Reposted from the Fabius Maximus website
By Larry Kummer, Editor / 22 February 2020
Summary: I talk to people who worry about the coronavirus epidemic and so read much about it – but know almost nothing, with facts lost amidst the rumors and misinformation. Here is a clear picture of what is known, so far. We learn more each day.
Important: the WHO has not yet declared COVID-19 (aka coronavirus) to be a pandemic – where the epidemic spreads rapidly across multiple regions simultaneously. The label “pandemic” describes a disease’s extent and speed of spread, not its severity. See the WHO website for details (here and here). The COVID-19 epidemic now might be breaking containment to become a pandemic. This is where the preparation during the past two months will prove its worth – or not.
The current status
From the WHO Situation Report of February 22.
So far there are 29 nations affected (5 new nations since February 3, two today). There are 1402 confirmed cases outside China (202 new), with 11 deaths (202 new). That is 768 cases plus the 634 guaranteed or tested from the Diamond Princess cruise ship. Reminder: the world’s population outside China is six and one-half billion.
- South Korea is experiencing the most rapid spread of the disease outside of China – so far with small numbers afflicted and an immensely strong response by its government and people. They have 346 confirmed cases: 1 new case reported on Feb. 18, 20 on Feb. 19, 53 on Feb. 20, and 100 on Feb. 21, and 104 on Feb. 22.
- The other nation experiencing a rapid spread is Italy, so far with tiny numbers. Using Italy’s numbers, there 54 confirmed cases (vs. 3 on WHO’s Feb. 21 report). Again, the government and people are responding strongly and proactively to contain the outbreak (details here).
- Iran reported its first two cases on Feb 20. There are now 18 cases and 4 deaths, which implies that there are many more than 18 people infected.
People take for granted this accurate, timely, and detailed data (esp. the “government can’t do anything” and “the UN is evil” folks). It did not exist for epidemics until recently. This information is collected according to the International Health Regulations (2005). All Member States are required to immediately report any new confirmed case of COVID-19 and, within 48 hours, provide information related to clinical, epidemiological, and travel history using the WHO standardized case reporting form.
Cases in the US
As of Feb 21, the CDC reports that 414 people have been tests and 14 cases confirmed – with no tests pending results.
As of February 15, the CDC estimates that so far this season (since September 9) there have been at least 29 million flu illnesses, 280,000 hospitalizations, and 16,000 deaths from flu. See their summary page and detail page for current information. But remember America’s new motto: “What, me worry?”
An overview of the epidemic
Excerpt from a speech by Tedros Adhanom, the Director-General of WHO, on February 21. Full text here.
“It’s hard to believe that only 52 days ago {January 1}, WHO’s country office in China was notified of a cluster of cases of pneumonia of unknown cause in Wuhan city. In just seven weeks, this outbreak has captured the world’s attention, and rightly so, because it has the potential to cause severe political, social and economic upheaval.
“As you know, WHO declared a Public Health Emergency of International Concern within a month {on January 30} after the first reported cases, as a result of the signs of human-to-human transmission we saw outside China. And because of the major concerns we had that this virus could spread to countries with weaker health systems such as in our continent. China has now reported 75,569 cases to WHO, including 2239 deaths.
“The data from China continue to show a decline in new cases. This is welcome news, but it must be interpreted very cautiously. It’s far too early to make predictions about this outbreak.
“Outside China, there are now 1200 cases in 26 countries, with 8 deaths. As you know, there is one confirmed case on the African continent, in Egypt {reported Feb. 15}. Several African countries have tested suspected cases of COVID-19, but fortunately they have been found negative.
“Although the total number of cases outside China remains relatively small, we are concerned about the number of cases with no clear epidemiological link, such as travel history to China or contact with a confirmed case. We are especially concerned about the increase in cases in the Islamic Republic of Iran, where there are now 18 cases and four deaths in just the past two days.
“With every day that passes, we know a little bit more about this virus, and the disease it causes. We know that more than 80% of patients have mild disease and will recover. But the other 20% of patients have severe or critical diseases, ranging from shortness of breath to septic shock and multi-organ failure. These patients require intensive care, using equipment such as respiratory support machines that are, as you know, in short supply in many African countries. And that’s a cause for concern. In 2% of reported cases, the virus is fatal, and the risk of death increases the older a patient is, and with underlying health conditions. We see relatively few cases among children. More research, of course, is needed to understand why.
“Our biggest concern continues to be the potential for COVID-19 to spread in countries with weaker health systems. …we’re working hard to prepare countries in Africa for the potential arrival of the virus. …We’ve also published a Strategic Preparedness and Response Plan, with a call for US$675 million to support countries, especially those which are most vulnerable.
“WHO has identified 13 priority countries in Africa because of their direct links to China or their high volume of travel with China. …an increasing number of African countries are now able to test for COVID-19 with laboratory test kits supplied by WHO, compared with only one just a couple of weeks ago. Some countries in Africa, including DRC, are also leveraging the capacity they have built up to test for Ebola, to test for COVID-19. This is a great example of how investing in health systems can pay dividends for health security.
“We have also shipped more than 30,000 sets of personal protective equipment to several countries in Africa, and we’re ready to ship almost 60,000 more sets to 19 countries in the coming weeks. We’re working with manufacturers of personal protective equipment to address the severe disruption in the market for masks, gloves, gowns and other PPE, to ensure we can protect health workers.
“During the past month about 11,000 African health workers have been trained using WHO’s online courses on COVID-19, which are available free of charge in English, French and other languages at OpenWHO. We’re also providing advice to countries on how to do screening, testing, contact tracing and treatment.
“Last week we brought the international research community together to identify research priorities, especially in the areas of diagnostics, therapeutics, and vaccines. …
“The increasing signs of transmission outside China show that the window of opportunity we have for containing this virus is narrowing. We are calling on all countries to invest urgently in preparedness. We have to take advantage of the window of opportunity we have, to attack the virus outbreak with a sense of urgency.”
The numbers for COVID-19
From WHO’s February 19 Situation Report. Footnotes omitted. See the report for footnotes with links to research. Links and red emphasis added.
“WHO has been working with an international network of statisticians and mathematical modelers to estimate key epidemiologic parameters of COVID-19, such as the incubation period (the time between infection and symptom onset), case fatality ratio (CFR, the proportion of cases who die), infection fatality ratio (IFR, the portion of all of those infected who die), and the serial interval (the time between symptom onset of a primary and secondary case).
“To calculate these parameters, statisticians and modelers use case-based data from COVID-19 surveillance activities, and data captured from early investigations, such as those studies which evaluate transmission within clusters of cases in households or other closed settings. Preliminary estimates of median incubation period are 5-6 days (ranging from 0-14 days) and estimates for the serial interval range from 4.4 to 7.5 days. …
“The confirmed case fatality ratio, or CFR, is the total number of deaths divided by the total number of confirmed cases at one point in time. Within China, the confirmed CFR, as reported by the Chinese Center for Disease Control and Prevention is 2.3%. This is based on 1023 deaths amongst 44,415 laboratory-confirmed cases as of 11 February. This CFR does not include the number of more mild infections that may be missed from current surveillance, which has largely focused on patients with pneumonia requiring hospitalization; nor does it account for the fact that recently confirmed cases may yet develop severe disease, and some may die. As the outbreak continues, the confirmed CFR may change.
“Outside of China, CFR estimates among confirmed cases reported is lower than reported from within China. However, it is too early to draw conclusions as to whether there are real differences in the CFR inside and outside of China, as final outcome data (that is, who will recover and who will die) for the majority of cases reported from outside China are not yet known.”
That last paragraph is important and often ignored. The fatality rate in developed nations is as yet unknown, but probably far lower than China’s due to availablilty of more advanced tools for treatment – especially for respiratory problems.
About transmission of covid-19
From WHO’s February 21 Situation Report.
“Currently, there are investigations conducted to evaluate the viability and survival time of SARS-CoV-2. In general, coronaviruses are very stable in a frozen state according to studies of other coronaviruses, which have shown survival for up to two years at -20°C. Studies conducted on SARS-CoV ad MERS-CoV indicate that these viruses can persist on different surfaces for up to a few days depending on a combination of parameters such as temperature, humidity, and light. For example, at refrigeration temperature (4°C), MERS-CoV can remain viable for up to 72 hours.
“Current evidence on other coronavirus strains shows that while coronaviruses appear to be stable at low and freezing temperatures for a certain period, food hygiene and good food safety practices can prevent their transmission through food. Specifically, coronaviruses are thermolabile, which means that they are susceptible to normal cooking temperatures (70°C). Therefore, as a general rule, the consumption of raw or undercooked animal products should be avoided. Raw meat, raw milk or raw animal organs should be handled with care to avoid cross-contamination with uncooked foods.
“SARS-CoV and MERS-CoV are susceptible to the most common cleaning and disinfection protocols and there is no indication so far that SARS-Cov-2 behaves differently.”
Conclusions
The combination of good global organization by the national public health organizations (coordinated by WHO) and high technology have contained the epidemic for 52 days. This time allowed implementation of screening and quarantine mechanisms, creation of diagnostic tools (based on decoding its genome), development of protocols for treatment, dissemination of equipment, and starting research about the diseases’ nature and cure.
The next few weeks might show what difference all that has made. Future historians might see COVID-19 as a new age of public health, with the first effective response to a pandemic. Time will tell.
It’s easy to follow the coronavirus story
The World Health Organization provides daily information, from highly technical information to news for the general public.
- There is their daily situation report, with detailed numbers.
- The Director-General of WHO gives frequent briefings, which are quite insightful.
- Their daily press briefings have more information. An audio goes up quickly afterwards. A transcript is posted the next day.
Posts about the coronavirus pandemic.
- The 2019-nCoV virus shows that we’ve built a better world.
- Hidden news about the epidemic sweeping across America! – How fake news drives out good news.
- Amazing but hidden news about coronavirus – Update about the epidemic, and why so few know the good news.
- Lessons from the coronavirus about climate change.
For More Information
Ideas! For some shopping ideas, see my recommended books and films at Amazon. Also, see a story about our future: Ultra Violence: Tales from Venus.
Please like us on Facebook and follow us on Twitter. Also, see these posts about epidemics…
- See the ugly cost of the next big flu pandemic. We can do more to prepare.
- Stratfor: The superbugs are coming. We have time to prepare.
- Posts debunking the hysteria about the 2009 swine flu in America.
- Posts debunking the hysteria about the 2015 ebola epidemic in America.
Films about scientists responding to global threats
In these films, we see scientists behaving according to their and our highest ideals.
When Worlds Collide
Contagion (2011).
Available at Amazon.
Available at Amazon.
Too late. The horse has bolted
It was never going to be contained anyway. The average person with average protective gear has zils chance of avoiding infection in a contaminated environment. Look at the number of health workers infected in China. They are fully kitted up and doused in disinfectant.
When it comes to my country I will not be wearing a mask. These guys are VERY tiny
The only thing that will stop this is nature – the slow reduction of the infectious capability of the organism- the way that every annual flu outbreak declines. Parasites never entirely kill out their host, That is if there is not a mutation. Then, start over
A fascinating saga
Anyone here suggesting a homemade disinfectant? So far I have heard of bleach and ethyl alcohol. Anything else to add?
Yep! Relying on a sugar-free 100% carnivore diet. Sugar suppresses the immune system massively. 1 can of Coke will get your T-cells down to near nil for 6 hours.
All you freaker-outers need to remember; for most folks who catch this, it’s a mild cold.
Ditto…I will not be wearing any mask or rubber gloves.
Avoid sick looking people, and just use regular squeamish behavior.
Do not touch people or objects in public places, do not stand real close to people when talking to them, wash hands a lot.
Odds are any particular person has nothing to worry about, and even if infected, most will live.
Hi Michael Carter, – Peracetic (per-oxy-acetic) acid is a significantly stronger oxidizer (breaks bonds) than bleach & also stronger than hydrogen peroxide (H2O2, pure hydrogen peroxide is almost as oxidizing as peracetic acid) . Peracetic acid is basically 2.4% hydrogen peroxide + 0.8 – 1.6% acetic acid + molecules of water.
Here are proportions for a small batch: 400 ml of 3% hydrogen peroxide + 100 ml of white 5% vinegar.
Directions: in microwave, or otherwise, bring 100 ml of vinegar to a boil … then add the 400 ml of room temperature hydrogen peroxide to that vinegar before the vinegar temperature is cool.
Mixed together at 36*C (97*F) yields 0.15% per-oxy-acetic acid (equivalent to 1,500 ppm) + residual acetic acid + H2O (from H2O2 hydrogen peroxide).
Note: glass best for stirring & storage; corrosive to all metals (wash any stainless steel implements promptly & avoid aluminum even for stirring).
Let cool in fridge & then can store in dark glass wherever cool. It is fully potent for up to 2 weeks before any per-oxy-acetic acid starts to break down. [Note: once your bottle of the 3% hydrogen peroxide has been opened that formula ingredient loses it’s original potency in 1 – 2 months. This type of thing happens with bleach too, when not freshly opened chlorine can be lost.]
Proper use as disinfectant: don’t blithely spray it misting around & avoid sniffing it (use face mask); also avoid skin/eye contact (use eyewear). During handling use latex or nitrile gloves.
Time of contact for disinfection varies. On natural surfaces (ex: wood) give it 5-10 minutes before wipe/rinse down, on hard surfaces give it 1-4 minutes before wipe/rinse down & you can also dip/submerge smaller item into it for about 1 minute before rinsing off.
Option if really, really, really got something you are worried about: then wrap it in porous paper to dip it 1st in 70% isopropyl alcohol for 2 minutes, then unwrap & put it into 10% bleach for 10 minutes, next (unwrapped) put it in peracetic acid for 7 minutes, then wash it off twice with 2% hydrogen peroxide to flush it clean & finally let item dry without rinsing it off with water.
[Note: if for some unlikely reason, you are attempting to treat something that already has a very low pH (ex: lower than formula component acetic acid) then be aware you can anticipate there will be some degradation of the active component of your peracetic acid.]
Disposal: do not pour down sink drain since risks contacting metal , rather highly dilute with water & pour down toilet bowel for sending to sewer.
Thanks Gringo. Much appreciated
There is so much knowledge at this site.
Edit: “2%” is typing mistake … meant “3%”
This virus is here to stay. Vaccination eventually may work but billions of people have to be vaccinated, it might take decades of catching up. If this is a natural generated virus it will mutate making it more difficult to eradicate.
If it is a laboratory product science and medical researchers should be given full access to data regardless where was the origin from. If that happens to have been the case it should be possible to engineer a harmless antiCOVID-19 to neutralise the the infection.
When has mass vaccination worked?
Never for idiots.
niceguy February 24, 2020 at 5:47 am
When has mass vaccination worked?
Polio eradication starting in 1988, so far reduced globally by over 99%.
Smallpox eradication declared in 1980, 40th anniversary celebrated last year.
What the hell has vaccination to do with eradication of polio?
How can you know polio was eradicated?
So you admit that by definition polio is never eradicated by a vaccine.
Thank you.
You can now run and hide in shame.
Thank you.
In fact in the US and much of the developed world, there is a long list of diseases that used to be endemic and kill large numbers of people on a regular basis.
Some of them are now becoming resurgent thanks to antivaxxers and allowing unscreened illegal immigrants to go wherever the hell they want.
For the USA:
Disease, Pre vaccination annual # of cases, Recent reports of # of cases
-Diphtheria, 21,000+ per year, now down to approximately zero cases per year
– Haemophilus influenzae, ~20,000/yr, now down to about 250 or less/year
– Hepatitis A, used to be ~118,000 cases per year, now down to ~ 11,000 cases/year
– Hepatitis B, used to be over 66,000 cases/yr, now down to ~11,250 cases/yr
– Measles, used to be over 530,000 cases per year, now down to 61 cases per year…had been close to zero
– Mumps, 162,500 —-> 942
– Pertussis, 200,750 ——->11,500
– Pneumococcal disease, 16,000+ —–> 4,167
– Polio, 16, 300+ ——> ZERO
– Rubella, 47,750———–> 4
– Small Pox, 29,000+ ————> ZERO
– Tetanus, 580 ———-> 14
– Varicella, 4,085,120 ———–> 449,363
The above have been reduced by, in order: 100%, 99%, 91%, 83%, 99%, 99%, 93%, 74%, 100%, 99%, 90%, 100%, 98%, 89%.
That was as of 2013. Anyone who feels like it can look for more recent number.
And nine vaccines currently in development that are showing promise:
Gonorrhea
Cancer
Malaria
Ebola
HIV
Norovirus
Universal Flu Vaccine
Heroin
Zika
SARS?
COVID19?
Sadly, all attempts to create an inoculation against jackassery and ignorance have failed miserably.
Thank you Nicholas. I learn a lot when I read your comments. The same for a lot of others here too. I have probably leant more here at WUWT the last 4-5 years than the rest of my entire life. You must be able to type 200 words a minute…
Do you admit that you have not found any trace of hint of evidence that one vaccine was EVER useful?
niceguy February 25, 2020 at 10:18 am
Do you admit that you have not found any trace of hint of evidence that one vaccine was EVER useful?
I just gave you two where global vaccination programs eradicated diseases, completely in the case of smallpox and by over 99% in the case of polio (Afghanistan being a war zone is a complicating factor there). Before the introduction of polio vaccines in the 50s every summer the outbreaks of polio in the summer were dreaded, doesn’t happen now. The last cases of naturally occurring polio in the US were in 1979 among Amish residents who had refused vaccination. Used to be millions of cases of smallpox around the world, none now!
What is “polio”?
Do you deny the explosion of “polio” following mass vaccination?
niceguy February 25, 2020 at 4:12 pm
What is “polio”?
It’s short for poliomyelitis, which is an infectious viral disease which infects the central nervous system and can cause paralysis (often called ‘infantile paralysis’). Typically transmitted via contaminated water, the outbreaks in the US that occurred prior to vaccination were usually in the summer and resulted in public swimming pools being closed down as they were seen as sources of infection. Polio was endemic in the US and Europe prior to vaccination in the 50s. In the US polio was one of the most serious communicable diseases among children, in 1952 nearly 60,000 children were diagnosed, many were paralyzed and over 3,000 died. Hospitals had ‘iron lungs’ set up in wards to keep polio sufferers alive. We even had a president who was a polio survivor.
In the US fighting polio was a national priority from 1946, the US began widespread vaccination in 1955 and the last case occurred in 1979 (in a religious community that rejected vaccination. In just two years in the US, following mass vaccination programs, the annual number of cases dropped by 90%.
My father contracted polio in 1922 and suffered with a paralyzed leg for the rest of his life. The family supported the British Polio Fellowship in fund raising to eradicate polio in the UK, following the mass vaccination program started in the 50’s polio was eradicated by the early 80’s.
Do you deny the explosion of “polio” following mass vaccination?
Absolutely, it didn’t happen!
Personally I find the nonsense you spout on this subject to be offensive.
If this link is accepted,. it may be of interest
https://cf-particle-html.eip.telegraph.co.uk/e1cc90ca-26cf-42e5-bad2-09703df3b575.html
for some reason S. Korea with more than 700 cases (apparently largest outside China) is not shown.
Italy is an odd case, they are unable to pinpoint source of sudden explosion. Perhaps they should check if there was a delivery of a Chinese made products, recently delivered to a large supermarket, department or discount store where many people may have had physical contact with infected products.
….My bet is that there is a considerable lag in reporting from Iran and Afghanistan. And the infection follows the old route – from Wuhan to Italy – The silk route.
My bet is also that the scientists who, a couple a years ago, speculated that the outbreak of ‘the black death’ in Europe in the 14. Century was caused by a virus from … Wuhan were right.
My guess would be Chinese tourists of whom there are always huge numbers in northern Italy. Hence many simultaneous origins of infection, most whom had gone home by the time they realized they were sick. If you were infected by the couple that used the table before you did, and left droplets on the napkin you picked up from the dispenser – you would never know. And then Italian social life is almost designed to spread this kind of infection.
My guess too. 250,000 Chinese tourists per month, on average. Not difficult to imagine.
The Big Money fashion brands in northern Italy have been bringing in Chinese labour for years now.
Given that a comment above from a poster on the ground suggests Italy has been lax in restricting air travel from China, and combining with the likely movements to and fro for the lunar new year, its probably no surprise there is an outbreak ?
Leo, I note with interest the lack of cases in Africa, South America, Indonesia, Mexico.
Sadly I think that this is a really bad omen for all who live in said places. Indonesia alone with a population of 260 million and an apparent CFR of 2% gives a death toll of about 5 million or more.
Indonesia claims that they have zero cases of Ncov-19 so far despite an annual average 5 million visitors from China.
The question is though that if you don’t test for the Virus how do you know if it is there yet or not ?
…could also be that it only spreads in the ‘temperate zone’.
(Trump doesn’t seem worried in India. )
Spreads in Singapore.
Yes, but it occurs to me that every hotel, bar, office and mall in Singapore is air-conditioned so you can argue that the virus is living in a temperate climate.
I am sorry but the “only 10% are seriously affected and the rest recover within a week” is simply not supported by the numbers we seeing from outside China. On 15th Feb Singapore was reporting 79 cases, yet today they only have 49 recovered, so not 90% within a week. Also the ‘CFR’ Confirm Fatality Ratio means what, exactly? The usual statistic is the Risk of Mortality, the likelihood of dying if you get the disease, which by China’s own figures is far, far greater than 2.3%. That number is deaths/infected, but says nothing about the large numbers of ‘serious’ cases which the Chinese doctors say have a 94% likelihood of dying. Risk of Mortality is looking like 15% to 20%, with teenagers and early 20’s largely immune to very high risk for over 80s.
The WHO failed at the start when its primary policy concern was to not offend China. They are continuing with that policy, publishing numbers that are largely spin.
We have yet to see if the improved medicine outside China makes a difference to the ‘serious’ cases. So far only one seems to have come out of ‘serious’, so it’s not looking good. Unless western medicine starts to show that it can rescue ‘serious’ cases the calculation of overall Risk of Mortality will stay as it is, for the cases outside China it is easy to do and is steady at around 18%.
If we see a difference in the West, I think it will come from fewer smokers, people standing further apart when they talk which inhibits droplet transmission. The Italians stand very close to talk, love crowded city centres and kiss on the cheek giving hand to cheek to mouth transmission.
Harry
I think the only difference in the West will be the transmission speed if anything, We have no herd resistance to this at all as a species so far. Sooner or later will be about the only difference in infection rates when it comes to Cov-19 all over the Planet. Refer to the Zerohedge tag line of “Over A long Enough Time Frame” for the final outcome.
Also everyone should keep in mind the effects of the so called Spanish Flu circa 1918 https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/three-waves.htm, it swept the Planet two or three times over all with the largest amount of deaths occurring during the second event.
Mind you that was when the current ability of such a bug was in the nascent stages of global travel when it took a good 3-6 months to get anywhere in a real hurry compared to a two or three hour trip to millions everywhere all over the globe. But also keep in mind that information traveled even slower then and that we have instant information at out finger tips in this day and age alerting us to WHO updates 24/7 letting us all know that everything is still all good and it is Racist to stop flights from China cause that might interfere with the global economy ….
We don’t know the history of the Spanish Flu genome, but I suspect it mutated before the 2nd wave. Most flu viruses do within a year. This virus was almost certainly created in a lab so it is less likely to mutate successfully.
As I said above: ‘If that happens to have been the case it should be possible to engineer a harmless antiCOVID-19 to neutralise the infection.’
It struck me that if what I read about the RNA of the virus is true it must also provide points of attack. It’s a Chinese virus, so “every strength is a weakness”. But I don’t know enough to be able to form an opinion.
Evidence is against this being developed in a lab. MedCram cited a study yesterday that found an near exact match to an existing bat coronavirus. Study was from several years ago.
That said, can’t at all rule out the possibility this leaked from the lab. There could have been valid research underway there to find a vaccine or treatment in the event of an outbreak…
Spanish flu death data are polluted with aspirin-related iatrogenic deaths, so trying to make any meaningful correlation or comparison with microbial pathogenesis is futile.
https://www.ncbi.nlm.nih.gov/pubmed/19788357
The reason for it being more deadly the second time round, is due to what we think is ADE – antibody dependent enhancement. I recently got this from the abstract of a virology paper (can’t remember the title), and what they said was that when the antibody titer drops below a certain level, the antibodies themselves actually facilitate the entry of the virus into the cells. That is why when it comes round a year later it can be deadly. This is truly worrisome.
That’s interesting, thank you.
“Antibody-dependent enhancement of severe dengue disease in humans”
https://science.sciencemag.org/content/358/6365/929.full
Yes, that was it. Thank you.
This was noted with SARS-1 and in animal trials of a vaccine candidate for that virus. Animals vaccinated died suddenly from ADE complications upon re-infection.
“Cut thru myths to see facts about COVID-19”
But yet, there is no distinction made between myth and fact in the article.
Do we know how much China has lied about the ‘facts’? no, not really
Do we know how much the WHO is lying about the ‘facts’? no, not really
Do we know how much speculation by global and national health organization is presented as ‘fact’? no, not really
This is an evolving situation and the ‘facts’ known today may very well be proven to be a myth tomorrow. Take for instance the “2-14” incubation period that was a ‘fact’ just a few weeks ago, and now we know that this has been proven wrong.
During the SARS outbreak, the mortality rate was initially around 2-3%, but after conclusion, ended up around 10%. the later data was based on further information and assessment. So comparing this to the ‘flu’ is frankly farcical. We just don’t know yet.
Overall, this kind of article is irresponsible crap. There are few ‘facts’ available to the public right now, and the authorities have a vested interest in controlling this until the situation has reached a peak to avoid panic and social order disruption.
Intelligent people should not be listening to what they are told, but rather be watched what is being done by authorities, such as hard quarantines and travel restrictions of towns across the world. Those in the ‘know’ are concerned, significantly so. China does not shutter their economy like this unless they are extremely concerned.
Don’t panic, but everyone should be adjusting their life in accordance with the clear evidence available in what is ‘done’, not what is ‘said’.
What everyone should be doing, is considering how they will cope with an outbreak in their locality and taking steps to keep themselves as safe as feasible.
With a potentially month-long incubation period, everyone should be prepared for a month sheltered in their home with adequate meds, food, supplies. Needing to run out to the grocery store because you ran out of TP is an irresponsible situation to be in.
Expect to be unable to get basic medical care. Be prepared with care items at home for everything below an ER/ICU visit.
Expect to have schools/daycares closed for weeks+
Expect to have the global supply chain for basic goods heavily disrupted for the rest of the year. Are your daily shoes on their last legs? Buy new ones now. Are your cars tires reaching the end of their tread? Buy new ones now. Too many folks are used to not having long lead times. Expect that to change in the near future.
Latest: Coronavirus Spreading In The Middle-East Fast. Besides UAE, Lebanon, Egypt, Iraq, Iran and Israel, Now Cases Emerging In Kuwait, Bahrain and Afghanistan.
This from
https://www.thailandmedical.news/
Speaking of data Larry the info we get in Beijing about Beijing is pretty high detail and consistent.
Total cases, suspected but not confirmed, cases in treatment, recovered, severe, and dead.
And then it is broken down by district, so my district has 62 now.
About 50% of staff is back at work after submitting medical checks twice daily for 14 days.
The number of people allowed in the building will increase over time.
For guys who love numbers you can go check the provinces outside ground zero and get a sense of
what a “prepared system” will result in.
Singapore is good proxy for what you will see in a diligent, prepared, condition.
of course one of my friends is predicting 10M deaths world wide. with math no less and a cup of assumptions
Steven, are you in China?
Get back while you can.
Mosher are you seriously trusting the number from Beijing ?
I have read your comments here for nearly a decade now, never ever commented though.
But seriously??? you are posting comment on China’s Beijing Data being “pretty high detail and consistent”
FMD!!! Talk about Jumping the Shark!
” we get in Beijing”
Good luck to you, Steven.
Further to what I said earlier, the best site I know of for up to date information is
https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/
How can we calculate the Risk of Mortality? Numbers from China are infected with state propaganda and are completely unreliable, the Diamond Princess was a petri dish and does not represent any kind of a normal population, and who knows what the figures from Iran actually represent. So I exclude all of those.
Risk of Mortality, for a disease where you either recover or die (unlike for example Prostate Cancer which many men die with, but not of) the RoM is basically deaths/(recovered + deaths) as a percentage.
During the Press Conference that Chinese medics gave, where they said the RoM was 2.3 % (and dropped their eyes and fiddled with their fingers as they said it) they also stated very confidently that 6% of ‘serious’ patients survive, and only 1% of ‘critical’. One thing we learn from this is that if you are going to use the propaganda technique of ‘hide your lies in a thicket of truth’, don’t get doctors to tell the lies for you. It’s not a talent their career develops. So I take it that the 6% recovery from serious figure is very probably what they really think.
One problem with estimating RoM is that those who recover generally do so quite quickly, but those who die often last out for some weeks.
Looking at the numbers from the site above, we can estimate a population for whom the disease has run its course and so make a calculation of RoM. Today with the exclusions above and accepting the 6% recovery from serious, we have 222 recovered, 46 serious, 18 dead, giving a RoM of 21%.
That is (18 + 46*0.94)/(18 + 46 + 222) as a percentage.
…and if you then speculate about the stark difference in RoM when considering patients age and lifestyle – and take into account median life expectancy, general health conditions and lack of treatment in the European middle age – you most probably end up in ‘black death’ numbers.
It’s serious.
I end up with approx 4% overall death.
My advice to smokers is to stop now. To others get yourself in good cardiovascular shape. I let myself get into bad shape for last 5 years. Because of this threat I have been hitting the gym everyday for last 3 weeks and will continue to. It is not that hard to improve your health, just a little will even help. Even a brisk walk each day will help. And eat a healthy diet.
Using only deaths and those recovered is not a valid metric according to any established epidemiological principle, or even basic logic.
All those two numbers tell you is how many have died and how many recovered.
It is useless as a predictive case fatality rate (which by the way is the correct terminology).
Larry described it mostly correctly up top.
Unless one knows how many mild cases there are, how many are asymptomatic, and how many of those now sick will eventually die, it is impossible to establish a case fatality rate that is valid.
Unless you know at least a slight bit about epidemiology, you ought to at least know that it is a science and has established ways of describing what is known.
Even outside of China there are obviously people with mild illness or zero symptoms who are infected and spreading the virus.
Or there would not be these pockets popping up where no known source has been identified.
There is some chance some evil bastard is spreading the virus on purpose around the world, but this is unknowable.
I am sorry, but you are simply wrong. That is how RoM is defined in the textbooks, specifically it is the likelihhod of dying once you have contracted the disease. I carefully included only the figures for outside China where the ‘mild’ cases that so many drowning experts cling to would be included, unless they it is so mild that nobody, including the patient noticed. Cases that are so mild that even the patient doesn’t notice are not usually counted as infected, except possibly in your strange world. There is a separate question of percentage vulnerable to infection, which is never 100%, and for this virus may be surprisingly low.
And thank you I do know quite a lot about Epidemiology, even more about Statistics, but the meaning of the terms ‘risk’ and ‘likelihood’ appear to be a mystery to you. That’s not surprising, medical statistics are frequently complete rubbish on first submission.
My strange world is a world where people have an illness that barely affects them but that they are able to spread to others, some of whom get very sick from it.
You know…like is happening now with this virus.
I have no idea what you do or do not know about virology, but there are long lists of infectious diseases which people can become infected with and display mild symptoms that some people are barely affected by, but they are nonetheless able to spread the infection.
Some are among the worst of the worst chronic infections.
People with HIV, HBV, HCV, Polio, Influenza, …it may be the case that most illnesses have large numbers of people who do not become very sick.
“An asymptomatic carrier (healthy carrier or just carrier) is a person or other organism that has become infected with a pathogen, but that displays no signs or symptoms.[1]
Although unaffected by the pathogen, carriers can transmit it to others or develop symptoms in later stages of the disease. Asymptomatic carriers play a critical role in the transmission of common infectious diseases such as typhoid, C. difficile, influenzas, and HIV. While the mechanism of disease-carrying is still unknown, researchers have made progress towards understanding how certain pathogens can remain dormant in a human for a period of time.[2] A better understanding of asymptomatic disease carriers is crucial to the fields of medicine and public health as they work towards mitigating the spread of common infectious diseases.”
https://en.wikipedia.org/wiki/Asymptomatic_carrier
This site is better, imho https://www.worldometers.info/coronavirus/
Stefan Molyneux has made recently some Videos, including interview with somoene from Hong-Kong.
Scenes of people locked in buidlings and military firing on people are quite disturbing.
The one thing that is interesting about the Diamond Princess is the infection rate. A cruise ship is an almost ideal world for transmitting disease (see novovirus outbreaks) and the ‘quarantine’ was no such thing. Several people got infected during ‘quarantine’. But, the total infected so far is about 700 out of 3,000 on board. Why?
The man who got infected in France and flew to his family in Majorca. He was infectious, kissing and cuddling is an ideal transmission environment, they weren’t infected (they were all tested). Why.
The super-spreader who flew back to England went to the pub the night before he showed symptoms, but no one was infected (they were all tested). Again, why?
All this does suggest that only a percentage of the population are vulnerable to infection.
We know (or we think we know) that the disease infects by attaching to the ACE-2 enzyme expressed from the lung, and that heavy smokers express five times as much as non-smokers, and that people with reduced lung function (the sick the very old) also express a lot more. Perhaps the disease needs a subtantial cohort of virus to get an infection started, and also perhaps the size of that cohort affects how likely you are to get swamped and slip into ‘serious’. For the young with little ACE-2 there is just never enough to get a big hit in at the start?
The people he infected at the ski resort could possibly have been infected from oral fecal route fomites due to his not washing his hands properly, to give one possibility (based on no evidence but just what is known from other illnesses), and after that he infected no one because he washed his hands better after that, in this hypothetical scenario.
This sort of thing is why with novel viruses or any novel illness, it typically takes years to have a good idea of exactly what was going on.
Think how long it was with other new diseases.
Ebola Reston is still a complete mystery as to the point of origin of the viral infection.
Animals were tested before they were shipped to Reston and were negative, but were positive upon arrival.
Twice.
Exhaustive efforts to trace the source came up empty, AFAIK, and I followed that story for years.
But over time the details will become more clear, especially in this case given the widespread outbreak and the particular circumstances.
It is pretty well established that many people have mild illness, and at least some are almost or completely asymptomatic.
But do not overlook that at this point there are many false negatives, and also perhaps some false positives.
Given what is known about the man, it most unlikely that the infection came from him not washing his hands properly. It is far more likely to have been droplets staying on surfaces in large numbers which even dutiful cleaning would not have gotten rid of them.
Even the family that visited after him entered an environment riddled with the stuff, all over surfaces, furniture, utensils that hadn’t been washed. An almost perfect infectious environment. The most bacteria ridden thing in a hotel room is the TV Remote.
It is believed that fecal transmission is not a risk, but urinary transmission is and droplets are the most likely routes. Aerosol was touted, and certainly the virus can be detected as aerosol but it is not a method of infection.
https://www.bloomberg.com/news/articles/2020-02-01/coronavirus-lurking-in-feces-may-reveal-hidden-risk-of-spread
“The discovery of the Wuhan virus, dubbed 2019-nCoV, in the fecal material of the 35-year-old man treated at the Providence Regional Medical Center Everett in Washington is “interesting,” said Scott Lindquist, the state epidemiologist for infectious disease at Washington’s Department of Health.”
“A virus-laden aerosol plume emanating from a SARS patient with diarrhea was implicated in possibly hundreds of cases at Hong Kong’s Amoy Gardens housing complex in 2003. That led the city’s researchers to understand the importance of the virus’s spread through the gastrointestinal tract, and to recognize both the limitation of face masks and importance of cleanliness and hygiene, Nicholls said in an interview.”
Any news on nicotine users that don’t smoke ? Chewing tobacco, snus, vaping. What is effect on ACE-2 ?
The increased ACE-2 seems (and a very uncertain ‘seems’) to be connected to reduced lung function, which smokers, especially heavy smokers do have. The same is true of heavy vapers, some of whom have seriously damaged lungs and look like WWI gas attack victims. I guess very light vapers, and two a day smokers would not be affected.
If that is true, chewing tobacco gets a bye on this one.
“We know (or we think we know) that the disease infects by attaching to the ACE-2 enzyme expressed from the lung, and that heavy smokers express five times as much as non-smokers, and that people with reduced lung function (the sick the very old) also express a lot more.”
I read a report the other day that claimed the Chinese have a larger percentage of this enzyme in their lungs than do non-Chinese.
Is this true? Are any of the deaths to date non-Chinese?
That was based on a very small sample, and the difference was explained by their smoking. So it seems it was smoking not race that made the difference. There have been native Italian deaths, although I understand they were over 80 and not very well.
People who recover usually do so quite quickly, but some of those who die struggle on for weeks. I have seen no detail on the ‘serious’ cases, which is where the deaths will come from.
Sorry Harry, but the latest figures seem to suggest that smokers are only marginally more prone to hosting the nCoV.
As for Vapers, you do know that the primary constituent of vaping fluid is the same as used as a carrier for asthma inhalers ?
UK’s FTSE100 index is 3.2% down, I assume the US market will be down similar amount. My modest share portfolio is down just under 4%
Interesting discussion. I have been following Dr John Campbell on youtube right from the start of the outbreak and have noticed a gradual increase in concern. Always placing emphasis on “evidence based” conclusions, he now thinks the WHO have dropped the ball. Sadly, he says, “I am convinced we are at the early stages of a global pandemic” and “I don’t understand the reasoning of the WHO”.
I also do not share the faith in the institutions that some people seem to express. We learn that Italy flew a number of people from China and did not quarantine them. Now they are where they are. Also, the US flew a large number back from the Diamond Princess sharing the same flight as the other passengers, who did not even know. In countries like Iran, it is even worse and they are unable to trace the source of contagion and have had to lock down whole areas. The true number of infected cases must be much higher based on the deaths, and one of those infected turned up in Israel.
Many bad decisions have been made, that is for sure.
About a month ago a person I know offered and informal poll on FB, asking about level of concern about this virus.
I wrote more than most since I have long traded biotech and have spent years studying epidemiology, virology, and immunology.
Here are a few of my comments quoted directly from 4 weeks ago.
Starting with my first thought:
” It is hard to not be concerned at least a little, particularly if one recognizes that at some point the world will face some sort of widespread epidemic of a disease for which no natural immunity exists.
Also concerning is the source of an outbreak is once again a market in which numerous species of animals are sold for food, with many of them being wild and exotic species.
And yet another reason to be somewhat concerned is the level of disruption being caused to various markets, even though at this point the illness has caused a low number of actual deaths. WHO authorities are now saying the disease seems to spread more readily between humans but is overall less likely to be deadly to an infected individual, than was SARS or MERS…which were the other two widely publicized outbreaks of a novel coronavirus illness in recent years.”
A couple of days later:
“Also concerning is that the greatest fear of health authorities is the rapid spread of illnesses around the world that now occurs, due to the large number of people flying between all parts of the globe on a daily basis.
All of the worst case scenarios for a widespread and deadly epidemic of a new disease presupposes that an infection can and will spread widely before anyone knows it is even occurring.
That seems have happened in this case, with the illness now appearing in the US as well as many countries in Eastern Asia.
How likely is it that a person who travelled to Wuhan and then to a country with a less effective and responsive health monitoring system in place than the US, will be identified and isolated before they can spread the illness to another generation of infected individuals?
Because this is the most likely way that a new disease is able to spread widely among large numbers of people all around the world…and exponential spread that overwhelms the ability to locate and isolate infected individuals.”
“My concern is not that this illness will lead to a large number of deaths in far flung locations.
It is simply that it is possible.
Such an event is sure to occur at some point in the future, although of course no one knows when or how bad something might get.
Being that it is likely to occur at some unknown and unknowable time, and be caused by something which will only be understood to be particularly deadly in retrospect, no one will know it early on…it will only become apparent as it progresses and at some point becomes uncontained and uncontrollable.”
All of these are from 4 weeks ago, including this next one:
“Of course, it should also be noted that many diseases which spread easily and/or are particularly deadly to people in one part of the world, fail to be equally deadly and/or to spread as readily in other parts of the world.
There are numerous reasons for why this is so…many parts of the world are notable for not having the same attention as other parts of the world to hygiene and general steps people can take to avoid getting sick or spreading an illness if and when they contract one.
Also people in more prosperous parts of the world seem to be less likely to become severely ill when exposed to a disease, perhaps due to being generally stronger and healthier to begin with.
Hand washing, daily bathing or showering, screens on windows and a general avoidance of being exposed to mosquitos when they are biting…such habits and living arrangements as we take for granted do not exist, or exist to a more limited degree, in other parts of the world and other populations of people.”
Yes, well said. I think a balance has to be struck between overconfidence in authorities to protect everyone, and panic. My own feeling is that the main authorities – WHO, CDC – are behind the curve, as was the stock market, although that now seems to be reacting to the picture that is emerging. There are just too many clusters suddenly appearing in developing countries for my liking and these countries have no way of tracing the origins, and poor ability to treat the seriously ill.
Life insurers may take big hit on this virus.
But the Annuity providers will make a fortune.
If I could identify companies heavy in annuities but not life insurance would be a good buy.
I don’t worry about the disease factor per se, but rather the economic factor. It’s a lot like the Irish Potato famine—all your eggs in one basket, so to speak. Cheap Americans and Americans who didn’t want their backyards sullied with actual manufacturing pushed us to buy so many things from China. We have reached energy independence, but not manufacturing. I have read China makes most of our antibiotics. Also, much of our clothing, much of Walmart’s goods, much of Amazon’s goods. Shortages will start occuring. We can and will make up for these, but the cost may not be cheap. Plus, China is in trouble and “in trouble” most likely means much cruelty to its people. Communists are not known to deal with adversity well.
Uk’s discount store Primark has already warned of imminent shortages, and a car manufacturer stated that essential electronics is transported back to the UK in suitcases on passengers flights.
China makes most of our basic medical supplies.
there were reports a week ago that China began recalling ships carrying such supplies.
Italy is hit hard;’200 known infected with the COVID-19, announcing that six have died.
This is the fullness of the ski season in northern Italy. There are tourists from all over Europe.
Well, this is not a myth.
I don’t trust the Chinese numbers, especially after their multiple adjustments, so I’ve been tracking the numbers in other countries, here:
https://www.worldometers.info/coronavirus/#countries
Those numbers now appear corrupted. Look in the ‘total cases’, and ‘recovered’ columns. For most countries it is obvious that the recovered victims are included in the number of total cases. However, Iran, France, Taiwain, the Philippines are showing larger numbers of those recovered than total cases. One can only assume that they are reporting active cases as total cases, or that the numbers are screwed up. Regardless, such clear and obvious inconsistencies in the numbers cast doubt on the entire report. Clearly there is no quality control in issuing this information.
The best site I have found is
https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/
What is your view on it?
Looks good to me. The site I have been using has corrected their numbers. They are now consistent. Makes me wary of everything, though.
Another site is https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
which has an interactive map.
At this point, it looks like if you are of European heritage and in reasonably good health, you will have a mild infection if it occurs.
But fear will empty the shelves, and shortages will occur. The solution, of course, is to stockpile food and medicine, which makes empty shelves and shortages a self-fulfilling prophecy. Still, I don’t think extensive traveling is a good idea at the moment.
They do include the recovered in the total, but they say separately how many have recovered.
One thing that concerns me is that only 2 from the Diamond Princess have recovered. That is worringly low.
Looking down at my waist, a modest food shortage wouldn’t be all bad.
Mr. Causey
Dr. Campbell has been doing great work and will come to be recognized as one of the true heroes in this ongoing tragedy.
Along with with Hong Kong’s Dr. Gabriel Leung, Wuhon’s deceased, courageous Dr. Li Wenliang, Dr. John has earned the respect of all who follow these events.
I would bring one item to your attention, relevant to the ‘sourcing/facts’ issue constantly discussed upthread … Dr. John is increasingly referring to “unnamed sources” for his presented data.
That is, his trusted, first hand accounts are relaying info to him that he is passing on to the world … prompting his growing pessimism.
Puts “official” data in a somewhat different perspective.
Thanks for that Joe.
Interesting that Iran has cases. I wonder how that happened? Clue — Chinese going to & from Iran doing something or other.
beng
So much speculation.
So much that we still do not know.
I have read numerous accounts claiming that there are various large construction projects ongoing in Iran that are sponsored by/conducted by the Chinese which involves a significant number of Chinese workers.
If true, that could increase the implications regarding the large number of Chinese projects all throughout Africa.
The airport in Addis Ababa has been mentioned as worthy of attention as it is a major ingress point from China into the African continent.
Most of the guys going from China to Africa to work for Chinese companies will be quite young, and so less likely to be carrying the disease. But not all of course.
Being young has nothing to do with whether someone is a carrier or not.
I read an interesting tidbit that Chinese workers returning to Africa were bribing local officials to let them go to their compounds unchecked.
Sorry, you forgot about Africa. Tens of thousands of Chinese workmen commute annually to and from Hebei Province for the lunar New Year. The fact there are no reported cases in Sub-Saharan Africa says more about the dismal state of medicine than it does about the Wuhan Flu’s presence.
Africa will be devastated by the Wuhan Flu. Poor Africa.
It was estimated that around 5 million people left the Wuhan area before the quarantine was enforced. Any of those with enough money could have gotten themselves transported to many different nations. That could explain the sudden rise in Italy for example.
The WHO are simply toadying to the Chinese..I just don’t believe the crap they’re coming out with.
I think we can assume the virus can’t be contained now and the genie is out of the bottle. Containment is as much economic as it is physical now as you can’t keep continually locking up large sections of the community from productivity or the cure is worse than the disease. We all have to take our chances now and in that respect if medical facilities are overrun we have to have a plan to prioritise the young dependants and their productive parents. That means having a succession of age fallbacks that the community calls upon to be denied critical care and scarce drugs and those of us with grandchildren have to understand that and stand up for it now.
Well Greta et al we’re about to give you back your childhood my dears and perhaps give you the respite you seek from your dreaded plant food and the dooming but I’d suggest you run those ICUs etc on fossil fuels for a while yet.
OK boomers so much for retirement and we’ll need all the retired medicos and nurses and lots more volunteers like a reserve army to be thrown into our hospitals and ICUs at the first sign of a raging pandemic as we can’t have our young medicos and nurses sacrificed at all like our young Chinese doctor as they’ll be needed to attend to the day to day medical needs of our progeny. We need to speak with our young people about this battle plan and fire up our politicians to understand what’s required and get their arse into gear as there’s no time to waste.
Interesting that our Western development has made our health status more resilient and our economic status more vulnerable. So highly reliant on communication and just-in-time delivery (including our daily food) we are ripe for the plucking.
If this does get serious one will have to move very quickly to stock up with essentials before the masses.
I suspect unless one is a prepper it may be a little on the late side to begin thinking about it.
It is one thing to stock up like for a hurricane season, where one might not be able to get food, medicine, etc, for several weeks.
And there is an outside world unaffected.
What can you do if it is everywhere and lasts for months and then becomes chronic?
Go to Costco and buy a few hundred pounds of rice and beans?
problem is figures that who/cdc/etc report/use are figures given to them by OTHERS.
even if the bureaucracies are trying to work honestly and efficiently (some will say they are others will say they are not, but thats not pertinent to this comment) they are DEPENDENT on info given to them by others who MAY have ulterior motives to fudge the figures in EITHER direction.
trust but verify, read the figures presented and compare them to what people on the ground themselves are reporting. and don’t blindly trust any source.
During a crisis bad info is the rule.
Only later can it all get sorted out.
How can anyone give medical stats for a whole country in real time, especially if there is a veritable emergency and people are scrambling?
Larry Kummer, thank you for this essay.