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Coronavirus: And so it spreads, lock downs in Italy, South Korea, riot in Ukraine

Coronavirus, Covid-19, cases outside China. Graph.

Coronavirus, Covid-19, cases outside China.   Source JoDiGraphics

The short not-good news: It’s looking like early exponential growth outside China

The cases outside China have reached 1,500. South Korean cases leap to 156, 204, 340, mostly centred on one church and one hospital.  In China, prisoners were discovered to be infected and a 29 year old doctor has died. The first death in Italy is confirmed, cases jump from 4 to 17, and the health minister there has cancelled or closed schools, events and shops in ten towns. The Iranian death toll has risen to 4, and Iraq has closed flights to Iran. Improbably Canada’s ninth case turns out to be a woman who flew from Iran, raising the worrying possibility that the virus is spreading undetected. Lastly, panic is spreading too. There were attacks in Ukraine to stop a bus of evacuees from China for their 14 day quarantine. It was triggered supposed by an email hoax.

Wise people might like to stock up the pantry just in case. As the people in some Italian towns just found out, there may not be a lot of warning.

The extraordinary rise in South Korea:

Four days ago South Korea had 30 cases. Now, 346. Where the percentage progressing to “severe” was nought, now it’s hard to calculate. How many infections did the country really have eight days ago? Officially, South Korea had 28, and of those, supposedly now 17 have recovered, 9 have progressed to severe and of those, 2 have died. It’s shifted from being the good news outlier to the place to watch.

In South Korea many cases revolve around the Shincheonji Church which is considered to be cultlike. According to the NY Times people sit on the floor packed together, with no glasses or facemasks, they come when they are sick and are taught “not to be afraid of illness”. So the sudden freaky rise may not reflect bad luck but a kind of amplified “superspreader on steroids” visits a “virus farm in waiting”. Unfortunately the authorities can’t find about 700 of the 1,000 worshippers who were there to check them. If only patient #31 in South Korea had not turned up there with mild symptoms.

Raw twitter tales of a country in seige

On the twitter feed of  #Coronavirus (if you dare) it’s tough. There are one or two images of people jumping out of windows in China, some mass killing of farm animals, plus even footage of pet cats and dogs being killed (it’s not clear they can catch this virus, as most viruses are species specific).  It’s a warzone, and checkpoints are run with disturbing military efficiency. There are many shots of people are being forcibly dragged away by the Hazmat police. It’s a poignant kind of thing. Some of these people may not see loved ones again and if they don’t have coronavirus there would be much to fear from being incarcerated with those who do. One (see below) shows people being led in a roped long line. Another shows masses of people allegedly waiting to get their money from a bank in China. Is this the first bank run? (UPDATE Probably not — comments under it suggest it is not a bank). In others, people appear to be collapsing on trains, or sometimes in the street. It’s all unverified, and hard to know whether it’s one freak event or even a fake, but it’s a strange land. If people are going door to door to kill pets in China, it may be just a sign of a desperate (and possibly pointless) panicked reaction by some local authority? (It didn’t appear to be for food, but then, there are tweets talking about starvation.)

How many progress to “Severe”? Still 0 – 11%

Trying to track nations (or cruise ships) with an 8 day lag from diagnosis to the “severe” state has become even harder with the numbers changing so fast that estimates change by the hour.

The most meaningful early guesstimates of how many cases will need medical attention are still ranging from 0 to 11%. Hong Kong 11%; Thailand 6% Singapore 9%; Taiwan 6%. But no cases have progressed to severe in Australia, USA, Malaysia, Germany, Canada and the UK (which together had 92 cases on Feb 14th). It’s not all bad news.

The numbers matter because it not only tells us how many people might get quite sick, it also gives us some idea of how many hospital beds we might need, especially of the Intensive Care kind. Severe cases need some assistance, or supplemental oxygen and estimates are around 1 in 6 severe cases will need the ICU.

Transmission: Aerosol or not?

Chinese officials say it is spread via aerosol but the US CDC still says “droplet”. Aerosol borne viruses carry on air currents, and are much harder to contain. It would explain why the Diamond Princess disease control of standing 6 ft apart on deck was futile, as was confining people to cabins possibly with shared air conditioning. Though one US medico warns that it looks just like influenza spread – airborne.  For a month twitter has shown Chinese medical experts behaving as though it was an aerosol.

…one US infectious disease expert cautions that, overall, the epidemiologic data continue to point to airborne transmission being the driver of the COVID-19 outbreak. “It’s almost a rewrite of the influenza playbook,” said Michael T. Osterholm, PhD, MPH, Director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota in Minneapolis.

The US CDC now lists five countries as having likely “community based spread”.

Given how little is known, stopping flights to these nations would seem wise, even just for a week or two.

On the plus side, if we believe communist statistics of no fixed definition, then the worst province in China is plateauing, “peaking” and the quarantine is having some effect. Ponder how draconian and difficult it is and how long they may need to maintain it for. If they have managed to stop millions from being infected in Wuhan and surrounds, they still have a vulnerable population, and even if they could theoretically extinguish the virus in those regions — there will be the continuous threat of reinfection from other provinces and other nations. What then, a new local lock down each time one breaks out? Having given the virus to Africa, it will be difficult not to get it back in return…

Many books are going to be written about what is happening in China at the moment

We feel for the people of Wuhan. Fofllow The @EpochTimes  (some images here don’t load in Firefox.)

Barricaded homes.

Internet cut off to most affected areas


Inexplicable scenes.

[UPDATE: Reading the comments underneath this Prof Hanke’s tweet, no one really knows what was happening. Were these people caught selling illegal masks? Did they break the “wear a mask” rule? Was it a mass arrest of a pyramid marketing scam? Was it the arrest of people playing poker, which apparently is now illegal during the outbreak. ] [Deleted the unlikely “bank run” tweet. Wait to see if there is any corroboration. ]  

 

The Optimistic Mantra (repeated):  Covid 19 will almost certainly be less severe outside China due to cleaner air, healthier lungs, better diets, lower population density, possibly genes (ACE2 receptor), cultural habits, more sun, better nutrition, lower rates of smoking, and better medical systems.  We also got a head-start. Estimates in China suggest 82% of people have only a mild infection, and we can still hope that the rate of mild infections turns out to be a lot higher in the West, or that some anti-virals in the multiple trials turn out to be useful and can be mass produced.

 Worldometer statistics with the % progressing to severe (underestimates)

The estimates from China of “% severe” are likely overestimates due to the lack of counting of asymptomatic infections.

The estimates from outside China are underestimates due to the 8 day lag.

Country, Total Cases New Total New Total Serious, % “severe”
Other Cases Deaths Deaths Recovered Critical
China 76,290 826 2,345 109 20,740 11,477 15%
Diamond Princess 634 2 17 27 4%
S. Korea 346 137 2 17 9 3%
Japan 110 1 1 22 5 5%
Singapore 86 47 5 6%
Hong Kong 69 2 6 6 9%
Thailand 35 19 2 6%
USA * 35 6
Taiwan 26 1 2 1 0%
Italy 22 1 1 1 6
Malaysia 22 17
Australia 21 2 11
Iran 18 4 0%
Germany 16 14
Vietnam 16 15
France 12 1 7 0%
U.A.E. 11 3 1 9%
Macao 10 6
Canada 9 3 0%
U.K. 9 8 0%
Philippines 3 1 2
India 3 3 0%
Russia 2 2
Spain 2 2
Belgium 1 1
Cambodia 1 1
Egypt 1 1
Finland 1 1
Israel 1 0%
Lebanon 1 0%
Nepal 1 1 0%
Sri Lanka 1 1
Sweden 1
Total outside China 1,525 4 11 202 26
% 1% 13% 2%
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