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Coronavirus: Australia, the island that could keep the virus out, is slowing the virus by flying it in?

Something does not add up

So the virus is on its way. Even though Australia has no known community transmission we are choosing to slow down the spread by actively importing it even though we are surrounded by a moat, and are pretty much self-sustaining. We have thousands of high risk people and the disease that’s coming is largely unknown — today there are reports a Japanese case of a woman medical experts had thought had recovered who tests positive again. Is this a biphasic disease like anthrax? That’ll be fun.

Winter is twelve weeks away for Australians, and we know the coronavirus potentially threatens to overwhelm our medical systems and could be a GDP-type hit on national economies. It’s highly infectious, and between 5 – 17% of current cases outside China require hospitalization, and probably 1 -3% will need intensive care. Inviting the virus to start spreading now will mean it will peak during winter — the worst possible time in Australia.

Australia is one of the easiest countries to protect from this scourge, yet we are obediently following policies of northern hemisphere nations in a different situation. Hmm?

As I keep saying, it’s easier to import a deadly virus than to bring in cut flowers to Australia.

Most people won’t get very sick, but China is still reacting somewhat like the it has the Black Plague.

Scott Morrison says “the pandemic is upon us” but also says don’t cancel large public events, you can still go to the footy. How to reconcile the two; is it coming, or isn’t it?

Based on all these things, the only logical approach is to close the borders temporarily until we know more. The medical experts I’ve talked to privately agree. Thousands of Australians agree (see the last essential survey). Yet despite that, almost no medical official, commentator or expert even discusses that as an option. Are they all afraid of being called a scaremonger? Is namecalling worse than being the person who decided to let the virus run rife, or do they know something they are not telling us? Perhaps, behind the scenes, the experts know that too many cases are already circulating without diagnosis? Officials are acting as if that’s the case. Somehow we shifted from “low risk” to “100% chance sometime soon”.  Germany has just announced six new cases and says “it’s facing an epidemic”. Trump has said “the risk is low” but warned schools need to be prepared to close. One US case with no known source has just been announced. Ominously, they acquired it before Feb 19th, but only just got tested. Evidently undiagnosed coronavirus was spreading a week and a half ago around Sacramento.

LATE NOTE: The US untraceable case suggests the virus has been circulating possibly since Feb 12th or so. Perhaps this isn’t as dire as it sounds. Whoever he caught it off may not have triggered a wave of deadly pnumonia instead perhaps just triggering colds and flus. That may mean the virus is already loose, and most infections are not severe. Then again, since no one is testing these kinds of cases, who knows? I hope someone is tracking pneumonia cases in Sacramento and starting to test them.

Latest claims are the Ro (rate of reproduction of the infection) was a 7.05 in the early days in China.  The draconian quarantines have reduced this to to 3.2. (by Jan 23rd, so it’s even lower now, hopefully). We have to bring the Ro below 1 to stop this. Every person has to infect less than one other.

How many will need a hospital?

Based on Worldometer stats, and bearing in mind there is an eight day delay between detection and progression to “severe” — the latest stats from semi-reliable countries on Feb 19th, the rate of progression to hospitalization is:  (severe cases/ total cases 8 days ago). Bear in mind that with the lack of current broad testing, these numbers may bear no resemblance to the actual number of cases.

There are zero cases progressing to “serious critical” from Australia (15), USA (29), UK (9),  Macao (10), Canada (8), Malaysia (22), Vietnam (16), India (5). That’s 114 cases with good outcomes. Many countries have had only one or two cases and complete recovery: Cambodia, Sri Lanka, Nepal, Egypt, Belgium, Russia, Philippines. Things are moving too fast in South Korea, Iran and Italy to make their statistics meaningful. Obviously all three had far wider spread a week ago than they knew of.

Is there any data on how this affects different racial groups, or is that information being kept quiet because everyone is too afraid of offending an ethnic group?

Singapore and Hong Kong appear to be doing good jobs of controlling the spread. Iran is a basket case, so is Indonesia (with no reported cases, but little testing and their medical policy is “it’s in the hands of Allah”. )

While graphs show exponential growth outside China, it appears (probably falsely) localized to South Korea, Iran and Italy. Presumably coronavirus has been headed via 747 out of all three for at least a week, which may be why officials have given up. They know outbreaks will occur next week, they just don’t know where.  What I can’t explain is why they won’t even try tracking and isolating these cases now and stopping further imports. The success of Singapore and Hong Kong suggests it might still be possible.

The comforting Atlantic headline:

 You’re Likely to Get the Coronavirus

Most cases are not life-threatening, which is also what makes the virus a historic challenge to contain.

James Hamblin M.D., The Atlantic

The Harvard epidemiology professor Marc Lipsitch is exacting in his diction, even for an epidemiologist. … it’s striking when one of the points he wanted to get exactly right was this: “I think the likely outcome is that it will ultimately not be containable.”

… even with the ideal containment, the virus’s spread may have been inevitable. Testing people who are already extremely sick is an imperfect strategy if people can spread the virus without even feeling bad enough to stay home from work. Lipsitch predicts that within the coming year, some 40 to 70 percent of people around the world will be infected with the virus that causes COVID-19. But, he clarifies emphatically, this does not mean that all will have severe illnesses.

At this point, it is not even known how many people are infected. As of Sunday, there have been 35 confirmed cases in the U.S., according to the World Health Organization. But Lipsitch’s “very, very rough” estimate when we spoke a week ago (banking on “multiple assumptions piled on top of each other,” he said) was that 100 or 200 people in the U.S. were infected. That’s all it would take to seed the disease widely. The rate of spread would depend on how contagious the disease is in milder cases. On Friday, Chinese scientists reported in the medical journal JAMA an apparent case of asymptomatic spread of the virus, from a patient with a normal chest CT scan. The researchers concluded with stolid understatement that if this finding is not a bizarre abnormality, “the prevention of COVID-19 infection would prove challenging.”
Originally, doctors in the U.S. were advised not to test people unless they had been to China or had contact with someone who had been diagnosed with the disease. Within the past two weeks, the CDC said it would start screening people in five U.S. cities, in an effort to give some idea of how many cases are actually out there. But tests are still not widely available. As of Friday, the Association of Public Health Laboratories said that only California, Nebraska, and Illinois had the capacity to test people for the virus.
Read it all, it has a long discussion of the timeline for a vaccine.

What to make of Twitter trends that show that more people are searching for the misspelled caronavirus than the correct spelling? That isn’t the case here in Australia where #coronavirus is #1.

The Australian asks “should you travel” and says “Yes, No, Maybe”. Jo Nova says “Why risk it?” — who wants to chance catching it on a plane or overseas — even if you only get the common cold, you may end up facing quarantine for two weeks. Of course, if you are away from home, it might be time to get back.

This may all look so much better (or worse) in a few weeks. We just don’t have the numbers yet.

The Optimist says: Perhaps this is a bad flu season and as long as we can stop the cytokine cascade in the vulnerable, or get some anti-viral working, we may not be looking at large deaths or mass quarantines. The Pessimist says:  do the math, stop the flights, and wait for the data.

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