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Coronavirus demographics — very much a risk for older people and the strange split in severe case rates 0 – 15%

The good news — babies and children appear to be not at risk. The not-so-great news, people over 80 in China have up to a 15% fatality rate (usual caveats, based on unreliable communist statistics and will hopefully be lower for many reasons, see below.) Note that even with the “one child” policy effects in China, that most western nations have a higher proportion of older folk — especially  France, Germany and Greece.

The news on “rates of severe cases” is mixed. Singapore, Japan and HK are looking at 15% early rates. But many other nations are looking at 0%. Hmm?

Coronavirus mortality, demographics, graph.

A/ Fatality rate per age group. b/ Demographic age groups in different nations.  C/ Relative mortality compared to China (apparently due only to the age demographic).    |  Click to enlarge.  Age and Sex of COVID-19 Deaths  REF China CCDC

*Fatality rates calculated by the China CCDC won’t include many unrecorded asymptomatic infections, nor the deaths outside hospitals and don’t appear to include the lag either.  But they show which groups are at most risk.

Worldometer now gives us rates according to sex and preexisting conditions. (Reproduced below). Basically there are 30% higher death rates in men, and death rates are 6 – 10 times higher in people with heart, lung or diabetic type conditions. That is partly due to the conditions themselves, but may also just be due to the ACE2 gene — which the virus binds too. Since variants of the the ACE 2 gene increase the risk of both heart disease, high blood pressure and diabetes, it may be that those with a genetic predisposition to those conditions are also predisposed to either the infection or to the more damaging effects from the virus. Given that young people with those same genes are able to cope and recover though, it’s not all “genes”.  Managing those conditions may help reduce the risk. For some reason, younger people don’t seem to progress to the cytokine cascade — the inflammatory response that gets out of hand.

The all important rates of progression to severe cases is spread from zero to 15%

Adjusted for the eight day delay in progression to severe symptoms, the number that keeps coming back is  strangely split at close to zero, or an unappealing 14% — Singapore has 4 severe cases out of the 28 it had on Feb 11th. (14%) Hong Kong had 49 cases on Feb 11th, and 7 have progressed to severe or critical. 14%. In Japan there were about 28 cases a week ago, and 4 of those are severe. (14%).  The Diamond Princess cases: 15%  severe (see below).

But in many places the news is good. South Korea is interesting, with 46 cases and still none classed as “severe”. Fifteen of those cases are only one day old, so don’t count, but 28 of those cases are eight days or more after diagnosis. This is encouraging. As is the lack of any “severe” progression in Australia (only five active cases left) and in the US, Germany, and France (apart from one death of a Chinese man, ten of the other cases are now at least ten days old and haven’t progressed.) Taiwan, likewise, had 18 cases a week ago, and apart from one death, none of the others have progressed to severe.

Why the disparity? Statistical fluke perhaps (South Korea only needs 4 severe cases to put it in the same category as Singapore et al)? Otherwise, genes, culture, diet, weather, hospitals and medical systems? Or possibly some strains of the virus may be evolved to be nicer already.

The Diamond Princess: — it ain’t over yet:

On Feb 11th there were 135 cases. Today there are 542, with 20 being severe. So about 15% of cases progress to serious (20/135).  We don’t know the ethnic or genetic breakdown, though we can guess the rates are higher because of the demographic spread. Cruise ships probably have few people from 0 – 40 years old.

Since there were another 88 new cases today that tested positive, clearly Cruise-ship-quarantine is a bad plan. There are fears that the Diamond Princess may yet spark a global spread:

 With people aboard hailing from more than 50 countries, the end of the quarantine raises worries the vessel could become the source of a fresh wave of global infections.

Undoubtedly these 88 new cases will not be the last new cases, and though the US, Australia, Canada, South Korea and other nations are wisely insisting on a further two weeks of proper quarantine, but Japan is not, and the Netherlands didn’t either. With 76 cases already inside Japan (presumably not former passengers of the cruise) they have apparently given up containment.

One expert in Hong Kong, who ought to know what’s going on, advised that even people who test negative today could test positive in a few days. Keiji Fukuda, the director of the School of Public Health at Hong Kong University thinks more quarantine is needed. Meanwhile another expert in Japan, who ought to know too, says the opposite:

An expert on infectious diseases said Japan has focused on preventing the virus from causing more fatalities. “My view is that Japan’s effort will be evaluated later not on the level of expansion of the spread, but on the rate of mortality,” said Shigeru Omi, a former WHO official who now sits on the Japanese government’s expert panel on the coronavirus. “That’s why our focus is now on community prevention control so that we can reduce mortality rate and lower the speed of expansion,” he said. “It’s impossible to stop transmission.”

So Japan is going to hope those who test negative and have no symptoms can wander around the nation and not infect too many others. Hope that works out for them. It doesn’t seem like a good strategy when their early rates show that 15% in Japan may suffer the severe form.

The world may become split between the no-virus states and the infected ones — call me an optimist — all clean countries need a two week mandatory quarantine as a barrier. Or we may (cheery thought) be in the early stages of a pandemic.

What to do if you are an 80 year old — especially with a high risk condition?

Time to think about improving preexisting conditions (make those doc appointments, fill those scripts, do that exercise, consider eating better). Think about the options if the virus starts to spread locally. Hopefully it wont. But there may come a point where having a stash of things at home and cutting back on shopping trips, parties and nightclubs will improve the odds. Buying up things that will be used anyway in the next few months seems like a low cost form of insurance, as long as they are stored well.

———————————————————–

Best case: West contains the spread

The Optimistic Mantra (repeated):  Covid 19 will likely 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 and, if we are not totally stupid, we might use that to our advantage. We hope we can stay above all this and help the poor sods stuck in China, and probably Africa, and possibly Indonesia, India, etc. We won’t be much use to them if we lose control ourselves. We really really don’t want to get on the wrong side of that exponential growth curve.

If countries manage to avoid the hospital meltdown the big impact from Covid 19 might be the economic fallout. Think about what you might need that is made in China, or rather, used to be made in China. Shelves may get quite empty of a few things in the next two months.

There are hints that the draconian Chinese lock downs might be slowing the spread. But even if that is the case there are many weeks yet of this to play out.

 COVID-19 Fatality Rate by SEX:

SEX
DEATH RATE
Male
2.8%
Female
1.7%

Source: Age and Sex of COVID-19 Deaths

Pre-existing medical conditions

Patients who reported no pre-existing (“comorbid”) medical conditions had a case fatality rate of 0.9%. Pre-existing illnesses that put patients at higher risk of dying from a COVID-19 infection are:

COVID-19 Fatality Rate by COMORBIDITY:

PRE-EXISTING CONDITION
DEATH RATE
Cardiovascular disease
10.5%
Diabetes
7.3%
Chronic respiratory disease
6.3%
Hypertension
6.0%
Cancer
5.6%
no pre-existing conditions
0.9%

Source: Age and Sex of COVID-19 Deaths

REFERENCE:

The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) – China CCDC, February 17 2020

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Rating: 9.2/10 (58 votes cast)
Coronavirus demographics -- very much a risk for older people and the strange split in severe case rates 0 - 15%, 9.2 out of 10 based on 58 ratings

107 comments to Coronavirus demographics — very much a risk for older people and the strange split in severe case rates 0 – 15%

  • #
    Peter C

    The Optimistic Mantra (repeated): Covid 19 will likely 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.

    Well I am going to put this here.

    The entirely press released data about the spread of the virus on board the Diamond Princess cruise ship points to a feacal-oral transmission route. The cases were increasing with time but not as fast as airborne transmission would indicate (to me).

    If so hand washing and toilet hygiene are the key mechanisms of Prevention.

    There are now quite a lot of people in various forms of quarantine. Another opportunity to study the transmission.

    221

    • #
      Bill In Oz

      Peter This is an important issue.
      The crew aboard the Diamond Princess
      Are mostly from countries and cultures
      With very different habits when it comes to
      Cleaning & toileting.
      Squat toilets are the norm among lower income peoples from
      Indonesia, Malaysia, the Philippines, Thailand, Pakistan, Bangladesh India etc.
      As is the custom of using the left hand to clean one self.
      Rather than paper & thoroughly washing both hands.

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      • #
        K in the UK

        Squat toilets should be cleaner from a transmission viewpoint than sit-down toilets. If one is wearing footwear, there is no contact between the toilet and people using it. Even without footwear in poorer areas, their is less contact and it is less intimate.

        010

        • #
          Kalm Keith

          Modern clothed humans are not in a position to take advantage of the fantastic “voiding” that would come with squats.

          Have you ever used a squat; you might give westerners some guidelines on how not to fall in or mess your clothing.

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        • #

          agree Bill makes some sweeping unfounded assumptions there.

          I also wonder what were these lower class bangladeshis doing on a cruise ship?

          210

          • #
            Bill In Oz

            But then I have lived in South east Asia for a year
            And needed to use squat toilets daily
            In my own home !.So NO assumptions at all
            just EXPERIENCE
            Which it would seem you lack Leafy one. !

            50

          • #
            Bill In Oz

            Re ” I also wonder what were these lower class bangladeshis doing on a cruise ship?”

            Poorly paid crew …
            Cabin staff, cooks, stewards etc.

            50

        • #
          Annie

          Having encountered some of these in the 1960s in Cyprus and more recently in the ME, no thankyou. :(

          50

    • #
      Konrad

      Peter, four lines of evidence now point to the feacal-oral transmission route:

      1. Many of those transmitting do not exhibit cold or flu symptoms.
      2. The pattern of infection on the Diamond Princess.
      3. The Hong Kong tower sewage system infections.
      4. The high expression of ACE2 receptors in the small intestine.

      As I have posted before, focusing on this infection route could lead to better prevention techniques, better rapid testing and possibly oral medications that make the gastrointestinal tract more inclement to the virus.

      I suspect doctors are reluctant to investigate this testing direction because it is intrusive/embarrassing. Ie: it is not technically difficult, just socially awkward. They are putting human dignity before human life.

      132

      • #
        Konrad

        It will be fun to look back at this post after the dust settles. (I’m a bit busy ATM keeping my friends with south east Asian ancestry safe, while the “trusted authorities” lie and lie and lie).

        That red thumb is a historical marker. A permanent record of how some respond to the truth, no matter how politely minimized.

        Let’s focus. We do have a serious problem, and no amount of lying is going to solve it.

        20

  • #
    Bill In Oz

    A well informed and well written post Jo !
    Thank you for helping us all stay ahead of the curve on this issue.
    Having read your post, the following thoughts are wandering around in my head
    1: The Japanese have abandoned containment of this disease. So when do we decide that all persons coming to Australia from or via Japan,
    Must do a 14 day quarantine period ?

    2: I still think that the cold temperatures in the Northern Hemisphere Winter in China, Japan, Vietnam etc
    is having an impact on the spread of this disease. And conversely that our Southern hemisphere Summer may be impeding the spread of the disease in Australia.

    80

  • #
    OriginalSteve

    I noticed a key phrase here – cytokine storm, a key player in the Spanish Flus killing ability….is this a re-engineered version of the 1918 virus?

    https://www.msn.com/en-au/lifestyle/health/heres-what-coronavirus-does-to-the-body/ar-BB108nxG?li=AAgfYrC&ocid=mailsignout

    “”In fact, signs of a full body blitz have been witnessed with all three of the zoonotic coronaviruses: elevated liver enzymes, lower white blood cell and platelet count, and low blood pressure. In rare cases, patients have suffered from acute kidney injury and cardiac arrest.

    “But this isn’t necessarily a sign that the virus itself is spreading throughout the body, says Angela Rasmussen, a virologist and associate research scientist at Columbia University Mailman School of Public Health.

    “It might be a cytokine storm.

    “Cytokines are proteins used by the immune system as alarm beacons—they recruit immune cells to the site of infection. The immune cells then kill off the infected tissue in a bid to save the rest of the body.

    “Humans rely on our immune systems to keep their cool when facing a threat. But during a runaway coronavirus infection, when the immune system dumps cytokines into the lungs without any regulation, this culling becomes a free-for-all, Rasmussen says “Instead of shooting at a target with a gun, you’re using a missile launcher,” she says.

    50

    • #
      OriginalSteve

      Makes you wonder.,…

      https://www.sciencedaily.com/releases/2007/07/070702145610.htm

      “Scientists Describe How 1918 Influenza Virus Sample Was Exhumed In Alaska

      “Date: July 4, 2007

      “Source: NIH/National Institute of Allergy and Infectious Diseases

      “Summary:

      “In an article in the journal Antiviral Therapy, scientists at NIAID narrate the story of how scientists discovered samples of the 1918 strain in fixed autopsy tissues and in the body of a woman buried in the Alaskan permafrost. The article places this discovery in the context of decades of research into the cause of pandemic influenza, and the authors detail the strange convergence of events that allowed them to recover and sequence the virus in the first place.
      …………
      “In a mass grave in a remote Inuit village near the town of Brevig Mission, a large Inuit woman lay buried under more than six feet of ice and dirt for more than 75 years. The permafrost plus the woman’s ample fat stores kept the virus in her lungs so well preserved that when a team of scientists exhumed her body in the late 1990s, they could recover enough viral RNA to sequence the 1918 strain in its entirety. This remarkable good fortune enabled these scientists to open a window onto a past pandemic–and perhaps gain a foothold for preventing a future one.

      70

    • #

      “.is this a re-engineered version of the 1918 virus?”

      Not. Cytokine storms happen in many situations and the gene sequence is definitely not related — not even a bit — to spanish flu. This is a single strand RNA virus, related to a bat version. Influenza are negative strand RNA not positive strand.

      150

      • #
        David A

        No, you may find this informative, ( not a bio-weapon, and quite possibly not natural either…
        https://harvardtothebighouse.com/2020/01/31/logistical-and-technical-analysis-of-the-origins-of-the-wuhan-coronavirus-2019-ncov/

        I saw a report about the ACE2 receptors that indicated chain smoking ( about 70 plus percent of men in China) caused a large increase in ACE2 receptors.

        I recall China was moving along with 20 percent severe cases! Even 15 percent severe will overwhelm hospitals with any decent RO. There are indications that the asymptomatic R0 may be close to 2, which is very much not good.

        Finally your death rates appear to have been calculated from current dead to total cases. This would greatly skewer the numbers low, and the cured number is yet very low. With an average symptomless incubation of 6 days, and 10 days to very serious, and about 4 more to death, you need to compare today’s death rate to over two weeks ago infected numbers. Simply consider a hypothetical of zero additional cases, then wait untill all current cases are either cured or fatal, that is your death rate.

        All the best…

        60

        • #
          OriginalSteve

          I noticed this point in your link, which also seems to hint at the use of some iffy viral manipulation processes used?

          “Early research found that COVID-19 targets the ACE2 receptor, which may be found in East Asians more frequently than other global populations, indicating that the Wuhan Strain COVID-19 was likely developed as part of a gain-of-function defensive project possibly linked to immunotherapy or vaccinations – never meant to leave the lab, but meant to serve as a Red Team to fight back against, not as an offensive weapon since the virus is likely wired to be more virulent among Asian populations. Further support for this is the fact that the Wuhan BSL-4 virology lab was already actively looking into the risks posed from bat coronaviruses, and actively researching coronavirus treatments – by definition both of these projects would require live virulent strains of coronavirus. And disturbingly, COVID-19 appears to have 10 to 20 times more affinity for the ACE2 receptor than SARS, according to a pre-print out of the University of Texas.

          20

        • #
          David A

          Meant to begin with Jo, not No

          20

        • #

          David, I personally am not calculating “Death rates” — I’m calculating “Severe rates” and doing it with an 8 day lag which I mentioned over and over… I don’t see anyone else calculating these rates which surprises me, because they are so central to estimating whether our hospitals will cope or not.

          As I estimated with Singapore even 5% severity will overwhelm hospitals in weeks.

          The estimates of the fatality rate age spread come from a Chinese study, and what I found interesting is the shape of the demographic curve, which doesn’t change whether or not the lag is accounted for. At risk populations (age 60+) are at risk. Though the % will fall. Since I mentioned that Chinese statistics ignore tens of thousands of asymptomatic infections in nearly every post I’ve done I didn’t want to bore everyone, but that’s the reason I didn’t dwell on the 15% figure.

          Added the ref to the chinese study and will add a note about the 15%. But the boring repeat-repeat caveat is that many deaths are not being recorded either in China. The fact is we have few facts.

          50

        • #
          David A

          Hi Jo,Regarding death rate I was of course referring to your linked post…
          SEX
          DEATH RATE
          Male
          2.8%
          Female
          1.7%
          Source: Age and Sex of COVID-19 Deaths

          Which AFAICT was total deaths now to total cases now.

          Regarding severe cases and the 8 day delay, ( from diagnosis?) I guess we will see. I am 100 percent confident you are correct, we know very little. From China I think all, official and speculative, RO and death rate numbers are WAGs. Seeing the economic shut down of China, how much can we trust ANY nations reporting?

          Of course in time this will sort out. ( Very hopeful for less severe cases in the ROW) However if we start to see quatrantinens disirpotionante to the official numbers, and stories of full hospitals, then time to be very cautious and prepared. After all, China shut down there economy and quarantined almost 10 percent of the planet for a reason; something spooked them, and good.

          10

      • #
        Konrad

        However cytokine cascade is likely what alerted the Chinese that the novel virus was a serious problem. Had it acted like the normal flu, and if the initial numbers had been as low as the Chinese claimed they would never have noticed against the normal number of flu deaths in Wuhan.

        But younger, healthier people seemingly to be partially recovering, then suddenly collapsing with hemorrhaging lungs or spasms from neurological damage, would be a big red flag. A number of the videos leaked from China appear to show cytokine cascade deaths.

        70

  • #
    LightningCamel

    Add a further 5 in South Korea making 20 for the day. At least 13 of these are linked to a church community in Daegu City. That is a high transmission in that group. I hope this is some trait restricted to this community because if that rate is at all representative of the rest of Korea look out?

    I’m finding the distribution of deaths in the tables presented hard to reconcile with the death rate of currently 12% in resolved cases. I would like to see an age distribution of those diagnosed but I suspect these figures don’t mean a great deal because such a high proportion are still unresolved. Perhaps the older people die sooner for example. Must go and read the paper but it is being reluctant to download just now.

    40

  • #
    Bill In Oz

    The South Korea new cluster of cases is interesting,
    It mirrors the situation in Singapore where members of the
    Grace Assembly of God Church were diagnosed witht eh COVID disease on the weekend.

    Is hugging each other a common behaviour in these churches
    At the end of the service perhaps ?

    40

  • #
    thingadonta

    There’s something funny about the death rate in Wuhan compared to everywhere else. Some possibilities:
    -there might be a higher death rate from multiple exposure, ie catching it more than once. Some diseases actually get worse the more you get them, (eg scarlet fever) although most don’t. The whistleblower Dr who died was exposed multiple times before he eventually succumbed. (This will also mean quarantine and containment works even better -it’s a fight against multiple exposure). There is a theory that the 1918 flu was worse for those who had been exposed to flu up to a few years earlier. The body over – reacted to the new flu strain, but it seemed it over reacted with those who recently had a milder strain.
    -there might be more than one form or strain, or it might be working in tandem with something else(such as viral pneumonia), circulating- in especially- Wuhun. In such a case, time might be a factor- the longer it circulates, the more likely someone will get the more severe form, or it may be easier to combine with something else circulating in tandem the longer it circulates (such as viral pneumonia)

    60

    • #
      LightningCamel

      The repeated exposure may be a factor related to immune system overreaction. The other thing which may be going on here is just time since infection. These data were taken up to Feb 11th so those outside Wuhan probably had significantly shorter times since infection as a group.

      40

    • #
      nb

      I have read that air pollution in Wuhan has been very bad for some years – sufficiently bad to result in protests. I haven’t confirmed this from additional sources, but it might be a factor.

      60

    • #
      David A

      Consider also that the hospitals were overwhelmed.

      20

  • #
    LightningCamel

    OK, got some of the paper and that helps to make sense of the descriptions found in the worldmeters graphs. The percentages of deaths in the various age groups are percentages of the cases in that group. So the poor old 80 and over group make up 3% of all cases and 20% of all deaths. People over 60 make up 31.2% of cases and 81% of deaths.

    These data are for Chinese cases so there will be various confounding factors.

    The download is still dodgy so only have parts of the paper yet. Might post more if I get the rest.

    40

    • #
      LightningCamel

      Hmm, replying to myself, hope that’s not a symptom of something.

      Another factoid from the paper regarding susceptibility of the age groups. Turns out that, as you might expect, older people die quicker. This is expressed as deaths per ten person days of infection. For the 80 and over group this is 0.111 deaths per 10 PD for the 70′s it is 0.056 and for the 60′s it is 0.024 and continues to decline sharply. What am missing so far is any way of estimating the deaths yet to occur within the group who are ill but still surviving. These may change the age distribution.

      The overall death rates decline with later onset. This will be partly due to treatment improving but also to deaths which have not yet occurred in the sample.

      It is OK to toy with the abstract figures but I do not forget that these are thousands of individual tragedies.

      80

      • #
        Robert Sewell

        If there is an immune response that is excessive, I would expect immuno suppressed patients to have a milder reaction to the disease. Is there any data pertaining to the group?

        20

        • #

          Thanks LightningCamel for going through those details. Interesting. Death rates declining may hopefully be a sign of the virus evolving. (OK, I’m being optimistic, I’ve seen no RNA analysis that suggests this).

          Robert, it’s not that simple. Instead cancer patients are more likely to die too. Our immune system is a complex army with many divisions. One wing can be underactive while another is over…

          30

          • #
            LightningCamel

            The virus evolution question is interesting and I’ve been pondering on it a little. If the primary spread is occurring in the asymptomatic period then there is pressure on the virus to prolong this to maximise its spread. This pressure will increase as, hopefully, isolation and treatment of sufferers improves provided that the strains with later onset also are less severe. It is a balancing act and, if later onset maintains mortality, it will be more dangerous. Past experience would suggest that delayed symptom onset will entail less severity but I’m not sure there is a lot of selection pressure in that direction.

            10

  • #
    TedM

    I know that this seems a bit far out there. But has it been considered that we may be looking at two different viruses orr strains. Possibly a more sinister virus escaping from the Wuhan lab, and a second virus deliberately released to attempt to cover the escape.

    80

  • #
    macha

    I recall a blog, maybe Rud, where tge thought was the escalation to fatality depended on how you got the virus. If by ingestion, then able to recover becausenin stomach the body has time to build defences. But if inhaled direct into lungs, billions instantly take hold.

    Australia’s relatively low humidity and summer probably dries them out too fast.

    50

  • #
    cedarhill

    There are some companies working on “better” and “quicker” diagnostic test of the Wuhan virus. In fact, all the media and concerned bloggers should rally behind this effort and expand it to test for ALL communicable diseases in international travelers.

    Imagine, a pinprick blood test of glucose testing fame, required of all international travelers prior to boarding any commercial transportation which crosses an international border. All international travelers not traveling by commercial transportation would be tested either at the border or when captured (i.e., illegals). Then quarantine ALL that fail — from TB to measles to whooping cough to chicken pox to common colds to seasonal flus to the alphabet soup list of mysterious and exotic viruses. If we can sequence a persons DNA completely in a couple of hours, we have the technology to do this. It’s just an engineering problem to solve.

    Basically, if containment is the plan, take those steps that make it workable. Even quarantine travelers if they show signs of, for example, any coronavirus.

    The only downside it if one stops all international transmission, one runs the risk of what happened to all those populations in the past where pathogens slipped in and slaughtered them. Small pox and the Native Americans comes to mind. Oh,m and the West is reintroducing all those pathogens, current mutations, with their open borders, no testing policies.

    70

    • #
      el gordo

      With the Black Death (viral infection) a third of Europe’s population was wiped out in very short time. The end result was that wages improved for those who survived.

      32

      • #

        What was this black death virus you speak of?

        24

        • #
          el gordo

          You are a google master young leaf, it wasn’t a bubonic plague carried by rats and fleas, but you already knew that. Presumably it came along the silk road.

          ‘Chinese travel agents are marketing bespoke “14-day, 13-night” packages to third-country transit destinations to help Chinese ­students enrolled at Australian universities get around the federal government’s coronavirus ban for as little as $2700 each.’ Oz

          50

        • #
          shannon

          The Black Death was NOT caused by a virus…
          It was caused by a bacteria …of a group species that is similar to human bowel flora…ie Coliforms
          Rats were the vector spread of the disease…..

          Viruses and Bacteria are miles apart and (annoyingly) get reported incorrectly… especially by the media.

          30

      • #
        mareeS

        It came to Europe after the Crusades, Via the fleas that lived on rats from the Middle East. It did indeed wipe out one third of Europe’s population in the Middle Ages.

        Last reported in Sydney Woollomoloo in 1920 after troops came home from the Middle East after WW1.

        30

  • #
    paul

    the quarantine period on ship is not to protect passengers and crew but to protect us and i note australian returnees still have to do 2 weeks in local quarantine

    70

  • #
    John F. Hultquist

    1. having a stash of things at home
    E.M. Smith (chiefio) has multiple postings on this topic

    2. According to cardiologists Rheumatic Fever leads to heart issues.
    They claim** my wife had RF as a child and this led to valve replacement. I wonder if the ACE 2 gene is linked to the childhood fever?

    **Wife’s mother (a nurse) likely treated an illness but did not take her to a clinic, so no report.

    40

  • #
    yarpos

    I wonder about the Japanese. I know from work experience they are fantastic detailed planners and can then execute well on those plans. Strategy , it seems is something else altogether.

    30

  • #
    Rosco

    Off topic – sorry – but I have just noted that the Nevada solar “tower of power” plant at Tonopah has gone bankrupt and shut down taking 3/4 million Obama dollars with it !

    https://www.reviewjournal.com/opinion/letters/letter-much-touted-crescent-dunes-solar-plant-goes-bust-1935510/

    https://techstartups.com/2020/01/06/1-billion-solar-plant-obsolete-ever-went-online/

    Sorry if this is old news.

    70

    • #
      Peter C

      Thanks Rosco,

      It was mentioned in a comment a few days ago.
      It is major news. The collapse of a hugely expensive solar project after just 4 years of operation.
      It never achieved the projected output.

      There has been almost no mention in the main stream media.

      Jo has not done a post yet but she may have something in the works!

      110

      • #
        Rosco

        What about this “The Ivanpah system is producing roughly half of its “solar energy” by burning natural gas to “pre-heat” the central collector fluid.”

        Seriously ? And yet the chirping class keep on with the mantra about net zero by 2050 ?

        60

      • #
        sophocles

        From a blissful position of total ignorance, I claim, with no foundation at all:

        It was all those clouds.
        They got in the way.
        The quiet sun and the Svensmark Effect ganged up on it.
        Darned Cosmic Rays …

        50

    • #
      Watcher of the road

      All unreliable, I mean ‘renewable’ energy systems will go the way of this useless project. Not entirely useless mind you, for it shows the way forward to those who have a couple of neurons and a connecting synapse between their ears. That way forward is cheap carbon-based energy for all, lifting the world out of poverty.

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        sophocles

        Modern nuclear technology has to be developed. The LFTR
        (Liquid Fuel Thorium Reactors) have to get the money now.
        The development has all been done in the background but over the next couple of years, we’re going to see the projects.

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    Penguinite

    Shades of the Plague that ravaged Europe in the 1400′s? The insidious spread much like the cruise ship experience!

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    dinn, rob

    notice how early this command was given.
    曾錚 Jennifer Zeng
    @jenniferatntd
    Yanyi Wang(also Wang Yanyi), director of #Wuhan Institute of Virology, issued a notice to researchers on Jan. 2 to pass on telephone message by #China’s Nation Health Commission, forbidding anyone to release info of #COVID19. Original and English translation here. #Coronavirus
    Image
    Image
    7:03 AM · Feb 17, 2020·Twitter Web App

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    Watcher of the road

    If the virus is becoming less virulent and less potent as time goes by, would that indicate that the original ground-zero virus was a designed one, a GMO, that escaped through the lab-door, and not naturally occurring through the evolution of a weaker common-cold level version? Just thinking (stupidly?) aloud

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      No. That is a normal transition that can occur with any virus, natural or not. There will be a cloud of slightly different versions out there, and the one which is the most contagious will win the race. Often that means it is less deadly because ones that kill people usually incapacitate them and they don’t shed as many viruses. But there is no guarantee, and having a variety of reactions and delayed incapacitation til 3 weeks after infection seems like a pretty potent combination. Sigh.

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    Brian

    The scale of the measures that China has taken to try and contain the virus are frankly awe inspiring. Nearly 50 million people in the area surrounding the source in total lockdown. Hundreds of millions in other areas under strict movement restrictions. This seems to have managed to slow the spread of infection dramatically. Unfortunately China was slow to react, due in a great part to the Chinese government system and the virus had ample time to spread before any containment methods were adopted. The first case of pneumonia, later diagnosed as Corinavirus was on 12 December 2019 so infection would have occurred in early December. Attempts to raise the potential problem were quashed by the government. The new Corinavirus was identified in January 7th but it was not until 23 January that travel restrictions and progressive lockdown of Wuhan were initiated. By that time millions of residents had travelled outside the area for Chinese New Year.

    Most nations have take this virus extremely seriously despite initial WHO advice to the contrary and for now appear to have it contained although there is no room for complacency. There are some disturbing trends in the latest status figures. South Korea registered 20 new cases. A small figure in isolation but it reflects a 39% increase in one day. Japan (excluding the cruise liner) had 10 new cases, a 13% increase. I suspect that the low death rate outside China reflects the availability of intensive care facilities for the low patient numbers. From the reports coming from inside China, medical facilities and personnel are overwhelmed which may be why the death rate there shows no signs of slowing down.

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    Konrad

    One issue that is not receiving much coverage is long term health effects.

    Given the virus targets the ACE2 receptor, how many of the “recovered” will have kidney damage or male infertility?

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      LightningCamel

      Have reports of male infertility but seems a bit early to be diagnosing that. Have not seen any data. Also a report of patients apparently cured either relapsing or being reinfected and suffering sudden major heart failure. The possible link is that smooth muscle such as heart muscle has a high number of ACE2 receptors. Again not much confirmation of this to add.

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        Konrad

        Indeed it is hard to confirm. SARS had (apparently) a higher mortality rate. The autopsies showed kidney and testicular damage.

        Unfortunately all dead in China from “Winne the Flu” are being immediately cremated. No autopsies are being done.

        With 40 mobile furnaces, each with a capacity of 5 tonnes of “material” per day, recently being trucked into Wuhan, we’ll have to wait on scientific data on those that have “recovered”.

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          Power Grab

          I saw an item today (probably on Twitter) that said that people who had previously been vaccinated with the SARS vaccine were more likely to die from Winnie the Flu. I like that name better than COVID-19, or whatever version of that they’re using now. When they keep changing the labels, I find it hard to keep up.

          Another item said that if you got Winnie the Flu and recovered, then got it again some weeks later, it was worse and more likely to kill you.

          I don’t remember when SARS was in the headlines, but perhaps younger people are less likely to die because they didn’t have the SARS vaccine.

          One more thing I saw is that Wuhan was the test bed for 5G, which many are saying is more harmful to humans than its predecessors.

          I watched 10 or 12 videos from China today that showed the authorities attacking people walking the streets, beating them up, and hauling them off. Some of the descriptions said the victims suddenly took ill and had to be “assisted”, but it occurs to me that since food is so scarce, people who collapse on the street might simply be starving.

          I’m inclined to believe that, most of the time, the “treatment” is worse than the disease.

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    Bill In Oz

    Nine millions residents of Wuhan to be checked for COVID disease in three days !
    The Chinese government is pulling out all stops.
    Extraordinary !

    https://www.news.com.au/world/asia/chinese-authorities-order-housetohouse-coronavirus-checks-as-death-toll-rises/news-story/0330b37972658cc1559706609620b2dd

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    LightningCamel

    The total for Korea for 19th is now up to 27, 20 of whom are associated with church services in Daegu. Suggesting one individual has been identified who has infected at least 15 others and been in contact with 166.

    Authorities “plan to test others who attended services as a precautionary measure”. No mention of attempts at quarantine or other containment.

    If this is actually what is happening then this seems a seriously inadequate response. We just have to hope that the individual with an Ro of “at least” 15 is in some way unique and that others of her church will not exhibit similar infectivity.

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    Sorry this is a bit o/t, but y-all may have heard about Manchester City being suspended from the Champions League for two years. Part of their defence consists of arguing that the emails on which the charges against them were based were ‘stolen’ and ‘out of context’. Sounds familiar?

    https://www.goalsn.com/2020/02/ferran-soriano-ceo-of-manchester-city-they-have-been-based-on-stolen-and-out-of-context-emails.html

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    LightningCamel

    Another little gem.

    The Worldmeters has been saying for days that Australia has 15 cases, of which 10 have recovered. the Australian Health Department site says that as of 0600 on 19th Feb we have 15 cases, of whom eight have recovered and 7 are in a stable condition. Right now I don’t have any information on recent changes in the “recovered” number.

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    MarkMcD

    “Worldometer now gives us rates according to sex and preexisting conditions”

    Surely this is an unworkable statistic with 57 different sexes in the world? :D

    How Dare They! No LGBTQ etc. types represented! They’re leaving them off the list as if they aren’t important and their imagined sexes don’t matter at all!

    We need a petition to allow the LGBTQ types equal opportunity to be in the coronavirus death stats. Otherwise it’s looking like this is a disease to eradicate men and women and leave the gender-confused in charge of the planet. :D

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    LightningCamel

    THe Department of Health is publishing Weekly Epidemiological Reports here which seem a reasonable summary of information.

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    STJOHNOFGRAFTON

    As a 22 going on for 72 oldie I recommend getting immunised against pneumonia. This jab may be a freeby for the chronologically qualified.

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    • #

      May help. But we still don’t know what proportion of the pneumonia is primary viral or secondary infections. I’ve been looking.

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        LightningCamel

        There seems to be agreement that antibiotics are of no use so that I think rules out secondary bacterial infections. Also reports, eg from Canada and India, that antivirals have had spectacular results. These are being tried in several places including China so we may have some answers soon.

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      David A

      I was hoping to get more details on China’s new pneumonia pathology for quicker identification of infected. All I have heard is somewhat vague; both lungs attacked, spotted buckshot spread of lung damage.

      WHO should be asking and getting information on this, possibly sharing with other nations.

      By now nations should have a decent guess at thus years pneumonia rate, and know if those cases start to shoot up.

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    Enoch Root

    Two deaths among Diamond Princess passengers. Both over 80.

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    Enoch Root

    I was wondering… Since the virus seem to use ACE2 receptors to get in the cell, are people with high blood pressure treated with ACE inhibitors or angiotensin blockers more resistant to the infection? Have anyone read anything about that?

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    AtomicPlaygirl

    Hi there, stumbled across your blog; thank you for your commentary on the nCoV. Not a professional (just a science lover), and had some questions.

    I have heard there are over the counter options to reduce the risk of a cytokine storm; is that true? I have found conflicting information, with some people saying Benadryl does, others saying statins, etc. I understand the immune system needs to ramp up but not get out of control as infection progresses, and that CS is a real potential issue here.

    IIRC, UV light can be used to disinfect rooms where contaminated fliuds (such as with Ebola), might have been spilled; is there any reason to think nCoV won’t also be destroyed by UV? I understand the potential viability of the virus could be up to 28 days. I think there was a JAMA article early on about P0 here in the US and his sinus discharge still had a high viral load even after he stopped showing symptoms. I’m a little concerned about infectious asymptomatic people and how to protect against this possibility. There’s so much we touch and come into contact with!

    Also, I think in the same JAMA article (perhaps?) they mentioned the virus appears to dislike high or low levels of humidity. Would be interested in knowing if my memory is right on that one too. =)

    Unfortunately I have had hypertension since my 20′s (in my 40′s now), so I am a bit concerned about the much higher mortality.

    Thanks for your time!

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    • #

      Good questions. Though I suspect there are no good answers.
      Here’s some questions back… do the famous and popular ACE blockers target ACEI or ACEII?

      If its ACEII are these acting on the same site as the virus?

      Does it downregulate expression of ACEII on cells or the action of ACEII?

      Are there neutraceuticals, foods, supplements, dietary changes that affect the odds of a cytokine storm?
      EG resveratrol, CoQ10, curcumin, sulforaphane….

      Who is most at risk of a cytokine storm?

      Are mitochondria involved with either Coronavirus infection or the cytokine storm?

      You can hunt for answers to those questions here: https://www.ncbi.nlm.nih.gov/pmc/pmctopmid/ at the incredible public library of medicine, though that does not mean there are answers or that they will be easy to find and understand or freely available.

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    Orson Olson

    THANK Joanne. The bad news is that outside of China, total cases infected have reached 1,000. We see doubting every 6 or 7 days. Thus, we – outside of China – will be like official counts of China in merely 50 weeks, ie, 50,000 infections. And 500,000 in 10 more weeks, And 50,000,000 in 10 more.

    Spanish Flu pandemic, but for older people shall be our reality next year.

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      Bill In Oz

      Orson, I think we should break that 1000 down by country.
      Some places seem more susceptible than others.
      The cruise ship Diamond Princess at Yokohama seems especially susceptible
      With well over 500 cases out of that 1000..
      And I see that 2 elderly persons who contracted the virus while on board have now died in Japan.

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      Orson Olson

      SORRY – I have embarrassed myself because the CORRECTED calculation – for infection doubling times – is much much, more scary.

      At 7 day doubling rates, it only takes 7 weeks for the world ex-China to become today’s official China size: from 1,000 to 64,000. And only another 7 week of weekly doubling to reach 8,000,000. With merely 6 more weeks (ie, week 20), we reach 1 billion cases.

      Thus, in less than two months, a head steam starts, and in less than another two, 8 million cases in East Asia? China’s harsh 5 weeks quarantine is coming to nearby nations to try and slow the mighty train of infection.

      How will summer slow this fierce and impossible freight train of infection? We hope tropical Singapore show us some differential evidence in the next month. We need time to improve near real time infections tools to sort people and contain the threat. We need more time to prove the effectiveness of anti-virals and produce and distributee both of these tools.

      Life will go on after Covid19 pandemic. But it will be demographically changed with big consequences to the age pyramid.

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        Golfsailor

        The big consequences may come to rescue a lot of government financial problems going on at least in Europe. This actually is probably cause firing of theories why not already quarantine Japan. Health expertise in Sweden as of yesterday said there was no or very little threat in Europe. At the moment that may be true but, traveling from Singapore, Japan and South Korea is still not restricted and will only stop when it’s too late.

        Yesterday we were invited to a sailing yacht for a day cruise outside Los Angeles on Sunday. It’sa friend who recently was in China. Three weeks ago. But to get out he had to travel to Japan first, stay one week before travel to USA. May I add, unnoticed. I will not go.

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    DonS

    Hi Jo

    Given the virus seems more deadly to the elderly you would think the Japanese authorities would have a less cavalier approach to how they are letting people off that ship to roam about the country apparently at will. Japan has one of the demographically oldest populations in the world so one would think they would be super cautious in handling this issue. As I said before, the Japanese government will have questions to answer.

    I think we can totally ignore the figures coming out of China too. It looks to me that the communists are using the virus as a cover to “disappear” thought criminals they have had their eye on for a while. Police without gloves or masks dragging people away because they have a dangerous infectious disease, really? I suppose if the infectious disease is a yearning to be free then that might explain it.

    I also saw a news post this morning reporting that the head commo in Wuhan has demanded that no new cases of infection will happen, or else! Typical control obsessed totalitarian response, command it and it will happen. Here we were thinking disease control was a matter of applying scientific methods to a problem when really all you need to do is command people to stop being counter-revolutionary by getting sick! Who Knew?

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      Bill In Oz

      The quarantine situation in Japan is odd.
      I remember reading that the Japanese government
      Attempted to place two persons infected with this disease in quarantine.
      And they two persons involved refused quarantine
      Because Japanese law does not require it.
      Bloody weird if this is the reality !
      And probably demands a response from other nations
      Such as placing Japan itself in quarantine .

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        Bill In Oz

        I see that there are 84 other people in Japan
        Sick with this disease
        As well as those who got infected while on the Diamond Princess.

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      Power Grab

      It has also occurred to me that the Chinese are taking this opportunity to eliminate “thought criminals”. The timing relative to the Hong Kong unrest is concerning.

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    LightningCamel

    South Korea is the really worrying place. Another 46 cases today, again mostly in Daegu taking the total to 104 and the country’s first death. I remarked in an earlier post that the reaction of the authorities was muted but the local city authorities are now calling on the central government to act but the time frame for effective control may have been missed. Most Koreans live in high rise apartments so if this rate of spread continues the options are limited and the horse may have bolted.

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      LightningCamel

      A local (Korean) press report has some context.

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        Bill In Oz

        It’s remarkable that it is all being done by local authorities
        And that possibly infected persons from the church
        Are being asked to self isolate !
        I do not think that the South Korean government
        Has the balls to sort out this issue
        Any more than Japan.

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    As Jo says, any reference to death rates now is known to be wrong–mild cases would be understated in any country–people get slightly sick and go back to work, or don’t get symptoms. In China no one thinks there is a widespread testing for this virus going on. There are not enough medical resources for normal circumstances, and certainly not enough for general testing. The bigger the number of mild cases turns out to be against the known deaths, the lower the death rate. It is very low.

    So: to mention 15% of people 80 and over dying is worse that stating, say, 2% overall. Are these seniors more likely to be reported for mild symptoms, or less likely? As long as we know many of them who have the virus are not being reported at all, we know that 15% is much too high. The clearer news, so far, is that people who are not 80 and over are at little risk of death, even if they are tested and found to have the virus.

    More infectious than SARS. Far less virulent than SARS. Of course it makes a less dramatic story to say that.

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    [...] The Diamond Princess was a cruise ship on a trip to China that was put into quarantine in Japan. There were 135 cases on Feb 11.  Today there are 542, with 15% being severe.  People onboard hailed from over 50 countries and the quarantine was ended allowing people to return home.  This in turn led to passengers on those flights being also quarantined when they got home. [...]

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