typical course of the disease, how people die, how people recover.
It’s tempting to divide 56 (dead) by 2000 (cases) and get 3%. This would be hardcore flu territory but not at all zombie panic zone, various ebola strains have wound up in the 25% to 75% range. But this would be bad statistics abuse.
At this stage, with a growing outbreak the bulk of the cases are probably new, while the dead bodies are early/old cases, so the percentage could be considerably higher. On the other hand, there are likely a large number of undocumented cases which will drive the real percentage down. And the early fatality rate, before victims and medical authorities learn about the existence and seriousness of the bug, will likely be notably higher than what it settles down to with everyone acting with full caution, even if it overstrains or even breaks the healthcare systems.
So yes, the number is going to be very hazy. But what is the magnitude of the fatality rate?
As for xenophobia… I very much doubt that any country’s health authorities could have contained something that spreads the way this has been described, and if the incubation duration numbers are right there’s only a low chance to stop international spread. I’d like to blame the local cultural proclivity for eating random wildlife, but I also know a lot of hunters who have strange things in their freezers. Thank god that deer don’t seem to carry much that crosses over because the midwest would be a wasteland.
EthylEster
AL wrote….Mandatory reminder: What I’m posting here is what catches my eye, mostly from twitter.
One would have to be in a coma not to have already realized this.
Sab
@Starfish: Thanks for the link to Tara C Smith. Hadn’t heard of her before and I should of because she is kind of local.
opiejeanne
@randal m sexton: From what I’ve read, the Spanish flu didn’t kill the elderly or frail. It mostly killed young adults, ages 20-40 .
For comparison, it might be good to know how many in the US have died of the flu in the same period of time as the Wuhan has been known about. I would almost bet that the flu number is higher, and yet people do not panic and so many do not get their damned flu shots.
The worst case of flu I’ve had in the last years was caught at the end of a trip to Italy, in 2014, so was sick after we got home, but mr opiejeanne started feeling sick two days before the flight home, while we were in Amsterdam. We missed our flu shot that year because it wasn’t released until September 1, and our plane left early that day, but it might not have prevented it anyway because when we contracted it, we were far down in the “heel of the boot”, an area filled with refugees and a surprising number of tourists, and one sick little boy who kept following us around at an event. We blamed him but it could have been any number of people we interacted with.
Matt McIrvin
@opiejeanne: Way more deaths from flu.
https://www.cdc.gov/flu/weekly/index.htm#ILIActivityMap
Fifteen kids died from flu in the US over the past week alone.
Some of the scariest reports of how the Wuhan coronavirus spreads seem like they can’t be true because if they were, wouldn’t we be seeing more new cases that aren’t people who came straight from Wuhan? I’d think the virus would have infected many thousands worldwide before anyone even knew it existed. Maybe my understanding of epidemiology is bad.
Matt McIrvin
@Matt McIrvin: (correction: those stats are from the week before the past week)
trollhattan
@randal m sexton:
Great comment, thanks!
PRC seems to have screwed the pooch initially presuming only active cases are transmittable, a belief now unraveling. Seems probable that the spread will be much wider, faster and there’s no closing that Pandora’s box. Thanks guys.
I used to take light rail to work daily and was forever getting colds. Now I only do so on rainy days, cycling the rest of the time and get sick far less often. The existential threat from cars is a tradeoff I’m more or less willing to take.
trollhattan
@Another Scott:
Can masks do anything for viruses? I fail to see how, unless they’re clinging to dust particles or somesuch.
Another Scott
@trollhattan: Yup, they’re on stuff. And wet stuff (mucus, spit) can help the virus live longer.
NewsHour:
We pick up all kinds of stuff on our hands, and we like to touch our faces. Masks and goggles make it more difficult to touch parts of our bodies that are excellent pathways to infection. So just having a mask on probably helps that way, also too.
Cheers,
Scott.
Fair Economist
@Ked:
Of the early hospitalizations, mortality was 15%. This is a pretty hard number. The question is what percentage of patients should have been hospitalized, which is very unclear. The modeling attempts are indicating the number is something on the order of 1 in 4 (very very rough though). 1/4 of 15% is 3.75%, so the 3% mortality is about what it is. The raw #cases/#deaths should be pretty bogus at this stage, but it looks like the various extreme biases (most cases unreported, most deaths not yet having happened) turned out to roughly cancel each other out.
Fair Economist
@Matt McIrvin:
It’s the two week incubation period. There has not yet been enough time. Also, the first non-Wuhan cases will probably be missed. Thousands of people come down with pneumonia each day. 2019-nCoV isn’t *that* distinctive – the intake nurse will say “have you been to China” and the patient will say “no”. Only if the case becomes very serious might they even test.
WaterGirl
@Ked:
On the one hand, I would say that we don’t know. On the other hand, I would say that we don’t know.
Fair Economist
@trollhattan:
Yes, because they come as part of sneeze or cough droplets. It’s not an absolute preventative but it reduces the chance. We just need to get the R0 below 1 anyway, not to completely stop transmission.
Robert Sneddon
Actually the Spanish Flu also killed a lot of young and elderly people. The notable thing about it was it also killed otherwise healthy young and middle-aged adults which doesn’t usually happen in a flu epidemic since they’re fitter and have energy reserves to overcome the high-stress attack on the body flu engenders.
Statistical analysis of a viral epidemic, measuring age at death is usually a “bathtub” curve with babies and young children at one side of the graph dying disproportionately along with elderly people at the other side. The curve flattens out in the middle where young strong adults get the disease and mostly survive. The Spanish Flu apparently triggered an immune response in otherwise-healthy adults that exacerbated the death rate in that clade.
The Wuahn-centred coronavirus that is getting the press reports right now is apparently killing mostly elderly and infirm people, notably ones with existing health conditions. I’ve not heard anything about young children being affected yet and the few adults that have presented with symptoms and been confirmed to have the disease seem to be mostly hanging on under intensive medical care.
Anne Laurie
@Starfish: Thank you!
(Other suggestions for people to follow gratefully accepted, y’all.)