In short:
- Outside China, 2% of cases have progressed to “severe”. But if the lag is eight days then progression to severe is more like 5%.
- In China about 1/5th of severe cases are “Critical”
- If that rate occurs in the West, hospitals will be overwhelmed if just 1% of the population gets infected.
- In Singapore, the doubling period for confirmed cases is about nine days.
- Currently the spread is not exponential outside China (most days)
News today: First victim in Europe — an 80 year old Chinese tourist.
Stats: Total cases outside China: 787 Deaths: 4 Severe cases: 18 (2%)
Early days of “outside China” data
The 2% rate of severe cases is an underestimate above. There is an eight day lag from diagnosis to “severe,” and then a longer lag to death. Total cases outside China on Feb 8th was 354. So a more realistic estimate is that about 5% of confirmed cases outside China have now progressed to “severe” (i.e. 18/354).
What does severe mean? It appears “severe” means hospitalized but not necessarily in ICU. In China, the rates issued in a Feb 7 press release were 82% mild, 15% severe, and 3% critical. From that, we might assume that only a fifth* of “severe” cases are critical and therefore in need ICU care, so outside China that might be 1% of all recorded infections. (Remember the Chinese statistics are all from hospitalized people, outside that in the whole population it probably is much lower, because many people apparently get a cold and stay home and aren’t included. Though there are some who stay home and die at home and they aren’t included either. Twitter shows vans visiting apartment complexes, and being loaded with bodies. How many? Who knows. This is why statistics outside China are the only ones that count.)
*Technically one sixth (3/15+3 — the accumulated severe plus critical total)
Estimating when trouble may really start in Singapore
So, with Western hospitals, perhaps only 5% of confirmed cases become “severe”, and only 1% of confirmed cases need an ICU. Current ICU bed availability in the West is typically about 1 bed per 12,000 of population (and there are even fewer of the proper “negative pressure ICU” rooms we need for best quarantine of an aerosolized disease**). Once the the infection has reached 1% of the total population in a Western nation, about 120 out of 12,000 people have a confirmed case, and about 1% of them — or 1.2 patients — will need an ICU bed. At that point, all the ICU beds are in use, and we have run out of ICU places — even if none are required for other uses. Not happy days in hospital-land.
Obviously we need to slow the spread of the virus urgently, aggressively, so that hospitals don’t have to send people home with an oxygen tank, a how-to-guide and good wishes. Even being optimistic and if the rate of progression to “severe” is only one fifth as common in the West as it is in China (there are reasons to take an optimistic stab), our current medical system stops being able to cope when about 5% of the population gets infected. All numbers are loose — the 5% rate of severe cases assumed in Singapore above might be too low — in Singapore the exact current rate is 8% in HK it is 13%. Sorry about all these numbers.
**Aerosol or not? There is a lot of disagreement over whether it is or isn’t?
The exponential curve we don’t want
The exponential growth of infections in China meant that hospital system was always going to get overwhelmed. It took just two months. The Lancet reported on January 24th that, of the first 41 patients admitted in Wuhan (by Jan 2nd), 32% ended up in the ICU and 15% died. In the Wang study the news was better: 26% of 138 patients needed ICU and only 4% died. But one month after the first study, by Feb 5th, Wuhan hospitals were overwhelmed and turning away all but the most severe cases.
As I said on my first post two long weeks ago, human brains don’t seem well adapted to planning for exponential curves. The doubling period inside China was six days in January. Outside China it is about eight days so far, though that is mostly dominated by the unfortunate cruise ship, which is in lock-down off Japan. Ominously, the doubling period in Singapore — which has dedicated advanced infection tracking — is about nine days (40 infections on Feb 8, and 72 today).
Singapore bad case: assume 10 day doubling, 5% progress to severe, 1% progress to ICU
To give some idea of how rapidly this might go, ponder that those 72 cases in Singapore could become 73,000 with ten doublings — which is only three months away. Of that, there may be around 3,500 severe cases and 700 ICU cases. There are probably around 12,000 total beds in Singapore hospitals. Occupancy rates already peak at 85% in March. That’s not a happy set of numbers.
To extrapolate (just to make a point), in less than six months the entire population of six million Singaporeans could theoretically have been exposed — except that sometime around four months the growth curve would slow, because a large section of the population will already be immune (we hope) and the most vulnerable will already have caught it. I expect things will be slower as we learn more how best to help those with it, and how to quarantine. But we can see why Singapore’s health officials are sweating and working so hard to track and trace and hunt down every last case (which they haven’t been fully successful at). What they are not announcing publicly is that without any effort to slow this, or any anti-viral or vaccine, and without entirely shutting schools, factories and enforcing a mass home quarantine, Singapore is only a few months away from hospitals reaching full capacity. We can all see why they don’t want to dwell on worst case possibilities in public. Beyond a few months, without a slowing, the unthinkable, potential pandemonium and mayhem unfolds. We hope that doesn’t even come close. But keep those worst case numbers in mind. Anyone who says “it’s like the flu” hasn’t run the numbers. This is nothing like the flu.
As hospitals fill, manufacturing systems and supply chains will decay. The system will be far beyond the normal epidemiological curves. It will be hard and then impossible to get enough masks, consumables, or even medicine (especially if it’s made in China). If things hit that point, it’s a “black swan”. China is deep inside that.
Best case: West contains the spread
As always, let’s repeat the optimistic caveats: 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. The point of this post is to raise awareness that Singapore is walking on a ridge between control and a deep abyss, and it’s not out of the question that the West may follow. We really really don’t want to get on the wrong side of that exponential growth curve.
Perhaps we are seeing the awful result of malnutrition in China?
I’m astonished to note in the Wang et al study that two thirds of those in the ICU are listed as having “anorexia,” whereas that one third that didn’t need an ICU were listed the same way. I am baffled that there is not more discussion of this. Does it mean malnutrition? Is it a bad translation? (Anoxia is spelt like anorexia?)
Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]).
Perhaps some medico’s can help out — it simply makes no sense that most elderly Chinese would be anorexic in the same sense as the term is used in the West.
As for dyspnea — it means means “shortage of breath”.
The good news: Outside China things are not exponential
Not yet anyway.
Coronavirus Cases outside China | Worldometer
Obviously it could go exponential, and probably will if the virus takes hold in places like Africa (which has just reported it’s first case). But Africa hasn’t done much testing, and has a large fly-in-fly-out (FIFO) population of Chinese workers. If things take off in Africa, we will need a new category of graph “Cases in The West”.
….
Still noisy early data, and we can’t tell at this point whether the West will keep control or lose it.
As long as the growth factor is below one (in the growth of daily cases below), the growth is not exponential. However, be aware that at some point our ability to slow the linear growth and keep it under “1” will be overwhelmed. It is simply not possible to do exhaustive tracking of each new case, tracing back to find the source and isolating all the other contacts. At 50 cases Singapore had one unexplained source. Is that the point nations lose control? We don’t know. Singapore might get lucky. They will be tracking hundreds of people.
Cruise boats aside I hope this is a pattern that stays under 1. But there is that nagging concern about untested cases and the superspreader wildcard. Perhaps Singapore was just unlucky and got one, or perhaps even the strain of virus there may be different. Mutations are high in single stranded RNA viruses so there is possibly a cloud of different ones spreading right now. The most infectious strains will win that race, we just hope they are also less nasty.
Daily growth curve outside China. The red line is “1”. Above that is exponential growth. | Worldometer.
There are new hints today that the virus may weaken hearts and that those recovered may still not be out of the woods. I need to follow that. There were reports like that a few weeks ago, but those referred to the first week of infection. People were sent home, then had to come back.
I’ve heard that China has very stringent tests before people are declared recovered, which is why it takes a month to get on that list. But of course, if the experience of fighting Covid 19 leaves long term damage in some tissues there is probably no data on that yet.
A historic event. Let’s hope it gets boring soon.
REFERENCES
Huang et al (2020) Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet.
Wang et al (2020): Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China – JAMA, February 7, 2020
I have read that lung damage starts before symptoms are obvious, which is a disaster for treating patients and recovering patients. Also that access to oxygen is not as good as in the West, a real problem in treatment and possibly why so many progress to serious and heart failure becomes a more likely result.
Even so, I suspect WHO are contacting government bodies directly this time and in turn governments are doing their best to stop panic flight and panic buying and panic reactions of all kinds. In Melbourne we have seen teams of Chinese in expensive cars raiding all stores and pharmacies to buy up masks and handwash, much as they did for milk powder. Whether this is real domestic concern or commercial opportunism is not known.
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In other words the idea of sending patients in China home with personal oxygen bottles is itself optimistic. These are not supermarket items.
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Hmmm…using 12v DC to crack water could produce O2 on demand ( as long as you safely burn off the hydrogen ). Not sure about what volume you would need to be useful. Anyone know what it might be in cc/min for a useful theraputic level of O2?
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A good Good point Steve.
From school days I think oxygen is normally about 18% of the atmosphere at ground level.
At altitude, say Everest, people can use tanked oxygen supplements, but at what level of “extra” I don’t know.
Apparently high oxygen is tolerated at low pressure.
In high pressure situations like scuba diving and submarine escape practice towers, the situation changes and it seems that pure oxygen is dangerous and in fact CO2 may be an acceptable dilutant.
It would be interesting to find out the actual percentage of oxygen in hospital tanked supplies because in certain situations it can be an extremely dangerous gas.
Interesting.
KK
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KK you have that slightly wrong. The concentration of O2 in the atmosphere at sea level is just over 20.9% normally rounded to 21%. The concentration on Mt Everest. Is much the same. What is different is the pressure. One needs to talk about partial pressure. At sea level the atmospheric standard pressure is 101.3 kPa, the partial pressure of O2 is 21 kPa. from a Google search partial pressure of O2 on top of Mt Everest is 53 torr (a torr is a mm of Hg and is equal to 0.1333kPa) This makes the partial pressure of O2 7.1 Kpa. I may be wrong but I recall that at sea level people and animals are in problems if the O2 concentration is less than 12% or 12 kPa. (this could happen in a fire where O2 is replaced with CO2, even a submarine underwater with people breathing out and a diesel engine running -a reason nuclear subs are a better idea) 7.1 kPa at the top of Everest is less than the problem level of 12. People will need additional oxygen or have developed a better respiratory systems that can withstand low levels for some time. I have been to Lhasa at 4000m high on top of the Palace (O2 partial pressure about 12.5kPa). I was OK but my wife had some problems and some others on the tour were in a bad way.
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Yes, I should have checked the oxygen.
The partial pressure explanation is right on, thanks.
Would explain also why in practice submarine escape towers under great pressure the oxygen needs to be diluted, with CO2 and why scuba diving with pure oxygen would be a disaster.
That’s good.
My wife and I went up in the train to the top of the Eiger, Munch, Jungfrau complex which also about 4,000 m. It was mainly just cold at 14,000 ft.
KK
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Monch
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A quick look online suggests that 24 to 28% might be OK in supplemental air.
Above that level requires careful, targeted use after clinical evaluation.
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… which just uses up the released oxygen.
Nett result: nothing. Really OS 😀
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No, the hydrogen burns up atmospheric oxygen leaving yo your pure O2 in your container
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having worked in Australian public hospitals for 35 years, training non health care workers to use oxygen at home isn’t a ten minute demonstration. Some patients/families take many days to be deemed safe for home oxygen. I can foresee plenty of fires/explosions in homes if this goes ahead.
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Hi Mark,
Is the main issue fire safety or does overdosing on the presumably enhanced oxygen also get a mention.
KK
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We spent a while in Indonesia visiting family late last year and flew home from Jakarta in early November. I spent four days in bed afterwards with the “flu” verging on pneumonia. Still have a persistent chest cough today in February. I wonder.
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Oh dear!
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I hope this clears up soon. Theoretically it wasn’t Corona virus, but you want to be healthy when the cold weather starts. If it was then you should be immune. Best wishes.
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Hi Jo
Ship off Japan in lockdown? Yes but No, from footage I’ve seen the passengers are wandering about the decks willy-nilly. The ship may be cut off from the shore but the passengers and crew are not being quarantined in their cabins. Wonder why the virus keeps spreading on this ship?
These people should have been evacuated from the ship 2 weeks ago and put in onshore quarantine but for some reason (Japanese xenophobia?) those in charge decided in effect to run an experiment to see if they could create the perfect environment for a coronavirus to spread i.e. a large number of people in a confined space with warm air being circulated throughout.
The whole episode has been a shameful disgrace for the Japanese health authorities and now the US and Australian governments have had a gut full and are organising an evacuation of their citizens from what may end up a ship of death.
I fail to see the logic in keeping these people on the ship. To stop the virus spreading on shore? but then take people off the ship when they get sick? Instead of having perhaps a few cases to deal with they are now going to have hundreds! What a bunch of peanuts! Questions will need to be asked of the Japanese after this is all over.
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You might want to check some of the numerous videos about the Diamond Princess. Passengers were kept in their cabins and have been let out on deck in small numbers to get some exercise (particularly those that had inside cabins). They were told to stay 6 feet apart, but people in the same cabin would not need to observe that advice.
Keeping people on the Diamond would have been more about protecting people in Japan initially, but now that the virus has spread it is becoming clear that this plan has to change. At the current time they are evacuating people testing negative to the virus, and it should also be noted that the testing was done in batches, so it isn’t clear whether the increases are a result of staggered testing or from spread of the virus on board. Most likely it is a combination of both.
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Don, This is normal maritime quarantine law !
Once it was clear that a person who had been on the ship
Was sick with Corona Virus disease in Hong Kong
It was also clear that others would probably be infected.
And then no country wanted to allow the passengers to disembark.
The Philippines, Taiwan, Korea & I think Shanghai in China, refused entry to this ship.
Why ? They rightfully feared the disease would then spread to their country !
All countries have the right ( indeed obligation ) to protect their own people !
Japan finally agreed that the ship could tie up at Yokohama.
And then Japanese sovergnty & quarantine law came into effect.
The Japanese are making the rules.
They are doing the testing at their cost.
They are hospitalising all persons infected with this virus at their cost.
And they did not allow other persons off the ship so as to avoid spreading the disease in Japan.
.
NB : Though Japan did offer onshore quarantine to passengers paying for it.
And the ship could ‘leave’ Japan & Yokohama.
But there was no other port willing to allow them entry so it stayed in Yokohama.
This Corona virus disease has revealed the fatal flaw in the . whole cruise ship industry :
A new infectious disease spreading among passengers
And then being refused entry into ports.
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I agree Bill and Bulldust. Japan has done the right thing and borne the cost as far as international law is concerned. The ideal solution would have been a kind of “Christmas Island” on Japan — but there were 3700 people involved. That’s a pretty big camp, and moving that many people is a risk. When this started they had no idea so many would test positive. Remember it was just one passenger who got off in Hong Kong who was confirmed with Coronavirus. We may never know now if there were other passengers who already had it at the time, or whether they all caught it from him.
The virus could have been:
1. partly spread before quarantine
2. Spread in food handling.
3. Spread through walks to the deck for 90 mins a day..
4. Spread through air conditioning. (possibly. I can’t confirm that).
I would have preferred our govt sent a plane to pick them up, and maintain the quarantine elsewhere. But then again, that’s what travel insurance is for, and we don’t expect govts to send planes to rescue people who break a leg overseas. I suppose insurance only applies after a diagnosis, not for healthy people under quarantine.
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Pinning this here … Covid-19 being reported as potentially man made.
https://www.dailymail.co.uk/news/article-8009669/Did-coronavirus-originate-Chinese-government-laboratory.html
Their CDC research lab is in close proximity to the infamous wet market. Tim Pool covers the story here:
https://www.youtube.com/watch?v=_FRRgKBBmAE
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BTW the Christmas Islanders (many from Wuhan) are going to be let out of quarantine from today. Given there are suggestions that Covid-19 can take longer than 14 days to become evident in a patient, I have to wonder about the wisdom of a 14-day quarantine period. The precautionary side of me suggests building in a safety factor of a few days would have been a good idea.
https://www.sbs.com.au/news/coronavirus-christmas-island-evacuees-set-to-come-home-shortly
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Bulldust these people in quarantine
Are NOT Christmas Islanders !
The residents of Xmas Island would be very annoyed at such a thought !
As for extending the quarantine to say 24 days ?
Yes I think that would be the wise thing to do
Prudent !
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Poorly worded by me … I think most here would understand the people I was referring to – Christmas Island quarantine folks.
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Quarantine — There has to be a limit somewhere. What evidence suggests 24 days is possible? Is it only one outlier?
If the median time is 3 – 5 days we would have seen most of the cases that were likely to happen and there hasn’t been many. So odds of anyone bringing that virus in are very low. They may be the safest bunch arriving in mainland Australia today compared to all the rest of the flights.
PS: Yes, been watching the theories on the Chinese lab for as long as I’ve been watching coronavirus twitter threads. Both theories are believable natural and man-made. We may never know — unless an insider spills the beans. Virus transfer from bats / pangolins believable, and leaked attempt at vaccine or something else believeable.
The research centre used to be 20km from the fish markets. In the last two weeks I see it’s got much closer?
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Hi Jo
OT but enjoy….if only for our own state funded bolshies…
http://catallaxyfiles.com/2020/02/17/scomo-yet-to-learn-his-abcs/
“It was reported in The Australian today that the Johnson Government is very keen on reforming (and reducing) the BBC by abolishing its license fee and instead enforcing upon it a subscription payment model.
“Naturally, the BBC progressive class are outraged and their Chairman, Sir David Clementi has launched an outspoken defence.
“It is reported that:
““Sir David argued that a move to a subscription model would mean a loss of earnings for the BBC that would lead to popular programs being axed and the introduction of Netflix-style payments could result in the loss of public service programming in a race to attract paying viewers.”
“The confused logic of Sir David has probably solidified the need for reform, starting with a new chairman that is commercial.
“According to Sir David:
“Government guaranteed rents are considered “earnings” not handouts.
If consumers paid only for the content they actually wanted to view the BBC would get less.
“This would mean the BBC would actually have to produce programmes people were actually willing to pay for (God forbid!).
Somehow in the Netflix-style race to attract paying viewers “popular” BBC programs will be axed.
“This suggests the BBC doesn’t understand what a popular program is, or at best can’t produce one that is economic.
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Jo I remember reading a series of “WTF’ type comments last week about there being
A ‘branch’ lab of that facility across the road from the Wuhan wet market.
It is now closed of course.
I cannot find that set f comments now but i think they were on Chiefio.
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Found the link to that for you Jo:
Posted by E M Smith on Chiefio on the 16/2/2020
16 Feb 2019-nCoV / SARS-CoV-2 / Covid-19 Corona Virus Outbreak
“An interesting connection to a “lab” has been turned up. Seems folks working with bats were about 300 yards / meters away from the Fish Market…So it might be from lab made, or from a lab bat biting folks, or not. But really, you put an infectious disease lab near the food market? Just OMG dumb. You are simply asking for lab personnel to pick up some fresh fish and such on their way home.”
At the end of this post : https://chiefio.wordpress.com/2020/02/17/some-food-storage-links/
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Sorry Jo – Wrong link !
Here”s the correct one :
https://chiefio.wordpress.com/2020/02/16/16-feb-2019-ncov-sars-cov-2-covid-19-corona-virus-outbreak/
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Jo, we returned from Jakarta early November after visiting family in Indonesia, I was laid flat by “flu” for 4 days at home and still have a persistent chest cough. No point being tested now, as I am fit and healthy otherwise, except for the cough, but there are no figures out of Indonesia, and our son is a WA miner who spends his offswing in Indonesia and is FIFO from Perth, same as many of his work colleagues.
Questions to be answered?
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Diamond Princess Aussies are going to be flown to Darwin on a Qantas charter and will commence a 14 day quarantine:
https://www.abc.net.au/news/2020-02-17/coronavirus-federal-government-medical-evacuations/11972720
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Why is Der Fliegender Holländer playing in my head?
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The ABC is reporting that almost half the passengers
on board the Diamond Princess at the start of the quarantine were Japanese.
This puts a new light on what is happening there I think.
I think we need figures showing the national composition for all on board.
And a list of the numbers who have become infected by nationality.
This may offer some clues about how it spread on board the ship
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And until they test everyone it’s all guesswork. We don’t know how many cases there are or who is most likely to catch them.
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I just caught a 4pm news segment of a ScoMo press conference announcing a Qantas plane is being sent to Japan on Wednesday to collect the 200 Australians on the ship in Yokohoma and bring them back to Darwin, where they will be kept in quarantine for another 14 days.
Cheers,
Dave B
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Singapore has a population of 5.6 million people crammed into an island 721 square kilometres in area. To put this in context Sydney has a population of 5.1 million in an area of 12,367 square kilometres and we consider it to be crowded. Given the population density and the number of Singaporeans that live in high rise (reall high rise) apartment buildings it will be a miracle if the virus can be contained.
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I have been watching the Singapore numbers with trepidation. It certainly looks like they are getting out of control. Being a major travel hub, this could vector out to multiple nations very quickly. A Singapore travel ban can’t be far away IMO.
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Speaking of Singapore cases, someone made a very good graphic of teh known cases:
https://twitter.com/hokxela/status/1228684478635098112/photo/1
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I was reading a report that noted the virus needs cool conditions to survive more than a day or so outside of a host and doesn’t like hot weather. Most likely, the Singapore experience is a bit like the cruise ship in Japan, where large numbers of people live in air conditioned apartments, possibly sharing the same air-conditioned air which is cycled through the building.
If the cold weather is aiding the incubation process, then Australia will be in for a very nasty winter as this is about when we can expect the virus to become out of control within the general community own here, especially considering the Chinese travel bans are sure to be lifted due to political pressure from China.
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At this stage the best outcome we can hope for is an Ebola-like mutation that inoculates the population ahead of the lethal version. Short of that, this is going to get a lot worse before it gets better… still looking forward to my cruise in April, I think >.<
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Nowdays a warm climate is no protection. People congregate in close proximity in nice cool air conditioned malls, clubs and picture theaters.
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This winter coming make some observations about the spread of colds & flu in your working environment ! One employee infected with a cold or flu virus spends 2/3 days coming into the office & then everyone has the sniffles or full blown flu.
ALL COURTESY OF THE AIRCON!!
Think about 3000/4000 people on a cruise liner with just 10 infected carriers coughing, sneezing & god knows what else!! Recipe for a ship full of sickness.
Commonsense certainly lacking & im no genius!
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That’s an interesting thought Graham.
But the cruise ship is in the NORTHERN hemisphere.
It is Winter there.
And from many reports quite cold there this year.
So the Diamond Princess’s air conditioning system
Has been circulating heated air.
And this virus apparently does not like or thrive in warm dry air.
It likes & thrives in cold moist air.
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Really! I thought this was a mystery virus that nobody knows a thing about!
Where does all the knowledge come from suddenly?
If the virus prefers cold, then turn the bloody heat & knock it over!
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Graham, Actually that may well be a great suggestion.
Corona viruses all apparently thrive in cold humid conditions.
But in the depth of Winter in China I wonder if many people are saving money on electricity or gas
And setting the temperature to something a lot lower.
I notice that none of the people quarantined on tropical Xmas island became infected
( Multiple tests each day )
And now all are going home tonight !
00
I quit smoking (again) last week – I’d only suggest you do the same.
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Anorexia in the medical sense means not eating as in no appetite
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Thanks. So not necessarily malnourished. Just not hungry.
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Sarc Jo?
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When we say ‘anorexia’ in Australia, we usually mean it as a shorthand for ‘anorexia nervosa’.
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Some of you may be old enough to remember Karen Carpenter, great drummer and then “front for” The Carpenters with brother Richard.
Wikipedia has:
“Carpenter suffered from anorexia nervosa, which was little-known at the time, and was briefly married in the early 1980s. She died at age 32 from heart failure caused by complications related to her illness. Her death led to increased visibility and awareness of eating disorders. Her work continues to attract praise, including being listed among Rolling Stone’s 100 greatest singers of all time. ”
1976 drummer video here: Karen Carpenter Drum Solo
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Yes.
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Sorry, I originally missed the point that this might have been a comment on the translation problem.
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But you’ve got the skinny on it now KK.
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🙂
10
Reposted from earlier today in an earlier version : :
Diamond Princess Update
Total number of people on board 3700
Number of people tested 1219
Total Percentage of people tested so far : 32.9%
Number who tested positive today : 70
Number testing positive with NO SYMPTOMS = 38 persons or 54% !!
Bugger !
Total Number on board testing positive to Corona Virus so far 355;
That is 29% of those tested !
Bugger !
Today thirty eight people out of seventy were carrying the virus with no symptoms.
That’s 54% !
Bugger !
Unfortunately we have no information about what percentage of the others infected were symptomless. But it was probably similar to 54%.
Bugger !
I suggest that these epidemiological facts became clear to the Chinese government in Mid January.
I suggest this is the reason why the Chinese government have imposed such a complete lockdown on Wuhan has the surrounding province on the 23rd of January.And has tightened those restrictions in the weeks since.
Link : https://www.abc.net.au/news/2020-02-16/diamond-princess-coronavirus-cases-70-more-confirmed/11970134
As for the passengers & crew on the Diamond Princess, I suggest that as they are a very mixed bag of people of various nationalities who’s governments have different policies and abilities to cope with infected citizens, it has been a very difficult problem for the Japanese government to deal with – short of shouldering the financial & medical burden & the risks of bringing all of them onshore
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Blast!
12
Twas on the good ship Venus, oh my gosh, you should have seenus, the ………….
?
02
Funny how outside of china, the issues seem less..
Just sayin’….
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It’s probably just a matter of time. Started in China in November ! They are three month’s ahead. The real frightening about this is not the deathrate, it’s the ability to spread undetected for maybe two weeks. Probably need 4 weeks quarantine to be on the safe side.
The death rate curve above is actually exponential so far. Which indicates the total number of cases too, with not only confirmed cases. Hope this will change.
If you didn’t buy a good mask it’s time before it’s out of stock. Buy a P100 with organic filters, best advise. Then we hope that will be enough.
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Masks are best bought by those who have the virus and are infectious.
Then the masks stop the spread of the virus.
But if the virus is coughed or spat out any old where
Any old folk coming in contact may pick it up.
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Wrong, the paper masks you see everywhere, give no or very little protection. They obvious do not stop spreading, that is false information.
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I think we need to widen the information base on this Corona virus and the disease it causes.
The South China Morning Post is published in Hong Kong.It is an English language daily staffed by people who are Hong Kong Chinese and who have links into China.
Here is a link to it’s news today : https://www.scmp.com/news/hong-kong/health-environment/article/3050848/coronavirus-man-middle-class-hong-kong
One thing immediately stood out when i looked at the total figures for numbers infected by country : Japan with 407 cases is the second highest after Mainland China. I suspect that the Japanese are VERY worried about the risks of this disease becoming established in Japan. And most of these patients are from the quarantined cruse ship in Yokohama.
This perspective explains the Japanese government’s policies with regard to the cruise ship anchored in Yokahama !
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2-13-20 According to Adalja (of J Hopkins Med.), the new coronavirus could become a member of the club of constantly circulating, endemic coronaviruses…If the coronavirus does become a permanent fixture among humans, one possibility — let’s call it outcome 1a — is that it winds up fluctuating with the seasons the way the flu does. In that case, it could retreat in the summer and return in the fall and winter each year.
“If you look at the trajectory of the virus and how it’s spreading in communities, coupled with the fact that we deal with coronaviruses every year during flu and cold season, those factors point to this coronavirus becoming a seasonal virus,” Adalja said.
The other four coronaviruses have seasonality too, Adalja added, so cases of the new one “may temper off as we leave spring and enter summer.”…
Coronaviruses, on the whole, are “somewhat less prone to mutation than flu,” Morse said.
There is also a chance — let’s call it outcome 1b — that the new coronavirus becomes milder and more similar to the other four endemic coronaviruses. But Morse said he’d be surprised if that happened.
“I’m not optimistic enough to think this one is going to do that initially,” he said. “It may eventually evolve into that, a circulating illness that resembles the other four, but it will take time.”…
SARS was far less contagious than the new coronavirus. SARS spread primarily in healthcare and hospital settings, and people weren’t infectious until they started showing symptoms….
Morse and Adalja both said a vaccine is essential if the world is to definitively control the coronavirus.
A lot of the public-health interventions are a “holding action to keep the virus from spreading in the short term until we get a vaccine,” Morse said.
Five leading drug companies — Johnson & Johnson, Regeneron Pharmaceuticals, GlaxoSmithKline, Moderna, and Gilead Sciences — have announced plans to research and develop treatments for the new virus.
The introduction of a vaccine would create a “sustained firewall” against its further spread, Morse said….
Wuhan, China, and at least 15 other cities have been quarantined as China attempts to halt the spread of the coronavirus. That’s about 50 million people on lockdown.
https://www.businessinsider.com/wuhan-coronavirus-mild-pandemic-how-it-could-end-2020-2
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“Sorry about all these numbers.”
Don’t be. It’s why I abandoned the MSM years ago & come here instead.
An excellent & rational post, as usual.
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Just a quick snark, the quitting smoking, at least you had filtered air, and kept people at least six foot away.
But, where are you finding the ” virus does not like heat and such” . And length of time for a test of a person, so, it has been active longer then we know, since an early variant was discovered?
10
Dear Miss Nova
Mr Davis has noted that smokers appear to be relatively immune:
https://cfrankdavis.wordpress.com/2020/02/11/how-to-prevent-coronavirus-start-smoking/
DP
22
Can I get tobacco on Medicare? Don’t think I could afford it otherwise.
50
You can grow your own …
You can cure your own …
You can’t sell it (without signing up with the tax man).
10
but you can give it away! 😀
10
While theraputic Oxygen is common, in an extreme event welding Oxygen can be put to use. Lots of production capacity and distribution available.
Normally operates on a non-hectic pace but could probably ramp up capacity quickly in a crisis. To the degree it is a useful therapy, we can
hopefully ramp up at a rate sufficient to keep up.
We don’t often appreciate how big the US is, and how much of the country is wide open spaces. Even close to our cities, there are areas of very low density as
compared to the rest of the world. Hopefully, if this thing comes ashore and is bad, we’ll be proactive in closing things down. Our internet society can accomplish
far more in a quarantine environment than was possible before; we no longer have to worry that the newspaper delivered to our door carries a virus.
The virus is already impacting supply chains. Business has spent perhaps decades prizing low cost over security and direct control. A cohort of young executives (and
young bureaucrats) may be learning a different lesson.
Allowing representatives of closed societies influence in international organizations will need to be rethought. The WHO has been sub-optimal, and clearly not free
of political influence. In prior centuries we had to develop a Law of the Sea, and rules for the radio spectrum and civil aviation.
Space, plague, and epidemic, and the possibility these can be weaponized, can not be left to the ministrations of thugs and ideologues, even these supported by large populations.
Progressives are probably not well equipped to deal with real, immediate existential threats, like covid-19 or locusts, as opposed to chimerical fallacies like ‘climate change’.
We need to be sure they understand the difference.
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Richard:
“A cohort of …..and young bureaucrats may be learning a different lesson”
They never learn. At least 80 years of enquiries, royal commissions, expert advice on controlling bush fires in Australia and we are still unprepared.
Worse, those who did prepare were fined. That was the man whose house was the only one to survive the 2009 fire in Victoria. And which State was the least prepared this time?
50
I wonder if those that continue to push for high density living ( to reduce the need for cars and burning fossil fuels etc. among other reasons) have started to join the dots and realise their dream solution has some significant side effects –contagious health issues thrive in those conditions.
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Depends on the cleaning habits of the population. Tokyo, which is one of the most densely populated cities in the world has a very good track record in terms of lack of diseases due the high standards of cleanliness and their universal health care system. Isolation has a lot to do with it I suppose. We too have a good health system and isolation but not sure about the cleanliness of the general population. I’ve seen some disgusting habit locally, such as spitting, not washing hands after going to the toilet and drinking straight off the tap with the mouth in the kitchen.
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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
One thing missing from thar list is poor personal hygiene in China in general. In particular a lack of hand washing. I work in a hotel in Japan and even well to do Chinese guests take very little care in hand washing and other personal ckeanliness concerns. Which is the total opposite of Japanese guests who are fastidious To an extreme.
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And the economy? Tyler Durdin offers some suggestions here.
The only item to rise is the cost of food.
The implications for Australian exports are discouraging. Greens will rejoice: CO2 emissions must fall significantly.
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This is shaping to have a greater economic impact than the GFC. The data indicates China’s manufacturing is rapidly shutting down. That alone will devastate the global economy.
The GFC took about 12 months incubation before the impacts were widely felt and a number of years before the general population had any idea of what happened. That situation was relatively easily resolved by the US government guaranteeing those deemed too big to fail.
The corona virus is already widely understood for its potential harm within 3 months of first signs. No government has the ability to manage the outcomes if it takes hold in a country. The fear will spread rapidly and be paralysing for the global economy.
Can the global economy operate without personal contact! Electrons sent virus free!
30
Not there by a long shot. The GFC in the US sent property prices and the stock market tumbling big time. Now they are hardly taking any notice. Of course things could change if the virus becomes a pandemic. Then it could turn out to be much worse than the GFC for a number of reasons, not the least of which is the US Federal Reserve will have a much harder time handling another financial crisis. Time will tell.
10
China is a key industrial supplier for the USA. Not much gets manufactured in the USA that does not have Chinese components.
Hyundai has already idled production of most lines in South Korea due to parts shortages.
https://www.wsj.com/articles/coronavirus-fallout-threatens-auto-industrys-supply-chain-11581105081
Typically auto makers have low inventories so any disruption in the chain has an almost immediate impact on production. It is not easy to find substitutes.
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Yes China’s economy is a concern but the US is still the more important one. If it goes down the toilet the whole world will go with it.
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But US economy is highly dependent on China. The GFC was simply solved with a few book entries; albeit it did impact consumer sentiment that rippled through production chains. The coronavirus is having a real impact on real production. It cannot be easily solved like the GFC. It appears to be out of control in China and is staying ahead of any government controls.
The slow down in Chinese production, for another month, has to hit Australian exports hard. We should see iron ore inventories building in Australia and prices falling precipitously.
10
It would appear that industry has slowed drastically in China, hence (coal fired) electricity production has dropped. So has gas usage. But food prices are up and wages are down (non-existent if the factories aren’t working).
Since the Communist Party needs continuing improvement in living standards/ wealth / assets valuation they must be worried. There could be a backlash against the Peking Government that makes HongKong small beer.
20
China is more heavily dependent on the US. The US goods and services trade deficit with China was $378.6 billion in 2018. They are dependent on each other but the US would survive a lot better if trade between the two were to stop completely.
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Have to say, I did find this interesting . . . . . .
“Nearly 10k Military Personnel From 110 Nations in Wuhan China Weeks Before Coronavirus Outbreak!”
https://www.youtube.com/watch?time_continue=554&v=p0DDXsPKGHw&feature=emb_logo
10
Interesting channel too. Lots of conspiracy stories. It would be almost impossible to determine which are true.
30
We’re in a bit of a bind. But, a wide range of related info might at least let us connect, or disconnect, a few dots down the track.
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Jo, regarding your comment about malnutrition: Those who dare discuss the unpopular GSM and the associated fallout to climate and food production (Zharkova et al – as the sun apparently doesn’t take kindly to being taxed) have been predicting that some of the first areas where food production will be disrupted will be China and its neighbours. We know North Korea has hit the skids the last few seasons but who would know what happens in China?
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1: Why does Singapore have more COVID 19 disease patients than Hong Kong ? ( And more than anywhere else except China & Japan ? ) Well Singapore is actively encouraging people to report if they get symptoms.. Health care is free and they get financial support. Hong Kong is not doing this. And BTW neither are Indonesia, Malaysia, Thailand, Vietnam, Cambodia, the Philippines…So I suggest there is a significant level of under reporting or even concealment happening in these countries.
Is there a way to screen passengers flying into Australia from these countries ? Or do we need to go the whole hog and impose quarantine on all persons flying in from those countries ?
2 :Going to church might be a problem ! Three new infections of Singapore residents/citizens were members of the same congregation.
this story from the South China Morning Post in Hong Kong : https://www.scmp.com/week-asia/health-environment/article/3050039/coronavirus-why-did-singapore-have-more-cases-hong
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Well, well, well. Who is playing this?:
https://en.wikipedia.org/wiki/Vitamin_D_and_respiratory_tract_infections
While the vitamin D is away, the corona viruses will play …
30
And vitamin C in big doses !
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One very important side-effect that has not been commented on is the impact on manufacturing. Where are the majority of computer components manufactured? China. There is already a short supply in Australia. Australia has outsourced majority of manufacturing and basically everybody relies on just-in-time supply process. I think this will have a much greater effect than the disease process itself.
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I was just wondering here.
This CoViD-19 outbreak seems to have stopped the protests on Hong Kong pretty effectively, eh!
Tony.
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Yes interesting thought. Would not put it past the Chinese. Does this mean the epidemic in China is mostly fake news? I wonder. Still it wouldn’t matter to them if the deaths were real. Dispensable.
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Aren’t they just “saving face” according to your Chinese friends?
00
I will ask them. I haven’t spoken to them for over week now. They have gone quiet. One was intending to go to HK to meet her relatives but changed her mind two weeks ago.
00
The response is they will only “save face” when they are caught with their pants down. That hasn’t happened yet.
00
I Readi a Straits Time newspaper I saw a report that mentioned that the protests are in abeyance because of the COVID 19 disease threat.
But that actual anger and distrust of the Hong Kong government s now even more widespread. Link I posed above Tony
10
What is happening about the conspiracy theory connection between Chinese citizens who were vaccinated against the SARS virus using Chinese made vaccines and the high death rate of these citizens compared to infected others? It cannot be just ethnicity or different treatment so is it just a conspiracy theory?
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FYI Daily updates on the status of Coronavirus
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/
01
Here’s the snag.
https://www.breitbart.com/radio/2020/02/14/expert-china-has-global-chokehold-on-medicine-can-shut-down-our-pharmacies-hospitals-in-months/
No doubt, Australia is in the same boat as the USA. All come about with the lefties idea that Chinese tourism, and Chinese University Students, would pay for all the medicine we need from China.
Does anyone imagine that our Government will do anything but sit on their hands about it?
Isn’t it funny. We have to build our own submarines, but not make our own medicines.
I’m willing to bet a few shekels that The Donald will be on to this before too long.
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I am waiting for some medicine to some in. My chemist told me on Saturday that most is actually made in India for the Australian market….
00
Singapore has lost control and is an indication of things to come in countries outside China. The majority of new cases have no connection to interaction with people coming from outside the island and the infection is being passed between Singapore residents. The real worry was reported in the Straits Times. “Despite 81 per cent of Singapore residents fearing Coronavirus infection, nearly 35 per cent said they would continue to attend an important event even if they had developed mild symptoms earlier that day”.
21
amazing-but-hidden-news-about-coronavirus
https://wattsupwiththat.com/2020/02/15/amazing-but-hidden-news-about-coronavirus/
full article
extract
The hidden story
On January 25, I wrote that that “the 2019-nCoV virus shows that we’ve built a better world.” The response by public health agencies was faster and more powerful than anything before in history, a combination of global organization and high technology. China’s scientists isolated the virus on January 9 and sequenced it on January 10. On January 20 the CDC released a diagnostic test for the virus. On January 22, China quarantined the city of Wuhan
It’s easy to follow the corona-virus story
The World Health Organization provides daily information, from highly technical information to news for the general public.
• There is their daily situation report, with detailed numbers.
• The Director-General of WHO gives frequent briefings, which are quite insightful.
• Their daily press briefings have more information. An audio goes up quickly afterwards. A transcript is posted the next day.
11
That article by Larry Kummer aggressively dismisses alarming reports and interpretations as alarmist. Worth reading though. It should be strengthened or weekend in a week or two.
00
And to kick things along
“The cruise ship had been shunned at port after port for fear it might carry the coronavirus, but when the Westerdam arrived in Cambodia on Thursday, the prime minister greeted its passengers with flowers.
Amid assurances that the ship was disease free, hundreds of elated passengers disembarked. Some went sightseeing, visiting beaches and restaurants and getting massages. Others traveled on to destinations around the world.
One, however, did not make it much farther than the thermal scanners at the Kuala Lumpur airport in Malaysia. The passenger, an American, was stopped on Saturday, and later tested positive for the coronavirus.
On Sunday, with passengers already headed for destinations on at least three continents, health officials were scrambling to determine how a big a problem they now have — and how to stop it from getting bigger.
“We anticipated glitches, but I have to tell you I didn’t anticipate one of this magnitude,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center.
With more than a thousand passengers from the Westerdam headed for home, Dr. Schaffner said, it may be harder than ever to keep the coronavirus outbreak contained to China. […]”
http://www.smalldeadanimals.com/index.php/2020/02/16/its-probably-nothing-51/
11
Well the ABC joyfully reported the safe arrival home of a couple from that ship here in Adelaide !
Ummmmmmm ?
00
I hope they have quarantined themselves
And been tested for carrying the virus !
Here is the ABC story : https://www.abc.net.au/news/2020-02-15/coronavirus-fears-adelaide-couple-home-westerdam-cruise-ship/11969098
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The Diamond Princess Cruise ship is being emptied at last.
I heard that another 70 passengers tested positive for CoVID19 yesterday.
The cruise ship experiment is quite important for determining how the disease spreads. Is it airborne, food, toilets or direct human contact?
I am not an epidemiologist myself, but it seems to me that a lot can be learned. It may not be too late for that. Analysis of the ships design, air circulation, location of infected people (ie cabins, decks), visits to bars, restaurants etc can all be revealing. The passengers are now being spread far and wide, but they can still be contacted. I hope that something is already underway, or at least soon will be.
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The various ‘foreign’ passenger nationalities have gradually being removed.
But there are still the crew on board ( 1700 )
And those Japanese citizens on board who have not tested positive to the virus.
Thus this impromptu quarantine ‘experiment’ continues.
I imagine that eventually the Japanese government will accept
That it must quarantine it’s own citizens onshore.
That will leave the 1700 odd crew.
Many of the crew – especially the numerous low wage waiters & cabin staff who dealt directly with passengers, a
Are from such countries as Bangla Desh, the Philippines, Indonesia, Pakistan, India etc.
This will be an issue i suspect.
These countries will not want to bring these citizens home as quarantining them will be expensive.
So the crew may well remain behind on board the ship for some more weeks.
Until after all of them have been tested negative or recovered.
10
This in the days of long voyages,three months sea voyage from England to Oz.
https://nepeanhistoricalsociety.asn.au/history/quarantine-station/ Today, around the world in less than thirty hours.
10
About 30 years ago there was a big push in Australia to control cretinism in Chinese infants.
Today there is still a high degree of ‘thyroid disease’ in China affecting about 200 million people.
http://www.chinadaily.com.cn/china/2016-06/03/content_25607805.htm
Some of this can be sheeted back to a lack of iodine in the diet.
When a cat with a low iodine diet, contracts a thyroid cancer, it can suddenly express hyperthyroidism when given a proper diet with sufficient iodine in it.
In humans with hyper alert immune systems, Hashimoto’s syndrome is a constant problem.
Numerous thyroid diseases, alone, could explain higher mortalities in China than elsewhere, when the subject is exposed to the pneumonic form of this virus.
Some of the triggers and susceptibilities for Hashimoto’s include being Taiwanese Chinese, having various viruses, being exposed to petrochemical toxins and having a child.
Since the one child policy was abandoned, more Chinese will be affected by this virus after pregnancy,than before, particularly if given too much or too little iodine, being Vitamin D deficient,and in a polluted environment,being exposed to environmental toxins in the air or water and food and being attacked by other viruses.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271310/
20
This on the latest update on the Worldometers site.
“14 new cases from the Diamond Princess cruise ship in Japan: a group of US citizens whose results for COVID-19 tests (done 2-3 days earlier) arrived while en-route from the cruise ship to the airport for a flight back to the United States.is on the latest update.”
So, tested, returned negative, let loose in an airport and then found infected. Others returned to other countries also, probably with no isolation in transit, infection status unknown. Passengers from the ship in Cambodia distributed around the world, infection status unknown. Possible 24 day incubation with asymptomatic infective period. I think Dr Schaffner with his comments on “making it harder to contain the virus to China” is now certain to be whistling in the dark. It has escaped and if capable of creating a pandemic in other countries it has the opportunity.
There is still a high preponderance of infections in people of Chinese origin but there is not enough available data to yet to make anything of this, genetics or opportunity. There have been a couple of candidate alleles which have higher frequencies in people of Chinese extraction but nothing definitive.
No new infections in Singapore in the latest report so that gives some hope but too early to say much either way.
30
Sorry, misread that report, actually tested 2-3 days earlier and results came back whilst in transit. Not much point in doing tests if you are going to let people out of quarantine before you get the results so IDK what’s going on. The point remains though, the current measures are not going to contain the movement of infective individuals.
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Corvid19 (Corona Virus D19) seems to be about as infectious and fatal as the 1918 Spanish flu, but with modern mobility will spread faster and further.
If we compare it proportionally to the flu then we can expect 25-30% of the world to catch it with 50-150 million deaths. Barely a blink in human progress.
10
This is just another fear campaign by the media and the elite. You didn’t fall for the doomsday Climate Change campaign, why not apply the same skepticism to this. Especially after SARS, MERS, Zika, Swine flu, Bird flu, Ebola fear campaigns that led to nothing.
This is merely the same playbook, ramped up.
We are all susceptible to these campaigns, as we are all hardwired to be attentive to anything that could harm us or our family. We also have a natural weakness that is easily exploited in trusting others (especially authority figures).
Be very sceptical my friends.
00
Worlds second largest economy shuts factories, empties streets, stops tanker deliveries to the point where other nations are closing factories due to supply problems. Costs untold billions and the aim of this GDP size scare campaign is…. ?
History is full of scares, but it’s also full of plagues. Only the data will tell us which this fits into.
20
More accurate, data from open countries like Japan and Singapore. Info from China is not reliable. First case now reported November 1st !
00
You might be right, time will tell.
History tells me that this is another scare campaign. The amount of control these people can get over a population only comes from peddling fear, and there is the motivation. But theories aside time will tell whether this is a fear campaign or not through the infection/death count (where I am sure if we all “survive” this the next narrative will be how the authorities “saved” us).
00
Whether by accident or design, the Japanese health officials have successfully created a live experiment using about 500 of the passengers on the cruise ship in Yokohama as test subjects. 500 data points are enough to develop numerous statistical analyses of the subject patients response to the disease. Smokers vs. non-smokers. Men vs. women. Old vs. young. Vegans vs. meat eaters. Kim-Chee eaters vs. non-Kim Chee eaters, one aspirin a day people, and so on.
Also, many passengers may have been taking anti-cancer drugs or other powerful medications while on their cruise. Some of these medications may have affected the response of the patients to the corona virus. There is a wealth of information available to collect and study from the patients taken from the ship.
Hopefully the Japanese will be prompt in reporting their findings to the world. It appears the Chinese are much too busy now just trying to survive, to have time for such careful statistical analyses.
10
anorexia
Anorexia in the context of that medical report means ‘lack of appetite’ not
malnutrition .
00
In China, Korea & Japan
It’s been a cold hard Winter this year !
Reportedly the virus thrives in cold weather
And dies in warm conditions.
So I wonder what temperatures the cabins on this cruise ship
have been at ?
And I wonder what temperatures the appartments in Wuhan
Have been set to ?
Maybe the difference in infections and disease
In the various locations where this disease has appeared
ARE DUE TO THE TEMPERATURE IN CABIN ROOMS OR HOSPITAL WARDS OR APARTMENTS ?
And in Singapore maybe it is time to turn off the A/C ?
00
Interesting supporting evidence for this here :
https://www.latimes.com/world/asia/la-fg-china-heat-20141115-story.html
There is no central heating in cities in China South of this line.
The Central heating provided by government is cheap.
The heating of each apartment by occupiers is expensive.
00
Oh nose…
https://wattsupwiththat.com/2020/02/17/chinese-study-the-killer-coronavirus-probably-originated-from-a-laboratory-in-wuhan/
20
I believe the evidence that this is a bat coronavirus manipulated by humans is now solid. This appears to be a biosecurity failure at a lab in Wuhan.
But this information is only useful if it assists with developing a rapid test or vaccine. If the Chinese had either, they would be using it instead of trucking mobile furnaces built into 20′ containers into Wuhan.
00