JoNova

Watching South Korea — it appears to have stopped the exponential spread of Coronavirus

Heartening. At its peaks last Saturday and Tuesday, South Korea acquired 800 new infections per day. Since then, whatever it is doing, South Korea has managed to keep the new daily cases between 300-800. That may not sound like much, but in exponential terms it could have been a lot worse. Is this the future for us in the West? Perhaps with aggressive action, and local or statewide lockdowns, wealthy western nations may get outbreaks under control. Will we spend the next year with periodic major lockdowns as outbreaks occur, but manage to keep the virus from en masse spread without hospitals being overwhelmed? But can poor countries achieve this? If not, we will have to close flights to stop repeated debilitating and deadly outbreaks, while doing our best to help them. The world will become divided into nations which have this controlled, and those who don’t. This is still the pandemonium I’ve been talking about for six weeks; we could have avoided it, but it’s better than other scenarios. It’s a middle-run scenario.

We are fortunate that this is not as airborne and infectious as measles, which might have made even this impossible. (Note that Coronaviurs is perhaps 500 or more times more deadly than measles, whose fatality rate is 1 per 100,000. Note the mass panic those outbreaks cause.) Keep the pantry stocked. Reduce your risk. Travel less. Avoid crowds. Wash hands. etc.

The death toll so far in South Korea is 48. Theoretically, even if they have passed the peak of new cases, the death toll will still double in coming weeks. In this one outbreak, 100 people may die, 10,000 plus people will have suffered a potentially debilitating disease, and tens of thousands will have been inconvenienced by quarantine and travel bans. There is also the financial cost of closing workplaces. Note also that there are major privacy issues with the South Korean approach to mapping and tracking victims and their movements by their phones.

When will the Australian Government stop telling people to keep going about their business as if nothing is happening? Presumably when there is an outbreak and it’s two weeks too late?

South Korea, new cases Coronavirus

South Korean cases of Coronavirus.

Extrapolating further than I should, if this is the peak and the decline starts soon and there are no new outbreaks, then in a month or so it may be safe to open flights again to South Korea. (Though if our outbreaks are not controlled, they won’t want our planes.)

The daily growth rate is shrinking — yesterday increasing by 7%. This is ideally a bell curve type rise and fall, and the huge spike on the 20th Feb is probably the discovery of all the cases that existed but weren’t detected in the days before. Is that what we are about to see in the US, which hasn’t been doing nearly enough testing?

Growth in Coronavirus cases in South Korea

Two weeks ago South Korea had only 200 cases, now it has 7,000. So the death toll of 48 (with a two week lag) is not a number we want to calculate, because it’s surely a wild overestimate. South Korea had more undetected cases then. Guess. Guess. Guess. O for data.

Deaths still rising following that “new cases” curve with a two (or three week) delay.

It will be at least another week before it levels off.

….

The first few cases in South Korea were very early (11 cases on Jan 31). It was doing well, but lost control.

Taiwan is worth watching:

How Taiwan managed to avoid a coronavirus outbreak

Taiwan is 81 miles off Mainland China. It is a highly urbanized state of 24 million people with an extremely high population density. It is also one of the first places where the new coronavirus epidemic manifested itself. All things considered, Taiwan was expected to have the highest number of cases outside China. Yet Taiwan successfully managed to avoid an uncontrolled outbreak and only has 44 confirmed cases.

Less than one year after the SARS outbreak, a National Health Command Center (NHCC) was established. The NHCC is meant to serve as a disaster management center command point…

Technology is a key ally when you’re fighting an outbreak, Taiwan realized. So they leveraged the national health insurance database to create a smart system to warn citizens and keep an eye on the situation.

The database was integrated with the customs information to generate a pool of big data. This data generated real-time alerts based on people’s travel patterns. It used QR code scanning and online reporting of travel history and documented health symptoms to classify passengers’ infectious risks. Then, Taiwanese authorities acted based on what the data suggested — and took some pretty draconic precaution measures.

People with the lowest risk were issued fast travel clearance, but people with higher risk were likely to be quarantined at home, whether they liked it or not.

Obviously, there is a lot of big government involvement. Again, we see hi tech tracking. Is that necessary? How much freedom will we have to trade in order to reduce the toll and curb the rising fear? Can we control this just with old fashioned quarantines and public information updates?

 Sobering

This 25 year old British man caught the virus in Wuhan on November 25. He must have been one of the earliest cases, and it was only recognised belatedly that he had Coronavirus. Twice, he thought he was well, only to relapse. But he does recover. I suspect this is the rarer “severe” type case in an otherwise healthy young man. Theoretically 80% of people get the easier five day version and recover. Notably, for him it’s 24 days before he feels well properly. Can this disease affect pets, which is very ususual? If so, can it affect other mammals, like livestock?

What it’s REALLY like to catch coronavirus: First British victim, 25, describes how ‘worst disease he ever had’ left him sweating, shivering, and struggling to breathe as his eyes burned and bones ached

Day 5: I’m over my cold. It really wasn’t anything.

Day 7: I spoke too soon. I feel dreadful. This is no longer just a cold. I ache all over, my head is thumping, my eyes are burning, my throat is constricted. The cold has travelled down to my chest and I have a hacking cough.

Keep reading  →

The irony: while Australia blocks fruit flies, China blocks deadly viruses

How long before China bans flights from the US, UK and Australia? Count the days…

Coronavirus: China orders travellers quarantined amid outbreak

[BBC] Travellers from countries with severe coronavirus outbreaks who arrive in some parts of China will have to undergo a 14-day quarantine, state media say.

Travellers from the virus hotspots of South Korea, Japan, Iran and Italy arriving in the capital will have to be isolated, a Beijing official has said.

Shanghai and Guangdong announced similar restrictions earlier.

Authorities are worried the virus might be imported back into the country.

Although most virus deaths have been in China, Monday saw nine times more new infections outside China than in.

Shanghai said it would require new arrivals from countries with “relatively serious virus conditions” to be isolated, without naming the countries.

Chinese official statistics suggest they are getting the outbreak under control, which is hard to believe, but they are acting like they do. If most of their population is still at risk of further outbreaks, then they would care about risky incoming flights.

Meanwhile our health ministers tell us it’s too late to stop the planes.

Cost of importing viruses *might* be more than cost of closing borders x 1000

Has the Prime Minister done the right cost-benefit calculations?

Forget the tens of thousands of deaths, pretend those lives are worthless, and add up the cost of shutting down schools, factories, public transport, sports events, conferences, concerts and everything else, because that’s not the cost of closing flights, its the cost of keeping them open. Factor in $5,000 a day for intensive care beds, plus workers staying home to look after kids, plus job losses. Include the costs of putting off most elective surgery for six months. Don’t forget people who will get sick of something else this year but will have to wait longer for help, so add some cancer patient deaths to the tally.

Ponder how much cheaper it is to live in a country free of this scourge? If Australian domestic tourists knew travel in NSW was safe, and if people in Sydney weren’t afraid to eat at Chinese restaurants, then Australian citizens could enjoy those holidays and dinners and thousands of tourist-related businesses might not go bust. If we let in risky flights then we earn two more weeks of tourism cash but maybe wipe out the small mum and dad businesses who can’t survive the cash crunch.

Australian universities are paying $7,500 to fly in students from China, who don’t even need to go through proper quarantine.

We can build holiday homes or extra hospitals. Don’t close the borders, just insist on a proper 2 week quarantine.

I can’t believe I’m hoping we can do infection control as well as China does…

Leading the pack, at about number 92, Australia bans flights from South Korea

South Korea added to Australia’s coronavirus travel ban list, restrictions for travellers from Italy

[ABC News] The Federal Government has expanded its coronavirus travel ban to include South Korea, and added additional precautions for travellers from Italy, amid fears about the spread of the disease.

The revised bans will be in place until Saturday, March 14 but the Government will review the situation within a week to determine if the travel restrictions need to be extended further.

Since the government was at least one week too late with the Iranian block, how will the medical experts stay ahead of the curve on other countries with no testing? Eg Indonesia? Or in this case, Europe and Dubai?

First case of Coronavirus in Western Australia that was brought in accidentally:

The woman in her 30s from Perth’s southern suburbs returned a positive result after holidaying in Iceland and the UK, and returning to WA via Dubai on Monday.

It’s still a soft loopholey quarantine:

Keep reading  →

In a word: bum.

WHO announced their estimates of 3.4% global mortality today. All the caveats apply — it includes rubbery-figures-from-China and comes from the Useless UN and a group headed by a star apologist-for-Xi. But here’s the thing, look at the numbers outside China (see the big table below), and its a similar ballpark. Sorry to rant on about this virus.

The World Health Organization had said last week that the mortality rate of COVID-19 can differ, ranging from 0.7% to up to 4%, depending on the quality of the health-care system where it’s treated.

Don’t look now: Big Numbers Coming. Assuming 60% of people catch it before some treatment appears, a death rate of 0.7% – 4% means bad news for some furry number from 100,000 to 600,000 Australians. Double that for the UK. And 1.4m – 8m in the United States. There is a wide range of mortality rates, which may reflect that there are two kinds of mortality rates here — one where people get great ICU care, and one where hospitals are overrun and they don’t. We’ll probably pin that to the low end if we keep cases limited, we eat well, don’t smoke, don’t have wild pollution, and hopefully we’ll get better and better at treating it. But even the low end numbers here are Not Nice. What this means is mass disruption to keep those numbers down — schools closing, factories stopping, no parties, delay the Olympics, etc etc.

The long lag is a bomb. It can be five weeks from infection to death and bureaucrats are weeks behind the virus.

Train meets hospitals

Let’s look at the Worldometer daily numbers, to get an idea of how many cases from 2 weeks ago have died, and how many cases from 8 days ago have got into breathing difficulty rates as “severe”. The data is starting to accumulate (unfortunately).

Hunting for good news, on the Diamond Princess, numbers are not so awful: based on 691 cases eight days ago, five percent are now classed as severe and the mortality rate of 454 patients two weeks later is only 1% (assuming all the deaths are correctly recorded there by Worldometer, and the severe cases stay on the “severe” list if they get well, which they might not). The Diamond Princess would be an older demographic too — so these numbers suggest that mortality is at the lower end of the WHO range. Maybe even “only 0.5%”. Clutch at good straws and hold on to that thought.

Looking across lots of countries (but not China, Korea, Italy or Iran) and based on 867 cases that were known just over two weeks ago, the mortality rate is a daunting 3.7%, and based on 1334 cases eight days ago, the rate of progression of all known cases to severe is 7%. If correct (and they may not be) these are the kind of numbers that would freak a hospital manager out. These don’t come from China, South Korea, Iran and Italy — all of which clearly have a lot more cases that they didn’t know about two weeks ago. So, see the table below, this is data from nations like Japan, USA, Hong Kong, Germany, France and the UK. They’re rough, not always taken at the same time of day, they may double-count Diamond Princess deaths (in national tally’s and boat tallies — any one know?) Feel free to point out mistakes.

These numbers are a train wreck for hospitals, even at the lower end. State Ministers in Australia got briefed recently and appear to understand that now as they they tend to be using the phrase “we may not have the resources”. Translated, that’s the code for “not enough hospital beds”. They’ve already warned people with symptoms to stay home. How fast we shift from chartered rescue flights and individual attention to “just call us, and stay in bed”. A few weeks is a long time in an unfolding pandemic.

Governments have been consistently two weeks behind this virus.

Everything they’ve done would have been so much more effective if they did it two weeks before they did. Now is the time to leap up and get ahead. Look at where South Korea and Italy are now, and just do it. We’re going to have to do it soon anyhow.

Peak Hour cometh

Modeling in Western Australia suggests the viral load here will rise in a few weeks, peak in August and settle down in Spring.The timing is about as bad as possible for us.

The curve we want to flatten. The Ro, Reproductive curves of infectious diseases. ResearchGate

It doesn’t have to be that way. No cases confirmed yet in WA (apart from the Diamond Princess cases). Thousands of deaths are coming, and don’t forget mass disruption to schools, uni, businesses, factories and elective surgery. All that in the offing and no one wants to cancel some holidays and flights to slow the train down? Are we so addicted to weekends in Bali and interstate footy trips that it’s unthinkable to just say “hang ten for a few weeks?”

WA’s chief medical officer Andrew Robertson said an outbreak in the state was now “probably inevitable”. “There are measures that could help delay it, certainly some of the border measures, [plus] self isolation and possibly quarantine if needed,” he said.

“And we will continue to try and contain this disease. But we accept that we have to prepare for the next stage and make sure that our systems are best prepared for the likely pandemic.” Many non-emergency elective surgeries are expected to be cancelled and doctors and nurses working desk jobs may be redeployed to treat patients on busy hospital wards. — ABC News

‘We may not have the resources’: Minister

If there are no nice wildcard surprises coming (new antiviral, lucky break, freak discovery) —  the aim of the game is to flatten the curve, slow the exponential growth and keep as many people as possible uninfected and out of hospital. That means no more unnecessary flights, no mass events, close the schools, do church online, get people to work from home if they can and do mass hygiene lessons for our nations.

Everyone needs to know how to wash hands seriously well, and not touch the tap or the handle in a way that undoes the point of washing in the first place. Did you leave those germs on the doorknob on the way in, and collect them again on your way out?

The have-cake eat-cake experts. When will the media pin them down?

Meanwhile last night the experts were still saying there was no evidence of community transmission in Australia and simultaneously that there was no need to stop the flights to Italy or South Korea. Go figure. If there is no community transmission, it’s not too late to stop the flights. If there is community transmission– then stop telling people not to wear masks, keep shaking hands, going to parties and the football. It can’t be both ways.

When community transmission is obvious and undeniable they’ll say “we expected this”.

Don’t let them get away with their double-speak.

Scott Morrison is choosing to let the virus fly in, can someone tell him these are not the deaths we have to have?

Scott Morrison almost got a hard question on the ABC last night. But he weaseled out of it — just following the expert advice, he said. No, dear leader. Do your own research. Ask some different experts. Ask some different questions. People’s live depend on you. Please send him the message (and tell Boris, Jacinta, Justin, and DJT too).

Given the gravity, we should call a halt to all flights without a two week quarantine (not pretend quarantine loopholes through Dubai, Thailand and Bali). Do it  just for a few weeks til we get more data. Winter is coming downunder. The best way to avoid this virus is to minimize trips, shopping and crowds. Start thinking about the long run.

 Amazing: LA Times finds a WHO expert who makes sense:

Mike Ryan, who runs the agency’s [WHO] emergencies program, pushed back against officials who wanted to “wave the white flag” and surrender to the disease’s hold. China took drastic steps to fight the virus, he said, and case numbers are now on the decline there.

Countries such as China and South Korea “implemented very, very strong measures that have affected their own economies and their own societies,” Ryan said. “It’s really a duty of others to use the time that has been bought. “That is not a reverse you can achieve with influenza. If that is a failure, we’ll have slowed down the virus.”

There can be a big benefit in slowing the virus’ arrival in a country for a few months, Ryan said. Many countries, including the U.S, are in the middle of flu season, so large numbers of coronavirus cases would overwhelm the health system.

 Too many in the deep state are waving the white flag.

UPDATE:

LATEST TALLY OF THE BIGGIES Worldometer