The Corona Epidemic – A Dangerous and a Less Dangerous Form

Guest Post by Wim Röst

Abstract

Nearly all the deadly infections of the corona virus are localized in the centre of the epidemic in and near Wuhan in the province of Hubei, China. This analysis leads to two main types of contamination: 1) breathing in the virus after a nearby contaminated person coughs or sneezes and 2) contracting the virus via the fecal-oral route, due to poor hygiene, that is not washing your hands. Of these two methods, the first is very dangerous. From the point of view of epidemics, the second form is potentially as dangerous as the first one. But for most individuals that are treated well the consequence of being contaminated seems to be no more deadly than a normal flu. Even so, the danger for whole populations and even for whole continents remains huge: every infected individual, who is not properly treated, can lead to a huge and dangerous epidemic.

Introduction

There is a large difference in fatality for people infected in Wuhan and the surrounding area and for people that are infected outside the province of Hubei. Nearly all deadly cases can be traced back to contamination in Wuhan, Hubei. This observation requires an explanation.

Becoming infected in Wuhan is more dangerous than becoming infected elsewhere

Outside Mainland China, the disease has resulted in death only in Hong Kong and the Philippines. Both victims traveled from Wuhan in the province of Hubei where they were infected.*

Outside of the province of Hubei (the origin of the epidemic) contamination by the virus seems to be much less deadly for individuals that were contaminated. Outside the province of Hubei there are only 14 deaths, out of a total of 563** deaths. Nearly all of that small number of deaths, in the rest of Mainland China, seem to have been infected in or near Wuhan, Hubei.

This leads to the simple conclusion that individuals that have been infected in Wuhan are at greater risk than people that are infected outside Wuhan.

The question is: why?

Types of infections

From tuberculosis we know that there are two main types: the so called ‘open tbc’ and ‘closed tbc’. Open tbc (lungs involved) is very contaminating and the consequences are far more severe.

For the Wuhan coronavirus various ways of contamination are proposed ***:

  1. Spread from person to person through respiratory droplets emitted by coughing or sneezing.
  2. Airborne – meaning: the virus is able to travel across a large room.
  3. The fecal-oral route. Viruses from a diarrhea can be transmitted by hands or other means to the respiratory system of the infected person.

This analysis leads to the conclusion that a fourth one should be added:

4. The fecal-manual route. A first infection in the digestive system of the first person is transmitted by ‘shaking hands’ with secondary persons that may transmit the infection to their own digestive system, causing a primary reaction like diarrhea.

Origin and spread of infections of the new corona virus

In the city of Wuhan which is the origin of the epidemic 55% of the first contaminations are proven to come from a market. In first instance the digestive systems of one or more customers of the market must have been infected by eating contaminated food, causing a diarrhea.

If the virus is first infecting the intestines of a patient the body probably has more time to activate its defense system after which a person gets protection by antibodies, constraining the severity of the contamination: “Reports point to mildly symptomatic but infectious cases of 2019-nCoV [2019 Novel Coronavirus], which were not a feature of SARS.”

Probably by the fecal-oral route, the respiratory system of one or more of the first victims, must have been reached in a second case, resulting in severe respiratory problems and in many deadly further cases.

In Wuhan contamination by respiratory droplets has been directly infecting the lungs of other victims nearby, resulting in many deaths for Wuhan and nearby. When large quantities of viruses are directly transmitted from lung to lung a totally unprepared and unprotected body gets a big problem from the very first moment: a viral load of up to 108 copies per milliliter is mentioned – 100 million viruses per milliliter.

Besides the above route the virus is transmitted via the fecal-manual route by seemingly healthy people whose digestive system has been infected but who are not aware of the type of infection or not even of becoming ill. People that are infected through the digestive route may or may not develop sickness symptoms like a diarrhea. These people themselves could not have or show problems in their respiratory system but they are still able to contaminate other people. For example, by simply shaking hands with other people with a hand with slight traces of the virus. The danger of a less than perfect hygiene (which is rather common) and more especially the hygiene in squat latrines has been mentioned in this informative article.

The fecal-manual route of contamination probably has been the case in most of the illness cases in the rest of Mainland China and in most of the secondary cases in foreign countries where corona infected people from China, not having respiratory problems, traveled to. The infection by an infected guest in the factory in Germany probably was transmitted by ‘just shaking hands’, which is what people in firms are used to doing when they meet each other.

Consequences

If the above analysis is correct, in case of sickness, two types of contamination must be distinguished:

  1. by the fecal-manual route
  2. by the respiratory route

The last one is by far the most dangerous for the individual because it directly affects the fragile lung system even before the slightest resistance in the body could have been built up. Both varieties however are very contagious and can spread the virus to many people which means that both varieties have more or less the same potential in creating a dangerous epidemic.

After recognizing the ‘dangerous’ and the ‘less dangerous’ variant different ways can be followed. The ‘respiratory group’ needs 100% isolation. For the other group 100% strict hygienic prevention measures should be enough to prevent further spreading. A ‘contactless period’ is needed but further complications for the infected person are much less probable which facilitates treatment and recovery.

The Big Danger

By seemingly healthy people the disease can travel to other locations and can be spread by persons that are not showing symptoms of the disease. The spread of this highly infectious disease might already have taken place to less equipped countries. In poor countries further containing of the very contagious disease will be more difficult than in China or in other more developed countries.

New possibilities for killing the epidemic?

The fact that people develop resistance against the disease by slight infections of the digestive system possibly opens up new ways to fight the epidemic. But it is not easy to imagine how this could happen without self-contamination of the lung system of some individuals or without transmitting considerable quantities of the virus to the people in the environment – things that happen during the uncontrolled spread of the virus.

Conclusions

From the geographical spread of confirmed cases of the corona virus the difference between two main types of contamination is inferred.

First there is, for individuals, the less dangerous contamination that only affects the digestive system of a patient. The patient himself often develops less severe symptoms but is still able to contaminate many other people by fecal-manual transmission.

Second there is the very dangerous variant in which the respiratory system is affected.

In case of ‘lung to lung’ transmission of infections the natural defense system of infected people does not have enough time to develop natural resistance against the disease. Very soon the patient is very ill and highly contagious in the most dangerous way. It is the contamination of the respiratory system that causes most deaths.

Outside Wuhan/Hubei contamination by the fecal-manual route probably is the most common way of becoming infected. This type of infection is less problematic in its direct effects because usually only the digestive system is involved. For the affected individual the contamination usually has less severe consequences but from the point of view of contaminating other people a high risk remains. Strict hygiene is needed.

Distinguishing the two forms of contamination, eases treatment decisions. Distinguishing the two forms of transmission leads to better and more efficient policies in fighting and constraining the epidemic.

Disclaimer: The author is a geographer, not a medical specialist nor an epidemiologist. Geographical data have lead to the above analysis which may be right or may be wrong but if right this analysis will have many advantages for policies regarding the epidemic. Many lives could be saved – which has been the reason to publish this not perfect and not complete analysis.

With regards to commenting, please adhere to the rules known for this site: quote and react, not personal.

In commenting, please be reminded you are on an international website: for foreigners it is difficult to understand abbreviations.

About the author: Wim Röst studied human geography in Utrecht, the Netherlands. The above is his personal view. He is not connected to firms or foundations nor is he funded by government(s).

Andy May was so kind to read the original text and improve the English where necessary. Thanks Andy!

*New York Times, Feb. 2, 2020

A 44-year-old man who traveled from Wuhan, China, the center of the outbreak, died in the Philippines, officials said.

South China Morning Post

Hong Kong confirmed its first death from the novel coronavirus on February 4, 2020, after a 39-year-old man died after travelling to Wuhan, the capital of the central Chinese province of Hubei. (Italic added)

**Current map of Coronavirus 2019 cases in China

Coronavirus map of China 9:00AM 2/8/2020. Click on map for an updated view.

Earlier numbers in more detail (2/6/2020)

Mainland China 28,085 Total Deaths 563

Province of Hubei (inclusive the city of Wuhan):

Confirmed: 19,665 (70% of total Mainland China confirmed)

Deaths: 549 (97% of total Mainland China deaths)

Mainland China exclusive the province of Hubei:

Mainland China 28,085 – 19,665 = 8,420 = 30% of total China Mainland

Total Deaths 565 – 549 = 16 – 2 (outside of Mainland China) = 14 = 2.5% of total China Mainland

Hubei:

The province of Hubei has 70% of total confirmed cases and 97.5% of total deaths

To compare: the rest of Mainland China has 30% of all cases and only 2.5% of all deaths.

Many confirmed cases, no deaths: for example, the province of Zhejiang, Mainland China

Confirmed: 954 (3.4% of total of Mainland China)

Deaths: 0 (0 % of total Mainland China deaths)

***CNN: February 5 coronavirus news

6:49 a.m. ET, February 5, 2020

Cruise infections raise questions about how Wuhan coronavirus spreads

From CNN’s Joshua Berlinger in Hong Kong

The novel coronavirus is thought to spread from person to person through respiratory droplets emitted by coughing or sneezing.

There’s currently no evidence that the virus is airborne — meaning, for instance, it doesn’t travel across a large room.

Still unknown: An important factor yet to be determined, however, is whether the virus spreads via the fecal-oral route, according to Dr. John Nicholls, a clinical professor in pathology at the University of Hong Kong.

Coronavirus cruise: Norovirus — a contagious stomach bug that causes vomiting and diarrhea — and severe acute respiratory syndrome (SARS) both spread by the fecal-oral route. Norovirus is also notorious for infecting cruise passengers.

Viruses like norovirus spread so quickly on cruises because “you’ve got so many people in a crowded area and people are sharing areas, touching places,” Nicholls said.

Questions raised: The infection of at least 10 people aboard a cruise ship now quarantined in Japan is raising questions about whether the Wuhan coronavirus can spread the same way.

169 thoughts on “The Corona Epidemic – A Dangerous and a Less Dangerous Form

  1. Very interesting and useful analysis.
    Thank you very much.
    Still sweating bullets in Thailand but maybe not as many bullets as before.
    Thank you again.
    We are of course taking all precautions.

    • Thank you Chaamjamal. I also have been very worried and I still am. But discovering the difference between regions made me aware of different patterns that existed. I hope my insight is correct and that it will help in fighting the virus.

      Especially countries with a poor medical and organisational infrastructure need full attention of the international community. And full support.

      • Nice article Wim.

        This leads to the simple conclusion that individuals that have been infected in Wuhan are at greater risk than people that are infected outside Wuhan.

        the most obvious reason to me is that the local medical services are unable to effectively deal with almost 35,000 cases !! How much attention is each patient getting ? If you are one of two patients with nCov in a hospital in a western country you are going to get all the love and attention you need. ( and probably an armed guard at the door ). No drug shortages or the doc just sees you once gives you a paper face mask.

        BULLETIN:
        I’ve been following the numbers in the WHO bulletins and , though I have not seen anything about this media coverage, the number of new cases has started to drop in the last few days.
        https://climategrog.files.wordpress.com/2020/02/2019-ncov-cases.png

        Remember you read it here first on WUWT 😉

        I held back on jumping to conclusions but it now looks real and significant compared to the exponential rise which characterised the data up to the 5th Feb.

        death rate is still climbing in a consistent way but that will lag behind changes in new infections.

        • Greg, a nice graphic you show. I have been following the numbers in the WHO reports and also from other sources and the very high percentage of newly infected people went down from some 60% extra every next day about two weeks ago to 11% right now. But the absolute numbers are still high. It is a hopefull sign indicating that China will be able to win the fight against the virus.

          The main concern remains the transmission of the virus to poor countries which already – unnoticed – might have happened.

          • What are these %ages you are presenting? Are you talking about acceleration?

            From my graph you can see that even the first derivative ( infections per day ) was climbing roughly exponentially until and including 5th Feb.

            Since the derivative of an exponential is still and exponential, that is a good indication is actually exponential growth and not just ” going up quickly” which is what journalists seem to think exponential means.

            With the exception of the blip on 28th Jan ( which may have been China finally getting more honest about the numbers ) the growth was a pretty classic exponential spread. There is a clear and sustained break from that pattern since 5th Feb.

          • Greg: “What are these %ages you are presenting? Are you talking about acceleration?”

            WR: no, decelaration. Two weeks ago the number of confirmed cases was rising with 60% of the number the day before. Right now the daily rise as percentage of the day before slowed down to 11% for the last two days.

            Here you find more information about growth curves: http://rocs.hu-berlin.de/corona/docs/analysis/current/ According to my information the graphics might be updated soon.

          • Wim Rost,
            Considering the close relationship between PRC & North Korea, is it reasonable to think there are no active cases there? There doesn’t seem to be any cases reported so far since international reporting/monitoring began.

        • I can’t agree with “the number of new cases has started to drop in the last few days.
          According to the the John Hopkins it is only in the last day it has dropped.
          As well as that you cannot believe anything coming out of official China.
          Just look at what is going on in the streets as they forcefully detain people suspected of being infected. Plus all the people involved in originally informing the world of the problem are now dead.
          There is a good summary every day over at Em Smith’s (Chiefio) forum here
          https://chiefio.wordpress.com/2020/02/06/6-feb-2019-ncov-corona-virus-outbreak/#comment-124510

          One comment is striking, it is about a Crematorium in the area that has been running 24/7 for 17 days, which suggests not hundreds, but thousands of dead.

          • A C Osborn: “I can’t agree with “the number of new cases has started to drop in the last few days.”

            WR: here is another graphic that shows the stabilisation of ‘new cases’, possibly based on the same source:
            https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases

            Your link https://chiefio.wordpress.com/2020/02/04/4-feb-2019-ncov-corona-virus-outbreak/ gave a good argument why as time passes the epidemic in Hubei should slow down: “The best thing to note is the generally mild symptoms in children and young adults. It may make them good germ vectors, but it also says you need not panic about the next generations.”

            This means that mild cases of sicknesses are resulting in many people with resistance that helps to slow down the speed of transmission.

            Of course the strong policy of avoiding contacts between people as practiced in Hubei and elsewhere also is a main factor in the stabilisation in the numbers of newly confirmed cases.

          • I would expect new cases to drop quickly in China because of the aggressive way they are trying to stop this. I’m not saying it is right, but forcefully detaining people in the street is an example of just how aggressive they are attacking this. They basically shut down their whole country. That has to have an impact on the spread of this virus.

          • China is running low on medical supplies…and even getting what supplies they have into Wuhan…
            one of those supplies is the test for the virus…

            China is only reporting people that they have actually tested for the virus….

            that is probably the main reason cases appear to go down

          • In a city the size of Wuhan I would expect thousands to die every winter.
            Before panicking, you need to see what is normal for those crematoriums.

          • Latitude is right, I think, they have run out of kits, that is the only reason the report of numbers has gone down.

            BTW, why are you assuming it really was the wet market? Patient zero was reported to have contact with wet market–but he wasn’t patient zero–there were 5 or 6 patients before him and they had nothing to do with the market.
            ____________
            https://www.soundhealthandlastingwealth.com/health-news/chinas-lab-for-studying-sars-and-ebola-is-in-wuhan-the-outbreaks-center/
            https://www.newswars.com/creator-of-us-bioweapons-act-says-coronavirus-is-biological-warfare-weapon/
            https://greatgameindia.com/coronavirus-bioweapon/

            https://www.podbean.com/site/EpisodeDownload/DIR7DD669CSWGJD
            The vast rumor now is that the pathogen source wasn’t the wet market but was 20 mi south in a military lab. The accuracy doesn’t matter; what people think, does.
            _____________

            I don’t know. But right now none of us do. Trump has appointed his task force to find out where it came from. Looking forward to their investigation.

          • If the origin of the virus was man made, I sincerely doubt any evidence will be allowed to leak, or even exist anymore. I doubt any investigation will come up with anything other than that which is allowed to be concluded.

            We are also at the end of the extended New Year’s holiday – I haven’t heard of further extensions. If there is a general push to get people back to work the number of cases might increase again.

        • Actually Greg, I first read of a possible reduction in numbers of new infections(fingers crossed) on Jo Nova’s blog, early hours of the 8th Feb Eastern Australian time, way ahead of Californian time.
          I’d like to think it is so but fear otherwise. I feel so sorry for the Chinese; what a nightmare.

    • I was booked to travel to Thailand last Tuesday Feb 4, via Nanjing. I cancelled the previous Friday.

      But here’s the silver lining:

      I’ve been getting emails from cruise lines promoting deep discounts on their cruises – like $159 cruises – Really! What a deal!

      Google QCL – Quarantine Cruise Lines.
      ________________________

      Ring-a-round the rosie,
      A pocket full of posies,
      Hush-a! Hush-a!
      We all fall down.

      • “Ring-a-round the rosie”?

        There are many variants of this children’s verse, in many languages around the world.

        So I am definitely not going to try and call you out on your favored version.

        I’m just going to say that the likelihood of it having ANY connection to past pandemics is very, very low.

        Sorry.

        • I knew that Andy. The Chinese Corona crisis is caused by a virus. Bubonic Plague is caused by a bacteria. I posted the following on Saturday:

          https://wattsupwiththat.com/2020/02/06/time-magazine-climate-change-will-make-lethal-corona-virus-epidemics-more-likely/#comment-2911914

          Bubonic plague is still endemic to some areas – including a region in Kazakstan where I ran a project decades ago. We stockpiled suitable antibiotics at our camp, and donated them to the local hospital when they got old – they had no such antibiotics and were very happy to get them. So much for socialism!

          Bubonic plague is typically spread by rats that carry a flea infected with the bacterium Yersinia pestis. The rats also die of the disease, and often go mad and come out of hiding and do a hideous dance before falling dead. There reportedly was an old saying at the time of the Great Plague: “Beware the dancing rats!”
          https://www.granger.com/results.asp?image=0020818

          As an aside, my home province Alberta is supposed to be the only rat-free region on the planet. We are assured by our government that this is true, and yet there are worrying signs of change. Albertans elected a socialist NDP government, which was recently voted out of office. Also, the federal Trudeau Liberal-Marxists got elected with a minority and insist on forcing their destructive climate change fraud upon us, ruining our once-strong economy. We need to shore up our borders – Alberta is no longer rat-free.

          • ratify
            rat•i•fy “răt′ə-fī”
            transitive verb
            – To approve and give formal sanction to; confirm.
            – To confirm; establish; settle conclusively or authoritatively.
            – To validate by some formal act of approval; accept and sanction.
            – To vote Liberal, NDP or Green in Alberta.

  2. A nephew of mine arrived here January 15, 2020 from teaching several years at a university a few hundred miles north of Wuhan. So far he and our immediate family have not experienced any symptoms from the corona virus.

    Returning to China to resume his teaching is now a problem since many airlines are temporarily interrupting their flights to China.

    • This leads to the bizarre conclusion that you should not wash your hands when you might have been in contact with external contaminants, since you are better off getting the disease orally. Assuming you are going to be infected eventually.

      • ” Assuming you are going to be infected eventually.”
        Yes , making bizarre assumptions leads to bizarre conclusions. We’ve seen this already in claims of what is necessary to do to society to fight a non existent problem.

      • Harry: “This”
        WR: I suppose you are not referring to noaapragrammer but to the post itself

        Harry: “the bizarre conclusion that you should not wash your hands when you might have been in contact with external contaminants, since you are better off getting the disease orally”

        WR: Everyone should avoid being infected. The virus remains very dangerous which comes to expression as soon as the ‘pneumonia form’ can develop.

        Unfortunately not very much information about the different forms (digestive system / lung system) per region is available.

  3. Video that is managing to make its way out of China leads me to believe the virus is more dangerous than Wim Rost is describing. Experts in other non-medical fields are also weighing in with their ideas. Dr. Francis Boyle is a biological weapon expert. Coincidentally, there are some Canadian connections to the Chinese Wuhan-based BL4 scientists. And the sudden, unexplained death of a Canadian researcher, Dr. Frank Plummer, recently in Kenya.
    https://greatgameindia/transcript-bioweapons-expert-dr-francis-boyle-on-coronavirus/

    • A couple of YouTube videos are extremely poor evidence for you to base your conclusions on. You seem drawn towards conspiracy crap with your mention of biological weapons.

      • And believing in the statistical “honesty” of the Chinese Communist Party who HID this virus outbreak for a month, and even reprimanded Chinese Doctors who tried to WARN the co-workers and the people of China, is also pretty poor evidence for you to base you opinion on.

        Truth be told, we have NO IDEA just how many people have been infected, or have died, in China.

        But we’re likely to find out in coming weeks just how bad this thing for all of us.

        But yes, for god’s sake, wash your hands, and avoid contact with anyone who potentially has been exposed.

        And stock yourself a couple of months of necessities.. Better to have them and not need them, than to need them and not have them.

        • This is of course the rub, personally I believe we have no idea of the actual number of cases and fatalities in China. Even the Chinese probably don’t have a good handle on accurate numbers. The Chinese government has not been known for openness and has a history of being opaque to the outside world, as is typical for totalitarian governments throughout history.

          Unless and until there is a significant outbreak in a country that is more open and forthcoming I think speculation about the virus’s lethality and infectiousness are just that, speculation.

          • But the Chinese government, like all dictatorships, is extremely competent at detention of citizens.

        • “But yes, for god’s sake, wash your hands, and avoid contact with anyone who potentially has been exposed.

          And stock yourself a couple of months of necessities.. Better to have them and not need them, than to need them and not have them.”

          Excellent advice, Ronald.

      • What YouTube videos are you referring to? Links? None of the videos I have seen were on YT. The biological weapon discussion in relation to activities by the Canadian, Indian and US governments and expelled Chinese scientists cannot be labelled crap. Dr. Boyle’s opinion is no more or less crappy than Wim Rost’s.

      • The n19 coronavirus has been sequenced and found to contain a gene insertion sequence available in science catalogs for biological laboratories around the world. This sequence is not natural. The virus is definitely engineered. It contains SARS and AIDS sequences, which suggests that it was aimed toward becoming a bioweapon. That is not proved.
        There are two high-level virus labs in Wuhan. The virus was most likely escaped from one by accident–there have been escapes there before.
        As to conspiracies–there have been conspiracies throughout history, and our time is no different. The US has a RICO Act– Racketeer Influenced and Corrupt Organizations Act because they are that common.
        Forty years after the Kennedy Assassination, E. Howard Hunt (also Watergate crook) confessed to that conspiracy on his deathbed. The term “conspiracy theory” was cooked up by the CIA to hide their involvement, and try to sucker people into believing magic bullet theories.
        The term “conspiracy theory” indicates a perverse and ironic gullibility.

        • I’ve read that we humans share about 70 to 80% of our genes with plants.
          It’s hardly surprising that two viruses also share gene sequences.

    • Oh come on, Frank Plummer’s death is not mysterious nor part of any conspiracy. Those of us who knew him in our home town of Winnipeg also knew he had very serious health issues due to his alcohol addiction that had resulted in him need a liver transplant. Tragic and sad though it is to have lost a great man, his death was not unexplained, sudden or unexpected. Also he worked on AIDS, not bioweapons. What a crock of total nonsense!

    • That reminds me about my times spent in Wuhan. Much or most of the time there, it is naturally cloudy. Pollution from coal fired power generation is especially bad.. It is often dusty with high particulate loading and continual respiratory irritation, though it does rain frequently, which cleans the air.

      In apartments in Wuhan, they tend to use ductless air conditioning. These usually can heat and cool. Often for heat, they use portable electric heaters. Almost everyone lives in apartments. I believe that this situation would exacerbate the respiratory route of transmission.

      In modern U.S. homes and apartments, we frequently use forced air central heating and air conditioning. Filters are built into these systems and UV air purification is readily incorporated into such systems, though not typically used. It really would make sense to have UV air sanitizers in places where the public gathers.

      Most people in Wuhan travel via public transportation, especially buses. Their train/subway system is very modern. However, in both of these modes, people are packed into confined spaces and most people stand so more or less they are face to face. Hopefully masks work because in general hygiene practices around sneezing, coughing, spitting are not very good. In general, their hygiene practices in all cases are poor.

      • “In apartments in Wuhan, they tend to use ductless air conditioning.”

        This is not a criticism of you because this “ductless” description is how the industry describes itself, but these systems really do have ducts, they are just small ducts, but they are still ducts, so they are not really “ductless”. Maybe I’m just being too picky. I blame it on the CAGW hoax. It causes me to question everything I see. 🙂

        • I think there are window type as you describe that do have ducts, but more are heat exchangers without ducts. Anyway, I meant to contrast this to our central AC systems that circulate air and in which filtration, humidification and purification are readily built in.

  4. Just a thought, not many people shake hands….but a lot of people can eat food that has been sneezed on, or prepared by unsanitary hands…..salad bars and buffets especially prone to the influence of many people……which would in the author’s hypothesis result in the less deadly intestinal version….

    • A couple of years ago, in my local bakery, the woman behind the counter who has a big red nose and kept sneezing , coughed on her hand and then directly picked up the loaf I had asked for to put it in a paper bag.

      I told her she could keep her infected bread and she was taken aback and made some stupid comment about what was she supposed to do , she had to cover her mouth. I won’t bother recounting the rest of the bollocking I gave her.

      When people get penalised to having time off sick , they will come to work sick and spread infections. I can not imagine a more effective way to spread an infection than a bakery worker spitting infected saliva and sputum onto her hands then handling unwrapped food.

      That was the last time I went to that bakery 😉

      • “Greg February 9, 2020 at 2:03 am

        When people get penalised to having time off sick , they will come to work sick and spread infections…”

        In my opinion,the worst offenders are those who pride themselves on never missing a day of work sick. They often measure their employees on whether the employee ever reports sick.

        I’ve had several bosses who dragged themselves to work, infecting people along the route and substantial numbers of their employees who had to accept/deliver work or get yelled at over the boss’s often petty disapproval. These same bosses would then shout and scream at employees when they call in sick.

        Let me reframe your scenario slightly differently.
        An employee arrives for work, feeling poorly and struggling, sneezing, dripping mucus, likely running a fever and the owner allows that employee to work behind the counter in a food filled shop and food handling equipment?
        A shop where pleasing customers ensures their return for more goods?

        Like the personnel I describe above, your shop clerk is likely one of these who doesn’t care about who she infected or taking any precautions to protect the health of others. She is or works for one of those characters who insist they are never sick

    • What people are forgetting is that although coughs and sneezes can spread the desease by direct breathing in of the droplets, that is not the only problem.
      The droplets can be transferred directly to the much used surfaces like door handles, grab handles (Undergound trains), light switches, hand rails and clothing or can be transferred to those surfaces from the infected person’s hands.
      Another serious problem is Air Con/Heating and Pressurised Aircraft cabins which circulate the virus far further than just a cough or sneeze.

  5. The fact that the disease may show indications of becoming less virulent may be because the virus itself is becoming less pathogenic as it transmits from case to case.
    Were it very virulent and killed all its subjects immediately, it would not transmit at all.
    For it to spread its best the subject not throw it off or die but wander around shedding the virus, a bit like those ‘common colds’ that seem to hang on.
    The conditions in Wuhan are ideal for a respiratory virus
    https://www.timeanddate.com/weather/china/wuhan/ext
    Cold and wet.
    Under these conditions the droplets holding the virus do not dry out and can circulate to others.
    Cruise ships with circulating air are a special example.
    In dry conditions this is less likely.
    The upper airways, in winter, are a bit cooler than usual and support viral growth.
    Hence the winter ‘cold and flu’ season.
    With no special knowledge I am very confident that this one will be beaten.
    We have all survived Bird Flu, Swine Flu, the Middle Eastern Respiratory Syndrome,the Black Death, Plague and the Spanish Flu.
    If not us, our worthy ancestors.
    The usually inscrutable Chinese friends of mine are openly anxious about this disease.
    In Australia whole courses are being postponed due to there being no students.
    Many went home for the Chinese New Year and cannot come back to Australia.
    We hope and pray this leads to some sort of relaxation of police rule in China, which alone could make these events,singularly from China,quicker to eradicate, root and branch, before they spread.

  6. Came across this little description about the time when the “Spanish flu” was at it’s height. Extracted from the Book ‘Tex Johnson Jet-Age Test Pilot’ at the time he had just been contracted to become a primary instructor during the rush to train pilots for the expansion of the USAAF in 1940:

    “On south takeoff I could see the foundations of the old World War I Camp Funston, where 22 years before I had shivered in the frozen ruts of the dirt road in 10-degree weather while Dad talked through the wire fence with is brother, my uncle Frank, quarantined by the epidemic. I’ll never forget the row upon row of dead bodies frozen stiff and piled like cordwood five feet high, waiting for burial when the ground thawed. I considered the progress since that day when Mother had waited in a side-curtained Model T touring car with a quilt over her feet and legs that retained the feeble heat of a kerosene lantern. The roads were frozen mud, 90 percent of the vehicles were horse drawn, and there was not electricity or running water or indoor facilities.

    Here I was flying over that same area at 90 mph in a closed-c0ckpit airplane warmed by a cabin heater. The roads were now paved, not a single horse-drawn vehicle could be seen, and electricity, hot & cold running water, and indoor facilities were standard-all accomplished in roughly 20 years. “

  7. Historically the fecal oral route has been the most pathogenic, only 2nd to a direct bodily fluid transfer such as HIV and Hepatitis infections with their STD or injection-druguser/needle-sharing blood-blood exposures.
    The aerosol-lung route of infection transmission is typically less so in probability of transmission.

    While lung involvement, once established, is likely the higher mortality event, it is the lower likelihood of transmission. With this route of transmission, once the winter-spring cold season is over, so too will this outbreak disappear. At least until next winter’s cold and flu season in the Northern Hemisphere.

    To note: Corona viruses are only second to Rhino viruses as the causative agent of those annoying but seldom life-threatening seasonal cold viruses we all get every few years.

  8. It’s a mystery to me why anyone wishing to be taken seriously accepts the numbers provided them by the Chinese Communist Party. At this point even the idiot journalists in the MSM have become aware of the false reporting.

    Never take numbers from the government in China at face value …. never.

    RIP Dr. Li Wenliang

    • Kevin, a lesson from history…
      Never take ANY numbers from ANY government at face value …. never…. ever !
      always check everything.

      Safer to trust a used car salesman than a politician.

      • Okay, technically I can agree, but saying it this way implies some type of equivalency. The CCP’s data manipulation, denial, and outright lies are on a completely different level.

        If a patient dies before being diagnosed they are assigning the death as due to preexisting conditions. Crematoriums that normally run three hours a day are now running twenty-four hours a day. One source says in Wuhan crematoriums are handling a hundred bodies a day.

        In Shenzen a few days ago, when the government numbers said 15 deaths in the city, a doctor friend of China vlogger Winston Sterzel was personally aware of 30. Another friend in another smaller city just outside Shenzen was visited by the police going through his apartment complex … the police told him there were three confirmed cases in his complex, while the official CCP numbers said zero in the entire city.

        These wide disparities are being reported throughout the entirety of China.

        Taiwan News … https://www.taiwannews.com.tw/en/news/3871783
        NYPost … https://nypost.com/2020/02/08/chinas-culture-of-lies-has-helped-spread-the-coronavirus/

        Winston’s latest video … https://www.youtube.com/watch?v=nkF4qYdNU9Y

        • I have read the articles and I saw the video.

          The last WHO numbers (report of the 9th or February) suggest that the trend is that the rise in cases is diminishing: less extra cases than the whole last week. The number of severe cases only rises by 1% instead of yesterday’s 26%.

          The message is that for China the trend is towards stabilisation. In that case the severe measures taken within China would give the wished results.

    • I’m not sure correct numbers even matter. We know it’s huge and spreading. We know the Chinese are now trying to contain it. What ever happened in the beginning is not relevant now. Seems 30,000+ cases should be scary enough. Making it 50,000 or 100,000 really changes little.

      As for trying to hide this, why would anyone expect anything different? That happens with virtually everything that is embarrassing to China. I would have shocked had they immediately announced the problem.

      I agree with saveenergy—it’s not very smart to trust any government numbers.

  9. You seem to be differentiating the infected into two groups and that they should be treated differently:
    “For the other group 100% strict hygienic prevention measures should be enough to prevent further spreading.”

    I think you are mistaken. It doesn’t matter how they contract it, it can be passed on through respiratory droplets from coughs and sneezes, just like catching influenza by not washing your hands.

    • Loydo: “It doesn’t matter how they contract it, it can be passed on through respiratory droplets from coughs and sneezes, just like catching influenza by not washing your hands.”

      WR: It DOES matter how people get the virus. As can be distracted from the numbers for the different regions in China and elsewhere contracting the virus in Wuhan has been much more deadly. In Wuhan there is much pneumonia with related lung to lung infections. But if the virus enters by the digestive route it seems that the body gets much more time (or is more efficient) in organising its defence by creating antibodies.

      Compare the different regions in the map: the number of infected people and the resulting number of deaths. For example Zhejiang now has more than thousand confirmed cases and not one person died so far. (click on the name Zhejiang on the right and when the region pops up on the map, click on the region and the data for Zhejiang will appear on the upper left in the map)

      • Wim, your proposed mechanism may be right or wrong, and either way, your observation should make a major change in epidemiology. This is a huge breakthrough for human health and we at WUWT were the first to see it.

        You have not mentioned infection through the eyes. Scientists will study that one as well.

        • Thanks for the compliment. I hope I have added in one way or another something to the solution of the problem.

    • “You seem to be differentiating the infected into two groups and that they should be treated differently:”

      No Loydo.
      He is probably correct. The virus infection once established in the lungs is an aerosol pathogen. While the same pathogen established in an infected host’s gut is likely a fecal-oral transmitted pathogen and not nearly as lethal for the host. This selects for two different preferred viruses. Corona viruses are a + strand RNA virus with high mutation rate even intra-host. +Strand RNA viruses are constantly evolving under host immune selection pressures. Even their +RNA strand without the viral capsid is infectious to a cell, but this comes with a high mutagenic cost to the virus.

      While both need to be treated with the best medical care, the gut infected person is more likely to unknowingly spread the virus, which is how it probably got started without notice.

      This corona epidemic will likely subside after the end of the normal NH cold and flu season by April. But it could still infect and kill a lot of people between now and then, especially those unfortunate few who contract a lung case of infection where respiratory distress is severe.
      So I’m not trying to minimize the danger, just that there is a light at the end of the tunnel.

  10. More deadly in Wuhan because only the most serious cases are treated and reported there. They are out of hospital beds. Only a small fraction of cases is reported, so mortality seems high.

    In the rest of China, less severe cases are also reported, so the mortality is lower.

    • Perfecto: “In the rest of China, less severe cases are also reported, so the mortality is lower.”

      WR: It is difficult to find numbers of severe cases per region. But all kinds of messages indicate that outside the province of Hubei cases of sickness are [much] more moderate, suggesting that the lung system is not [yet] involved. Which leads to the conclusion of contamination by the digestive route.

      The big danger that remains everywhere is that the lung system will (!) get involved by secondary contamination by the person himself: the fecal-manual route. Than the transmission to other people (as I understand it) will become much more deadly.

      • Thanks for the reply. I don’t see how you can discount the simple hypothesis that the difference in mortality is because the Hubei medical system is operating at capacity, but the rest of China and the World are not. We know that they have been building emergency field hospitals in Wuhan. This saturation effect explains the apparent difference in mortality.

        More complicated theories about routes of transmission are not needed to explain the data.

        • Perfecto: “This saturation effect explains the apparent difference in mortality.”

          WR: If your assumptions about saturation of the medical system within and outside Wuhan are correct there still is another problem. For the severest respiratory problems there is no real cure. Hospitals and ‘the best hospitals’ will make a difference but not all of the difference.

          First the question must be answered about the percentage of severe cases (pneumonia) in Hubei and outside of Hubei. Both in relation to the first appearance of cases in the region.

          I must repeat that I have read many times about mild symptoms for cases outside of China. And the fact that persons with pneumonia don’t travel seems logic enough by itself to exclude this group for infecting people far from Wuhan. That opens the way to other forms of contamination than by droplets in the air.

  11. more especially the hygiene in squat latrines has been mentioned

    I have to note that while travelling in India (many moons ago), I found public squat toilets to be abominable. I had to wonder, while performing on said toilets, if people literally stood on their hands and had explosive dirareha (sp?) all over the walls. In 35C heat and high humidity it was a nightmare.

    I’m told it’s because of the way people ‘wash’ with water afterwards, and just flick the residue on the walls. And people wondered why diseases were so common?

    At least I eventually discovered that dysentery is not so unpleasant the second time around. Luckily I’ve avoided a third bout, so far at least.

    • In the seventies I had the same experience in West Africa. Having dysenterie myself I had to visit a local hospital. The originally white squat toilet showed brown walls the lowest couple of decimeters above the floor. But in that circumstances one has no choice nor time to find an alternative.

    • In 1995 I was doing some research in a library in a large city (pop. over 100K) in Ukraine when I needed to relieve myself. I asked my translator to ask one of the librarians where their restroom was. He came back and said that it was an outhouse located in the alley behind the library. When I entered the small 2-seater outhouse, I noticed wooden dowel racks with a dozen or so wrinkled toilet paper strands that were stained with various shades of yellow. Upon return to the library I asked my translator about those strands and he said, “Oh, those are courtesy wipes in case you forget to bring your own paper.” (Before traveling in Ukraine I had been warned to carry my own toilet paper, so I had brought along quite a few toilet packets I had saved from rations used on field maneuvers during the Vietnam Era.)

  12. Another possibility is there are 2 types operating at once, with one more deadlier than the other.

  13. No no no!
    There are two main factors that affect mortality
    The age/health cohort you are in and the availability of high quality medical care.
    On average 2% of patients will die but they are heavily skewed toward old people with smoking history/health problems. Most of the overseas people are not in this high risk grouping. If you are in it then mortality is likely 15-25%. SARS was the same, 50% of people over 55 died. Young healthy people have a much lower risk excecpt for pregnant women and health care work exposed to very high doses.
    Obviously Wuhan has the other problem of having insufficient medical care for the 60000 people with viral pneumonia, which likely pushes death rates up to 5% in untreated patients.

    Also death rates can appear lower at the start of an epidemic because of the lag between contracting the virus and dying is several weeks (2-3w) post symptoms is the danger period for this according to the Chinese. SARS increased from 4% mortality rate
    to 10% by the end as deaths caught up to infections.

    • Rob JM: “On average 2% of patients will die”

      WR: The point made is that if Hubei is excluded the actual number for the rest of China is only 0.3%. Ten times less than for the province of Hubei. Those numbers are suggesting that the dangerous pneumonia form is found especially in Wuhan and surroundings.

      Actual numbers:
      Mainland China:
      Confirmed 37,555
      Deaths: 813 = 2.2%

      Province of Hubei (inclusive Wuhan):
      Confirmed 27,100
      Deaths: 780 = 2.9%

      Mainland China without the province of Hubei:
      Confirmed: 10,455
      Deaths: 33 = 0.3%

      Rob JM: “Wuhan has the other problem of having insufficient medical care for the 60000 people with viral pneumonia”
      WR: What is the source of the number for Wuhan? Total infected cases in whole province of Hubei (inclusive Wuhan) as reported: 27,100 of which only a part developed pneumonia.

      • Wrong math.
        Those who die, have been infected for weeks.
        You have to normalize the death number to the number of healed.
        Dead: 800
        Healed:2000
        Mortality: 30%

        • Alex: “You have to normalize the death number to the number of healed”

          WR: At the end of the epidemic you perhaps could do so in case you would know how many people became infected over the whole period. But now we do not even know how much people have been infected: many only show mild symptoms (especially younger people and people outside of Hubei) and are not registered at all.

    • You propose different routes if infection as the primary reason for different CFR. Fair enough. But thst is just one of many possibilities.
      I can imagine for example thst this population in Wuhan has perhaps had other Corona virus epidemics in the distant past and it is the sequential infection that leads to serious illness like Dengue.

  14. Let me pass this on to anyone who might benefit from it.

    There are two notable facts about the distribution of flu:
    – It exists primarily in the mid latitudes, and
    – It is most common in winter.
    The likely reason for both is that most of the population north of about latitude 35 is vitamin D deficient in winter. People cover up for cold winder so there is much less skin exposure to sun, and even with exposed skin the sun is so low in the sky that UV is limited.

    My personal experience is that the first time I was tested I was seriously deficient. It too 2 years and, eventually, 20,000 units/day to raise my blood level to reasonable. Testing is essential as I would never have taken that large a does without test support.

    Since reaching a reasonable level, I have not had a bad flu or cold for almost 10 years.

    Colds and flu can be treated with short term, high dose vitamin D. Detail here https://vitamindanswers.com/vitamin-d-hammer-beating-the-flu-in-72-hours/

    I mention this because vitamin D is involved with the part of the immune system that attacks viral infections. I think it likely that the high dose treatment will work for most viruses.

    • My body is naturally deficient in vitamin D, I have to take at least triple the recommended adult dose to maintain normal levels of vitamin D, so my immune system would benefit from vitamin D pills.

      But I’m not about to take a walk around Wuhan armed with a few vitamin packets.

    • “Since reaching a reasonable level, I have not had a bad flu or cold for almost 10 years.”

      What is your normal daily dose of Vitamin D now after reaching a reasonable level?

      • Still 20,000 IU/day. My last blood level was 69 ng/ml. That’s a little over target and if it keeps going up I’ll need to cut back what I take. Still, I’ve been taking that amount for over 10 years and my blood level was stable in the mid 60s until recently.

        The useful range for blood level 25-hydroxy vitamin D is 50 to 100, in that there are clear bad things happening outside that range in either direction.

        ++PLS

    • I live in the tropics in Oz, and we get a lot of sunshine during the winter. We also get a typical ‘flu season.

      Go figure.

    • The highest peak in 1918 flu fatalities was the second wave, which occurred in the summer and was twice as high as the third (winter) wave.

  15. I’m concerned some “mild” cases might actually be misdiagnosed severe cases.

    The CDC is concerned about a spike in cases of severe lung damage caused by vaping, apparently due to an additive which can cause lung damage.

    An interesting feature of vaping damage is the victims don’t notice the symptoms of the lung damage, or don’t recognise what is happening, until they are on the brink of death – the damage to the lungs accumulates quietly until lung function crosses some critical threshold, after which they’re in big trouble.

    I suspect something very similar is happening with the new Corona virus – some people carry on with mild symptoms, quietly accumulating lung damage, until the lung damage cross a critical threshold, after which they need intensive care and are likely to die.

    The evidence is stories of some of the cases – for example, there was a case recently where someone boarded a flight in Melbourne, not obviously ill enough to concern flight crew, but left the flight with serious symptoms – a 2 hours flight. The transition from mild to severe symptoms is that quick.

    • “…some people carry on with mild symptoms, quietly accumulating lung damage, until the lung damage cross a critical threshold, after which they need intensive care and are likely to die.”

      My mother was a nurse ~1918 to ~1925. She often said that most 1918 pandemic fatalities were people who “carried on” instead of staying in bed.

  16. Wim Röst thank you for your article, interesting reading.

    IMHO the UN can do something useful for a change. Without been sound like an elitist, a big campaign against said toilet/hygiene practice in about ~3billion of planet Earth population is warranted (Asia, Africa, Balkan and even in Russia)
    It is ironic, the lack of hygiene that give a somewhat better protection for the person… unfortunately propagating the virus further.

    Regard the question where is it come from… most of this virus originate from China. Next to the Himalaya. I read an article long time ago how migrating birds get high in the atmosphere and exposed to meteor/comet dust regularly. Eventually bring it down to the surface. Would be interesting to track the source of this event to there and not to the local market. This is the Panspermia hypothesis and is out of topic here, apologize to bring it up.

    • Mick: “IMHO the UN can do something useful for a change. Without been sound like an elitist, a big campaign against said toilet/hygiene practice in about ~3billion of planet Earth population is warranted (Asia, Africa, Balkan and even in Russia)”

      WR: I support every suggestion to the UN to concentrate on real problems to be solved. Attention of the UN to the real problem of bad hygienic circumstances in many poor countries could have helped billions of people and could have made the world quite a bit safer. If the virus will spread to Africa the UN (and the rest of the western world) will regret their bad choices.

      Trillions are asked (and spend) for ‘Climate Change’. Have we ever heard the word ‘trillions’ in regard to improving hygienic circumstances in poor countries?

      • And the way we are planning to “tackle” climate change is going to do squat for hygiene in parts of Africa and Asia!

    • No need to seek ET causes. Its genome shows that this new coronavirus, like its cousin SARS, came from bats, via an intermediary mammalian host. In SARS, the intermediary was civets. Chinese researchers have recently suggested pangolins, the scaly anteater, as the intermediate host for the Wuhan coronavirus. They’ve not yet published their findings however.

      Pangolins are allegedly the world’s most trafficked mammal, as their scales are imagined to have medicinal powers, and their meat is a delicacy in China. Civets are famed for their role in producing the world’s most expensive coffee. In China, they’re kept in cages and fed coffee berries.

    • Interesting point. It’s been observed that there is a correlation between bad flu outbreaks and inferior conjunctions of the sun and Venus. This puts Venus on a straight line between Earth and the sun and would allow the solar wind to strip off parts of the atmosphere of Venus and carry it into Earth’s atmosphere.

      It seems really unlikely that a virus from Venus could infect life on Earth, but the correlation seems real so something might be going on.

  17. I too am no epidemiologist but I am sure I heard that a pathogen that kills its host is doing itself no favours! As the disease spreads might we not find that the virus mutates into a less dangerous form? Could this explain why the most serious infections were where the epidemic first started?

  18. Sadly, I don’t think much can be deduced from the discrepancy in death rates between Hubei and the rest of China.

    The health system in Hubei is clearly overwhelmed. Yesterday there was a count of 345,000 people (cumulative) who had moved through quarantine. Right now there appear to be around 30,000 people per day moving into and out of quarantine. How many of these are in Hubei is unknown. There are stories from Hubei of people who are very sick who cannot get into hospital because of a lack of test kits. They are supposedly being directed to quarantine.

    The question of test kits is interesting. Just what is the capacity to perform testing in Hubei? Can they really confirm more than 2 per minute? The PCR test appears quite complex.

    Many organizations have estimated, right from the beginning, that there may be over 10 times the number of actual cases as confirmed cases.

    If anyone in Hubei was suffering from a mild infection, it would be massively risky to attend any centre where there was a large concentration of Coronavirus patients. They might not already have the virus, and would be taking a large risk of acquiring it.

    All in all, I would be more inclined to believe that there is massive under reporting of cases in Hubei, than that the virus there appears more deadly.

    • russell robles-thome: “Sadly, I don’t think much can be deduced from the discrepancy in death rates between Hubei and the rest of China.”

      WR: So far I did not find a reason why the death rates for the rest of China would be underreported if compared to the numbers for Hubei.

      russell robles-thome: “Yesterday there was a count of 345,000 people (cumulative) who had moved through quarantine. Right now there appear to be around 30,000 people per day moving into and out of quarantine.”

      WR: What is the source for the numbers?

  19. This is pure speculation and as such not helpful or at least premature. The data base is very unreliable, the potential explanations are numerous, including genetic, mutation of virus strings,time laps etc. and the conclusion as to observe hygiene self evident.

    • Alexander Vissers: “This is pure speculation and as such not helpful or at least premature.”

      WR: The right hypothesis might be preceding the proof. Or may lead to a rejection of the hypothesis. Discussing an hypothesis – even if containing a premature conclusion – might be very helpful. The wide divergence of the death rate between the province of Hubei and the rest of China asks for an explanation.

    • Once public transportation systems ceased operating, transmission by this mode would have dropped precipitously.

      • “WR: The right hypothesis might be preceding the proof. Or may lead to a rejection of the hypothesis. Discussing an hypothesis – even if containing a premature conclusion – might be very helpful. The wide divergence of the death rate between the province of Hubei and the rest of China asks for an explanation.”

        I believe the question is valid. Your observation may be correct. Alternatively, I understand that public spitting is commonplace in China. Since the virus is spread in sputum, and since pre-symptomatic viral spread is high (half, I read), then the reduced spread on ships may be because of the absence of spitting on ships. One further test of this possible alternative explanation might be observing the virus in Singapore. I recall that Singapore has high a penalty for gum chewing. I doubt that Singapore tolerates public spitting….does anyone know?

        • Public spitting was common in China. There were spitting pots in the streets. People knew exactly how to spit in such a pot. But years ago I read that the Chinese government banned spitting.

    • Thank you Gary.
      I somewhere read that doctors and others involved with the epidemic are that busy with individual cases and with the most severe symptoms that another view (like this geographical one) could remain out of sight. For that reason I thought my analysis could add to the discussion about the epidemic and its forms of transmission.

      As a generalist (geographer) I often have to cope with the fact that I am not a specialist in specific fields. But often we can add some insight.

  20. I’ve been watching various YouTube videos from a fellow who posts as SerpentZA. He’s a South African, married to a doctor in Wuhan, and trains Chinese medical professionals on various equipment.

    He is extremely down on the reports from the CPP and its communication structure that discourages bad news from moving upward. He is extremely down on how China’s laws against rumor mongering were used to suppress the early reports of the outbreak.

    He says that China has always listed the cause of death on death certificates as any preexisting conditions, that, by itself, leads to artificially low numbers.

    In other posts and other readings, The Wuhan virus seems primarily airborne and respiratory, not intestinal. At least some of the superspreaders of SARS in Hong Kong were linked to a fecal-oral route, I have not heard of superspreaders of the new virus.

    An early post from Jan 24 remains the most informative and eye opening, everyone should watch

    https://www.youtube.com/watch?v=lk5XkhUKMDM

    A recent post, mostly a plea for common sense, a plea to drop the diversion on racism, a plea to help Chinese citizens, and a warning to disbelieve any numbers coming from the CCP or through WHO and their Chinese/CCP members. https://www.youtube.com/watch?v=nkF4qYdNU9Y

    Other posts look at areas with visual evidence of cases and deaths in area where the official counts are zero. One I saw a couple of days ago showed officials sealing doors to force quarantines on the residents. Absolutely incredible.

    • The second video (short enough to watch the whole thing) is informative. BTW, Winston lives in LA now, I think with his Chinese wife.

  21. This is newish (Feb 3) and describes China’s membership in the WHO, I have it on in the background now. While some of the content is necessarily speculative, I suspect by the end you won’t believe another report from WHO about the Wuhan virus.

  22. I am disinclined to think that an oral/fecal route is somehow different from an inhaled route and that there are different types of viral transmission based on solely geographic location because there is a much simpler explanation. Hand washing (in this case) is not so much to prevent oral/fecal transmission as it is to get any virus off your hand that you picked up from a surface before you went into the bathroom. This prevents you from contaminating your nose mouth or eye after touching an infected surface. Hand washing should be done often and the easiest way to get people to hand wash is to get them to do it while they are in a bathroom where there is a sink and soap handy. Also linking the hand washing to going to the bathroom simply means you do it regularly. The virus killed more people in Wuhan simply because more people got sick there and it went uncontrolled and unrecognized (and therefore untreated) for longer. Add to that the fact that their medical system has been overwhelmed and of course there are more deaths. They are probably prioritizing who gets treatment leaving the elderly and members of the public considered less valuable untreated. This would fit with the stories of elderly people being sent home instead of being admitted to hospital. Outside of China every infected person that is identified is in hospital getting every treatment that can be thrown at this bug. As for those who transmit the virus without showing signs of infection or only being very mildly infected, that’s just the way all these viruses work. A lot of people get this bug and don’t die from it. For a lot of people it is just like a common cold and can be even milder so they would shed virus even if they did not get sick. I will take the simpler explanation before taking a more complex one based solely on a geographic explanation that has other more obvious explanations. But keep thinking. Ideas ‘out of left field’ like this one are sometimes the ones that give unexpected solutions.

    • Justin Burch: “I will take the simpler explanation before taking a more complex one based solely on a geographic explanation that has other more obvious explanations.”

      The three principle questions for a geographer are: “What”. “Where” and “Why There”. If there is a stunning difference for what I find in Wuhan/Hubei and in what I find outside of Hubei then there must be an explanation.

      The first that comes into mind is the time difference: infections started later outside of Hubei. But in that case there should already have been a considerable rise in the number of deaths in ‘the rest of China’.

      Only in 3 provinces there are 3 or more deaths: in Henan (6), Heilongjiang (6) and Hainan (3). They respectively have 1033, 307 and 131 confirmed cases. The province of Henan is next to Hubei. Compare this to 780 deaths for Hubei and 27,100 confirmed cases.

      Source: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

      • Has it been confirmed that less-severe cases came via the fecal-oral route? I didn’t see a reference for that.

        One theory about why things are so much more severe in Wuhan may be a little bit fringe, but sounds like it could be explanatory: A (purely speculative) secret anti-SARS vaccine trial might have been conducted there, leaving people with a much-heightened reaction to a coronavirus with these characteristics.

        I have no idea if the researcher quoted here is legit or not (he does have something like 56 peer-reviewed papers; I’m just saying I’m not qualified to evaluate him), but it’s an interesting theory that would do a lot to explain why there’s such a difference between Wuhan and elsewhere, or at least between China and other countries. (It’s obvious that China has been suppressing news, so it’s hard to know whether the differential between Wuhan and the rest of China is real or not.)

        In any case, here’s a link, FWIW:
        https://www.theepochtimes.com/senior-u-s-scientist-wuhan-coronavirus-most-likely-linked-to-lab-event_3232413.html

        (I also don’t know what credence to give his assertion that it’s a case of a virus escaping a lab (like the one in Wuhan), but I’ve come across a couple of others saying that it’s extremely unlikely to have crossed directly from bats into humans.

        • That link is dead. At any rate one does not need to specualte on a secret vaccine. it is entirely possible that their have been in the past other similar corona outbreaks in Wuhan and hence we see this same phenomenon. It also accounts for low to zero moratlity in children

          • Ah – excellent point about a possible prior outbreak that had the same sensitizing effect. Good supporting point about that also accounting for zero mortality in children: You’d have expected children to have been inoculated with a vaccine, had one existed.

  23. When I was travelling to China regularly, I used to watch many SerpentZA videos. Some of your information is incorrect. Where did you get the idea that Winston’s wife is a doctor in Wuhan?

    They used to be based in Shenzhen, where he trained doctors there. He was basically forced out of China by the government a couple of years ago. I don’t know if his wife is still in China and I don’t know where he lives now.

    • I may well have some of those details wrong. All those videos are some 3X longer than necessary so I wasn’t paying as much attention as I’d like. The first video left me with the impression that his wife was in Wuhan, perhaps that was in the past. As you noted above, he’s now in LA, so probably with his wife. His in-laws came for a visit before the outbreak became news and have umm, extended their visit.

      I never heard of Winston’s videos until all this broke loose. One of my coworkers whose daughter spent a lot of time in China was surprised I had found him.

      • He’s done videos on Chinese scams to help travelers avoid becoming victims and these are very useful if one is traveling there. He became a target of the Chinese government when some of his criticism became noticed.

        Without a doubt the Xi regime is oppressive and is taking away freedoms of the Chinese people, as well as from visitors. I will have no regrets if I never return to China, though I did have fun in Wuhan with friends at Captain Jacks and Brussels Beer Garden, probably the best two bars in this second tier city of 11 million. High end hotels have bars, though they are expensive.

        I hope that my former colleagues are managing. I deleted my WeChat account and reached out to only one former colleague who didn’t say much other than thank you for concern. One coworker’s mother is a doctor and I worry about her the most.

  24. As a general rule learned from experience it is very difficult to describe the actual behaviour of an epidemic such as this within the first few weeks. We are certainly in those first few weeks as far as the statistical observation of the Wuhan coronavirus outbreak. There are many different theories that may explain the lower death rate outside of Wuhan and no one can claim to know the real answer but let me just add one more which is consistent with what we know of deaths from respiratory viruses such as influenza and corona viruses. The typical pattern is an infection beginning with dry cough, fever and lots of respiratory secretions in the upper airways for corona virus. It looks like a common cold. Death typically occurs when an individual develops widespread inflammation in the lungs which causes difficulty exchanging oxygen and CO2 and which appears clinically indistinguishable from acute respiratory distress syndrome (ARDS). This is a widespread lung injury which will lead to death in many who develop it but most individuals will recover without this complication.

    We don’t know why certain people are more prone to ARDS than others but this is an illness that can affect young previously healthy people. Certainly older and more debilitated individuals are at higher risk of death but ARDS is the likeliest cause of death in young fit people with these viruses.

    With that background it is important to recognize that the development of ARDS and eventual respiratory death typically develop over several days to weeks. The application of modern critical care with supplemental oxygen, non-invasive ventilatory support, and mechanical ventilation can support those with the most severe lung injury for weeks before they ultimately recover or die. This means that the outcomes for many of the most severely affected by this new corona virus are not known to date. We are in the very early upswing part of the epidemic curve and it is far too early to see all of the outcomes that will occur. There will be more recorded outcomes, and more deaths per infected individual in those areas where the infections occurred earliest in the epidemic (i.e. Wuhan). Where the epidemic spread is more recent there will not be many individuals who have been ill long enough to die from ARDS. If this is at least a partial explanation for the variable death rates, and I believe it must be, then the final death rate will likely be above the 2% reported overall and this would explain a death rate closer to 5% in Wuhan so far. The rate in Wuhan could also increase because their epidemic is not yet mature and I wouldn’t be surprised at numbers as high as 7%.

    The possibility that the rates of severe illness and death are much higher is also supported by reports that 14-16% of those known to be infected are classed as critically ill. I would expect a substantial number of those classed as such will die ultimately even with modern health care supports but, if cases continue to rise rapidly, the ability to provide such support will be severely stretched and death rates may trend even higher.

    As many others have mentioned another phenomenon that may reduce the death rate would be the finding of many more minimally symptomatic people who don’t present to medical care thus increasing the number of mildly affected individuals. This would be a very welcome and not surprising finding but it would also substantially increase the pool of individuals capable of spreading the virus and make containment more difficult.

    Finally it is important to recognize that these numbers are based on the reported statistics coming from a country whose health care services are likely extremely stretched and where the ability to accurately find and report every case and death should be at least partly suspect. Is there under-reporting of cases and deaths due to logistical issues – quite possibly. Are there political and civil reasons to want to diminish the perceived severity of the epidemic – most probably. None of this is meant to be a critique of the Chinese government response to this epidemic. This is a huge disruption to normal social systems and would be a severe test of any national government. China deserves all of the support and sympathy the world can offer. We are all in this together.

    • Thank you for all of this information.

      The daily rise in severe cases since the 27th and the percentage rise in % of the total of severe cases the day before, all numbers for whole China as I noticed them are as follows:
      461
      976 112%
      1239 40%
      1370 11%
      1527 11%
      1795 18%
      2110 18%
      2296 9%
      2788 21%
      3219 15%
      3859 20%
      4821 25%
      6101 26%

      The rise in % of the previous day remains strong.

      Do you perhaps have any information about the percentage of severe cases outside of Hubei?

      According to what I have read about all cases outside of China nearly none of those cases showed severe symptoms and I presume this is also the case for ‘the rest of China’ given the low numer of deaths outside of Hubei, a number which is not quickly rising either.

      Inverse reasoning leads to the conclusion that there can only be a low percentage of severe (lungs involved) cases outside of Hubei but confirmation or disconfirmation by official numbers is lacking.

      • There are reports of severe cases and two deaths outside of China. All of what I know about this epidemic is from published statistics. There are very few cases relatively and most of those cases are “young” in their evolution so it is not surprising there are few severe outcomes outside of China so far. I have no first hand knowledge and take all of the reports with some skepticism (a sound scientific perspective) The very unfortunate outbreak on a ship docked in Japan will be very interesting to follow as it is a closed population and should give some very helpful clues on infectivity (reproduction rate), pathogenicity as shown by severity of illness and death rate, and what measures are effective to control spread. I continue to hear various experts state whether the current control measures are sufficient, deficient or over the top but I don’t trust any of those judgments as sound at this time and only the passage of time will allow a better understanding.

        However bad this epidemic is or becomes, I suspect, as is typical of most modern epidemics, that the worst effects will not be from the infection but from all of the various reactions to and the fear generated by the epidemic. China faces very real risks of economic harm, civil disruption and collapse of civil order in some jurisdictions and I suspect their very aggressive response is in large part driven by the need to avoid that. Again this is not a critique of China. The same type of thinking is prevalent in democracies where the perception of the voter as to how well a politician protects and improves ones own circumstance is key to the politicians fortunes.

      • I should have mentioned that for cases outside Hubei but in China I am only aware of the differential death rate where, near the Center of the epidemic it approaches 5% and outside of that region 2%. As stressed above the rates don’t just reflect the actual severity of the infection in different regions/populations but also the maturity of the epidemic in any region. The longer individuals have been infected the more severe outcomes and deaths will be recorded as there is a large lag time between infection and ultimate death.

        • Andy Pattullo: “there is a large lag time between infection and ultimate death”

          WR: is there any indication about the average time lag between infection and ultimate death?

          The cruise ship in Japan took the sick man on board the 20th of January:
          “The checks began after an 80-year-old Hong Kong man who had been on the ship last month fell ill with the virus. He boarded the luxury cruise liner in Yokohama on 20 January and disembarked in Hong Kong on 25 January.”
          https://www.bbc.com/news/world-asia-51409800

          • To know the lag time one needs to know when someone is first infected and then when they become maximally symptomatic or die. The earliest anyone on the ship could have been infected by the index case is when that man boarded but the infections could have taken place anywhere between that date and when he disembarked on the 25th. That helps to narrow things down but then there are likely several secondary transmissions from others who were infected by the index case so it becomes murky. The ship may work as a closed system that gives some more insights into this and other questions. I have posted elsewhere the statistics regionally for deaths in China that clearly show a rising rate the more established the epidemic is and this is likely a function of that lag time.

            With influenza and modern medical care it is not at all uncommon for a person who dies of ARDS to do so many weeks after first becoming symptomatic. Some will linger on ventilation for months. It is also worth noting of that among those most severely affected, having ARDS, most do survive but many have markedly damaged lungs for life and substantially reduce exercise tolerance.

          • Andy Patullo: “I have posted elsewhere the statistics regionally for deaths in China that clearly show a rising rate the more established the epidemic is”

            WR: Could you give us a link to those statistics? Or post them here as well?

    • Following is a useful link for updated statistics:

      https://www.worldometers.info/coronavirus/

      From the above source as of February 9, 2020 17:55 GMT there were a total of 37612 cases, 6198 of those in severe condition, 815 deaths and 2990 recovered. This means of those identified as being infected 18.6 percent ((6198 + 815)/3762) have either been made severely ill or died. Of those with a reported final outcome (death or recovery) 21.4% (815/(815+2990)) have died. THIS DOES NOT MEAN the actual death rate will be any where near that high – it may all be due to the limitations of the reporting to date and the lack of counting mild or asymptomatic cases.

      However the phenomenon of increasing death rates with age of the epidemic may well explain the following death rates: Wuhan 4.8%, Hubei province 3.1%, other provinces 0.16%, all of China 2.1%.

  25. Two observations:

    1. Regarding the slowing rate of new cases: If new cases were increasing, in just Hubei Province, at the rate they were increasing a week ago, which was around an 18-20% increase per day, we would now be seeing around 50,000 to 60,000 confirmed cases in Hubei and a daily increase of around 10,000 cases. In another week, there would be nearly 200,000 cases and a daily increase of 40,000 cases.

    Does anyone seriously believe that the testing resources of Hubei Province would not be completely overwhelmed in another week if that were the case? I doubt it. So the question then becomes, at what point will they, or more to the point, did they, become overwhelmed? Hubei cases were going up at an exponential rate of 19% per day until they leveled off at about 2500 cases per day (numbers are approximations). Is 2500 the upper limit of cases that can be diagnosed per day with existing medical resources? I don’t know, but I would bet it’s somewhere less than 40,000. In other words, the cases could still be increasing exponentially but are just not being diagnosed by official testing. And if that’s the case, they could also be dying without being diagnosed.

    Add to that the report that the Shanghai health commission has claimed that the virus is now found in aerosol form. Whether that report is true or not, I have no idea, but if the virus is present in aerosol form it will be tough to stop. That would also explain how people seem to contract it so quickly, as in one person contaminating four or five family members all at once, or so many people returning from Wuhan to their home countries carrying the virus even though they left China when the confirmed cases were quite low.

    2. Regarding the low number of deaths in virtually all other provinces, including zero deaths in a province with over 1,000 cases and almost 200 recoveries: Officials routinely get “disappeared”, or at least severely penalized, in China for revealing information the central government does not approve of. Reportedly, nearly half the population of Wuhan left the city for other parts of China during the Lunar New Year, so the virus was almost certainly carried throughout China in respiratory form by those travelers, especially since every mode of mass transport would have been overcrowded at that time. A far more reasonable speculation, which is what the article above is also, is that deaths are occurring throughout China but are being vastly underreported. That could also be the case for confirmed cases in other provinces. China’s economy was already fragile due to several circumstances. The last thing its leadership wants now is a pandemic and the officials of every province are no doubt aware of that fact and could be behaving accordingly.

    • “The last thing its leadership wants now is a pandemic and the officials of every province are no doubt aware of that fact and could be behaving accordingly.”

      “The last thing its leadership wants now is the world learning there is a pandemic and the officials of every province are no doubt aware of that fact and could be misbehaving accordingly.”

  26. “The infection by an infected guest in the factory in Germany probably was transmitted by ‘just shaking hands’, which is what people in firms are used to doing when they meet each other.”

    There is a lot to be said for the Indian custom of greeting others by holding one’s hands together in a prayerful position and saying namaste.

    Namaste (nah-mah-stay) originates in Hindu religious practice. The word comes from Sanskrit, the classical language of religious texts in Hinduism and it means “I bow to you,” and is used as a greeting.

    • A fundamental of infection control for all of these respiratory viruses is the use of effective hand washing/sanitizing after contact with anyone who might be an infectious source. It is likely with many of these viruses that skin to skin contact with secondary contamination of wet membranes (eyes, nose and mount) by contaminated hands is an important if not the most important means of transmission. Once that is understood then the issue of fomites (inanimate objects/surfaces that may be temporarily contaminated by touch) becomes a concern. These viruses may persist and remain infections for at least a brief period of time on surfaces once contaminated. I am reminded of photos during the SARS epidemic of Asian riders on transit wearing masks to avoid droplet spread from sneezing coughing individuals but in the photo they are holding on to bars and handles on the transit which have almost certainly just been held by many other riders. This is not meant to scare but just to emphasize that regular hand washing/sanitizing and avoiding unnecessary touch of hands to eyes/nose and mouth when out in public paces is a key measure in reducing risk of infection. These cautions are useful anytime colds, flus or other respiratory viruses are circulating in a community. Perhaps one additional benefit of masks is that they may prevent you touching your nose and mouth frequently.

  27. Here’s some low-quality data and worst case math, but it is an interesting look at the other end of medical care:

    https://twitter.com/anilvohra69/status/1226321939297267714 says:

    Wuhan has 49 crematoriums, which can each burn 5 bodies every two hours. They’ve been working 24 hours a day for 17 days now.

    49 x 17 x 24 x 5/2 = 49,980 bodies.

    However, the source is not very credible, and others have found fewer crematoria. An estimate of the normal daily deaths is under 250, which doesn’t jibe well with 49 crematoria.

    • It’s probably substantially lower than that but who knows? There is also something odd going on with SO2 emissions around Wuhan. Some people are claiming that levels are way above normal in the past few days and speculate that it is due to burning medical wastes and/or bodies. Don’t know who to believe.

    • Here’s a different, more personal look at Wuhan crematoria, see https://www.theepochtimes.com/exclusive-funeral-homes-in-coronavirus-ground-zero-cremating-dozens-of-bodies-a-day_3228938.html

      On Feb. 1, Chinese health authorities announced mandatory cremation for people who died from the coronavirus.

      The official at the first-mentioned funeral home said that about 60 percent of the bodies come from private homes, while 38 percent are transported from hospitals. Most of the corpses coming from homes are people who died from the new coronavirus, he said.

      People who died at home from the virus are unlikely to have been officially diagnosed with the illness—given that diagnoses are issued at hospitals—and therefore do not count toward the official death toll.

      Of the 127 bodies received by the crematorium on Feb. 3, eight were diagnosed with the virus, while 48 were suspected of having the illness, based on their death certificates, the official said. It is unclear what was specified as the cause of death for the remaining 71 bodies.

      Stretched to the Limit

      The senior official at the first-mentioned funeral home said his staff of around 110 people has been stretched to the limit, working round the clock to transport bodies from hospitals and private homes and cremate them.

      “We transport the bodies 24 hours a day,” he said. “Now every single male employee is involved [in this task]. As long as they can still move, they will work.”

      The facility’s 11 furnaces are cremating bodies nonstop every day, he said.

      The official said that at this rate, he would need 40 to 50 additional staff to keep up with the workload, adding that current staff have not taken a day off since Lunar New Year’s Eve on Jan. 25.

      “I’m on the brink of collapse,” the official said.

      “We are exhausted and can’t get any rest,” he added. “Now I would feel grateful if I can sleep for two or three hours a day.”

      The official added that he’s been in touch with the Hankou Funeral Home, whose “workload is even heavier than mine.”

      That facility, located in downtown Wuhan, is officially designated by authorities to cremate bodies of coronavirus victims from downtown Wuhan hospitals.

  28. Wim Röst,
    An interesting and reasoned transmission vectors vs mortality hypothesis, given the uncertainty of real infection and mortality data available. Thank You (!), for posting here. Having survived a persistent bout of intestinal ‘flu’ that transitioned into a severe pneumonia in February 2019, I have a visceral appreciation of these types of viral infections.

    • Thank you, J Mac. I hope you recovered completely and I can imagine that you follow the discussions with special interest.

      • Wim Röst

        An interesting ‘detail’: the quadratic fit’s behavior since Feb 1

        day | num | diff | x² | x

        .1 | 259 | 46 | 2.11 | -4.82
        .2 | 304 | 45 | 2.12 | -4.84
        .3 | 362 | 58 | 2.17 | -5.45
        .4 | 427 | 65 | 2.25 | -6.43
        .5 | 492 | 65 | 2.29 | -7.04
        .6 | 565 | 73 | 2.34 | -7.67
        .7 | 636 | 71 | 2.34 | -7.80
        .8 | 724 | 88 | 2.38 | -8.41
        .9 | 813 | 89 | 2.42 | -8.99
        10 | 910 | 97 | 2.46 | -9.66

        The death toll’s quadratic coefficient is growing.
        No wonder!

  29. My take:

    Parasites never entirety eliminate their host

    Virus’s gradually lose their ability to infect as they reproduce – unless there is a secondary mutation which is purely over to chance

    To overcome resistance in hosts built in response to past infections they reinvent themselves on a regular basis after an outbreak. This is why there is no universal vaccine and infections occur on a ~ annual basis

    Authorities hardly ever over-state casualties during an emergency

    There are probably a number of viral infections circulating in China right now e.g. the common cold. Therefore health centres get flooded.

    My predictions (% chance):

    Real infection numbers in China at time of this post: 10 x that being reported

    Global pandemic and fatalities of the scale of Spanish Flu: 3%

    That China can contain the outbreak: 20%

    That it spreads to Nth India and is not controlled there 80 %

    That the outbreak has a significant impact on the world economy 80 %

    That the outbreak causes a global recession 40 %

    I could go on but this is enough

  30. Some thoughts.

    The medical services in China have at this point been overwhelmed, so if the figures are inaccurate, its more likely due to reporting protocols breaking down than malice. In any event the ‘Official Figures’ out of China have to be taken with a large dose of salt at this time ?

    Viruses have, from my limited knowledge of the subject, a fondness for different parts of the body. This one likes to be settled in the lower respiratory tract, hence its potential to turn nasty. No doubt viruses that enter by the mouth (faecal manual) lose a number of their millions of friends down to the decidedly hostile bag of hydrochloric acid we call a stomach. But it remains the case that once in the mouth they have access to the mucosa and a trip down the trachea.

    Still holding my breath, but a little over 2 weeks since the brown stuff went into the fan, there’s yet to be hundreds of cases popping up in western countries. So by the end of the coming week we should know if a bullet has been dodged ?

    As others have pointed out, the apparent lack of cases in Latin America, and Africa, are probably cause for concern that the nCOV virus could get a start in areas where the medical system is poor to non existent. If it does, no doubt the virus will back for a potential sequel in the West next winter. :O

  31. Good essay! Note that corona 2019-nCov is a RNA virus. RNA viruses mutate at a relatively high rate compared to DNA viruses. The more human 2019-nCov pass through they higher the probability of it changing to a less infectious disease or a more infectiuous disease.

    Influenza viruses are RNA viruses with a very high mutation rate. The 1917 Spanish Flu started as a rather mild flu, believed to have started in US training camps. By the time it got to Europe and then back it mutated into the most deadly flu virus in recorded history.

  32. I think this is BINGO:

    There is another indication that cases in the Rest of China are less severe than in Hubei. Both Hubei and the Rest of China have more or less the same number of recovery’s*:
    Hubei 1480
    Rest of China 1444

    It has been argued that Hubei has more deadly cases because the epidemics started earlier in Hubei. But if the severity of cases would be equal everywhere, recovery’s in Hubei also should be higher than in the rest of China: more people should have been dismissed from the hospital: because they became earlier sick and because there are more cases of sickness in Hubei, nearly three times as much. But the number of dismissed patients is NOT higher in Hubei.

    Assuming that deadly cases and recovery’s follow the same time path the ratio in deadly cases Hubei/Rest of China indicates the number of recovery’s to expect for the Rest of China.

    The ratio of deadly cases of Hubei vs. the Rest of China is 780 vs. 34: the number of deadly cases is 23 times as high as in the rest of China. So the number of recovery’s should have been 23 times as high as the number of recovery’s in the rest of China. But they are NOT.

    Recovery’s in the Rest of China are nearly equal, indicating that the seriousness of infection in the Rest of China could be 23 times lower (!) than in Hubei.

    Besides the above, some Hubei infected people travelled to the Rest of China possibly wearing the more deadly type of contamination (lung to lung) as happens in Hubei, raising the death toll in the Rest of China, which would even diminish the severity of the Rest of China contaminations.

    * Source of the data 9th of February 2020: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

    • I assume that data is from Chinese authorities. If so, it means nothing.

      It may be better than nothing, but not much better.

      • Ric I have seen all of your comments, also on earlier threads on this topic on WUWT. I also had a look at the latest thread on Joannenova (see the link of Roger Knights below).

        And I had another look at the numbers, searching for the number of recovery’s in western countries. https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

        That number for recovery in western countries up to now is very low. Infections started later which could have delayed recovery. I suppose all officially recovered people in western countries have to be tested well which possibly was not the case in [Mainland] China.

        I have not seen many recent messages about the further development of corona sickness cases in Western countries. Those developments could tell us more about the developments to expect.

        If numbers of the WHO / China can not be trusted, the analysis given in this post is only valuable in case WHO / China divided all numbers by the same factor X.

        If the WHO/China numbers are totally unreliable in the way that they don’t reflect the actual (geographical and medical) situation in China the conclusions drawn in this post were not based on correct data and probably could not be drawn. All judgement relies on trustworthy data.

        I also reread the valuable information that Andy Pattullo has given in his comments. I can recommend everyone to read his comments carefully. He commented also here: Andy Pattullo January 25, 2020 at 6:57 am

  33. Included just as a reference:

    Total flu cases worldwide 2019/2020
    380 000 000

    In Hospital
    4 000 000

    Dead (complications releated to flu or ILI (Influenza like illness))
    200 000

    Which disease are you most likely to contract nCOV or Flu??

    The PPE for flu also works for nCOV

    https://www.cdc.gov/flu/weekly/index.htm

    • From some of the SerpentAZ video, R0 may be between 2.5 and 4.something, IIRC. The Case Fatality Ratio may be much higher than influenza. Let’s see if exponential growth keeps up for a couple months or if people can get the R0 below 1.

  34. Epidemic suppression APP ? – Perhaps someone is already working on this, and I know it is a globalist wet dream, however the development of a personal proximity app which can log time, date and duration of all personal interactions with other people (or their smartphone to be precise) with automated infection danger alert could be a hugely beneficial tool in epidemic suppression assuming people can (a) self report and (b) self quarantine

  35. The comment below is an extensive one which also is published on the next thread on WUWT on this subject by Rud Istvan: https://wattsupwiththat.com/2020/02/10/wuhan-coronavirus-a-wuwt-scientific-commentary/

    In this thread a reaction has been asked on the study https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1 “Clinical characteristics of 2019 novel coronavirus infection in China”. In this reaction is referred to this post which is the reason to repeat the comment below. It might be that interesting reactions follow on Rud Istvan’s thread.

    First of all, I myself would be interested in the conclusions of Andy Pattullo on this study. He is an expert in this field and he knows better than a layman as me how to weigh all the medical info in the study.

    Second: this is a very long comment that I will also copy to yesterday’s thread. It might contain important or at least interesting thoughts/conclusions.

    Some elements I picked up from the study which is about 1099 hospitalized patients from 552 hospitals in 31 provinces through January 29th, 2020.

    – “4 out of 62 stool specimens (6.5%) tested positive to 2019-nCoV, and another four patients in a separate cohort who tested positive to rectal swabs had the 2019-nCoV being detected in the gastrointestinal tract, saliva or urine”.

    WR: Because this study is about hospitalized patients, the big unknown is how many people have been infected but did not show any symptoms or did only show very slight symptoms. Most of them will not have been hospitalized. But they probably played a role in the transmission of the virus.

    The 6.5% of researched stool specimens of hospitalized persons that tested positive for the virus is an indication that the digestive system plays a role. The study: “Collectively, fomite transmission might have played a role in the rapid transmission of 2019-nCoV, and hence hygiene protection should take into account the transmission via gastrointestinal secretions.”

    The important role of the gastrointestinal secretions in the transmission is clear. But there is no clarity about the role of gastrointestinal secretions resulting in natural resistance (the development of antibodies) in only slight or very slight infected persons. Which could be an important field of research.

    – “Our findings were consistent with the national official statistics, reporting the mortality of 2.01% in China out of 28,018 cases as of February 6th, 2020 [11,23].”
    – “The fatality rate was lower (0.88%) when incorporating additional pilot data from Guangdong province (N=603) where effective prevention has been undertaken (unpublished data).”

    WR: Effective prevention could have played a role in the low death rate for the Rest of Mainland China compared with Hubei. The yesterday suggested low rate of lung to lung transmissions for those areas is another possibility https://wattsupwiththat.com/2020/02/08/the-corona-epidemic-a-dangerous-and-a-less-danerous-form/.

    An indication for the possible importance of the lung to lung contaminations in creating severe cases can be found in a study that found out that “of more than 1,000 cluster cases, 83% were identified as family clusters.” Cluster cases generally refer to “more than two infected cases within a limited space”. (Source: https://edition.cnn.com/asia/live-news/coronavirus-outbreak-02-11-20-intl-hnk/index.html Most cluster cases are spread among families, China officials say. From journalist Alex Lin in Hong Kong)

    The paper concludes:
    “ – In summary, 2019-nCoV elicits a rapid spread of outbreak with human-to-human transmission, with a median incubation period of 3 days and a relatively low fatality rate.”
    – Absence of fever and radiologic abnormality occurs in a substantial proportion of patients on initial presentation while diarrhea is uncommon.
    – The disease severity is an independent predictor of poor outcome.
    – Stringent and timely epidemiological measures are crucial to curb the rapid spread.”

    WR: Elsewhere the study concluded: “These findings will inform the mass public, clinicians and policy makers the true transmissability of 2019-nCoV which has resulted in a major social panic.”

    The high transmissibility is probably a main factor in the ‘major social panic’. The overwhelming growth of the number of patients in a short time and the lack of medical possibilities puts a high pressure on the whole society. Prevention in the spread of the epidemic plays the central role to control the what is called here ‘major social panic’.

    Understanding the way of transmission in less severe cases (!) might play a main role in the development of the right policies to win the fight against this epidemic.

    Possibly such a research could also lead to finding medical ways to stimulate healthy people to create antibodies without the medical risk of developing and later spreading the sickness. One of today’s commenters MarkW February 11, 2020 at 7:51 am told: “My dad was a doctor and of the 5 kids, none of us missed a single day of school due to illness. I always thought that this was because dad brought home micro-doses of whatever was going around on his clothes every day.”

    If so, those micro doses if given to healthy people in a non-risky way (through the digestive system?) might lead to a way to fight effectively this epidemic. Specialists should research whether this could be an option.

    One of today’s commenters, John Sheperd February 10, 2020 at 11:38 am guessed that in China only one out of ten Chineses people will go to a doctor in case of sickness. Doing research in this group that does not visit a doctor might help in finding out the real spread of the virus and might also help in finding the best way to end this epidemic.

  36. CDC: We Absolutely Assume The Reported Cases in China Are An Underestimate.
    https://www.youtube.com/watch?v=QEtvhMgauq80:57

    As additional cases of the coronavirus epidemic are confirmed in the U.S., Dr. Anne Schuchat, Principal Deputy Director of the Centers for Disease Control and Prevention (CDC) provides an update on the CDC’s ongoing response on Tuesday, February 11.

    Schuchat addresses the possibility that the epidemic could be highly underestimated

  37. A doubling of the total number of deaths?

    https://www.bbc.com/news/world-asia-china-51482994
    BBC: What is the new diagnosis method?

    The province – which accounts for more than 80% of overall Chinese infections – now includes “clinically diagnosed cases” in the number of confirmed cases.
    This means it includes those showing symptoms, and having a CT scan showing an infected lung, rather than relying only on the standard nucleic acid tests.
    Of the 242 new deaths in Wuhan, 135 are such “clinically diagnosed” cases.
    That means, even without the new definition, the number of deaths in Hubei on Wednesday was 107 – a new high for the province.

    WR: this indicates that the number of deaths for Hubei probably has to be doubled. At least.
    “Of the 242 new deaths in Wuhan, 135 are such “clinically diagnosed” cases.”

    • INCORRECT NUMBER OF DEATHS REPORTED – CORRECTION

      The in the last comment noticed doubling of the number of deaths for February 13 has been corrected. The new number now is “116 new deaths (including 8 clinically diagnosed)”.

      “The National Health Commission of China, in its February 14 official report, deducted 108 previously reported deaths and 1,043 previously reported cases from the total in Hubei Province due to “repeated statistics.” We have updated the daily (Feb. 12 and Feb. 13) and cumulative totals accordingly.”
      Source: https://www.worldometers.info/coronavirus/#feb-14

      The complete numbers for Hubei according to the same source:

      Report from Hubei province for February 13:
      4,823 new cases (including 3,095 clinically diagnosed)
      116 new deaths (including 8 clinically diagnosed).
      51,986 cumulative total cases (including 15,384 clinically diagnosed)
      36,719 currently hospitalized, of which:
      – 27,081 (73.8%) in mild condition
      – 7,953 (21.7%) serious
      – 1,685 (4.6%) critical
      690 new hospital discharges (including 214 clinically diagnosed)
      166,818 close contacts have been tracked
      77,685 people are undergoing medical observation

  38. Moving this here:
    You propose different routes if infection as the primary reason for different CFR. Fair enough. But that is just one of many possibilities to account for apparent discrepencies you note.
    I can imagine for example that this population in Wuhan has perhaps had other Corona virus epidemics in the distant past and it is the sequential infection that leads to serious illness like happens wirh Dengue.
    That would explain geographical differences as well as age differences.
    A similar expalnation was made for the Spanish Flu

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