Guest Post by Willis Eschenbach
OK, here are my questions. We had a perfect petri-dish coronavirus disease (COVID-19) experiment with the cruise ship “Diamond Princess”. That’s the cruise ship that ended up in quarantine for a number of weeks after a number of people tested positive for the coronavirus. I got to wondering what the outcome of the experiment was.
So I dug around and found an analysis of the situation, with the catchy title of Estimating the infection and case fatality ratio for COVID-19 using age-adjusted data from the outbreak on the Diamond Princess cruise ship (PDF), so I could see what the outcomes were.
As you might imagine, before they knew it was a problem, the epidemic raged on the ship, with infected crew members cooking and cleaning for the guests, people all eating together, close living quarters, lots of social interaction, and a generally older population. Seems like a perfect situation for an overwhelming majority of the passengers to become infected.
And despite that, some 83% (82.7% – 83.9%) of the passengers never got the disease at all … why?
Let me start by looking at the age distribution of the Diamond Princess, along with the equivalent age distribution for the entire US.
Figure 1. Number of passengers by age group on the Diamond Princess (solid) and expected number of passengers given current US population percentages (hatched).
When as a young man I lived in a port town with cruise ships calling, we used to describe the passengers as “newlyweds and nearlydeads”. Hmmm … through some improbable series of misunderstandings and coincidences, I’m in the orange zone now … but I digress …
In any case, Figure 1 shows the preponderance of … mmm … I’ll call them “folks of a certain distinguished age” on the Diamond Princess. Folks you’d expect to be hit by diseases.
Next, here’s the breakdown of how many people didn’t get the virus, by age group:
Figure 2. Percentage of unaffected passengers on the Diamond Princess. “Whiskers” on the plot show the uncertainty of each percentage.
In addition to the low rate of disease incidence (83% didn’t get it), the curious part of Figure 2 for me is that there’s not a whole lot of difference between young and old passengers in terms of how many didn’t get coronavirus. For example, sixty to sixty-nine-year-old passengers stayed healthier than teenagers. And three-quarters of the oldest group, those over eighty, didn’t get the virus. Go figure. Buncha virus resistant old geezers, I guess …
Next, slightly less than half the passengers (48.6% ± 2.0%) who got the disease showed NO symptoms. If this disease is so dangerous, how come half the people who got it showed no symptoms at all? Here’s the breakdown by age:
Figure 3. Percentage of Diamond Princess passengers who had coronavirus but were symptom-free. There was only one illness among the youngest group, and they were symptom-free. As in Figure 2, the “whiskers” on each bar of the graph show the uncertainty.
Again, a curious distribution. Young and old were more likely to be symptom-free, while people in their 20s, 30s, and 40s were more likely to show symptoms. Who knew?
There were a total of 7 deaths among those on board. All of them were in people over seventy. So even though the generally young were more likely to show symptoms if they had it, it hits old people the hardest.
Finally, according to the study, the age-adjusted infection fatality rate was 1.2% (0.38%–2.7%). Note the wide uncertainty range, due to the small number of deaths.
For me, this is all good news. 83% of the people on the ship didn’t get it, despite perfect conditions for transmission. If you get it, you have about a 50/50 chance of showing no symptoms at all. And the fatality rate is lower than the earlier estimates of 2% or above.
It is particularly valuable to know that about half the cases are asymptomatic. It lets us adjust a mortality rate calculated from observations, since half of the cases are symptom-free and likely unobserved. It also gives a better idea of how many cases there are in a given population.
To close out, I took a look at the current state of play of total coronavirus deaths in a few selected countries. Figure 4 shows that result.
Figure 4. Deaths from coronavirus in four countries. Note that the scale is logarithmic, so an exponential growth rate plots as a straight line. Blue scale on right shows the deaths as a percentage of the total population.
At this point at least, it doesn’t appear that we are following the Italian trajectory. However … it’s still early days.
Finally, a plea for proportion. US coronavirus deaths are currently at 67, we’ll likely see ten times that number, 670 or so, might be a thousand or three … meanwhile, 3,100 people die in US traffic accidents … and that’s not 3,100 once in a decade, or 3,100 per year.
That’s 3,100 dead from auto accidents EACH AND EVERY MONTH … proportion …
My best to all on a day with both sun and rain here, what’s not to like?
w.
As Always: When you comment please quote the exact words you are referring to, so we can all understand who and what you are discussing.
Terminology: Yes, I know that the virus is now called 2019-nCoV, that it stands for 2019 novel CoronaVirus, and that the disease is called Covid-19, and that it stands for COronaVIrus Disease 2019 … so sue me. I write to be understood.
Data: For those interested in getting the data off the web using the computer language R, see the method I used here.
Other Data: A big hat tip to Stephen Mosher for alerting me to this site, where you can model epidemics to your heart’s content … Mosh splits his working time between Seoul and Beijing, he’s in the heart of the epidemic seeing it up close and personal, and he knows more about it than most.
Are you absolutely sure that 3,300 figure for auto deaths is per day and not per month?
Thanks, dak. Brain freeze … fixed now.
w.
Willis, the statistical analysis begs a numbers of questions, which likely skew the data.
Foremost of these is the propensity of young people to socialize and engage in promiscuous sex with strangers.
The opposite is likely true for older folks.
Cruise lengths are typically brief, and passangers self-isolated as soon as they became aware of the problem.
Finally, the crew (likely mostly Filipinos) are younger and live in much closer quarters than the passangers. This elevates the risk of communal exposure, as the crew has to interact with each other and the passangers.
RobR March 16, 2020 at 6:37 pm
Data is always skewed. And as a side issue, “begging the question” doesn’t mean that. It means assuming the answer. You mean “brings up a number of questions”. [Exit grammar mode, apologies]
True, although I’ve not heard anything about any sexual spread, and lots about airborne and foodborne and surface-borne spread.
Patient Zero boarded the ship on 20th January. They were kept together for one full month. They didn’t know the virus was aboard until the first of February. No details on self-quarantine.
Absolutely.
Look, all I can do is use the experiment as we have it. The numbers I’ve given you are for everyone aboard the ship, passengers and crew alike. Even with younger crewmembers, the age skew is still way old.
Finally, regarding the “risk of communal exposure”, I can’t think of a better place than a cruise ship to make sure everyone is exposed, passengers and crew alike, if the crew is infected. The crew is the most exposed, as you point out, and they are cooking and serving the food and cleaning the rooms and interacting with passengers and other crewmembers 24/7.
w.
Willis.
Having lived aboard ships and submarines, I too can attest that it would be a breeding ground for such a virus. Especially if it has a fairly long incubation period.
@RobR
RE: Old people being chaste…
To quote Queen Amidala of Star Wars; “You assume too much.”
re: “Even with younger crewmembers, the age skew is still way old.”
Yes … some age skew. I will also submit that these were (are?) “active” oldsters with (what I will call) nominally functional and (probably) ‘clear’ lungs, as opposed to those with longer bed-ridden histories and bascilly inactive, living in a full-care rest home scenario (as in Washington State.)
This brings up the ‘health’ (or biological age or physiological) age thing versus simple chronological age.
Be nice to know the health histories of all involved.
I traveled on cruise ships for 15 years a young person and the interactions of all levels of people were immense. The below-decks crew, engine room and such, interacted greatly with the other crew in their time off and the service crew had tonnage of interactions with the passengers all day long and even at night. Entertainment went way into the night, so interactions were constant. Cooking was constant also, as there was early breakfast on deck, two sittings of breakfast, lunch on deck with time to go to the two sittings of lunch, afternoon tea with more food, dinner with two sittings, and a late dinner about 11 PM. One could eat and interact with food all day long. How a virus did not get everywhere is indeed a question.
“Patient Zero boarded the ship on 20th January. They were kept together for one full month. They didn’t know the virus was aboard until the first of February.”
Really, Mr. Eschenbach, don’t you think it is misleading to say they were kept together for one full month, when they were under quaratine for half of that month?
“[2]. Upon returning to Yokohama, Japan, on February 3rd, the ship was held in quarantine, during which testing was performed in order to measure COVID-19 infections among the 3,711 passengers and crew members onboard.
Passengers were initially to be held in quarantine for 14 days. However, those that had intense exposure to the confirmed case-patient, such as sharing a cabin, were held in quarantine beyond the initial 14-day window [3]. By 20th February, there were 634 confirmed cases onboard (17%), with 328 of these asymptomatic (asymptomatic cases were either self-assessed or tested.”
Willis, the correction is appreciated.
The ratio of passengers to crew is approximately 1:0.7.
With this in mind, the total age group likely skews toward the younger side.
My only point is, it is difficult to establish any statistical inferences with so many unknowns.
In fact, your flawless statistical analysis my paint a false picture of COVID-19 disease spread and death rates.
In a perfect world, a demographically congruent group of people would all interact equally with each other in a confined space.
Having never been on a cruise, is their separation between socioeconomic classes? That would be and interesting dynamic to know/track.
Willis
Diamond Princess data is definitely worth analysing. It would be interesting to know how many of the 83% who didn’t contract the virus actually had it but recovered before testing was carried out. Probably not many because the time (Jan 20th to Feb 1st) is too short The UK CMO claims PHE (Public Health England) has a test almost ready for use. I assume it checks for antibodies in the blood. I think the CMO has a theory that there a lot of asymptomatic cases.
“And as a side issue, ‘begging the o’ doesn’t mean that. It means ass uming the answer. You mean ‘brings up a number of questions’.”
Bravo! Unfortunately, at least some dictionaries are now including RobR’s meaning. A professor friend of mine many years ago gave up trying to get his students not to use it with that meaning. Instead, he tells them to use “logically begs the question” for the original meaning.
Thanks for clearing that up: “passengers” means all on board. So the 1,400 aged from 20-49 were almost all crew and subject to greatest exposure risk. Their low likelihood of contracting, and high survival rate are good news for that cohort.
@ Ironargonaut:
“Having never been on a cruise, is their separation between socioeconomic classes? ”
“YES” there is separation, …… the “affordability” of their sleeping quarters. 😊
Coronavirus – the “prevention” will surely prove to be far worse than the “contagion”.
There may be 3,300 auto accident deaths per month on average but the numbers are not spread evenly throughout the year. These two weeks at the end of March are among the worst two weeks of the entire year for accidental deaths, especially among 16-24 year olds. This is due to spring break, and is the reason why I’ve been predicting that Corona Virus will likely actually decrease the death rate in the USA over the next two weeks.
Unfortunately, the death rate will probably be much higher in the long run, but also not from this novel cold virus, but from the crashing of the global economy and all the hardship that comes with it. We’re close to completing the successful amputation of our heads to “save” us from this cold.
I’ve been tracking Chris Martenson at peakprosperity. (I think you’d enjoy; he’s a numbers guy too) His point is the death rate rises dramatically when the health care system gets overwhelmed and this may be what’s happened in Italy. He called the situation the Disaster Princess; seemingly the passengers still had full access to functioning health care.
@Willis and @John Finn
The current test which is a PCR to find the virus is the wrong test. All it finds are the currently infected. A test that measures antibodies in the blood to the virus which we know are present as some medical authorities are using plasma from infected patients on new patients with some success in reducing the symptoms if not curing them.
I would think that a test for antibodies done on a statistically significant sample of people in each world region would show that almost everyone has had the infection already.
It is really important that this test is done as it might stop the panic if people knew that almost everyone had already had the disease so no point in world economy killing lock downs. The avoidance is worse for everyone than the disease for a small minority
@ Robert W Turner
“We’re close to completing the successful amputation of our heads to “save” us from this cold.”
Right on, …… and this ‘headline’ this morning is proof of the above …..
“ Around 6 out of 7 with coronavirus may be undetected, study finds ”
Now that’s quite a “magic trick”, ……….. counting the undetected cases.
Coronavirus – the “prevention” will surely prove to be far worse than the “contagion”.
“… way old” Willis?
I’m wishing you’d stayed in grammar mode.
Slacko March 18, 2020 at 6:46 pm
Slacko, I have no idea what you mean. Are you objecting to me saying that even including the crew the age skews “way old”? Were you not able to understand that? Is there some grammar rule against that?
From the web:
and
and
In mystery,
w.
Willis
Please read my post below or the comment I just left on your blog, where I managed to misspell my last name.
Thanks
John Macgowan
John Macgowan March 16, 2020 at 10:09 pm
Inspired by your comment, I added Hubei Province, the location of the infection focus of Wuhan city, to my graph. Of course, since the population is much less than China as a whole, the number of deaths per ten million is much higher than that of China as a whole.
Now, if the US death rate gets as high as Hubei Province, that will be about 18,000 dead …
Thanks for your kind words, John.
Regards,
w.
Will, the Diamond Princess is being analyzed by lots of researchers as an experiment. Like every experiment, it has limitations. But it’s the best we’ve got for the moment. Carry on!
“Foremost of these is the propensity of young people to socialize and engage in promiscuous sex with strangers.
The opposite is likely true for older folks.”
Speak for yourself, at the age of 78 I am as promiscuous as I was at sixteen – given the opportunity.
Applause 🙂
“Speak for yourself, at the age of 78 I am as promiscuous as I was at sixteen – given the opportunity.”
That really doesn’t tell us anything. If you weren’t promiscuous at all at 16…
If the stories coming out of “The Villages” and other retirement communities in FL are even remotely true (including the rates of venereal disease), the propensity/frequency of sexual relations of seniors easily exceeds that of younger age groups.
You beat me to it. As a former Florida resident near the Villages, I was familiar with published reports that it was the leading place in Florida for STDs. There is no evidence that morality improves with age.
When you are in your 70’s or 80′ s and have lost your partner or are divorced what do you have to lose
?
A factor in Italy was the availability of ventilators in intensive care. Old people’s ventilators were removed to be used on others. No choice.
There’s always a choice. The value judgements used and the consequences of the choice do vary, but that does not change the fact that a choice was made. People just like to say “there was no choice” to evade responsibility for the really difficult decisions that we are sometimes forced to make.
Paul, I think he meant that they were having to choose and that making the choice was unavoidable in the circs . . .
That theoretical self isolation you mention is balanced by the fact that just about nowhere in a cruise ship is truly isolated.
> Foremost of these is the propensity of young people to socialize and engage in promiscuous sex with strangers.
>
> The opposite is likely true for older folks.
Talk to anyone who has worked in an “old folks home” / assisted living facility, and you will quickly be disabused of this notion.
You might be surprised about promiscuity among the older folks
One of the communities with the highest STD rate in Florida is a retirement town no one under 50 allowed to live there
According to the article I read, it was the cooking crew that was the origin of the virus, so it kind of guaranteed exposure to all on board. Everyone has to eat. It’s just amazing that more didn’t get sick. This cruise was indeed a “perfect petri=dish”. We never would have gotten such accurate stats anywhere else.
Can I just add that in Florida, it is a well known fact that cases of STDs in retirement communities are a big problem.
“ STD transmission among the elderly is unfortunately a common and growing problem. For example, between 2007 and 2011, chlamydia infections among Americans 65 and over increased by 31 percent, and syphilis by 52 percent.”
One point:
“The propensity of young people to…engage in promiscuous sex with strangers” is likely overblown. In fact, if anything, the rising generation is quite disinterested in sex, for a number of reasons, including the widespread availably of pornography, the #MeToo attitude that allows women to say “no” with alacrity. (And yes, the “porn” thing is stunningly true; in fact, the number of young men who’d prefer view porn and masturbate to having an actual meaningful relationship, much less a casual one that still represents a lot of effort, would blow your mind – no pun intended).
Hi Willis, I found this article when researching how to do statistical analysis that I have barely used since university.
There was a metric to show the how unlikely a particular sample was to differentiate against the actual population. IE for the Diamond Princess sample to differ from the reported population is 1 in 5000. Does this mean something to you and can you calculatte it? I fear China initially needed high morbidity to quell the HK uprising, and its looking like Italy is counting anyone who dies with Corona Virus in online dashboards. If you look at Germany’s figures, the mortality rate is somewhere near the common flu.
Many thanks, and keep up the great work,
F
Still, your point is well taken – be more aware of the drivers on the road who are afflicted with the Coorsvirus, BudLitevirus, whiskeyvirus, etc. than with those carrying the Coronavirus.
Thanks to the social isolation and the closing of bars and restaurants, Corona virus might turn out to be beneficial to overall health.
@RLu – Tell that to the people who opened stores, restaurants and bars in the last six months. And their employees. These “restrictions” (my county in Silicon Valley, California just asked everyone to “shelter in place” for the next three weeks) may be good for “health”, but entrepreneurs and poor people in the service industries? Well, we all have to make sacrifices, right? Well, I mean, they do. So what if you’re increasing the homeless population… safety, right? /sarc I’m fine, maybe you are too, but there are a lot of people taking this on the chin right now.
I have not heard an estimate of possible improvement in the rate of new influenza cases after all the changes being made in our lives and economy.
The flu and covid-19 spread by the same mechanisms. Social isolation should decrease transmission of the influenza virus. It would be funny, as in ironic, if the majority of lives saved by the current hysteria turn out to be due to decreased flu deaths.
Maybe a society-wide lesson for the future.
Either way, Death has its needs. We have to allow some way out. Currently death is seen as a newsworthy event, at any age and any condition.
And keep in mind that for every person killed in an auto accident, many more are injured, a great many of them gravely injured.
As someone who survived a fatal auto wreck as a young man, in which my best friend was killed and the issue was hardly certain for me over a period of several weeks, including two heroic operating room bring back from the dead moments…I can tell you, being really messed up and surviving by force of will, medical heroics by people who have devoted their lives to helping others, some luck, and just being a little stronger than the guy next to you who died ( I had just quit a job as a bicycle messenger in which I rode a heavy bike hard and fast from sunup to past sundown every single day, rain or shine, foot of snow or dry road, for well over a year. That helps when you are crushed nearly to death) is listed in the stats as “lived”, when the truth is far from that simple.
Many will spend their lives dealing with the consequences of something that did not kill them, but might have, and very definitely changed the way they will be able to live their lives, which in many cases are severely degraded and drastically shortened.
The same is true for people who get viral pneumonia but manage to survive it. For some it is a lousy two weeks, for others, a grueling challenge that tests their ability to endure right to the very limit, and for many such illness leaves them never the same, and takes years away from them.
It will be interesting, if social-distancing goes on long enough, to see whether there are statistical blips of the sort we’re said to have seen as a result of the dietary restrictions during WWII. Fewer traffic accidents, especially drunken ones, for instance? I’ve read that Japan knocked a big hole in its ordinary seasonal colds and flu, evidently by ramping up hand-washing etc.
Ever seen the stats on traffic accidents during blizzards?
They list every accident as being caused by the storm, but do not mention that during the four days it was snowing, traffic accidents were about 1/100th of what normally occur over a ten state area when the whether is good and roads are clogged.
Willis,
The paper by Neil Ferguson, et al, “Impact of non-pharmaceutical interventions …”
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
seems to be the basis for the policies of avoidance currently crashing economies world wide. This paper is based on certain assumptions of the rates of transmission and case fatality rates for COVID-19 illness.
The Oxford University Center for Evidence-Based Medicine has published its own estimates of transmission and case fatality rates for COVID-19 illness.
https://www.cebm.net/global-covid-19-case-fatality-rates/
These estimates are much lower than those assumed by Ferguson, et al, and more in line with, or lower than, your estimates based on Diamond Princess data. Do you see anyone out there working to validate the work of Ferguson and his collaborators? If this work can’t be validated, it would be a very dubious justification for widespread radical changes to our society and economy.
I’m 74. I never get the flu and no flu shots either. I almost never get a cold, and when I (every 2 or 3 years) do, it will last a few days and be gone.
This winter, I had a very strange ‘cold’. No runny nose or fever, just a very persistent wet cough that lasted 10 days, couldn’t shake it.
Could it have been first round of Corona? If it was would I have some immunity now? More interestingly with respect to this post, what if cruise ship had high population like me? What if your numbers are reflecting a second hit from corona? Maybe there was a mild first round variant.
I suspect you had Covid-19. I wouldn’t call it first round, as it appears there is a very wide range in how people respond to the SARS-CoV-2 virus.
Given the atrocious state of testing in the US, a lot more people may have had Covid-19 than are counted and if we run out of potential victims, the epidemic may end suddenly and sooner than people expect. Not tomorrow though!
Yeah, you likely have good immunity, though I hear that coronavirus immunity fades quicker than most.
The theories about early rounds of the virus are highly unlikely, in that we havent seen the associated cases of pneumonia that occur at anywhere near the frequency seen in the known outbreaks.
Italy is running a 3-6% mortality rate in Lombardy. That kind of thing would noticed.
Why do you presume Lombardy in Italy to be typical?
Good to see your comment, Paul BAHLIN. I had almost the exact same thing. I also never get sick. I’m in my early fifties. My cough lasted over a month, I ran a fever, and I had dizziness and virtually every other C-19 symptom listed. I was so short of breath that going up the stairs made me wheeze. This was insane because I regularly do rigorous treadmill running (and weight lifting) and have built up a lot of endurance. I started slamming Robitussin thinking it was a cold, but it didn’t go away so I assumed “flu.”
I figured I’d picked it up because I was around my nieces and nephews for the holidays. But now that I think about it, this never happened in past years.
Whatever this was, I’ve never coughed so much in my life. I would wake up from coughing and go back to sleep, then wake up again. Now that I have some hindsight, I remember I had the flu in 2003, but the symptoms were different (they included digestive issues).
For what it’s worth, I’m in the DC metro area.
Ditto
I had a very strange illness late Nov early Dec.
I went thru stages ,sore throat ,fever ,muscle aches, headache, lasted about three weeks but never enough to be more than an annoyance.
I had what sounds like exactly the same thing, but with deafness in one ear, in the first 2-3 weeks of January. But it seems to early to have been COVID-19.
Rich.
Very very unlikely. The symptoms don’t match. More likely to be one of a million other possible viruses.
There have been a few reports among my acquaintances of a strange cold or flu in January (New Zealand so in summer). I had a 2-day cold also in January, which is unusual for me. I can’t remember the symptoms but was not concerned, as it resolved quickly with increased Vit C and colloidal silver.
Unless I misunderstood your question, he states in article
“That’s 3,100 dead from auto accidents EACH AND EVERY MONTH … proportion “.
So yea, he’s saying per month, not per day.
Have a great day 😊
The Devel here is that more than 50% of those between 50-90 and all other can have the virus whithout symptoms?
The follow-on question would be: “Do those ~50% who test positive, though symptom-free, pose a risk as contagious carriers?”
And a second follow-up: “What exactly does the test identify with a positive or negative finding?”
As half who test positive are symptom-free, i.e. their immune and inflammatory system is not elevated due to the virus, something is resisting infection–what?
it is 35,000 per year as an average
The 3100 must be world wide
Brilliant.
The Willis data genius at his best.
Thank you.
My big question is, if we are panicking over 1000–3000 deaths from a virus that is essentially a flu that attacks the immunologically compromised and elderly with complications, why do we not panic over the 30000–60000 Americans who die from the common flu every year? It makes not sense. There is a hypocritical factor here. Where is the perspective?
There is a CDC projection of 200,000 to 1,700,000 U.S. deaths. Willis’s analysis seems correct, however. Of course we cannot say now what the final toll will be, but I think someone is going to have some explaining to do. I imagine they’ll take credit for actions that drastically saved lives.
Drastic measures where taken on the ship also, to project that number into a population assuming no drastic measures taken would be just plain wrong. Patient zero on ship for 11 days. Assuming he presented w/symptoms after 5 days and then began spreading disease, that would leave six days for him to spread and one day for everyone he infected assuming they also started spreading at exactly 5 days which is short since incubation is 2-14 days many probably were not contagious until after quarantined. Lets get some perspective, 10 restaurants on ship plus room service. How many people really came within six feet of him? How many ate in the same restaurant on the same day he did? All this data does is show to me that quarantines work if as contagious as made out to be.
ironargonaut March 16, 2020 at 9:36 pm
Not true, according to an article by a Japanese expert who visited the ship while it was under quarantine.
w.
Wow, great link Willis.
This story answers a lot of questions, but in fact I already knew what was happening on that ship was very far from what any professional would call a “quarantine”>
Also striking is the tone deafness and apparent butt covering of authorities who were more concerned with blame and appearances than with addressing the questions raised by Iwata.
Consider his describing what he saw as a lax attitude and a complete failure to follow best practices. And then the response from authorities:
“Japan’s health authorities hit back at Iwata’s statement, telling The Asahi Shimbun on Wednesday that it was a misconception that the ship was not in the hands of qualified professionals…”
But Iwata never said the people were “unqualified”, or that they were not “professionals”.
He described a failure to follow best practices, to take the illness seriously, to observe well understood principles of infection control, etc.
What this shows is that these people pushing back at Iwata were not listening to what he was saying and taking steps to address the deficiencies. Instead they were reacting with irrelevant denials, and failing to hear what was being said.
One of the obvious conclusions in this whole debacle is to underline the difference between medical professionals on the front line of patient care, and bumbling bureaucrats with fancy titles but little to suggest they are knowledgeable or intelligent guardians of public health.
ironargonaut: “Assuming he presented w/ symptoms after 5 days….” Why assume, when the article Willis cites says zero was symptomatic on Jan. 19? Might want to push the “c” button on your calculator before trying again.
Paul you are correct I should not have believed this article that read as if he was on ship for whole time but since he was only on ship for 5 days, my number is actually pretty good one day less to spread. Willis I read your link and stand by my statement. Could not watch his video as it was removed. Article says in adequate, but that doesn’t mean the same as letting passengers mingle. Some isolation was occurring you do not account for this.
First sensible comment on the thread!
I rely only on cdc.gov for information about the CDC. I can find no such prediction. If you got this from a media source then you can be sure they are doing their usual sensationalizing. It may be picking upo a statement by someone who may or may not have been actually associated with the CDC and blowing it out of proportion.
In any case, don’t believe any media articles and keep your brain active when listening to bureaucrats or political appointees, they may be talking “off the cuff” or vying for attention. Stick to considered official statements for accurate data.
Charles Higley “Where is the perspective?”
WR: Here is the perspective. Merkel said that 50-70% of the (German) population is supposed to be infected. As the Spanish Flu learns this mainly happens in some months (at that time two big waves and a small one). 70% of the US population is about 230 million people. 20% needs a hospital (46 million), 5% an intensive care bed (11.5 million) and 2.5% is supposed to die (nearly 6 million). As soon as the medical system gets overwhelmed the death rate rises from* 0.5% (South Korea), 0.9% (‘Rest of China – ex Wuhan/Hubei) and 1.2% (Princess Cruise) to 5% or more (Wuhan and now Italy). Doubling the 6 million to 12 million deaths.
A full blown epidemic overwhelmed the top medical system of Wuhan and Northern Italy at around 10.000 registered cases. That’s why nobody should want a full blown epidemic.
Preventing a full blown epidemic means fighting the virus from the very first moment like in a real war. China and South Korea show that it is possible to beat the virus. If the virus can’t transmit at all (!) in some weeks it will die out. That is why social distancing and containment is that important.
In western countries people often are going ahead of governments. Flights and activities often were cancelled on a large scale before most governments acted. But ‘better late than never’ this total fight against the smallest enemy has to happen. To prevent the collapse of the medical system and more.
* A very good analysis and data: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca
More data and special country pages (click on country name) https://www.worldometers.info/coronavirus/
And for Willis: great and very useful analysis. Thanks!
Consider being given a choice: We can each spend two weeks of isolated confinement in a room at home (computer, cell phone, TV, video games, books, Kindles, whatever…) and not even interact during that time with people we live with if at all possible…OR…have this drag on for month after month, getting gradually worse for who knows how long, and have severe economic and other sorts of disruptions of a severe nature and for an interminable length of time.
Nicholas,
If a major portion of the population is unproductive for two weeks, it will crash the economy – hard. And most likely, it wouldn’t even stop the spread, just delay it. But with a crashed economy we would have a lot more deaths.
Paul,
I do not know what counts as a major portion.
I am talking about every man woman and child.
But of course my thought experiment is a hypothetical.
Even if there was some way to compel compliance, or if people of good conscience simply realized it was possibly an effective way to nip the whole thing in the bud, it would be unsafe and unwise, because there are too many bad guys, too many critical jobs, too many emergencies, etc.
But if two weeks is long enough for most people to clear the virus, and if for two weeks not one single new person was infected, the amount of live virus in the country would fall sharply to a tiny fraction of it’s present value.
That is long enough for virtually all fomites to become nonviable also.
I have to wonder though, if we are watching the same financial news and paying attention to the same economic reports, etc.
The economy has already crashed.
Airline bookings are about 1/3 to 1/2 of what they were last year at this time. Every restaurant and club and concert and movie theater and sporting event and meeting of over 10-50 people…all cancelled and closed.
Hotels are empty and cancellations are accelerating further and further out on the calendar. Same with airlines…cancellations are accelerating rapidly.
In short, what was inconceivable a few weeks ago is a reality today…it has already happened, and the trends are not slowing, they are accelerating.
A major portion of the population is home, and not even going out for food or recreation or taking vacations.
Entire major industries are closed down.
The economy is crashing…or crashed, depending on how you define the term.
Two weeks, then what?
No other cases? No travel? No new case? No re-import?
On CNBC, Bill Ackman, the well known investor and hedge fund manager, was just saying he had this same idea as I had, but he thinks the President needs to announce everyone is gonna stay home for 30 days, all over the world, and the US will lead and start right away.
If we do that, the progress of the disease will be halted.
If we do not, this will go on and on, and very few companies can survive an extended period of what is happening.
The major auto companies are about to announce they are shutting down production.
Boeing is in danger of declaring bankruptcy, as are the airlines, every hotel company, every restaurant, sports leagues, movie theaters, basically the entire hospitality industry and ancillary services and vendors.
Boeing says they have no liquidity ad access to credit has dried up. They need 50 billion in the short term to survive.
The ways things are being done, this will go on and on, and none of the things shut down has any logical point in time to restart and reopen unless there are no new cases, or very few and a successful treatment is found. I am very hopeful about remdesivir, but it is also likely it will only help a percentage of people. Plus it is not a pill, it is a IV drip every day for ten days, and so no one will be getting that for prevention. Plus antivirals in general have side effects that are manageable but not appropriate to inflict on healthy people.
No one take chemotherapy to prevent cancer. Likewise, no one takes antibiotics in case they might get an infection.
Our economy is crashing, it is doing so now, it is well underway, and something bold and sweeping is the only way to keep it short.
Otherwise it will drag on for a very long time, and likely this is a new disease which will go around the world either seasonally or episodically.
Oh, nice guy…why are you not out in front of the companies injecting people with vaccines for this new virus?
According to you, they are the ones giving everyone the disease and there is no such thing as acquired immunity or antibodies or antigens so why are they doing it.
Get your sandwich board and doomsday bell out and hit the bricks…the world needs to hear your message of uselessness.
“they are the ones giving everyone the disease and there is no such thing as acquired immunity or antibodies or antigens so why are they doing it”
More proof your mind is not functioning properly
The mantra seems to be ‘Flatten The Curve’. The big deal is social distancing. Does it work?
There is this anecdote concerning the Spanish flu of 1918.
I realize it’s an anecdote, not data. Nevertheless, it’s interesting.
In those years, Philadelphia was the second largest city in the country, with some 1.7 million people. Additionally, during the WW II period, hundreds of thousands of extra people were squeezed into the city.
Philadelphia has a large naval base in the city, and is also a busy port on a major east coast river, and was no doubt heavily in the middle of much of the war effort, and vast numbers of people coming and going into and out of the country.
Saint Louis was at the time the fourth largest city in the country, and did have a military base, but it was ten miles from the city, and the city itself had a population of just over 700 thousand.
I am not trying to say that those were not very likely tragic decisions that causes many of the deaths, but the situations are not strictly analogous.
Population differences alone meant that an equal proportion of deaths would be an absolute number about 1/3 as large in St. Louis, not even counting how prevalent the infection may have been prior to these events.
Reading about this event (the Spanish Flu Pandemic), it is apparent that for every assertion and theory one can find, are others that flatly contradict it.
Oops, WWI period, meant to say of course.
16,000 x 700,000 / 1,700,000 = 6,588
So, St. Louis had about 1/3 the deaths on a per capita basis. That’s hardly a flat contradiction.
Do you purposely misread comments?
Do you purposely write confusing comments?
If someone misunderstands something you said, the most fruitful strategy is to assume that you haven’t communicated well.
I’ll take that as a yes.
The point is the Spanish flu was far worse in port cities, cities with naval bases, cities on the coast that received large numbers of returning vets, etc.
A parade did not cause all the deaths.
Pittsburg had a higher number of deaths than philly, and it is a far smaller city.
New York had the highest death rate and number of deaths…it is the arrival point for the bulk of arriving troops, and a transit point for outgoing soldiers as well.
Philadephia had a massive number of sick navy personnel arrive just prior to the worst of the upturn in deaths.
As for politicians ignoring the warnings…this was widespread, and even after places on the East Coast had experienced massive waves of deaths, cities across the country still refused to shut down gathering places and give appropriate warnings.
Instead, as in philly and many cities, they downplayed the dangers and told people it was just the grippe.
Also…philly had 1.7 million residents, but a huge number of additional people in the city every day…back then the city was known as the place that made everything.
It was the China of the early 20th century.
Factories by the hundreds, massive ones.
There were well over 2,000,000 people in the city in that time, many soldiers, many transient laborers.
“there is no such thing as acquired immunity or antibodies or antigens so why are they doing it.”
@moderator
Block that crazy.
Death rate on Princess 1.2% ?? 7 fatalities out of 3700 total passengers and crew is .00189.
Do they mean death rate over cases of contamination?
Which is a useless metric in general as many people can’t get tested and would NOT even get tested if they could, as they don’t need healthcare and have no clear symptoms.
Replying to Lowell T Wrucke: I think the calculation is 7 fatalities out of 634 confirmed cases. which I get as 1.104 (also not 1.2 but close, and possibly I’ve made a mistake). I don’t present this as the opinion of an expert. Also I’m not arguing that this is a more appropriate measure than the one you suggest. But I’m guessing that “death rate” has an accepted meaning among epidemiologists.
This time it’s the Boomers most at risk.
The Boomer’s parents are the ones most at risk.
If one is 70 and up, the mortality rate appears to be around 8% — probably lower, because we don’t know how many people are actually infected. Boomerism started in 1946 and went to 1964 or so. The early Boomers (1946-1951) are 74-69 years old, well in the danger zone. The youngest Boomers are not quite there yet, but are close.
As a cohort, none are as self-absorbed as the Boomers. I’m one, I should know.
Perspective doesn’t sell newspapers, drive website hits, cable news show ratings or those who have short positions in stocks. The media oligarchs are started the panic and are fueling it so they can make more money and for the benefit of statists who can restrict freedoms.
Charles H,
Although, influenza mutates every year, vaccinations and resistance (due to past episodes) suppress the infection and mortality rates.
The novel nature of this coronavirus has the potential to be much more deadly than annual flu, for several reasons;
– Natural immunity is likely low
– A vaccine is not available
– The extended incubation period increases the infection rate.
– The kill- ratio, (although uncertain) is substantially higher than influenza.
Steven Moser has been sounding the alarm bells for weeks from Korea. This is a deadly pandemic and how we behave largely determines the outcomes we face.
Fortunately, reluctant family and friends took my advice three-weeks ago and stocked of on essential food supplies. Plan for the worst and hope for the best.
“Be Prepared” – The Boy Scout Motto
re:
Just curious, what were your preparations for Y2K?
Follow-on, what were your preparations for H1N1 (2009), Bird flu, MERS, the “Mad-Cow” disease episode in the 90s, etc.
Do you get a flu vaccine each year?
SNIP – You’re welcome to post on anything but vaccines.
w.
Jim,
While I certainly don’t owe you an answer to your questions, I’ll tell you anyway.
Yes, I received a flu shot, and I took the usual precautions to ensure my computer was updated before Y-2k. I took no real actions related to the other items on your list.
Unfortunately, the media and the administration (to some degree) misled the public regarding the danger of the Wuhan virus.
One notable acception was Tucker Carlson on Fox. The media on the other side of the aisle, were mostly interested in using the outbreak as a reason to bash Trump.
Thankfully, the CDC’s situation reports indicated a global pandemic was likely 2-3 weeks ago.
The writing was on the wall for those willing to look.
SNIP – Give it a rest, amigo. Like I say, you’re welcome to post regarding anything but vaccinations, where you have an idee fixe …
w.
“Like I say, you’re welcome to post regarding anything but vaccinations, where you have an idee fixe …”
I still need your excuses, thug.
Also, the French health authorities that you accused of being antivax would probably want your excuses.
(Snipped) SUNMOD
re: “Please provide hard evidence showing vaccine benefits.”
Not you again? The “poster boy” for anti-science and full-out denial of vaccine efficacy?
niceguy March 17, 2020 at 8:28 am
Please stop trying to divert my threads into a meaningless debate on whether vaccination ended smallpox and polio. The hard evidence is that those diseases are no longer present anywhere in the US. But obviously, you are either too prejudiced or too blind or too stupid or too immune to facts to see that.
Seriously, STOP WITH THE CRAPPY NONSENSICAL ANTI-VAXX PROPAGANDA or I will be forced to ask the mods to simply ban you. You are welcome to discuss the topics regarding the Diamond Princess. But if you keep up the anti-vaxx nonsense I will do my very best to get you permanently banned for trying to hijack my threads.
There are hundreds of websites out there where your inane comments on vaccination would be more than welcome. They probably wouldn’t even notice that your logical ability rivals, but doesn’t exceed, that of a banana slug. THIS IS NOT ONE OF THOSE WEBSITES. Stop it. Just stop it.
(Please excuse the personal attack on “notsoniceguy”. I’ve tried the nice route, I’ve tried the logical route. Perhaps this will get through to him)
w.
(I am watching now) SUNMOD
SNIP – as I said, no more vaccine nonsense from you.
w.
Are you a member of the flat earth society?
SNIP – NOTHING ABOUT VACCINES! Is this too difficult for you to understand?
w.
Are you joking? Why are you comparing the deaths of the flu during a whole year with a pandemic that just started. Obviously the deaths are few in the first weeks.
The argument that persuades me is that we apparently have enough ICU beds and ventilators to handle the normal volume of severe cases of flu complications–whereas Italy is showing us what it looks like when a new virus causes a spike in simultaneous complications, and the ventilators run out. No one wants to look on the ventilator shelf in the ICU and see something that looks like the toilet-paper shelf at the grocery store. It doesn’t take a very high percentage of case complications to overwhelm an ICU/ventilator inventory that’s not scaled for it. That means the population in general may be at minuscule risk, but the ICUs–where the problem is highly concentrated–are at a severe one, which can be a horrorshow.
Good point! I wonder if next January we will be forced into lockdown for three months so we minimize ordinary colds and flu?
Charles
I make that point every day and am told there is no comparison between flu and corona virus. I think there are more similarities than differences and it is therefore relevant to point out the tens of thousands who routinely die of flu every year, even though they may have had a flu jab.
tonyb
why do we not panic over the 30000–60000 Americans who die from the common flu every year?
To ask the question is to answer it.
The “common” flu is just that, common. It isn’t a new threat, one that we initially had very limited understanding of how it’s transmitted, that hides for a while and then acts fast, and with a theoretically wide risk band. Car accidents, HIV, suicides, etc are also all “common”, i.e. they’ve already been factored into peoples’ thinking AND emotional responses. Heck, HIV will claim over 13k people this year, and you pretty much have to VOLUNTEER to get it.
Respectfully.
the hysteria is fabricated
There are always someone who benefits significantly from disruptions like this. If you have a lot of money to invest, you want the stock market to fall from 29,000 to 20,000 . . . great time to invest as the market will recover
One must be aware that the MSM had been void of “sensational “ news. They must have such news to survive.
Control the news and you control the world.
RE “That’s 3,300 dead from auto accidents EACH AND EVERY DAY”–source ?
Wiki has For 2016 specifically, National Highway Traffic Safety Administration (NHTSA) data shows 37,461 people were killed in 34,436 motor vehicle crashes, an average of 102 per day.[1]
https://en.wikipedia.org/wiki/Motor_vehicle_fatality_rate_in_U.S._by_year
The table below shows the motor vehicle fatality rate in the United States by year from 1899 through 2018.
In 2010, there were an estimated 5,419,000 crashes, 30,296 deadly, killing 32,999, and injuring 2,239,000.[2] About 2,000 children under 16 die every year in traffic collisions.[3] Records indicate that there were 3,613,732 motor vehicle fatalities in the United States from 1899 to 2013.
Fixed, thanx.
w.
That’s 3,300 dead from auto accidents EACH AND EVERY DAY … proportion …
That is world-wide, not US.
https://en.wikipedia.org/wiki/Motor_vehicle_fatality_rate_in_U.S._by_year
Annual Global Road Crash Statistics
View the WHO’s infographics on road safety facts.
Nearly 1.25 million people die in road crashes each year, on average 3,287 deaths a day.
Thanks, Leif, fixed. The beauty of the web is that my mistakes rarely last more than a few minutes.
w.
Not to put too fine a point on it (I did after all raise many of these same points in one of the earlier WUWT articles), but there are many injured severely for every death.
And for everyone killed in an automobile accident, there are a large handful killed in other sorts of accidents every single day (or month or whatever the chosen time period), and those people are just as dead and the situations often just as if not more tragic and oftentimes ultimately preventable.
I am not entirely enamored of comparing these deaths to deaths from other illnesses, or from other causes, but I would certainly not ignore the jarring disparity between how various harms and losses are treated.
What is being overlooked and needs to be crystallized and enunciated is that the cross section of those being harmed and killed by this novel illness does not align at all with that of people who suffer a bad or fatal outcome due to the seasonal flu or to any sort of common cold.
A few single cases can serve to just bring the aspect I am referring to into the light: Right now in the US, there are two emergency room physicians in ICU units due to this disease. One on each coast. One of them is a otherwise healthy mid-40s surgeon with many years of experience in dealing with victims of infectious diseases in an acute care setting, and he became ill long after the illness was known and being guarded against. The other is an even more experienced doctor in his 70’s, who has avoided becoming infected by a patient for some 50 decades, only to be infected by a disease everyone was on guard for.
When was the last time anyone heard of this sort of this occurring?
Seasonal flu almost never results in pneumonia in healthy adults between the ages of 16 and 65.
Oops type again.
That should be 50 years, or 5 decades…not 50 decades of course.
Willis, there is evidence of people being confined to cabin on the princess. I don’t know how much mixing there would have been through the aircon or with the crew delivering meals and drinks etc.
People either had balconies or they were allowed out to walk around for a little while each day, and told to stay a distance away from others…but the passageways are narrow…you can see videos and pics of people walking past each other in opposite directions with no way to stay more than a foot or two apart as they passed.
And from what I read…the cabins all have forced air and I saw nothing about HEPA filtration, which would take a lot of energy to force enough air through such filters for that many cabins.
So they all had shared recirculated air.
This is the opposite of how a hospital, for example, would quarantine people with a disease that spreads by air.
Most hospitals use PTAC units which serves only the room where it is installed. This is similar to motels.
but if you are in the US that is the world
Generalize much?
Called smoking -the Chinese and Italian men smoke heavily. Basing policy on unlike communities and cultures is rather silly
Whoa, good point!
And the reason why some people are exposed to the virus but show no symptoms, is because they were exposed to it in the past.
Covid-19 was identified in 2019, there is no evidence to support the claim that it never existed before 2019. For all we know it could have been around humans for millennia.
In my opinion cvd-19 is an election driven false crisis.
Klem,
Fact check: Mostly false.
In fact it is well known that the outbreak commenced at the end of 2019.
And no one who knows what they are talking about has ever said the virus did not exist prior to the zoonotic event that passed it to human beings in Wuhan, most likely in November of 2019.
It came from a reservoir which exists in some population of wild animals, and is originally derived from a species of fruit bat in that region of the world.
The rate of genetic drift is generally well characterized, and so the emergence of this virus as a distinct strain with unique characteristics can be accurately dated with some degree of precision.
You should try to have better opinions.
Whatever the origin, the stock market crashing and the economy shutting down is not a false crisis, it is a real one.
“In my opinion cvd-19 is an election driven false crisis.”
Maybe you should wait until this virus runs its course before deciding it is a false crisis. I hope you are right.
If it is election-driven then it will be over by about Christmas this year then?
The question I have is,”Who is stoking this crisis?”
re: ” The question I have is ”Who is stoking this crisis?” ”
The question should be: “Who has the most to __gain__ from painting the presentation administration as being incompetent and inept in handling this affair?”
Unfortunately the data show that the virus is not more deadly for smokers.
What data?
I don’t think I’ll get a response. The only data I’ve seen on the matter is the absence of data. One study included a row for smokers, but it had no data.
The Chinese have a number of issues that set them apart from the US: 3-5 times as many smokers (increases ACE2 expression in lungs), a culture of alcohol abuse (depletes lung glutathione), prevalence of hepatitis B (depletes glutathione), horrid air pollution (oxidative stress on lungs), possess type of haptoglobin that causes a depletion of vitamin C, and more TB.
Iran also has a problem with TB (as does Italy). TB’s symptoms are indistinguishable from coronavirus illness symptoms. Co-infection of TB with a virus is 5 times more fatal than either one alone. Are the coronavirus patients being tested for latent TB? TB is difficult to test for, so probably not.
In China people eat all sorts of meat, spitting in the streets and have questionable hygiene. In Italy there are 5000 sweat shops employing Chinese( many from Wuhan ) making clothes and living in insanitary and overcrowded conditions. Throw in Holy Communion , kissing during greetings, wearimng jewellery,etc and the R0 which is the figure for spreading disease could be high.
Inasmuch as there are still, as of 16 Mar, 233 active cases, 15 of which are classified as critical, the error range for the fatility rate should be much larger, it seems to me.
Secondly, we do not know when the first person became infected. If it was at the last port, it could easily be that eighty percent of the paasengers were never exposed, or do you have evidence otherwise? It seems you are making an unwarranted, and unstated, assumption that all passngers were actually exposed, or am I reading this wrongly?
Could this not be evidence that quarantining works?
“That’s the cruise ship that ended up in quarantine for a number of weeks ”
The ship sat there for weeks with all passengers and crew active on board.
No, it didn’t READ THE STUDY. It went under quarantine on 3 Feb. The testing was done by 20 Feb.
jtom March 16, 2020 at 6:21 pm
READ THE STUDY. It’s in there.
w.
Ok, they identified someone who was onboard for five days who displayed symptoms before boarding and later tested positive. He boarded the ship 20 Jan, and by 3 Feb, two weeks later the ship was in quarantine. Where is the argument that more than 700 passengers were EXPOSED to an INFECTIOUS person during this two week period?
How many contacts would be required? He could pass it on, but whomever he passed it to would go through an incubation period before becoming infectious. I can find no good estimate of what that period is. Without more data, I think it is unwarranted to believe people were exposed but not infected.
Please address this, Mr. Eschenbach.
The virus was first detected on an 80 year old passenger six days after he had departed the ship in Hong Kong (his home town); he had been on the ship for 5 days prior to disembarking in Hong Kong, having boarded it in Japan. Apparently, notices to the ship about this passenger went unread, and there was also a 3 day delay in authorities taking any actions when it arrived back in Japan. It’s probably going to be difficult to answer your questions, although quarantining definitely works when it can be done.
The relationship of age vs expression of symptoms by infected passengers is a clue to something, although this too could be confounded by the fact that patients were not necessarily infected at the time. I find it all very interesting. I hope that enough blood work was done so that this can be analyzed along with the above.
Thanks for an excellent, informative article. It would be interesting to know more about the medical histories of the 7 who died. Is age the only common denominator?
Absolutely interesting.
I wonder if good food has something to do with resistance and immunity?
For sure they will eat well and varied onboard the cruise ships.
Compare and contrast with 12,000 dead in the US from the 2009 swine flu pandemic.
About 7500 people die every day in the U.S. or about 2.74 million/year, although this year is a leap year.
The last pandemic to hit the US is liable to prove deadlier than the current one. IMO that’s a relevant observation.
It also infected (some 59 million) and hospitalized a lot more people, so was probably less fatal, despite its high total mortality.
re: “So I dug around and found an analysis of the situation …”
So did I, after reading this account by Tina Hesman Saey, science writer on that same report you read:
About Tina Hesman Saey – Tina is the senior staff writer and reports on molecular biology. She has a Ph.D. in molecular genetics from Washington University in St. Louis and a master’s degree in science journalism from Boston University.
I saw a video today in which a Wuhan crematorium worker was interviewed at some length. Based on the numbers that were eventually elicited, some 25k people died in Wuhan so far. If the death rate is actually 0.5% it means they actually had 500,000 cases, not 68,000. Deaths are still running at up to a few hundred a day.
Italy may be the best and most truthful data set available outside the ship travellers. Let’s look at these numbers and ratios in a month to see if the cruise ship was indeed an indicator for the general population.
What was the time period for that 25K of people that died in Wuhan? I’d guess that typically 200-300 die every day in Wuhan from other causes.
Definitely that cruise ship make up is different from the general population. The passengers in general were not poor and the older passengers were probably relatively healthy.
Population in Wuhan is 11 million. Lifespan in Wuhan per Wiki (yeah, I know) is 81 years. So 1/81st die per year, that’s about 370 per day.
w.
Italy’s population has a lot more elderly people by percentage and much more socializing among the old and young.
Italy is an outlier for various reasons. Approximately 30% of the Italian population are no-responders to antibiotics, presumably because of excessive use. Italian hospitals have a reputation for being “bacteria-friendly”. An extremely high percentage of the deceased are 65+ years of age, with medical preconditions that worsen the immune status. Now push comes to shove: these people fall ill from the virus, bacteria intensify their condition et voilà: intubation, artificial respiration and infusions are being needed. Then, the knell sounds…
I thought the technical term for the virus was SARS-CoV-2 Virus and the disease it causes is currently being called COVID-19.
Not interested in suing anyone, but I wonder if WHO won’t even call the virus by its technical name, aren’t they just contributing to the fear and panic by consistently called it the disease name COVID-19 which is what is killing people. The SARS-CoV-2 Virus is what is giving most young and middle ages people people the case of the sniffles and a cough, or they don’t even know they have it, and are of course still carrying and transmitting it to others. It seems only the Panic part is being spread wholesale by the powers that be. Just my observation IMHO.
Just call it the Wuhan virus, or Wuhan coronavirus. That name can last, COVID-19 or whatever it’s supposed to be, is unsustainable. See, I can’t use it without looking it up to check I’ve got it right. Wuhan – no issues.
The Chinese don’t like that and we must all do what China wants, especially the WHO.
“especially the WHO”
And the Western press.
Charles H,
Although, influenza mutates every year, vaccinations and resistance (due to past episodes) suppress the infection and mortality rates.
The novel nature of this coronavirus has the potential to be much more deadly than annual flu, for several reasons;
– Natural immunity is likely low
– A vaccine is not available
– The extended incubation period increases the infection rate.
– The kill- ratio, (although uncertain) is substantially higher than influenza.
Steven Moser has been sounding the alarm bells for weeks from Korea. This is a deadly pandemic and how we behave largely determines the outcomes we face.
Fortunately, reluctant family and friends took my advice three-weeks ago and stocked of on essential food supplies. Plan for the worst and hope for the best.
“Be Prepared” – The Boy Scout Motto
WUHAN FLU.
I do not know of anyone who is feeling or reacting the way they are due to the naming of the disease and the virus, or confusion and inconsistency thereof.
But I do know that no small part of the irrational response is due to the many wild rumors and jackass assertions regarding the origination of the virus.
And I am also fairly certain that part of the reason for the rapid spreading of the illness is that so many people insist on underestimating, downplaying the significance thereof, and even making assertions that the whole thing is a nonexistent hoax.
The exaggeration, blame gaming, finger pointing, and general obtuse jackassery of the MSM regarding nearly every aspect of the whole thing, is certainly not helping anyone.
Would it not be an amazing thing if these people took it as part of their job, or even just as part of their obligation as sentient human beings, to do what they can to help the situation, to cast light and not heat, to use their platform and their pulpit to educate and inform, or merely to have a general sense of responsibility as informed adults to be a positive force in life, instead of a divisive and hateful force for discord and chaos.
I noticed a few less “Gotcha!” questions from the press at the president’s new conference yesterday. The significance of the virus problem seems to be sinking in a little bit.
Willis,
The Insurance Institute for Highway Safety – Highway Loss Data Institute website states that there were 36,560 deaths on the roads in 2018. Your point is still well taken.
Brian
more curious when factoring that many US deaths occurred in one nursing home. I suppose the more spread out nature of the US population contributes to slower rate of fatality rate? What about people getting sunshine/vitamin D?
The U.S. has a fairly young demographic and for that reason the ultimate death rate should be lower than that observed in Italy for example.
It’s known that vitamin D boosts immunity. It’s been added to milk since the 1930’s to reduce rickets and that campaign worked but still many people are deficient in it. It’s possible that 10 or 15 minutes/day of sunshine or a UVB lamp would be more beneficial than the flu vaccine for example.
With proper dieting, sunshine and more active lifestyles we could certainly reduce the obesity epidemic, heart and kidney diseases and diabetes. Lobbyists don’t want that though.
landed in Seoul on Jan 24th from beijing
First order of business> Vitamin D shot.
Figured that this thing would get way worse and its not sunny
The problem is just as many studies shows it does nothing, if you give people placebo and tell them it’s vitamin D you can actually get higher results. It’s the same for vitamin C, Zinc and any other voodoo cure anyone comes up with.
You can also take up meditation apparently the quacks in psychology says there is data showing that will increase your immunity
https://www.psychologytoday.com/us/blog/women-autism-spectrum-disorder/202003/3-reasons-meditate-in-the-battle-against-coronavirus
So many quacks and so few ducks.
Imagine lumping the intake of vitamin D, vitamin C and zinc with “other voodoo cure”s. Wow.
Vitamin D might actually be THE vitamin NOT to take- it is good for common cold/ flu but apparently the response it provokes in the body is the very one COVID uses to proliferate.
No vitamins cure any disease, unless the disease is a vitamin deficiency.
And what does it mean to say “the response it provokes in the body is the very one COVID uses to proliferate”?
That makes no sense.
Do you know what vitamin D is, and how it functions as part of the immune response?
It sounds like you have no idea what makes something a vitamin, or how viruses reproduce in the body.
And no one has to take vitamin D. Your body makes it whenever you are exposed to sunlight.
Are you seriously suggesting corona viruses do more harm in people who spend more time in the Sun?
@Nicholas McGinley – I have to take Vitamin D with calcium since I have osteoporosis – it’s prescribed by a couple of medical professionals treating my condition even though it’s not a prescription, formally. Being from a northern climate my sun exposure is limited.
I did not mean it in the context of no one requiring it medically.
Yes, if one has a deficiency, you need to take it, or get injections.
Most people should take a supplement.
What I meant was, it is not necessary to take it to get a large amount…going in the Sun with exposed skin will do the trick.
Vitamin D is required for a white blood cell to carry out their functions.
They need to have a molecule attach to them to start the process of cell signaling with other immune cells, for antigen presentation, and for antibody productions, IIRC.
The immune system is utterly incapable of functioning without it.
BTW…all vitamin D requires UV light.
The stuff they put in vitamin suppliments is made using commercial UV lamps.
There is no other known way to make it.
Animals with fur make it by secreting precursors, and then sun transforms it into vitamin D on their fur, and they ingest it by grooming.
Every creature for hundreds of millions of years has needed and got vitamin D which needs UV light…even creatures that live below the level of sun penetration in the ocean.
They get it from things that live higher up and it drifts down to them, or swims down, or whatever.
Not sure about sea vent communities…but it has been well known for a long time that UV is the only way to make vitamin D, and this has been true for over 400 million years.
Oh I should really give one of the many fact check
https://factcheck.afp.com/health-experts-say-there-no-evidence-vitamin-d-effective-preventing-novel-coronavirus-infection
Answer FALSE or MISLEADING take your pick.
Thanks Willis
One wonders why Italy is in such a mess…?
ps As a 30+ years at sea person I well know the progress of any bug through the crew and scientists ….
It is politically incorrect to generalize about any ethnic group, but I will report what I have heard: Social distancing among Italians as they converse with one another is closer than average, allowing for more touching of each other and exchanging airborne droplets from speaking.
” Social distancing among Italians as they converse with one another is closer than average”.
That’s quite true, but you wouldn’t believe how close other populace like to get to each other.
Still, I think that Italy’s abnormal death rate is in large part due to the fact that many cases of infection remain undetected, thus inflating the death rate
I’m sure thats true but the actual number of deaths in Italy is startlingly high. No doubt that means far more are infected than has been shown by testing, but that simply asks a different question – why so many infections in Italy compared with France say?
Because being aware of the Italian case, we could act before (two weeks or so) with respect to the infection proliferation.
Despite this, I presume the number of unknown cases may be very high in France too.
Good news :
– Italian cases per day shows the beginning of an inflection (see : https://www.worldometers.info/coronavirus/country/italy/). The worst may be behind them.
I have heard two rumours passing around the Web. Totally unchecked. I repeat them here because WUWT is a superb place for deflating incorrect data…
1 – The Chinese/Asian ethnic group is supposed to have a greater average of ACE2 receptors in the lungs than Caucasians. This is the receptor the Wuhan virus connects to. So you might expect an increase in transmissibility in this group.
2 – The north of Italy is a leather manufacturing area, and has many companies bought by the Chinese and staffed by Chinese workers. So, given 1), you might expect high levels of the disease there.
I have no idea about the truth of either of these assertions, or how to check them….
Luckily you have an Italian on hand.
” The north of Italy is a leather manufacturing area, and has many companies bought by the Chinese and staffed by Chinese workers. So, given 1), you might expect high levels of the disease there. ”
Actually the highest concentration of Chinese is in Arezzo, Tuscany, usually classified as Central Italy and they’re for the most part in the textile sector. In the north at least every city and also a good number of small towns now have a Chinese restaurant and/or shop.
I have seen no data and I don’t know if they exist about the ethnic breakdown of coronavirus cases, but the deceased seem to be if not all nearly all “ethnic” Italians.
I think the ACE2 vulnerability was from smoking nicotine, not anything to do with genetics.
Just going by what I have read and seen, there is supposedly a lot of traffic between China and Italy.
The Chinese leadership is trying to float the narrative that the Wuhan virus actually originated in Italy, They claim this is the reason Italy is being hit so hard, because the virus originated there. And the Chinese leadership is also trying to blame Americans for the Wuhan virus. Anyone but themselves, it seems.
To extend your point, Tom, the following opening is excerpted from:
https://www.wired.com/story/covid-19-is-traveling-along-the-new-silk-road/
Also note that last year Italy signed onto China’s “Belt and Road Initiative” (BRI) to the consternation of her EU neighbors. Many stories can be found online detailing that.
Yes, the southern silk road route through Persia (Iran) to Rome was the entire purpose of the ancient Silk road, which was trade with the West (Europe) through Rome. Much as the same new Belt and Road Initiative to present day Europe. Although there are also now other ports of entry such as Athens right next door. But the ethic population in Greece is much lower than northern Italy.
The fact that northern Italy has a lot of ethnic Chinese travelling and living there should tell the story correctly. How many millions of ethnic Chinese Han were allowed to leave China for the 4 corners of the world in early to latter January before China basically admitted they even had a big problem going on. This was a colossal failure of the Chinese leadership to not only admit they had a problem, but they tried to silence and cover it up for at least 3 weeks while allowing millions of their potential infected citizens to escape around the world. This is what we will get if we allow the unbridled Chinaifcation of the world. Probably not PC to say so, but this is the truth of the matter.
Maybe this has something to do with smog – https://www.nzz.ch/wissenschaft/italien-weniger-smog-als-folge-der-coronakrise-ld.1546699
Wuhan had the worst air quality in china, northern Italy in europe.
Hi Willis,
Excellent analysis. What is your take on the massive amount of “self-isolating” that is now in full force? How long will we have to put up with this? And what might we see in the next few weeks that could be a good indication that we can begin relaxing this rather extreme reaction that grips the USA in particular?
“And what might we see in the next few weeks that could be a good indication that we can begin relaxing this rather extreme reaction that grips the USA in particular?”
People will calm down as they see that they can buy all the supplies they need. There are temporary shortages but they are attributable to delivery problems not availability of supplies, and the delivery problems will be sorted out very quickly.
The next two weeks are critical to keeping our health care facilities from being overwhelmed.
In the next two weeks we will have a much better understanding of the extent of the infection and where we need to concentrate our resources.
Once we get the infection rate coming down without our health care facilities being overwhelmed, then we can relax a little bit.
The next step is can we actually stop the spread. That may or may not be possible, but we may have bought ourselves enough time to blunt the fatal effects of this virus for many of those most vulnerable.
If we decide that the virus cannot be contained, then we will have to resume business as usual, while taking our newly-learned vurus fighting techniques, and take our chances with the Wuhan virus just like we take our chances with other viruses. Most people will survive the Wuhan virus no matter what.
Staying apart for two weeks will help the situation very much whether the virus can be contained or not.
Keeping the economy on hold is not good. The sooner we can get back to normal the better, and everyone knows this. The good thing is the US economy is very strong and this virus has not changed that. If we can get back to normal in a few months, then the economy will boom again.
But the longer we are on hold, the more businesses there will be that cannot stay afloat and that will certainly take its toll on the economy. Trump and Congress are going to try to keep a lot of those businesses going as long as possible and that will help, but the main thing is we need to get back to work as soon as possible. We can afford a few weeks to save lives, though.
Yes to this.
Willis Id rather take my chances on a square rigger to Bermuda than any of those cruise ship monstrosities.
‘”Sea Fever “by John Mansfield.:
I must go down to the seas again, to the lonely sea and the sky,
And all I ask is a tall ship and a star to steer her by;
And the wheel’s kick and the wind’s song and the white sail’s shaking,
And a grey mist on the sea’s face, and a grey dawn breaking.
I must go down to the seas again, for the call of the running tide
Is a wild call and a clear call that may not be denied;
And all I ask is a windy day with the white clouds flying,
And the flung spray and the blown spume, and the sea-gulls crying.
I must go down to the seas again, to the vagrant gypsy life,
To the gull’s way and the whale’s way where the wind’s like a whetted knife;
And all I ask is a merry yarn from a laughing fellow-rover,
And quiet sleep and a sweet dream when the long trick’s over.
Masefield … one of my favorite poems. I’m an inveterate seaman, see my post Addicted To The Ocean, or In Which I Finally Understand The Fairweather Gale, or my 12-part story of a Pacific crossing called A Pacific Penance. Heck, read all of them, rollicking sea-tales all.
w.
Going to do that Willis. Had an Opportunity to Crew on the Lady Washington –
years ago a 90day trip. Out of Coos Bay. Wife said ‘When you get to Grey’s Harbor, the divorce papers will be ready.” Took the wind out of my sails,so to speak. Had to be satisfied with the Potter 19…
Wife’s mostly Cherokee and she had that ah, I call it “Warpath look”on her face.
Never go beyond that.
Ever.
I have done both extensively. Sailing especially on square-riggers requires youth and strength. Criticism of cruising usually comes from those who have not tried it – it is wonderful, interesting, and relaxing especially for we older folk.
Willis
Were all the tests completed within two or three weeks of the ship leaving land? If not, a considerable percentage may have been infected, and fully recovered, prior to testing.
Another thing to keep in mind, is that this will not hit the entire US equally. When I looked this morning, West Virginia still hadn’t reported any cases. There is an opportunity there to share resources between different parts of the country.
Indeed!
In Washington State: (pop. 7.5 mil. 904 cases – 48 dead.)
King County pop. 2.25 mil. ——- 488 cases – 43 deaths (29 @ at “Life Care” home)
Pierce County pop. 900,000 ——- 38 cases – 0.0 deaths
Snohomish County pop. 800,000– 200 cases – 0 deaths
Spokane County pop. 500,000 —– 3 cases – 0 deaths
Clark County pop. 475,000 ——– 3 cases – 0 deaths
From Gov. “Insane” Inslee:
“Given the explosion of COVID-19 in our state and globally, I will sign a statewide emergency proclamation tomorrow to temporarily shut down restaurants, bars and entertainment and recreational facilities.
Restaurants will be allowed to provide take-out and delivery services but no in-person dining will be permitted.”
Outrageous uninformed reaction that will absolutely help bring on a recession here. IMHO
DANNY DAVIS March 16, 2020 at 9:36 pm
“Outrageous uninformed reaction that will absolutely help bring on a recession here. IMHO”
May I help?
“Trump-hating premeditated reaction that will absolutely help bring on a recession here – Orange Man BAD! Vote for the geriatric in November!”
Fixed it a bit for you.
Beat me what Boris is doing, except stirring the pot.
Auto
WV’s population is only about 1 million people, and the largest city in the state has around 40,000. On weekends the West Virginia University football team plays a home game with 50,000 attendees, Morgantown becomes the largest city in the State. The rest of the population
There’s also a growing suspicion that the virus may have been there already, based on admittedly anecdotal information about large numbers of severe, flu-like cases back in December and January.
It’s hard to figure, though, how such a thing could happen. Still, several of my family living there and their friends reported being hit by a flu like nothing they’d ever experienced before, with some requiring hospitalization for days from pneumonia.
Time will tell.
One of my long time friends now living in Montana got a very similar type of thing in mid-December 2019 which put him in the hospital for eight days with pneumonia. It was the worst bug he ever had, and he counts himself lucky to be alive.
I ended up in the ER with flu like symptoms in early Dec.fever,cough,diarrhea. sent me home a couple of days later-wife was in Nursing facility due to here it wen through the plce like wildfire. couple of people may have died from it. This was NE Oregon..High cold dry at the time…no Snow or rain. wife never got “it’…
It would be very informative if we had the distribution of passengers who required intensive care. It is not provided in referred study.
Salute!
Thanks, Willis.
Some studies that support your observations are now coming along, ones by “The Lancet” outfit are most interesting, as one of theirs concerned this old geezer your/our age who has a good example of COPD.
Turns out that high blood pressure, diabetes, coronary problems and stroke survivors had more fatalities than we “born again breathers” that had smoked for two score years before quitting.
One study acted as the climate alarmists should and actually used the words “hypothesize” that there could be cause/effect between the virus effects and the medication the folks listed were taking. In short, the ACE2 inhibitors made it easier for the virus critters to glom onto to their nose, throat and lung cells.
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext
Great work, as usual Willis.
Gums sends…
Gums cites a Lancet article hypothesizing that ACE2 inhibitors facilitate viral infection.
That seems odd to me since the ACE2 enzyme is the cell wall site the virus plugs into thus facilitating infection.
ACE2 inhibitors prevent calcium from crossing into the arterial cell wall helping to keep the vessels pliable.
An hypothesis is an idea, nothing more.
It says nothing about what is true, or even likely.
It is basically a formalized version of a imaginative musing, or idle speculation.
Merely the starting of point for finding out if an idea may have any shred of merit.
Also, the early “studies” I read, and read of, on the subject were all highly problematic, purely speculative, tiny sample sized, and used obtuse inferences and conjectures, and were ultimately nothing but jargon-y and highly referenced forays into guesswork dressed up as science.
For example, a follow up study to the first one on the subject used as a reference base a data set gathered from a study of victims of lung cancer, in order to characterize a “typical” cell surface receptor population cross section for airway epithelia.
Personally, I would not place great stock in breathless Reddit posts regarding highly technical scientific or biomedical issues.
Anyone who does not have the background to place such speculative and problematic ideas into perspective and context is just asking to be misled and misinformed.
I believe that properly speaking a “hypothesis” is an idea capable of making specific predictions which can be tested to confirm or refute the hypothesis.
Therefore somewhat more than an “idea”.
You would make a terrible climate scientist.
Under your definition of hypothesis I’m not sure that Darwin’s theory of evolution qualifies as a hypothesis, let alone a theory. You are requiring “specific” predictions which can be “tested”. Darwin’s theory tries to explain how new species arose in the past with no attempt to insist that it absolutely had to happen that way.
I have read that academic philosophers — who are not coming at this issue from a fundamental religious background — have often objected to Darwin’s idea of “survival of the fittest”, saying that strictly speaking it just amounts to “survival of those that survive”. They wonder what, specifically, it means to be “fittest” and how can you test for it ahead of time, not knowing exactly what new environments and stresses the organisms will encounter. Afterwards, of course, you can come up with a story or explanation for why some survived and others did not — but that’s exactly the problem is, isn’t it, it’s afterwards — so why is it a “prediction”?
Not ACE2 inhibitors I believe, but ACE inhibitors which effectively increase the expression of ACE2.
This includes type-2 diabetes treating and anti inflammatory drugs like thiazolidinediones and ibuprofen.
There is a clinical trial underway in China to test thalidomide for efficacy against Fluhan Wu.
No joke…saw it on clinical trials dot guv website.
FluHan Wu is an attempt at lame humor though…
Gotta think of something that rhymes better with Fu Manchu.
The Center for Disease Control is the official agency for reporting epidemics, not the Media. They gather data for the US – CDC estimates that so far this season there have been at least 36 million flu illnesses, 370,000 hospitalizations and 22,000 deaths from flu. Also flu deaths peak in winter, and generally decline to low numbers at the start of April. That is the Baseline for the US- and the CDC has stated that “this last 2019-2920 season has low to moderate flu numbers” That is, it is very much a normal flu season.
Now look at cv figures so far. There were 41 US deaths for the last 3 weeks, and now the total is up to 68, and we are nearing the end of the flu season. Meanwhile, our markets are running out of food, refrigerators and shelves are empty, and there are upcoming shortages of critical supplies for months. The American worker has always continued on, despite these problems, except for now. The anti-cv “epidemic” actions of the State and Federal governments should be brought into open public discussion now, and not months later. We need to get back to work….
+100
No place in the USA is “running out of food”. Lack of prompt resupply does not equal lack of resources.
Wild, unfounded proclamations like this are more harmful than the damn virus.
what about the people who tested positive once they returned to their own country in the 14 day period afterwards…I am fairly sure there were some in Australia for starters!
Excellent article Willis – as usual. Thanks.
Thanks Willis. You are da champ.
Things don’t look too good for Italy… Wow.
Very informative. Thanks. The WorldOMeter site indicates 233 still active cases and 15 “serious/critical”. Is your data more up to date? Or might the final result be a substantially higher mortality rate?
Nice job Willis!!!
In perspective:
CDC estimates that so far this season there have been at least 36 million flu illnesses, 370,000 hospitalizations and 22,000 deaths from flu in the USA alone (10/2019 to present)
In the last 24 hrs approximately 60 people died from influenza related complications. In the next 24 hrs another 50-60 people will die from complications due to Influenza.
Total Corona virus deaths in the US 80 total.
Total Corona virus deaths world wide 7100.
2017/2018 US Flu deaths 86000
2009/2010 H1N1 cases 2 billion plus ( we estimate 1 in 3 people on planet earth were infected with H1N1) fortunately it was a very mild form of swine flu.
Source: CDC weekly flu report : https://www.cdc.gov/flu/weekly/index.htm
Johns Hopkins Corona virus Map : https://coronavirus.jhu.edu/map.html
Willis, the correction is appreciated.
The ratio of passengers to crew is approximately 1:0.7.
With this in mind, the total age group likely skews toward the younger side.
My only point is, it is difficult to establish any statistical inferences with so many unknowns.
In fact, your flawless statistical analysis my paint a false picture of COVID-19 disease spread and death rates.
In a perfect world, a demographically congruent group of people would all interact equally with each other in a confined space.
I didn’t see anyone mention the studies that show two different strains of the virus. Wouldn’t make more sense (taking into account Italy and Spain) that the cruise ship just had the less virulent strain of the virus? Hence less infected, and less serious cases. The cruise ship would be a perfect place for this to occur, only one patient bringing on the strain, whereas in a country like Italy, you have multiple vectors of infection… ??
Excellent analysis! (Excellent reporting, too.)
However, confounding factors:
1) As noted by several here, the population of a cruise ship is skewed from that of the general. The aged will not be the most vulnerable aged – they are people who have had good medical care, and do not live in heavily polluted environments. (The demographic of old + wealthy also has a much lower smoking rate than even the US population as a whole.)
2) The major cruise lines are, after previous very bad experiences, very close to OCD about cleaning. More than a nursing home – more than many hospitals, in fact. (A norovirus outbreak was the worst of those incidents – and is a far nastier thing to get loose. If I hear about a “novel norovirus” – that is when I will fill the shelves and freezer and lock the bunker door.)
3) Also as noted, the younger demographics are the more social with strangers – and also have a shorter social distance. (Us old grumps don’t want to be hugged except by very close relatives. Many of us not even then.)
Was this data taken after everyone cleared the period of incubation?
I get a strange feeling when people compare the absolute number of death by automobile accidents and the absolute number of deaths by COVID-19. That’s not how you determine that automobile accidents are worst than the flu by the absolute the number of deaths. They are not the same death rate!
Someone people even tried to compare the number of death from COVID-19 in the U.S. with the number of death of H1N1 back in 2009, but they failed to mention the number of cases involved.
From the CDC : https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html
“From April 12, 2009 to April 10, 2010, CDC estimated there were 60.8 million cases (range: 43.3-89.3 million)… 12,469 deaths (range: 8868-18,306) in the United States due to the (H1N1)pdm09 virus.”
That’s:
12,469 deaths/60,800,000 cases = .02 % Death rate
Put that into perspective. And from Willis’s article above, “according to the study, the age-adjusted infection fatality rate was 1.2% (0.38%–2.7%)”. Now, if the U.S. gets 60,800,000 cases of COVID-19, God forbids, that’s a possible death count of ABOUT 729,600 at the 1.2% death rate.
Let us not forget that an infection can spread very quickly… exponential anyone?
Cheers,
Chuck
Exactly, it’s like comparing the normal aging of your home to either a spark of fire (but it’s just a little spark!) or some termites (but it’s just a few termites!). Some conditions are chronic and stable–sad facts of life. Others are a sign of something that you’d better get a handle on quick, before they overwhelm your resources.
I had the same curiosity and not 10 minutes ago shared this with some friends.
How about a random group sampling?
The Diamond Princess – a mini-city of 3700
Total cases 696
New cases 0
deaths 7
recovered 456
active 233
serious critical 15
Math-
696 out of 3700 = 18% got the virus
7 out of 696 = 1% of the infected died
More:
https://www.worldometers.info/coronavirus/
You can follow the tally globally and by country.
There have been 182,457 recorded cases.
Active 95,682 Closed 86.775
95,682 Active-Currently Infected Patients
89,519 (94%) in Mild Condition
6,163 (6%) Serious or Critical
86,775 Are closed cases
Cases which had an outcome:
79,617 (92%) Recovered / Discharged
7,158 (8%) Deaths
But missing is any estimate of total people infected as is done with the flu.
Most people infected with the corona never get tested, treated or counted.
They are out there and infectious, with or without symptoms just like people with the flu.
But millions have the flu in the USA alone.
If the cruise ship mortality rate (miraculously) ends up extrapolated to a global scale then we have been witnessing……. something odd?
7,158 deaths divided by 182,457 cases = 3.9%
The point is… the total number of infected is actually much much higher than 182,457. So, the percentage is wrong, and is much much lower than 3.9%.
No you are misled, mistaken and missing the point.
The number of global cases is not 182,457
It is far more and unknown. Likely in the millions world wide.
That 182,457 is only the number who were processed by medical facilities and there can be no mortality rate derived from it.
That’s why the captured populous on the cruise ship is meaningful.
My 21-year-old nieces went on a sold out spring break Caribbean cruise. They left out of Florida on the 8th and returned on the 15th. They had a great time and so far no reports of illness.
Incubation period: 5-15 days.
Hang on, over 700 died in Italy yesterday and you expect less than 4000 deaths in the US?
Italy also reports that 99% of the deaths were people with underlying health conditions and those over 80. Speculation is that this is happening because Italy has a tradition of multi-generational housing that the US does not.
Neil March 22, 2020 at 2:26 am
Neil, I have no idea who “you” is or where said prediction was made … please quote exactly what you’re referring to.
w
Thanks – a very interesting analysis, Willis.
I am hearing that the test (used in Australia at least) has a ~ 30% false positive (I think) error rate. If this had been the case for testing on this ship, can you tell us what the effect would have been on your results?
“Really, Mr. Eschenbach, don’t you think it is misleading to say they were kept together for one full month, when they were under quarratine for half of that month?”
So JTom, I guess you figure the regular crew members working under duress were able to effect the perfect “quarantine”. Really ? All these untrained crew members moving food, plates, forks, knives, cups, glasses etc. according to some ad hoc undefined protocol were doing just as well as trained medical staff. What they did on the ship, and it was probably the best these untrained workers could do, was probably for naught. Trained medical staff are having a hard time establishing effective quarantine. The crew never had a chance to be effective. Personally, I would view their whole time on the ship as “exposure”time
Willis, regarding your 83% non-infected rate/17% infection rate…perhaps an interesting “coincidence”:
Compare to the 2009 H1N1 swine flu pandemic. In the US (https://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm), the CDC estimated there were 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (range: 195,086-402,719), and 12,469 deaths (range: 8868-18,306) from April 12, 2009 to April 10, 2010. The population of the US in 2009 was 306.8 million. 60.8/306.8 x 100% = 19.8% infection rate.
Coincidence?
Drcrinum
One of the survival advantages deriving from genetic diversity is that animals seem to have an inherent natural immunity of something like 10% of the population, even when they have never previously been exposed to a novel pathogen. That is one reason that, when given an antibiotic, one is strongly urged to complete the entire regimen. Some bacteria are more susceptible and are the first to die. One will then start to feel better. However, if the remaining bacteria are not continued to be hammered, they will come back and all will have resistance to the antibiotic.
Curiously, Clyde, some recent studies say taking all the antibiotics kills all of the pathogen except the most resistant … which is left with no competition and takes over immediately as the main form. And that advances resistance rather than discouraging it.
Funny how life works.
w.
My understanding is that a course of antibiotics is supposed to be designed to allow ample time for the immune system to mop up all of the population of the infectious organism.
By the time of the conclusion of a systemic infection, the number and amount of immune cells and antibody protein fragments in the system of the patient is immense.
As an example, at any given time, the population of immune cells in the blood and tissue of a healthy person is some three to 5 trillion cells, a total mass of ten pounds or more…and maybe twice that.
And the compliment system is a collection of chemicals that has a mass of several pounds all by itself.
By way of comparison, the brain is around 3 to 3.5 pounds.
But the response that is ultimately generated by a person with a strong immune system to rid a person of a systemic infection may consist of an ADDITIONAL temporary population of cells, cytokines, and various other immune system molecules, twice as large or more, as the normal population, which itself may have 98% of the total mass within tissues rather than circulating in the blood or lymphatic system.
A normal white cell count for a healthy adult is between 4,000 and 10,000 cells per milliliter.
When an infection is present, a typical value for the WBC count might be 25,000 to 50,000.
And these cells are being produced in prodigious quantity on an ongoing basis at such times.
With the exception of pathogens that have found some way to hide within cells in a dormant form, there is generally zero pathogenic bacteria just hanging around in the blood stream or within tissues. In order to overcome or be in temporary equilibrium with the innate and adaptive immune systems, vast numbers of any pathogenic organism must be present.
Memory cells ensure that there are no stragglers infecting us at the conclusion of an illness.
@Willis – actually, referring back to your earlier excellent post, antibiotic response also follows a Gompertz curve. Take a ten day course – the first couple of days, not much response; days three through eight, most of the critters die; the last two gets enough of the rest that the healthy immune systems cleans them out. (One reason that an MD should evaluate the immune system of each patient before prescribing – a compromised system requires a longer course.)
Willis
Certainly it is possible that a normal regimen of antibiotics will not kill all of the pathogens, and the patient doesn’t fully recover. That is why in particularly problematic infections the physician may follow up with treatment with a different antibiotic. It is a fine line to walk between not giving enough and giving too much.
Inasmuch as toxins are rated with an LD50, the amount of toxin in, say, milligrams per kilogram of body weight that will kill 50% of the subjects, I’ve often wondered why a 100 lb woman will be given the same antibiotic dosage as a 200 lb man. It would seem to me that 1) the woman is given too much, or 2) the man is given too little, or 3) neither gets the optimum dose. I’ve never gotten a satisfactory answer when I’ve asked a physician.
As an aside, I’m going to guess that the susceptibility of people to a pathogen looks something like a normal curve. That is, some on the tail will be extremely susceptible, those on the other tail will be extremely resistant, while most people will fall somewhere in between. That can probably be expected to be the behavior of pathogens exposed to antibiotics as well.
Doses for dogs are typically weight dependent. Likewise, a major reason for reduced dose recommendations for children.
It is also strange that they do not advise everyone to start every course of antibiotics with a double dose, to get the blood level up into the therapeutic range as quickly as possible.
It takes more to perfuse a person than it does to keep blood levels above the therapeutic range once the system is perfused.
Everyone should do their own homework on things like the proper course of time and the best antibiotic to use, unless you think your doctor knows everything and is never wrong.
Was just teaching this in class last week Willis. Basically you need to hammer them initially and keep going for the full course.
You might find this movie I showed interesting.
The “experiment” does not include description of treatments, if any, that were applied.
Late breaking info indicates that a common anti-malarial drug, chloroquine, has potential to prevent and cure 2019-nCoV. See for one example:
https://www.nature.com/articles/s41422-020-0282-0
I doubt the Princess passengers were treated with any anti-virals but cannot say for sure. If they weren’t, and if chloroquine is effective, then predictions of future outcomes from this disease (based on Princess outcomes) may be overly pessimistic.
Thanks, Mike. The article says:
Both of those are great news. Me, I’ve taken a lot of chloroquine in my life … I’ve had malaria four times, and I’ve blocked malaria from developing when it started coming on another four or five times by taking three chlorquine “daily doses” each day for three days.
So if I get the virus, I know what I’m gonna try …
w.
Willis. Chloroquine is a zinc ionophore. Helps the zinc get through the cell wall. Chloroquine is also used in some cancer therapy.
It’s the zinc that does the job inside the cell.
I see claims that zinc + chloroquine is being used in South Korea. Steve Mosher, do you have any info on this?
w.
They most certainly were treated with remdesivir.
At least 14 of the sickest of the Americans taken off that ship got remdesivir.
Hundreds more who have been hard hit by the disease in Washington state alone have got the drug.
All of these were given the drug on a compassionate use basis, IOW not as part of a clinical trial.
All 14 recovered.
I have been giving a heads up on this for over a month, and it is still possible to take advantage of a possible pop in the price of the stock.
The Street seems to hate Gilead, even as it may have the drug that at the present time is the single best hope of putting this episode behind us.
We do not need to get rid of the virus to change the trajectory of the economy, only to find out that there is a drug that will prevent death in most cases of severe illness.
https://www.wsj.com/articles/experimental-drug-helps-some-americans-ride-out-coronavirus-nih-doctor-says-11584094955?mod=business_lead_pos2
I wonder what the long term tolerance would be to taking remdesivir as a seasonal preventative, especially for the elderly. Mechanistically, its mode of prevention and cure seems sound.
Never happen.
As a matter of fact 15 critically ill US passengers were used by Gilead as a first test group for remdesivir treatment. This is likely to have affected total mortality, since they all survived.
2 strains of the “Wuhan” corona-virus are known to be existing side by side. One is more agressive than the other (as discussed in prior WUWT post invoking this virus) & at least one case had simultaneous infection with both known strains.
Which means, to me, that extrapolating from the Original Post cruise ship data to global “Wuhan” corona-virus data has some limitations. If the cruise ship had relatively acceptable consequences & cruise ship exposure involved the less agressive viral strain that doesn’t mean we can deduce similar consequences in situations involving the more agressive viral strain.
Strange numbers out of Germany.
An “interesting” article about the situation inside the Diamond Princess.
https://www.businessinsider.com/seasoned-expert-visit-diamond-princess-ship-scared-terrible-hygiene-2020-2
Thanks, Astrocyte, fascinating. It reinforces my assumption that there was continuing infection despite the ship being quarantined.
w.
It’s good news that controls were inadequate but outcome was not catastrophic.
“Again, a curious distribution. Young and old were more likely to be symptom-free, while people in their 20s, 30s, and 40s were more likely to show symptoms. Who knew?
I did. An age-related decline in the naive T cell compartment fully explains this. Both the lack of symptoms in the young (a robust Type 1 viral response with fever is more common after puberty), and in the elderly where declining age-related proliferative responses in T cells in the host delays viral responses or simply allows the virus to replicate without response (chronic infection, very bad).
See this graphic from my PhD dissertation at UMass Medical School.
https://drive.google.com/file/d/11Xx1V8-pP6nNIwddpuzZagmuSKP57hcI/view?usp=sharing
Proliferation of T-cells is necessary to allow them to multiply to the numbers needed and to differentiate into various forms that both directly attack and kill virus infected cells and to provide vital “Help” to other cellular functions like B-cells to proliferate and become plasma cells that secrete immunoglobulin (antibodies) to neutralize free viral particles in the circulation and in tissues. As we age our telomeres (the ends of our 43 chromosomes in every cell = 96 telomere “ends”) shorten due to steady proliferative erosion, essentially a biological clock on cell division limits. This cell division limit is called the Hayflick Limit.
From this resource:
https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1570&context=gsbs_diss
If you don’t know, T-cell responses are necessary (essential) for defeating a viral infection. Depending on the virus and the route of infection, the B-cel cell humoral (antibody) response may or may not be essential. In respiratory viral infections they usually are to prevent recrudescence. Both B-cells and T-cells must undergo selection for virus specific patterns and then those selected T and B cells must vigorously proliferate to then go fight the virus throught the body, both with antibodies, and with T cells killing infected cells before they can release their virus.
Excellent! Thank you for this.
Joel, thanks as always for your interesting and informative replies.
w.
Also thank you for the link to the full paper. Currently collecting various papers etc. for a blog post – and it’s not easy finding ones that I’m sure aren’t overly biased.
Joel O’Bryan
March 16, 2020 at 9:12 pm
“Both B-cells and T-cells must undergo selection for virus specific patterns and then those selected T and B cells must vigorously proliferate to then go fight the virus throught the body, both with antibodies, and with T cells killing infected cells before they can release their virus.”
————————–
So the efficiency of response depends on “selection for virus specific patterns”,
Which very much tied to the virus and the antibodies fusion on the blood stream.
In the very first stage of a viral infection (respiratory organ),
the chances of such effective response been in time triggered, are very little, as there very little viral penetration of the blood for not saying none, definitely no antibodies (the proper one), so;
The response will be by default, good but not properly efficient,
due to the fact that the “selection for virus specific patterns” will be based on the default, the default immunity setting response, good, the best under this circumstance, but still not the proper one
required… as it will not match for the proper response required.
But as the infection of a population increases, the heard immunity will quickly stabilize and rely in the proper response, as chances of the viral and antibody fusion in the blood will increase considerably,
and subject the immune system to respond by relying in the proper parameters for “”selection for virus specific patterns”, and therefor be far more efficient… and in same time flashing out the “pollution”
from the less efficient response of the first stage.
A heard insulation or isolation, definitely not helping much in such a case, only extending the time of the first stage response, which may be a good response, but not as efficient as the proper one…
Thanks Joel.
Please do not mind of letting me know if you see that my understanding as expressed being wrong.
cheers
Willis,
You said, “Buncha virus resistant old geezers, I guess … ” That is probably more prophetic than you realize. It has been said that “Age is only a number.” The older people who were on the cruise are probably more ambulatory than is typical of their age group, probably more affluent, and therefore has probably had better medical care than average. Inasmuch as comorbidity has been strongly correlated with deaths, we may be able to assume that, on average, those taking the cruise do not have the same level of comorbidities as smoking laborers from Wuhan or northern Italy. A cruise ship doesn’t select as strongly for physical fitness as a skiing holiday, but even a ship, what with stairs and outdoor recreational activities, probably eliminates the least healthy in their age groups. So, it wasn’t a perfect ‘test tube’ for what will happen to the land-locked “geezers” in the US, but it probably provides some insight on who the real high-risk people are.
In any event, I am a little perplexed by the reaction of the Media and political leaders to what is still a relatively small number of deaths in the US. We know very well that the vaccines that target specific strains of flu virus, sometimes completely miss the mark. Apparently, this year, with 20,000+ seasonal flu deaths, is one of them. Yet, in all the decades that we have been hit-or-miss vaccinating, we have never had the panic reaction to an ineffective vaccine that was little better than no vaccine. The Media and the public has just accepted what seemed to be inevitable, tens of thousands of deaths.
There have been objections to the UK response claiming that “herd immunity” will only last a few months, at best. Yet, again comparing to seasonal flues, we know that the flu viruses mutate and that is one reason we have to get vaccinations annually. If “herd immunity” is established, even temporarily, that probably gives the world a year to develop a COVID-19 vaccine. There is a lot regarding this pandemic that just doesn’t seem to add up.
“In any event, I am a little perplexed by the reaction of the Media and political leaders to what is still a relatively small number of deaths in the US.”
ITS NOT ABOUT THE DEATHS
Indeed. The danger is not the viral infection itself but the risk of not having enough capacity in the health care system to provide what would be normal treatment.
Now the main danger to society is the absolutely insane over reaction by politicians which seems likely to trigger another financial crisis which will do far more harm than good.
Now I have to go. France goes into housebound curfew in a few hours , I want to take a last breathe of freedom before the end of the world.
Steven Mosher
March 16, 2020 at 9:51 pm
Yes Steven,
“ITS NOT ABOUT THE DEATHS”
it is about “The projected death blossom” by the gutless and the unworthiness”
It is a very very low profile viral infection, far lower than any common cold flu.
Very very soft and even benign.
In this example that Willis brings here it is very clear.
Actually the rate of infected in that “experiment” is far higher.
Tests do not pick it up due to the fact that such tests do not detect or can not detect outside the incubation period proposition.
Infected ones with the virus in the state of dormancy or hibernation do not test positive.
That how soft and undetected such a viral infection this one is.
The tests used and applied, seems to be on detecting directly the virus… which will be ok with the cases that have just completed the incubation period.
Low capability of detection for general population, due to low window, due to this virus infection being too soft…
As far as I know, the test thus far happens not to be an anticorps test.
When a viral infection gets within a “herd”, it actually means that it consist also as an anticorp “infection” too,
and in such as a kind of viral infection as this one, the anticorps “infection” very much will overrun the virus… as there will not be hibernation or dormancy in case of the anticorps “infection”.
In this case, as put here, Steve, the only thing we may claim as success by this preventing draconian measures imposed globally,
is simply a very little delay in the consideration of the elderly getting the anticorps before the virus…
Steve, there is a full blown anticorps “infection” in the “heard” going on,
and this draconian crazy measures only slowing that one down, when in the same time no much impact at all on the virus… as the virus infection has a very much slower path…
When I said the first time, that this viral infection looks like an implemented natural “vaccination”
I was not joking or being irresponsible.
cheers
You English is not sufficient to make your comments decipherable, unfortunately.
Nicholas McGinley
March 17, 2020 at 4:11 am
Nicholas,
you may be right, but the chances of you being right are less than chances of me been right, when telling you that the problem there or here, happens to be your lack of knowledge in this matter… more than my English not good enough in this case.
So take a breath and let others here like Steven or Willis to respond… if they like to.
Besides,
was not a comment addressed at you, therefor you should have stayed away if the only thing you have to say it happens to be a complaint about my language.
See, easy, you will very much easily understand this reply to you, in consideration of my English,
because you have good enough knowledge in such issues as gossiping or social moaning…
comprende amigos!
Please do not start moaning about my Spanish too now, will you!
cheers
What the SNIP are you babbling about?
Incubation period does NOT mean dormancy or hibernation.
Greg
March 17, 2020 at 10:24 am
Greg,
Thank you for your interest and effort.
But how do you think that dormancy and hibernation has nothing to do with incubation period or not meaning anything there,
when and where actually the length of incubation period tied also very much so to such as.
Any understanding at all of the seasonal period setting of the seasonal flu.
Wait for it, dormancy and hibernation…. oh well that happens to be the clause of softness of a viral infection, the length of dormancy and hibernation in consideration of incubation period… stalled or extended, by the merit of the viral infection been too soft…
The dormancy and hibernation synchronizing of a viral infection, like in the cold flu influenza, with seasons, consist as the softness of such viral infections.
If you ever believed that such seasonal infections went way temporarily because the virus went way, you wrong mate…
The virus still there, dormant or hibernating, till the condition right or ripe to flash out again… very much in proposition of incubation period essentially.
Hope this further supports a further explanation.
Please keep asking, if feel like… 🙂
cheers
Mosher
If it isn’t about the deaths, then what is it about? Virtue signaling? With 20,000+ seasonal flu deaths in the US up to this time, versus 60 COVID-19 deaths, it is obvious that the seasonal flu patients are requiring almost 3 orders of magnitude more bed space and resources than COVID-19. Will the COVID-19 pandemic ever match the seasonal flu? I doubt it unless there is something about its behavior that we don’t know.
I’m not Mosh, but I can tell you what it’s about. It’s about not overwhelming your health care system with too many seriously ill patients … that leads to bad outcomes for everyone, including increased deaths.
w.
Willis
https://www.msn.com/en-us/news/us/some-ask-a-taboo-question-is-america-overreacting-to-coronavirus/ar-BB11gh4K
If we were quickly approaching filling half of the available ICU beds, then I would say that it was time to put the breaks on the transmission. However, we don’t seem to be near there.
A question I have asked before, and haven’t received a good answer for, is “Why in years past when the flu vaccine has missed the target strain(s), we haven’t panicked and instituted lock downs? Why is there no public discussion of the 40,000 US deaths from seasonal flu [as claimed in the link above] as compared to the ~70 COVID-19 deaths?”
I recently saw a graph of the daily infection rates of the so-called Spanish influenza for New York and London. The rise/peak/and decline took place within less than 2 months without the kind of extraordinary disruption of business, education, and social activities that have currently been implemented. The intent is to “flatten the curve.” However, what happened in Wuhan doesn’t look fundamentally different from what happened 100 years ago, without the unprecedented restrictions.
The deaths are bad, the potential deaths are worse, but look what is happening with the economy already and we are still in the going-up phase.
https://unherd.com/2020/03/the-scientific-case-against-herd-immunity/
“Why the Government changed tack on Covid-19”
(The UK govt)
Very clearly written, you should read it. Some quotes:
* “the case fatality rate of COVID-19 is over a hundred and fifty times higher than influenza fatalities in a typical year”
* “Another is that the influenza virus mutates rapidly, […] In comparison, COVID-19 and coronaviruses in general mutate relatively slowly”
* “Another difference is that the influenza virus exhibits clear evidence of seasonality, while evidence shows only a weak relationship for coronaviruses.”
* weather alone (i.e., increase of temperature and humidity as spring and summer months arrive in the North Hemisphere) will not necessarily lead to declines in case counts
* “Finally, there is a lack of evidence that lasting herd immunity to COVID-19 was possible in humans when acquired by infection, and that recovered cases would be prevented from reinfection.”
Thanks, yet again Willis, for another very informative article, this time on the Diamond Princess and the Covid-19 Panic.
“For me, this is all good news. 83% of the people on the ship didn’t get it, despite perfect conditions for transmission. If you get it, you have about a 50/50 chance of showing no symptoms at all. ”
what makes you think its perfect for transmission? folks spend a long time isolated in their rooms.
There are also interesting cases. Like the dude on the bus in china who infected folks at a distance?
Also the call center in Korea.
Not to nit pick but the ship is not exactly a good experiment.
any ways nice work
Next.
I hope people See that sometimes science cannot do controlled experiments. AND STILL
we have some understanding, some knowledge, some things we can rule out.
Steven Mosher March 16, 2020 at 9:30 pm
Thanks, Steve. Someone above posted as follows:
Seems pretty perfect for transmission to me, particularly with the crew cooking meals and cleaning rooms … not to mention that the Diamond Princess has 12 bars and clubs, a theater with live entertainment, various venues that “host events like karaoke, trivia, Japanese storytelling, retro quiz contests and theme dances”, a swimming pool, activities like carpet bowls, beanbag toss, Ping-Pong, egg drop challenge, bingo, golf chipping, basketball free-throw, ukulele, hula, ballroom dance and Bollywood dance lessons, a demonstration by the executive chef, art auctions, spa seminars and shop staff lectures, movies and concerts, and various unhosted get-togethers (LGBT, bible study, veterans and military).
Not to mention a casino, dances, a library, a spa, a Japanese bath, five dining rooms, a buffet, an internet cafe, shops featuring logo apparel, toiletries, jewelry (costume and gemstone), watches, liquor and perfumes.
And you think this is not perfect for transmission? Not sure why. Information from here.
See also this article by a Japanese expert who went on board during the period when it was quarantined … he said the hygiene was terrible and quarantine procedures non-existent.
Best regards, stay healthy, my friend,
w.
Still not seeing any evidence that it is perfect for transmission.
good?
better than most?
based on the experience in Korea the church service appears to have been better.
lets put it this way. 1 lady goes into church and 1000 people get sick
dude goes into work and 50% of the people get sick.
The right question might be what was different about the ship?
The right question might be why is the Diamond princess an exception?.
Thanks, amigo. My very first question above was, why only 17% getting the virus? So I’ve asked the right question.
Next, I can’t find anyone (but you) saying “1 lady goes into church and 1000 people get sick”. I find this:
and this
and this
So near as I can tell, the one woman, “Patient 31”, didn’t GIVE coronavirus to the people in the church—she GOT coronavirus from the people in the church.
Finally, I’m not seeing why a church, where you are for a few hours, would be a better place to spread coronavirus than say the theatre or the bars or the restaurants or the chapel or the whole ship of the Diamond Princess, where they were for a month.
Regards,
w.
PS—I asked somewhere in the thread, I’ve read that in Korea they’re using zinc + chloroquine as a treatment … true?
I think because how close they sit in that particular church, plus apparently being sick is not a valid excuse for nonattendance!
https://www.cnn.com/2020/02/26/asia/shincheonji-south-korea-hnk-intl/index.html
From what I’ve read the zinc+ chloroquine treatment sounds very promising, I’m taking zinc supplement (I’ve found Zicam to be effective with colds). I hope that the US will check this out and if it looks effective adopt it and not the ‘not invented here’ approach that they did with the test (and messed up).
Someone brought it up at the Presidential news conference today so maybe it will get followed up?
https://www.cdc.gov/mmwr/volumes/69/wr/mm6911e2.htm?s_cid=mm6911e2_w
There is another problem with infering R0
from the diamond princess.
R0 estimates can be dominated by superspreaders.
no superspreader ( person with a LARGE viral load)
low r0
Same with SARS and MERS
Thanks, Steve. You keep talking like there are regular spreaders and one single solitary superspreader. That is NOT what your paper said. Look again at the distribution above. According to your link, there is a range of R0 among the individuals, and the range is continuous from zero-spreaders to people with a very high R0.
As a result, according to their numbers in the run I showed above, there would be no less than 48 people who infected more than five people (R0>5), and 21 who infected more than 8 people (R0>8). So the idea that there are no “superspreaders” in a group of that size comes up hard against the claim by the authors of your link that it is a distribution from people that don’t infect anyone at one end to people that infect a whole bunch at the other end of the distribution.
Nor does this change a whole lot in different runs. In the run of the calculations I showed above, there were 48 people with an R0>5. Running the calculations 100 times give us a mean of 43 people with an R0>5, with a maximum of 56 and a minimum of 26.
This is also true for even more infectious people. In this run there were 21 people with an R0>8. Running the calculations 100 times give us a mean of 18 people with an R0>8, with a maximum of 25 and a minimum of 10.
So it is mathematically very, very unlikely that there would be no people with a very high R0 in the group.
Regards, and stay well, my friend,
w.
Steven Mosher
March 16, 2020 at 9:30 pm
Next.
I hope people See that sometimes science cannot do controlled experiments. AND STILL
we have some understanding, some knowledge, some things we can rule out.
————–
Yes Steven,
and this “experiment”, no matter how some will start to water it down,
it shows clearly that there were no any such scary spikes, that required draconian measures to considerably force it down to a degree, so there will be no overwhelming….
The whole thing happened to be too flat, Steven… by it’s own merit… no scary spikes there whatsoever.
Even with no any extra support, the outcome would have being the same, pretty much,
with no any overwhelming of the medical service of the ship.
This experiment, good enough at that point, on ruling out the bases of this global mad panic:
“The overwhelming of the hospitals”… WOW.
cheers
Thank you Willis, excellent analysis and very prescient. So much hysterical conjecture at this point it’s a relief to have an objective examination of the Diamond Princess experience.
Unusual, there isn’t a distribution by sex.
Let us not forget the 500,000 deaths in the US alone, per year, from smoking cigarettes…
Automobile deaths also illustrate an important point. How many more do you think
there would be if there were no restrictions on speed, safety, drink driving, training, road quality etc? Society has learnt how to reduce automobile deaths to a manageable number by enforcing a large number of restrictions (speed limits, traffic lights, road rules, etc) all of which we expect people to learn and be tested on before they get behind a wheel. Car manufacturers are also required to install safety devices like seat belts, brakes etc and test their cars for safety in collisions. Which took decades and significant government intervention before deaths got as low as they currently are.
Now apply the same lesson to COVID-19. Dramatic government intervention now is likely to save a significant number of lives (leading people to ask what all the panic was about). Do nothing and there will be mass casualties, if only because hospitals do not have enough spare capacity to cope with all the additional people requiring treatment.
Dear Willis
May you please do another data presentation against time.
Number of Microbial swabs taken for viral/bacterial infection.
Number of swabs investigated for virus.
Number of swabs investigated for Covid19.
Number of test kits available for Covid19.
Number of testing facilities available.
Number of news items referencing Covid19.
Number of positives for Covid19.
Number of positives for other pathogenic virus or bacteria.
Number of pneumonic deaths.
Could be an interesting graphic
So far no one has responded to my queries as to how the artifacts of tests, publicity and ayailability are accounted for in the outbreak statistics.
Sorry, John, but as far as I know, nobody has that data. At best, we MIGHT find out number of tests, but even that I haven’t seen.
w.
Dear Willis
I have followed your work and know you understand the questions I asked as they are the ones you usually nail first.
Stephen McIntyre’s ‘Starbuck Hypothesis’ comes to mind here. If I was advising the President or the WHO, the first thing I would want to know is the how, where, what, why of the data. Until that is known we are flying by the seat of our pants.
As for cruise ships, I understood many finish their cruise in a freezer as they often choose a ocean voyage as their final farewell.
Thanks for your reply.
I don’t understand the ‘age-adjusted’ fatality rate.
There were 696 infections and 7 deaths. All the deaths were older than 70 years.
But the 70+ year cohort was overrepresented by a factor of three compared to the general population. If the Diamond Princess had had a typical distribution, there would have been 400 70+ people, not 1200. This would adjust the number of deaths downward to 2 or 3. The infection rate would be unaffected because all ages were more or less equally likely to catch the virus.
So we would have 2-3 deaths from 696 infections, a rate about 0.3%, which is not much above the common flu.
Willis
For the past two weeks I have been looking at the data from the WHO on CoronaVirus, their report on deaths by cause and country for 2016 and the estimates for past diseases and pandemics to try and get some perspective on the CoronaVirus.
One thing I noticed recently in the WHO numbers is that most of the cases (83.6% to March 15) and deaths (96.3%) in China have been in Hubei Province, population 59.2 million. This would be a death rate of 52 deaths per million people to date. Extrapolating to the U.S.A. this would be about 17,000 deaths compared to the 20,056 who died from Cirrhosis due to alcohol use in the U.S.A in 2016 or the 34,200 who the CDC estimates died as a result of the 2018-19 influenza.
S. Korea with a population of 51.3 has a CoronaVirus death rate to today of 1.5 deaths per million people and probably represents the best example of where a significant number of cases (8326 to date) have been effectively controlled by early testing, quarantine and social distancing.
While I think some of the measures being taken in Canada and the US are a bit over the top I believe most are warranted and will save a significant number of lives. Based on the data to date CoronaVirus is no where near as bad as some headlines have tried to portray it but if we did nothing it would likely lead to far more deaths than a severe flu year. It will also be a good test of whether our governments and people can handle the next edition of the Spanish (Kansas) Flu when it arrives.
I have been a fan of yours since you first started posting at WUWT and I think I have read most of your posts here and on your blog. I consider you to be a true scientist and one of the most articulate writers I have encountered. I hope to read many more of your posts and analyses.
I’ll post about symptoms here to avoid stepping on anybody else’s commentary. Original Post details non-symptomatic cruise ship passengers who contracted “Wuhan” corona-virus.
Start with the understanding that the virus uses a person’s ribosomes to manifest & that pro-inflammatory cytokines, which are driving symptoms experienced, are started up by cell mitochondria. It may be worth stating that viral ribosomal use in a cell & own cell’s ribosomal use go on at the same time.
Age is often when the number of ribosomes in a cell increase to high levels; which can cause the cell to contain a lot of proteins not necessarily being of practical use. A high level of ribosomes in a cell can create feedback that up-regulates (increases) what is called the mitochondrial termination factor; which down-regulates (decreases) the transcription of mitochondrial DNA, leading to reduced bio-genesis of mitochondria in the cell.
This high number of cellular ribosomes provoking less cellular power (ATP) generating mitochondria has the additional context where-in ribosomal activity is the single highest user of cellular ATP. In other words being old & readily tired is, in part, a function of excessive obsolete ribosomes hanging on in cells draining ATP, while at the same time the excessive ribosome count is holding back new ATP (energy) generating mitochondria forming (bio-genesis). In younger adults, unless there is some reason, there are not as great a number of ribosomes in a cell. As for children there are growth phases which require changes in ribosomal number to change accordingly & (since ribosomes can not be recycled, so to speak) growing cells need to transcribe lots of ribosomal RNA for making ribosomes – but senescent cells (common in elderly) that keep doing this complicate cellular ATP energetics (by limiting number of mitochondria).
Although viral use of ribosomes does not preclude own cells’ use of ribosomes (most cells have abundant ribosomes , & in a growing cell every minute there are thousands of the sub-units of ribosomes being formed) in a cell with excessive numbers of ribosomes the relatively meager number of mitochondria do get diverted into pro-inflammatory cytokine instigation (rather than ATP energy production) once viral RNA fragments get abundant. Which in turn has relevance for the degree to which a viral infected individual symptom cascade kicks in.
Since infection is not a steady state of linear occurrences, as the viral usage of cellular ribosomes increases this loads the cell interior with viral proteins. And this, coupled with the high ribosomal content cell’s original high protein content, apparently sees the viral usage of cell ribosomes become more, at the expense of the cell’s original rate of ribosome usage.
I’ve some chores pending so will break here, unedited.
A commentator mentioned the elderly on the cruise ship is unlikely to be representative of elderly in the general population; likewise not comparable to those in old age homes (& elderly with pre-existing conditions). My input regarding this my assumption the virus infected elderly cruise passengers who suffered little had essentially reasonable number of cellular ribosomes in infected cells.
Elderly with modest caloric intake & exercise have smaller nucleolar (distinct from cell nucleus) sizes, so possibly many of those on the cruise ship were active enough for their level of meal intake. Depending on how the so-called nucleolar remodeling complex is performing certain sub-units (ex: TTF1- interacting protein 5, abbreviated as TIP5) there will be lots of active rRNA transcribing (ex: when TIP5 very low), or only moderate activity transcribing rRNA (ex: when adequate TIP5 ).
What needs to be elucidated is that depending on the number of ribosomes/cell different messenger RNA is getting translated via ribosomes. When there are normal amounts of ribosomes in a cell then primacy is for short length messenger RNA; which is usually important for growing cells & functionality/maintenance vital for children & still relevant to adults.
However, when excessive ribosomes are in a cell lots of longer messenger RNA that otherwise has low translation begins to disproportionally use the ribosomes. Normally there is rRNA that is actively transcribing & rRNA that is not transcribing.
Which sets the context for the immunological feature I want to elucidate. This is not going into great depth, so I’ll put things in general terms.
Our bodies respond to viruses & yet they have to be able to keep responses within bounds that do no more than sustainable personal damage. Interferon (generally termed) is an important anti-viral we can produce.
Interferon binds to a ribosome in a way that interferes with viral use of that ribosome.
Interferon also instigates a cascade of relevant DNA up-regulation & gene down-regulation.
What is called the interferon promoter is usually in a cell due to normally being selected for ribosomal transcription. But the ribosomal promoter does not act to provoke interferon messenger RNA getting transcribed by ribosomes without cause, because the body will undergo undue immunological processes.
When a virus gets into a cell then the interferon promoter is supposed to instigate interferon making & likewise the cell will transcribe more interferon promoters for amplification of interferon levels. However, when there are excess ribosomes in that cell the messenger RNA for interferon (& interferon promoter) is not necessarily given priority by ribosomes which are taxed by the ideally low translation frequency messenger RNA.
My point is that slow interferon response gives the virus more opportunity to get established before being significantly challenged by subsequent defensive changes interferon occasions. This, I posit, is related to how sick the virus makes someone.
“US coronavirus deaths are currently at 67, we’ll likely see ten times that number, 670 or so, might be a thousand or three … ”
__________________
May have misunderstood, but applying the figures from the ship as quoted by Willis (17% infection rate of which 1.2% death rate) to the US population as a whole I get a much bigger number than “670 or so” or even “a thousand or three”.
US population as of 2020 is ~330.4 million (worldometers.info). 17% of 330.4 million is 56.2 million. If the death rate among the infected is 1.2% that equates to over 670,000 deaths – 1.2% of 56.2 million infected persons.
Where did I go wrong?
TheFinalNail March 16, 2020 at 10:33 pm
You left out the fact that the ship is a perfect situation for infection, while the world is not, and there was no social distancing, self-quarantining, or other control measures going on.
Korea has seen the deaths level off, they’re at 75, might get to 100. See Figure 4.
They have 51 million people. By your calculations, they should have 17% of 51 million times 1.2% = 104,000 dead …
The same is true in China. They’ve also leveled off, right now they have 3,232 dead. By your calculation, it should be 17% of 1.44 billion times 1.2% = 2.9 million dead …
I’m sure you can see the problem.
Best regards,
w.
Thanks for the clarification Willis.
Willis,
Sorry to labor the point, but in the case of China, as you report, a population of 1.44 billion people and a (hopefully) levelling-off death total of 3,232, assuming a death rate of 1.2%, suggests that the infection rate is very low. (That is, infected people ill to the extent that they require treatment and thus appear in the data.) In the case of China, it would suggest that ‘infection requiring treatment’ is lower than 0.02% of the population. That would also fit with your estimate of around 670 expected deaths in the US.
That’s fair enough, assuming we can trust the Chinese figures; but it doesn’t hold true for Italy, for instance. Italy has a population of 60.5 million. If ‘infection requiring treatment’ really is just ~0.02% of the population and the death rate is ~1.2%, then you would expect to see a death total in Italy of around 145 people. It’s already almost 15 times that (2,158 deaths reported to date). The Chinese and Italian figures seem to contradict one another with respect to rates of infection and death. I would be more inclined to trust the Italian figures, but that’s just me.
Thanks for another interesting post.
Are they Chinese or Italians. 30% Italians do not respond to ani biotics because of over use; working in cloth factories with high fibre content in air produces long term lung problems, working in doors does not develop lungs, elderly population, 5000 sweat shops with Chinsese living and working in poor conditions, high infection due to kisses used in greeting, bacteria problems in Italian hospitals , other winter deaths recorded due to Corona virus.
China and Italy are unlikely to be honest about all the factors influencing spread and morbidity.
Denmark was the only member country that objected to imprisonment of humans to study this virus.
All other ranking countries agreed including the USA, Canada and Australia (the origins of the bulk of WUWT readers and commenters) .
The Diamond Princess event shall (in a generation) be exposed as classical Nazi like human experimentation.
Too many people in top Gov & Med Worldwide know about this exercise for it not to be recognized as a heinous disgraceful scandal.
Say what? It was a ship run by an American company with people from around the world, in a Japanese port. What do you think they should have done? Let them leave? Cut them loose in Japan? Let them get on airplanes and go home?
Also, I can find nothing about Denmark “objecting” to the quarantine.
Finally, quarantines of infected people are done all the time for various diseases, and nobody screams “NAZI!!”.
w.
OK Willis . . . no symptom passengers were to be moved to on-shore quarantine.
That was ‘stopped’ and Denmark voted against it.
But you’re right Willis it’s a loony conspiracy.
[I look forward to your apology in due course].
Warren, I NEVER said it was a “loony conspiracy”. That’s all you. Stop trying to put words in my mouth. It angrifies my blood and I tend to strike back twice as hard.
Next, you still haven’t provided a link to the claims about Denmark … and as to them “voting” against it, when and where was the vote, and why would Denmark get a vote about a ship in Japan?
Next, half the passengers carrying the virus were without symptoms … I’d vote to keep them on the ship, and I’m sure the Japanese wanted the same.
As to an apology, you can osculate my fundamental orifice.
w.
I am also curious about this “vote”.
When?
Where?
Lot’s of people thought it was a bad idea. I did not hear anyone yelling loudly about Nazis at the time.
Let’s see where you voiced these concerns when it might have made a difference, eh Warren?
For the record, right here on these pages, i said several times I though it was an awful idea and they need to get those people off that ship before they are all infected.
A day after my most vocal comment on it, in which I listed the day by day running totals, the US sent planes to evacuate our people from the ship.
No one voted, no one was asked.
We went and got our people.
Personally, I was wondering by what authority those people were ordered confined to that ship until whoever was making the decisions told them they could leave?
Japan?
How?
If I was on that ship I would have been screaming loudly and continuously to get me off of there.
As far as I was able to gather at the time, the cruise line and the Japan government decided what would happen.
I got really irate myself when I read that the original 14 days was being extended/renewed for a fresh 14 days whenever anyone was found to be infected, for all of the people the newly infected passenger had been in contact with.
This made no sense, and it was then that it was obvious they had to be gotten off that ship.
With that plan, the people on the ship could be there for years as one and then another person contracted the disease and others had a fresh 14 days tacked on.
It was a bad idea from the start.
It was nothing like a quarantine.
I view my fundamental orifice more as an entrance rather than an exit.
Yesterday I said of the fatality rate: “Until there is a vaccine, times that infected number by 1%.”
Eschenbach: “you’ll have to flog your incessant attempts to gin up more hysteria on some other website. Here we do our best to deal with the truth and the science, and not fall for hype from folks like you.”
In response I quoted other sources giving similar numbers, including one from this paper https://www.medrxiv.org/content/10.1101/2020.03.04.20031104v1 estimating it to be quite a bit higher at 1.6% (1.4-1.8%).
Today he writes: “according to the study, the age-adjusted infection fatality rate was 1.2% (0.38%–2.7%)”
Yep. Yesterday, we didn’t have much in the way of numbers that included symptom-free cases.
Today, we have the Princess Cruises numbers that finally include symptom-free cases, not the best, but better than nothing. Might be 0.4%. Might be 2.7%. Might be anything in between.
When the facts change, I change my mind? What do you do?
w.
PS—My objection was mostly to you trying to politicize the issue, viz:
While Trump was acting, Democrats were obsessed with impeachment and also with attacking Trump for his actions …
w.
The shortage of tests and their initial flaws were due to the Obama administration’s having mandated sole viral test kit responsibility to the CDC, which blew it. Trump was right to unleash the private sector, cut out by the previous regime.
He also caught flack for restricting flights from Asia and Europe, which actions now appear wise.
Only 71 new cases in US yesterday.
https://www.worldometers.info/coronavirus/
How can we tell if they’re new cases, or existing cases discovered by increased testing?
That is what ‘new’ means in this context. Identified and reported.
“My objection was mostly to you trying to politicize the issue…”
False. Your spittle flecked, shouty little rant was a direct response to my quote above.
“I don’t know how many times I have to repeat this, but some folks just don’t seem to get the memo.
WE DO NOT KNOW THE MORTALITY RATE OF THE DISEASE YET!… blah, blah, and not fall for hype from folks like you.”
Then YOU proceed to politicize. What? you changed your mind on that? Well played.
Auto accidents? Wow. Lets see if you think this is all out of “proportion” in a few weeks time, when you’re confined against your will and people are dying in hospital carparks. All hype right?
(My objection, is your chronic inability to stick with the topic, anymore dishonest attacks like this will get snipped) SUNMOD
Well we know them better than for climate change which currently stands at 0.00000001%
Un Natural statistical effects of this virus.
Man made Virus.
Intelligent design.
Or a Bat did it.
Testing and Tent Hospitals Please
Willis,
so far so good. However, there are still 233 open cases from which 15 are in severe or critical condition. By now I assume the 218 will recover and hope the 15 will also end with recovery. Two days ago they has 32 in severe condition that recovered so odds are good. Just not over yet.
Yes, Rolf, it could get a bit worse. All I can do is analyze it with the numbers that I have.
w.
I guess the Italian are not using antivirals or chloroquine or they are facing another strain, way more deadly. Can the Italian people of Lombardy be so fragile if everything else is the same ? Hard to imagine.
They have a very high level of hospital infections. Even without being overloaded. I doubt that gets any better.
There also cultural differences which may be at play. I have only met a few italians here in southern France but they cannot breathe without talking unless in a chemically induced coma. Assuming they are are the same at home they must spend most of their waking lives facing each other at a distance suitable for transmitting Covid-19 virus .
Hi Willis,
My sister-in-law, from near San Jose, has now taken up residence at Travis AFB.
[Last we talked she said “navy” but she also said the food was better than the information they were getting. ]
She and friends from the retirement village traveled on the Grand Princess; they can now visit — with masks — out on the grounds of the base. The are individual in motel-like rooms. I’m sure data are being collected on all the guests and crew, so a new experiment.
Their independence day is next Tuesday, the 24th.
Interestingly, they were given the opportunity to be tested. They refused. A positive test would reset the day-count to zero. They prefer to self-quarantine in their own village.
Some data on Grand Princess: She sailed with some 2,000 passengers and a crew of about 1,500. When news came that some passengers on a previous cruise got infected with Covid-19, she sailed back from Hawaii to Oakland, where she is still quarantined. Everybody showing symptoms was tested. Results: 19 crew members – all now recovered – and 2 passengers infected.
The numbers are strikingly different from Italian numbers. I wonder if it is the same pathogen. She is now anchored with a skeleton crew of some 350 in the Bay.
I’ve said this before…no one is checking to see if people have antibodies to this disease. Just because we noticed it in 2019 doesn’t mean it’s the first time that it has spread. It might not have been as deadly and just passed under the radar as an unidentified type of FLU.
83% of the cruise ship not getting the disease for a highly contagious virus (they keep suggesting an R-Naught of 2 or greater) just begs for some blood testing for antibodies. I think a lot of people are completely or partially immune to this virus. Types of corona virus are known to cause common colds – we just never looked into it this closely.
I the cruise ship is an accurate example, then approximately 80% of the U.S. is vulnerable. The virus infection would just die-out with a low R-Naught. With a very high one, we should see a quick peaking and then a rabid leveling off – just like China is seeing.
This is just a hypothesis, but I keep seeing signs that this virus is acting contained (or bounded) by some unidentified factor which partial immunity would fit.
Yes, I too wonder whether the virus (or a version that gives at least partial immunity) has been circulating for longer than we think. If a majority of those infected are asymptomatic and those with symptoms present as flu, it would be difficult to spot. I suspect that it might have been circulating with a low R0 maybe since October or November.
The UK government said yesterday they are hoping to get a test for those who have had the infection should be available soon. That’s going to actually tell us what is going on.
“This is just a hypothesis, but I keep seeing signs that this virus is acting contained (or bounded) by some unidentified factor which partial immunity would fit.”
And what about the CPAC meeting, with thousands in attendance, where a person who tested positive for Wuhan virus was present but there has been no indication that the person infected anyone there, even though some of the attendees felt they should self-quarantine themselves. It’s been about a month since that meeting and no additional infections that I have shown themselves.
Tom
Same for the PDAC show, one of the largest mining shows in the world in Toronto. I was there March 1st and crowds were smaller than in the last few years. A couple weeks later all attendees got emails notifying them of a man from Sudbury who had the virus. He had mild case. No news since then.
I was in China 2017 for a longer stay. I had what I thought was a cold and got a cough that wouldn’t go away for several weeks. Ended up at a hospital in Shanghai, did a chest x-ray. At that time my lungs did show the same glass at the bottom as this virus result in today. That doctor told me then, he never saw anything alike before. He was a specialist on x-ray evaluation at a high profile hospital for foreigners.
So I guess there was something around before. Just not as lethal and not as epidemic. My wife didn’t get it at that time.
This virus is deadly only for Catholics (Italy) and Moslems (Iran).
The Moslems lick the shrine Gitter, get a lot of virus and die.
The Catholics dip their fingers into holy water as they enter the church. Then they go eat Pizza with these very fingers, get a lot of virus, and die.
All others are not really in danger.
Instead of writing crap about people and things (commonplace … in short) try to take advantage of the experience that the same people are doing (now) for you too (it may also be that you will need it) …
It is not “crap”. It is a fact. See the statistics.
One should add “corona-party” youngsters in Belgium.
These die as well.
The random factor cannot be discounted in this case and this group of people.
There may well have been one or several super spreaders who were infecting a large proportion of those they had contact with. Perhaps one or more servers who had a certain part of the ship or list of passngers they were responsible for, or something of that nature.
Maybe there was one part of the ship that was spreading contagion, like maybe a public bathroom, and some people use public bathrooms, and others never ever do.
And/or, perhaps there were many people who know/knew enough to be able to protect themselves and their kids or partners from infection, while others were blithely unconcerned or did not have the perspicacity, judgement, or wherewithal, to take adequate measures to avoid exposure to/ingestion of a sufficient number of virions to constitute a minimal infective dose.
It should not be assumed that everyone was exposed, or that everyone took equal steps to protect themselves, or that everyone had similar habits and routines that may have either protected them or exposed them.
And I just want to reiterate the randomness factor: Someone walking around spreading virus will surely and for certain encounter some people and not encounter others by shear random chance. Someone walks into a restroom and uses the far stall, and someone else the near one. Someone uses the left wash basin, someone else the center one.
Someone touches the cold water faucet, someone else the hot.
One person avoids touching any object in the room, lifting toilet seat with bottom edge of shoe, and someone else pays no attention to what they are touching and thinks they have washed their hands when they rinse with cold water for three seconds, then grabs the faucet and turns it off.
Then turns left instead of right and comes face to face with a spreader, while the other person turns the other way and never sees him. Some people are touchy feeling, or close talkers, shaking hands with people, standing and talking loud and close. Others are there to spend time alone, and not given to getting overly friendly with strangers.
I would like to see a map of who got it, a list of who cooked and served for which cabins, who ate in which dining rooms and when.
And then, once this is all over, see an antibody test from people who tested negative to see who may have been minimally exposed and had an early immunological response to a small exposure.
Nicholas, see my comment to Mosher above.
w.
Willis,
I should have made sure to say that I was not intending my remarks to be a criticism of your article and your analysis.
In fact and as per usual, you have done a fine job of presenting what is known and analyzing it using objective means.
I am not claiming any special knowledge here, just offering my own thoughts for what some may find a helpful or new perspective.
Thank you for the reply, and for your attention to this important issue!
The problem with many restrooms is that in spite of having hands free water supply and hand drying that with clean hands one has to use the door handle to get out of the restroom.
The best restrooms are the ones with a zig-zag entrance and no door.
One of the problems may be the fact that flushing a toilet sends an aerosol plume into the air which spreads widely, contains whatever was in the bowl, and lingers in the air for as much as hours later.
Given that, no door may not be such a great idea either.
And ICYMI, this virus is present in the feces of infected individuals in large quantity, and seems to cause a high incidence of “unconsolidated” solid waste, which greatly increases the quantity of contagion in the plume.
This article is concerning the phenomenon in a particular setting, but it is generally applicable to flushed toilets and in particular the high pressure ones that are common in public and commercial building restrooms…the kind with no toilet tank that use the pressure in the water supply pipes instead of a tank of water.
See here:
https://aricjournal.biomedcentral.com/articles/10.1186/s13756-018-0301-9?fbclid=IwAR3gMsUT2VdLv-OjIiktomiLbhQpqMzo2JnU_kNws-5SC-ACQpxzdeFhHZQ
Perhaps the squat toilet is not as bad, though disgusting, as aerosol generating ones.
Nicholas
You said,
It should not be assumed that everyone was exposed, or that everyone took equal steps to protect themselves, or that everyone had similar habits and routines that may have either protected them or exposed them.
Just like the general population.
“Finally, a plea for proportion. US coronavirus deaths are currently at 67”
This is a list of mass shootings in the United States that have occurred in 2020. This article only includes shootings with at least four total victims, including the shooter(s). As of February 29, there has been 55 shootings that fit this criteria, resulting in 74 deaths and 199 injuries, for a total of 273 victims.
https://en.wikipedia.org/wiki/List_of_mass_shootings_in_the_United_States_in_2019
That list says it is for last year…2019.
Nicholas
if you scroll to the bottom there’s an update link for 2020.
Over 2000 abortions are done daily on average in the U.S., many are late term.
From the CDC:
“The majority of abortions in 2016 took place early in gestation: 91.0% of abortions were performed at ≤13 weeks’ gestation; a smaller number of abortions (7.7%) were performed at 14–20 weeks’ gestation, and even fewer (1.2%) were performed at ≥21 weeks’ gestation.”
re: “From the CDC: … and even fewer …”
Percentages; what does this mean in terms of absolute numbers (positive integers)?
10s? 100s? 1000s? Many …
This is fascinating stuff, thanks so much Willis.
Yay, Mosh-man!
If COVID-19 doesn’t get you your fellow American might .
Virus fears fuel spike in sales of guns and ammunition
Just as grocery stores have been stripped bare by Americans panicked by coronavirus, guns and ammo have been flying off the shelves too.
https://abcnews.go.com/Business/wireStory/virus-fears-fuel-spike-sales-guns-ammunition-69625881
There’s already millions of guns and billions of ammo around, if somebody was out to get you, they’d have done it already.
It might be nice if I could purchase a virus that would prevent another from giving me a virus that I don’t want.
@jamorpuss – This discussion is about the virus issue. Not guns. You seem to be all about guns. Guns, guns, guns. Are you sufficiently triggered now? Go find a thread somewhere about guns.
Thank you. I have been waiting for this.
I suspect the coronavirus lab test may be specific, but has a low sensitivity. It’s a new lab test, and there is no way it could have been checked. A sentinal case in Australia, a student, caught it from his mother. His mother tests negative. She got it from her doctor /employer.
if correct, it explains the low positive rate on the Diamond Princess.
Could the virus be carried on the surface of people who do not get affected but can pass it on to someone in close contact?
One bit of information that I have been unable to get is the residence time of the virus on various surfaces before it becomes inactive.
Is a detergent effective in killing the virus? IIRC I was told by a ministry vet during the 2001 foot and mouth outbreak that they could destroy the fat on the surface of the virus and render it ineffective.
Depending on the surface the virus can last for several days. Detergents are effective in killing the virus as are such things as Chlorox and hydrogen peroxide, on surfaces such as doorknobs, kitchen tables etc. wipe it on and let it dry for several minutes.
RT-PCR is not a new test, I’ve been teaching PCR to students in a lab setting for 15 years. The only new part of the test is the primer set which makes the test specific for the virus. The machines that run the test are about the size of a Keurig coffee machine but for this test need to be run in a sterile lab environment. Each machine can run multiple samples and the protocol takes about 45 mins, preparing and loading the samples will take a similar time.
A Bat Did it..
https://www.scientificamerican.com/article/how-chinas-bat-woman-hunted-down-viruses-from-sars-to-the-new-coronavirus1/?utm_source=pocket-newtab
What we need to know are the race, sex, age, nationality, smoking or not, drinking or not, pot or not, prescription profile, supplement profile, disease history, weight, height, and over-the-counter profile for every passenger. This information should be made public so that hundreds of millions can analyze it.
Why is this information being withheld? It is stupid.
Because medical history is personal information, not public.
Monster
It is personal when it is associated with an identifiable individual. The aggregate statistical information should be made publicly available.
“What we need to know are the race, sex, age, nationality, smoking or not, drinking or not, pot or not, prescription profile, supplement profile, disease history, weight, height, and over-the-counter profile for every passenger. ”
Add to that: Vaper or not?
(A study has found that vaporized propylene (sp?) glycol protects mice from flu. https://www.cabdirect.org/cabdirect/abstract/19422701086 )
Excellent analysis Willis. The lack of increased hit on older group is very interesting.
In France over 3000 are killed on the roads every year. Over 4000 a year are KILLED by hospital infections in France every year. We are about to go into slave-style curfew in a few hours on the strength of 129 deaths over the last month !!!
Macron has just announced 300bn euro package ( about 12% of GDP ) to fight the virus, having spent all his time in power advancing “austerity” and cutting pensions.
There is far more to these govt responses than is warranted by the health issue. As they say : never waste a good crisis.
Currently the per-capita death rate due to COVID19-positive viral activity (including other additional complicating infections) in the US is 1 in 11.5 million.
For a solid perspective, per-capita natural death from old age is 1 in 122.
443 people in the US were killed by hammer blow in 2018… 1 in 738,600. So being too close to a hammer is ten times more lethal than the current “world shattering” plague…
“Finally, a plea for proportion. US coronavirus deaths are currently at 67, we’ll likely see ten times that number, 670 or so, might be a thousand or three”
Well, at least its a falsifiable prediction. Is it plausible?
The death rate is a function of the infections on average 18-20 days back and of treatment effectiveness. Most of the infections will not have been confirmed. The infection rate going forward is a function of social distance and transmissability in the existing conditions.
The 67 deaths suggest total infections of about 50k at present, mostly unconfirmed. This is the key variable. How many cases are there out there in the population, but untested, to lead to the number of observed deaths?
Then going forwards, if the death rate is around 2%, considering average treatment effectiveness as things progress, this should lead to a cumulative total of around 1,000 deaths in the US about three weeks from now, or about April 7.
There’s a lot of uncertainty, but this would be the number to watch to confirm or falsify theories. Willis’ prediction is for a cumulative total from the entire epidemic in the US of at most a couple of thousand. This prediction is for reaching close to his cumulative total estimate by April 7.
So then what would this predict going forwards? Depending on how effectively the new social distancing measures are, transmissability could vary. The important question is the doubling period in days of total infections. Suppose its a week, which is something like what the UK scientific advisors are estimating for that country. In that case by April 7 there should be a total of infections (again mostly not confirmed) of about 400k. By the end of April this should lead to a cumulative total of about 8,000 deaths.
Well, at least its falsifiable and the test and data are running continuously now in real time. We shall find out together in a matter of days. If we do real lockdowns, infections might stop. At that point, confirmed cases would continue to rise during the incubation period and with increased testing but real new cases would start to fall, and deaths would follow.
The test for lockdown is automobile traffic in cities. If it falls by 90% or so, and if the streets are deserted, and people are getting food by delivery left at the door, then its real lockdown. Otherwise its partial, and may or may not be effective, depending.
The key thing we don’t know yet is how many people there are with symptom free infection and recoveries. If this number is high, Willis could be right and the above kind of scenario will not happen, not even close. This could be one reason for apparent low transmission. If lockdown is effective, that too will dramatically reduce cumulative death rate, not least because it will allow better treatment of more intense cases.
People all over the country are turning up infected with no idea how they got infected or who passed it to them.
So as a matter of factual logical inference, there are a great number of infected people.
After all, is it likely that a few thousand people have spread an illness to hundreds of cities in 49 states across and area of 3.8 million square miles in a matter of weeks?
BTW…a city and a country full of people getting food via deliveries left at doors is not a lock-down, it is a different mechanism for transmittance.
Just like being trapped on a cruise whip being served meals three times a day by crew, some of whom were infected, was not a quarantine.
How many people will an asymptomatic delivery person infect?
Lookey here…an Amazon warehouse employee has tested positive.
I wonder how many other people there have the virus?
How many packages did he handle, cough or sneeze on, etc?
They have same day delivery there, and next day for lots of other places.
Also, I was just reading that there is a study showing that the crew of the cruise ship was infected and still serving people and handling everyone’s food.
It never made sense…why are passengers confined to their rooms, but crew are mingling with each other, in contact with every passenger many times a day, preparing and handling food…
Why would anyone think the crew should not have had the same restrictions as the passengers?
Like, what…only people who paid to be there get a virus?
Utterly idiotic.
Same with delivery, or everyone going to get food at a drive through.
One person delivering, or working the drive through, or prepping the food or the packages…is infecting people all day long!
I will take my chances in a huge Walmart, stay away from anyone, go in the middle of the night, do self checkout…and do scan and go at Sam’s Club. Touch nothing but items right out of the crate and scan them with my phone and be out of there.
michel March 17, 2020 at 1:04 am
“Finally, a plea for proportion. US coronavirus deaths are currently at 67, we’ll likely see ten times that number, 670 or so, might be a thousand or three”
Looking at the US data the number increases by a factor of ten in ~12 days so I would anticipate being over 1000 deaths by the end of the month.
Yes, the quoted phrase is from Willis’ article. As I say, at least its falsifiable, and I think it very likely to be. The problem is that the death rate in 2-3 weeks from now is a function of the number of cases in the population. Not the number of confirmed cases, the number of actual cases.
Nothing in the way of isolation and quarantine done in the next 2-3 weeks will have any effect on deaths during those 2-3 weeks. After that they may bring down the death rate by bringing down the number of infections.
We shall see.
michel March 18, 2020 at 2:04 am
Yes, the quoted phrase is from Willis’ article. As I say, at least its falsifiable, and I think it very likely to be. The problem is that the death rate in 2-3 weeks from now is a function of the number of cases in the population. Not the number of confirmed cases, the number of actual cases.
Yes, which is why I focus on the death stats. All the distortions to the testing regime make the confirmed case stats unreliable for analysis.
Consider the number of people in cities all over the globe who have been infected, then multiply by the proportion of infected people known to the total number, and consider that 16 weeks ago or so, in mid November, the total number of creatures with the virus who were in any way in contact with any humans on the planet, may have been and likely was a sum-total of one.
One animal in a cage in one random market in one random city in a place few outside of the region had ever heard of or been to.
And in that short span the virus is or has infected the bodies of many tens of thousands of human beings all across and entire planet.
So what happens in 16 more weeks?
Could it be that being a ship the Diamond Princess spends all her time on sea water.More often on the open ocean.Passengers are exposed ocean air.Lungs are being filled,with ozone for example.
It is hard to say how many had the disease on the ship. Some could of had it, then recovered quickly, and then tested after recovery. The test would then show up negative.
There is a hypothesis that might explain the age distribution.
That we have had one like this some years ago, without knowing it, and old people have still got partial immunity. Until they are so old that their immune systems are compromised.
Babies still carry immunity from parents and in any case are less socially interactive. Young fully active people are the most socially mobile, and have less immunity.
As I say, just a hypothesis, but the fact is some people get it and have almost no symptoms at all.
“As I say, just a hypothesis, but the fact is some people get it and have almost no symptoms at all.” That seems quite in line what a friend of mine, a veterinarian, with over 30 years on the job, has told me. When you are in contact with a family of viruses, as veterinarians often are, there is more than a fair chance that there is some sort of side immunity, which may be the reason why this virus is recognized by the immune system as somehow unfriendly and triggers a response.
So if you have pets like cats or dogs mainly, as carriers of corona virus family members, your immune system becomes more robust.
I note that the number of deaths aboard the cruise ship is low – so any small amendment will have a large effect on the percentage.
That said, has there been a correction for deaths expected from natural causes? There are regular deaths on board cruise ships – in fact, there’s a special web site tracking them https://www.cruiseshipdeaths.com but I can’t see how to get an average out of it…..
I calculated the number of deaths to be expected in a month in the absence of covid-19 based on the passenger count by age group on the ship from https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v2.full.pdf and the Social Security life tables for death rate by age from https://www.ssa.gov/oact/STATS/table4c6.html , and got 6.5, with a standard deviation of 0.7. That’s not significantly different from the 7 actual deaths. Calculation is here: https://docs.google.com/spreadsheets/d/17hBCRj6CTN_dsUyFpDMulzwhoP9x1eXbosHO3YAEprw/edit?usp=sharing . I think this is really important, and I would appreciate it if someone would check my calculation.
https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-by-air-land-sea/cruise-ship-travel says the death rate for cruise ship passengers is 0.6 to 9.8 deaths per million passenger-nights. There were 3700*30 passenger nights on the diamond princess. So even at the high end, only 3700*30/1e6*9.8 = ~1 death was to be expected. So never mind.
The Diamond Princess spends all her time on sea water.On the open ocean or moored off shore,passengers are exposed to sea or ocean air. Could this exposure provide lungs with a degree of protection? Does ozone have an impact?
I am not a fan of conspiracy theories.
However, believing the virus “jumped” abruptly from a bat to a poor Chinese guy on a seafood market is a nonsense. Chinese eat bats raw since 10,000 years.
And this should happen in Wuhan. 600 km away from any bat, but at the very center of the virology research in China.
I put here a list of references. Not any dubious CT sites.
Rather, these are Nature, NYT and like these:
1. https://en.wikipedia.org/wiki/SHC014-CoV
2015:
2. https://www.nature.com/articles/nm.3985.pdf?origin=ppub
A SARS-like cluster of circulating bat coronaviruses shows potential for human emergence
2015:
3. https://www.nature.com/news/engineered-bat-virus-stirs-debate-over-risky-research-1.18787
Although the extent of any risk is difficult to assess, Simon Wain-Hobson, a virologist at the Pasteur Institute in Paris, points out that the researchers have created a novel virus that “grows remarkably well” in human cells. “If the virus escaped, nobody could predict the trajectory,” he says.
4. Aug. 5, 2019:
https://www.nytimes.com/2019/08/05/health/germs-fort-detrick-biohazard.html
5. August-September 2019:
“Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products”:
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
Emergency department (ED) visits related to e-cigarette, or vaping, products continue to decline, after sharply increasing in August 2019 and peaking in September.
6. 18. Okt. 2019 – 27. Okt. 2019:
https://en.wikipedia.org/wiki/2019_Military_World_Games
7. 24. November 2019:
https://www.military.com/daily-news/2019/11/24/cdc-inspection-findings-reveal-more-about-fort-detrick-research-suspension.html
8. 27. November 2019
The first identified COVID-19 Chinese victim
Has never been to the seafood market.
Strange story.
Regarding the older passenger aged between 80 and 95, I am 93 13.3.27, we were the pre anti biotic times. Is it posible that we have already exerienced such virusus before and are now imune.
It seems likely that social media and politicians like a pamic, from which they can then “Sav e us”
that it is no worse that a bad case of the usual flue season, and best to let it go through the community, and let things gs return to normal.
When noting deaths, we should also compare e these figures wit what on e can expect in “Normal times””
VK5ELL MJE
Stay well, bro’, the world needs more geezers like you and me.
H44WE w.
Important note I would like to share. French health officials are warning about using fever reducers with covid.
https://www.google.com/amp/s/amp.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection
Identified as fake news.
Forget it!
Or not.
https://www.dailymail.co.uk/news/article-8121255/NHS-no-longer-advises-coronavirus-patients-ibuprofen.html
We have an anti fake news law now. I hope our own gov isn’t violating it right now!
I agree with the doctor, but not for the reason he mentions, i.e., Ibuprofen suppresses immune system. The very thing he recommends – acetaminophen – suppresses the immune system by depleting glutathione. Ibuprofen is bad because it increases ACE2 expression in the lungs.
And another thing, anti-imflammatories are typically prescribed for this infection to tone down the immune response, so the doctor’s reasoning makes no sense.
Thanks for insightful article Willis.
However, unless we take steps such as social separation, the disease will continue to spread until at least 50% of the population have been infected with subsequent immunity. As long as the R0 is above 1.0, the number of infected will grow. Even if the morality is as low as 1%, the number of deaths will be horrible high.
The only way to stop it before we have vaccines or effective antiviral drugs is to take steps to reduce the R0 to below 1.0.
We can hope for the best, but we have to take actions, and we have to follow the advises from the government.
/Jan
Indeed, Jan. I support social distancing, hand washing, all the usual precautions.
I suspect we will have both a cure and a vaccine before too long … if I get it, I’m taking zinc and chloroquine.
Stay well,
w.
Running? I thought you had an obesity problem over there?
Tonyb
What? Do you Insinuante that Europe has a worse obesity problem than the US?
Do you get chloroquine without prescription over there, or do you have to visit a doctor and simulate Malaria to get some?
/Jan
No idea, Jan, never bought it anywhere but in the tropics … ok, a bit of research shows that yes, you need a prescription. I reckon my Dr. would write me one, he’s known me for forty years …
w.
I just wonder what the effect of salt in the air on a cruise ship is? Salt seems to have a fairly good record as a preservative…….
The SARS virus rapidly loses its ability to stay stable on surfaces when temperature increases and relative humidity increases. For the life of me I don’t understand why government is not telling businesses to increase temperature and humidity their buildings.
Study:
https://www.hindawi.com/journals/av/2011/734690/
Common sense – that seems quite rare today – would suggest that it would be far easier to try to isolate those who are 60 and older with other medical conditions and their carers. This is a relative small percentage of all people. Then having fairly strict measures to limit the movement and contact of the rest of people over 60 for say a couple of months.
The rest of the population can continue with normal contact excluding those who have medical conditions that makes them vulnerable. There are some serious logistical problems like hospitals and caring homes and keeping these people supplied and cared for during isolation. However, continually keeping everyone apart at two arms length and not allowing contact with surfaces that are not continually being cleaned appears a complete impossibility. The economic damage is also likely to hurt the health and welfare of far more people.
I wonder if the virus were allowed to move quickly through the healthy and under 60 population that we would find far less deaths among the total population, far less economic damage and a significantly reduced period of disruption? I hope some doctor/biologist can address these matters on this site.
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
You can play with the numbers to get your own estimates. They have them for the critical variables. Its a pretty simple model. If they are right, Willis’ forecast is way, way optimistic.
In some ways, they want to kill the patient so they can save him.
look at the R0 ,it starts at 2 and goes up to 2. 6 when Wuhan was 2.54. look at social habits such as spitting. Italy had a R0 of 1.7 . USA and NW Europe will have R 0 of less than 1.7. Also large numbers of people in Wuhan will have become ill with the virus very early on. It is likely large numbers in Wuhan became infected at the beginning and so with a R) of 2.54 the total numbers increased rapidly. Also many may have had poor health . Consequently, Willi’s approach makes sense .
Adding to my previous comment:
If – according to Dr Birx – the virus not appearing in 99% of people who are sick, this means the US has shut down the biggest economic system in the world for a virus that is not appearing in 99% of the people who are sick. Truly disturbing but I doubt the media, politicians and many medical people who have fanned the flames of the virus alarm will ever be held accountable for the huge economic damage they have caused. This is not unlike those promoting climate alarm.
So far, in the United States, from LabCorp and Quest, they’re running about a 99 to 98 percent negativity.
https://m.youtube.com/watch?v=bpE2NijA5tQ
Dr Wodarg is a retired German public health official, a former MP, a pulmonologist and epidemiologist. Whas he has to say about statistcs, databases etc. concerning Corona is worrying. We are being mislead by scientists and politicians craving for public attention. Activate subtitles unless you are fluent in German, please.
He may be right about everything. He’s certainly correct that this “crisis” has created conditions for a power and money grab that is short on rationality.
Thank you for some sensible medical information.
Douglas Altman, † 2018, waged a long-running campaign to improve the use of statistics in medical research. A professor of statistics in medicine at the University of Oxford, in 1998 Altman described the problem: “The majority of statistical analyses are performed by people with an inadequate understanding of statistical methods. They are then peer reviewed by people who are generally no more knowledgeable. Sadly, much research may benefit researchers rather more than patients, especially when it is carried out primarily as a ridiculous career necessity.”
This problem continues today. A leading biologist, I know well, recently told me about the link between funding and how researchers distort and lie to obtain support. I have also had many conversations with an engineer who is deeply disconcerted by the way media, politicians and many medical people are spinning with statistics. To adapt the phrase
There are three kinds of lies: Lies, damned lies and coronavirus statistics
Just discovered Dr Wodarg’s lecture Lösung des Corona-Problems: Panikmacher isolieren i.e. Corona problem solved: Isolate panic makers.
It is short but only in German.
https://www.wodarg.com/vortr%C3%A4ge/
Someone listed three simple steps to deal with the virus:
1. Wash your hands regularly
2. Do not go outside if you are feeling sick
3. Do not watch CNN 🙂
All of the cases from the cruise ship were intensively treated. If these numbers scale up on a national scale the no. of symptomatic cases in just the UK will still be over 5 million. The death rate will be higher than the implied 264 k in the UK because the health infrastructure will be unable to cope with the sudden exponential rise in demand.
Get in before the rush or don’t get it at all……
Willis..thank you again. Always enjoy your take, and personal excursions.
I may have missed it in your acticle or comments, but hasn’t the accuracy of tests has been an issue. Would knowledge of test accuracy change your assessments?
I thought there was an issue of the EU tests with high false positives. Wouldn’t that reduce the “has virus, but
no symptoms” grouping?
Thanks again, and keep safe
I had just sent the following opinion letter to our local paper when I took a look at your commentary. It doesn’t address the cruise ship directly, but it does support the attitude, which I think you share, that we need to maintain a critical look at the effects of our response to the situation.
The current strategy of “social distancing” will not stop the spread of the corona virus, but we hope that it will slow it down enough to buy time for organizing medical facilities and developing effective treatments. That it will thus save lives would seem to be an unanswerable argument for pursuing this strategy.
But we face other existential threats than the corona virus. From the CDC website:
“Suicide…was responsible for more than 47,000 deaths in 2017…In 2017, 10.6 million American adults seriously thought about suicide, 3.2 million made a plan, and 1.4 million attempted suicide.”
It is clear that many of us are living on the edge. The current strategy of alarm, social disruption, and economic chaos may well push significant numbers over the cliff. Epidemiologists and political leaders should pay attention to the effects of “social distancing” on this at-risk population.
From the report …. (asymptomatic cases were either self-assessed or tested positive before symptom onset)
“tested positive before symptom onset” is not the same thing as asymptomatic. How many people who tested positive LATER showed symptoms?
Thanks for this very informative post.
Indeed, there are data that do not add up.
Compare France and Germany with respect to the ratio :
r = (deaths + Serious cases) / total known cases.
r(France) = 8.26%
r(Germany) = 0.276%
Knowing that France and Germany have quite similar healthcare indexes there is a Big discrepancy between the two.
Someone is wrong somewhere.
Yes, something is amiss.
Let’s assume that they know how to tell if a patient is dead or not. Then, perhaps the testing for the virus could be wrong.
The French have an entirely different culture of greeting. In Germany, a handshake and that’s that. The French, even adults, embrace each other and it is quite common to kiss each other on the cheek.
This does not change the ratio (see my post) and the declared cases are in the same range.
In France, by custom, we kiss (on fait la bise) 2, 3, or 4 times according to the region.
By now, not so much.
Non Nomen
The same applies to the Italians who in addition are very family oriented with frequent tactile contact at get togethers encompassing several generations, many of who might be infected but don’t realise and pass on the virus to the older generations .
This is different to Anglo nations who on the whole are more stand offish and do not hug kiss or embrace even strangers
tonyb
it might be the way tests are being carried out. If France, say, were restricting testing to just those presenting at hospital while German tests included a large proportion of the less severe cases that could go some way towards explaining the discrepancy.
I’d take some of the numbers with a pinch of salt at the moment. All countries have a lot more cases than the figures published. The UK probably has 50k cases at the moment while the figure from tests is less than 2k. This is good, in a sense, since it reduces the fatality rate.
Hi Willis,
Thanks for this data, very interesting. However, I interpret them somewhat differently than you do. The reason is your assumption that transmission conditions were ideal. They were not. Cruise companies have great experience with viral infections like Norovirus and know precisely what to do. I bet the crew has been following a protocol based on long and informed experience.
What happened on the ship was that the moment it was clear the a virus was going around they imposed a lock down, strictly confining passengers to their cabin. We saw them on the news complaining about it, not understanding. But that stopped the transmission conditions from being ideal to pretty tough from the virus’ point of view. The large percentage of passengers not getting infected does not reflect their susceptibility but the success of the lock down protocol.
Now that should be considered good news too.
There were communication failures that led to long delays before any action was taken. In one case, notification that a Hong Kong passenger tested positive for the virus was not even read for 72 hours and this was in addition to the time that it took for the test results to come back, which was several days on top of that.
Cruise companies may have good protocols but unless they follow them, there is no effect. In addition, a link above concerns a virologist that went on board and who described the conditions on the ship as frightful.
In retrospect, this is good news.
6 people died out of 3700 on a cruise ship where they would have been subject to repeated contamination and where 32% are over 70 years of age of which 5.4 % are over 80 years of age. This is death rate of 0.16%. The flu epidemics of 1957 and 1968-9 are likely to be worse. How many days were people on the ship before quarantine started ? Everyone was probably infected or every surface waws contaminated. The virus last 9 days on plastic and 4-5 days on wood and metal.
The R0 figure is how many are infected by a single person. The peak at Wuhan was 2.54, it is now 0.34 and in Italy it was 1.7. How does this compare with flu. it would be interesting to look at flu deaths since 1945.
It was 7 people dead and about a dozen still in IC. Still, not like what happened in Wuhan.
It could be that a more virulent strain is dying with the dead people it kills.
Ed
Nice theory and well argued but bearing in mind the number who come down with such as noravirus I am not sure their systems are as good you say
tonyb
Ed Zuiderwijk March 17, 2020 at 6:21 am
Thanks, Ed, but a Japanese epidemic expert who actually visited the ship and says the exact opposite. He said he’s worked with lots of epidemic diseases and this was the first time he felt he might catch one.
w.
Really great work Willis. Thank you.
Thanks, Jeff, on my planet your approval is valued.
w.
Re: Occult Transmission
The China strategy was to “chop off” the curve by brute force…rather than heading slowly into “herd immunity” status (as is usually done for influenza).
As I think about that, the claim that a significant number of infections result from transmission from asymptomatic carriers cannot be true…or it must be rare.
If significant numbers of occult carriers were constantly “at large” in China, outbreaks would pop up all over the place. Total population quarantine would be required to prevent those “occult” infections. Quarantine WAS required in China for whole families when any family member showed signs of illness including fever (which was measured on all workers daily). But a general quarantine has not been in place.
“Chopping Off” the Curve prevents herd immunity from developing (at least very quickly), so China is still vulnerable to the resumption of the epidemic…too few have immunity.
The UK appears to be aiming for herd immunity. That is probably going to horribly overtax the hospitals in the next 3-4 weeks. But afterwards, the population becomes immunized…without a vaccine. They are trying to isolate those over 65 (as we are in the US), so that should help a lot toward preventing overwhelming the system, but this elderly (UK & USA) will have to remain isolated until herd immunity is established or until we have a vaccine. The UK should have herd immunity in 12 weeks…the US in a year if we stay locked down.
It appears that the US is “locking things down” tightly enough to keep from overtaxing the system. However that prevents herd immunity from developing sooner than about a year out. So widespread immunity will ultimately depend having an effective vaccine soon…and “soon” also won’t happen before the year is out.
We have a precedent, an infectious disease much more transmissible than the Wuhan virus: measles.
With no vaccination, we had the horror of 1 death for 25000 persons and a few proportion of cases were serious: most cases were young and at that age it’s almost never serious.
With mass vaccination, the proportion of cases that are very serious increased greatly.
(That data provided to you by the heath authorities aka provax people.)
niceguy, STOP WITH THE ANTI VAXX COMMENTS!!!! This post is about the Diamond Princess. I warned you about this already.
If you continue, I will personally do something I never do. I will simply snip anything about vaccination out of your posts. I don’t like doing that, but you remind me of the mule in the story.
TL;DR version: You are more than welcome to comment about anything else. But if you comment any more about vaccination, on this or any of my posts, I’m gonna have to get out my 2×4 …
w.
You are unhinged.
The moderators need to do something about you. I have warned you before.
Stop promoting unproven dangerous drugs.
Stop attacking me.
Stop the insults.
Just take some calming pills.
(Stop derailing the topic!) SUNMOD
Willis, he’s a proven idiot; do as you see fit (preferably a ban, IMO).
SNIP – take your vaccine rants, questions, ideas, and soliloquies elsewhere, thanks.
w.
You are a bunch of pathetic bullies. This website is crap.
niceguy March 18, 2020 at 10:05 am
If so, then surely you should stop posting here. You should take your brilliant thoughts, like say your genius claim that polio vaccine had nothing to with polio eradiation worldwide, to some other website where your fantastically insightful ideas might find some agreement, no?
You’re welcome to do that, you know … in fact, I’d go so far as to encourage you to do so.
Regards,
w.
“If so, then surely you should stop posting here”
FREE SPEECH
Therefore, be it RESOLVED, that ng be “voted off the island” on the grounds of absolutely no redeeming value, social or otherwise, on a permanent basis.
SNIP – I told you, NO MORE DISCUSSING VACCINES FOR YOU!
w.
(Snipped) SUNMOD
niceguy March 17, 2020 at 4:36 pm
Ah, yes, I am so humiliated. I cover myself with sackcloth and ashes.
w.
SNIP – No discussion of vaccines, either pro or con.
w.
SNIP – You’re a slow learner, aren’t you? Pick another topic, any other topic.
w.
No thug. YOU ARE A SLOW LEARNER.
I want your excuses.
SNIP – Was I somehow unclear? Leave vaccination along and post about something, anything, els.
w.
“STOP WITH THE ANTI VAXX COMMENTS”
What comment?
My comment disappeared or maybe I didn’t hit send. All I wrote though was very nice work Willis, this helps very much.
Thank you.
Variable susceptibility: some may have been immune due to having fought off another virus earlier in life.
7 people out of 3711 died. That’s a mortality rate of 0.001886
…
There are over 300 million people in the USA.
…
300,000,000 * 0.001886 = 565,885
…
Oh, and don’t forget that there are less than 70,000 ICU beds in the USA
That’s not a like for like situation as 300 million Americans are not locked up in a small room being infected by people serving them food
tonyb
Correct, half of the 300 million people are running around infecting each other.
As has been said often on WUWT, cold weather kills more often than hot weather. I would suggest that an economic downturn is more dangerous to more people than the corona virus.
“Seems like a perfect situation for an overwhelming majority of the passengers to become infected.”
What isolation measures were taken? Did the crew and staff split up ? were different kitchens used for the infected etc?
Willis,
Good job!
JimG1
Hi Willis. On a hunch I googled: “diamond princess” “no smoking” policy
Found this:
“We recently completed a cruise on the Diamond Princess. There was no smoking permitted inside the ship, including the Casino and Churchill Lounge. I’m not sure if there was a smoking area topside by the pool area. There was a small designated area on the Promenade Deck. On rough weather days the doors to the Promenade Deck would be roped off. Smokers would go under the barriers.”
https://boards.cruisecritic.com/topic/1492522-discuss-implementation-of-smoking-policy/page/36/
I have all along felt strongly that for a disease that exploits unhealthy lungs the U.S. should NOT be taking mortality rates from China, Korea, Iran or Italy at face value. A very high percentage of older men in all of those countries are lifelong smokers, and a lot of the women smoke too.
My guess is that the numbers in those countries will turn out worse than the Diamond Princess numbers but that U.S. numbers will look a lot like the Princess numbers, at least as regards mortality.
Their numbers wrt transmission are at odds with the one local incident I know about. A friend of mine from the East Side of Seattle discovered that he and about a hundred others had all been exposed when a friend they had all been regularly playing contact sports with was an early WA Corona death.
He says that everyone he talked to in the group had gotten sick about the same time. Knowing they had been exposed they all figured they had Corona and self quarantined. As testing came available all who got tested (about 10) came up positive.
Most had a mild to ordinary flu. Some got a sicker but all got over it reasonably quickly while the fellow who died was known to have some serious health problems.
His sense of it in retrospect: hyper-transmissive. If you get exposed your going to get it. Second, its just an ordinary flu. It’s not a big deal. Their group is not young and except for the guy with pre-existing problems most of them breezed through it.
They are all very active with probably close to zero smoking.
Smoking was apparently a very significant factor in China.
However, I’m not sure it is simply “unhealthy lungs”. One of the main effects of habitual smoking is that it incapacitates the hemoglobin which gets permanently bound to carbon monoxide and thus useless for oxygen transport. A tobacco addict will only have about 40% functional red blood cells.
Thus any infection affecting the lungs hits a system which is already severely compromised in its capacity to transport oxygen. This quickly means you need an oxygen supply and a ventilator.
This sounds not just unlikely but flat out untrue.
For one thing, the amount one smokes and the way the tobacco burns must affect CO content, and how one smokes (inhale deeply, shallowly, etc?) will have a huge effect on the amount of carbon monoxide in the lungs and hence the blood.
But just from a basic knowledge of blood chemistry, I can say for sure this is untrue.
A normal hemoglobin count is a fairly wide range, 14-17 for men and 12-15 for women (due to menstruation), and anything below 10 is called anemia.
I have had severe hemolytic anemia several times, and I can tell you, anything below 10 for a man is considered a life threatening condition.
Only 40% of red cells being functional would be equivalent of a hematocrit below the level that would sustain life. Ascending a mountain would kill you if you were not already dead.
Unlikely anyone could survive, let alone be walking around on their feet, with hemoglobin reduced to 40% of normal.
Some smokers are athletes, and in fact it used to be common.
And I wonder…why do you single out tobacco?
Is that the only leaves that produce CO when burned?
I do not think so.
Someone who smokes marijuana absorbs over 5 times as much carbon monoxide as a heavy cigarette smoker.
For the record, I do not smoke, never have touched a cigarette, take no drugs like alcohol or pot.
But facts are facts.
Smoking is bad for you, but 60% of RBCs being useless is malarkey.
And it would be 5x worse for a pot smoker because the smoke is more acrid/dense and is held deeply in the lungs for as long as possible, typically. Also 3x the tar, and that is compared to unfiltered cigarettes.
Just the facts.
Call me Joe Friday.
re:
The cilia , you left out ANYTHING about the cilia …
After all the cilia are responsible for ___________ and _________________. Right?
https://medlineplus.gov/ency/imagepages/19533.htm
Willis
Very nice article with some important information.
I think by definition those on the cruise, whilst elderly and often on medication will not be severely ill otherwise they would not be going on the cruise or allowed to join it. A cruise ship only has certain medical facilities that are suited to common illnesses not the severely ill.
It is the over 70’s with severe underlying health conditions who seem to be succumbing, but even then it is not everyone. So locking down everyone because of their age profile seems counterproductive as you will destroy the mental and physical health of those who get our and about every day and need the social aspect as well as the exercise.
Everyone says you shouldn’t compare corona virus and flu, let alone traffic deaths but why not? Plenty of lives could be saved by making flu jabs compulsory, preventing smoking and heavy drinking, making obesity a thing of the past, dropping the speed limit etc.
It is surely highly relevant to point out that during the flu season in the UK some 180 people will die every day in a bad season/ Latest figure today is 14 deaths from corona virus since yesterday.
Ps. To me, going on a cruise would be purgatory so I was surprised at figure 1 which you say are only passengers and yet includes a surprising amount of under 50’s. Definitely No crew are included in the figures, who you would expect to be in a younger age group?
tonyb
The UK appears to be in the very early stages of the exponential growth so it’s difficult to be project the number of deaths at the present. Looking at the UK figures there was an increase in cases of 400 today, based on other countries the doubling time was 3-4 days so could be 1000+ cases per day soon. One of the differences with flu seems to be the impact on the hospital and ICUs, seems like that COVID-19 has a much bigger impact/patient.
Yes. If you do the same basic math on the UK numbers, there might be, right now, about 50,000 cases in the population, of which only about 2,000 have been confirmed through testing. So in about 18 days time this would be expected to lead to around 1,000 cumulative deaths. The current lockdown measures would only lead to a lower death rate a couple of weeks later as they lower infections.
Numbers subject to very large margin of error, but I think this rough calculation and the Italian experience is a much better guide to what may happen in the US than extrapolating from the special environment of a cruise ship.
Today’s increase in the UK ~700 so new cases likely to exceed 1000 in a day or so.
Has the nCOV fatality rate exceeded the City of Chicago homicide number yet?
There’s another cruise ship data point: The Grand Princess had passengers infected with nCOV – who later debarked and some died. But 60 of them went on the subsequent cruise – I am still waiting to see what the 1st (original) cruise infection rate was, but the 2nd cruise infection rate was apparently really, really low.
Of course, the 2nd cruise – they were trapped for a lot less time…
Am I reading this right: 100% of the children on the DP had the virus but had no symptoms? If so then they were the primary carriers and spreaders of the contagion?
According to the document that Willis linked to, there were 16 children in the 0-9 age group. Only one of these children tested positive and that child did not exhibit any symptoms producing the 100% result in Figure 3.
No error bar is shown for that result, but if it had been included, a 95% bar would be one-sided reaching down to the value .05.
I would guess that the 20-50 age groups are basically the “crew”. Though it is misleading to think of them a the ship’s crew. They are hotel staff.
It seems cruise ships have about 3:1 or 4:1 guest to staff ratio.
I like R direct call method for data. Have to remember to locally cache a hash of the dataset used for configuration/data management.
Spread of the new flu (Coronavirus) is being countered with a lot of publicity and intense preventive measures. It will be interesting to see how much the intense preventive measures reduce the mortality rate of the old flu which has been averaging about 50 a day.
“For me, this is all good news. 83% of the people on the ship didn’t get it, despite perfect conditions for transmission.”
About that “perfect conditions for transmission”, we all “know” that cruise ships are like that, but are they really? For an industry which targets the older and wealthier, the industry provides all sorts of services, from cooks to entertainers. I would hope they also provide doctors and nurses.
And for an industry which is linked in the public’s minds with norovirus, I would also expect that they are quite serious about containing the spread of viruses.
How did the Diamond Princess measure up? Was the 83% good news in any way the result of something they did? Getting people to stay in their rooms?
For another study of the mathematics of epidemics, this paper is not so optimistic:
https://doi.org/10.25561/77482
https://spiral.imperial.ac.uk:8443/bitstream/10044/1/77482/2/Imperial%20College%20COVID19%20NPI%20modelling%2016-03-2020.pdf
“In the (unlikely) absence of any control measures or spontaneous changes in individual behaviour, we would expect a peak in mortality (daily deaths) to occur after approximately 3 months […] we would predict approximately 510,000 deaths in GB and 2.2 million in the US, not accounting for the potential negative effects of health systems being overwhelmed on mortality”
From their Table 1 “Current estimates of the severity of cases”
In the 80+ age group, “% symptomatic cases requiring hospitalisation”: 27,
“% hospitalised cases requiring critical care”: 71,
“Infection Fatality”: 9.3%
It deals with health services becoming overwhelmed. The worst case is when the doctors and nurses become infected, then paraphrasing someone else, “hospitals become hospices, places you go to die”.
The proper quote, from Dr. Mehmet Oz
https://www.foxnews.com/media/dr-oz-coronavirus-hospitals-weak-link
The referenced paper offers no data about infection and/or lethality by gender. I’m curious if the Wuhan virus differentiates significantly in infection rates, seriousness of the infection, and lethality between males and females.
@ Willis
Thanks for supplying data and evaluation. Maybe, this can be of some help for your work:
https://www.euromomo.eu/
“Mortality monitoring in Europe
Welcome to the EuroMOMO website. We publish weekly bulletins of the all-cause mortality levels in up to 24 European countries or regions of countries. The weekly bulletin is published every Thursday around noon.”
As someone who lived and worked in Asia for 20 years the China curve presented, while based on the official available data, has a high likelihood of being in accurate in terms of total infected, total dead and any ongoing cases. What is correct is China’s ability to enforce quarantine even if involves welding people into their apartment buildings. The China figures are about as accurate as the BOM adjusted Darwin ones.
Having been on one in Dec there is also some skewing for cruise ships. Every time you enter a food area the staff have you use an anti-bacterial hand wash. Internal railings are always sticky with cleaning and disinfecting solutions so the likelihood of infection from surfaces is reduced. None of that stopped me from getting a bad cold for the last few days however.
As an Australian I fear we are just at the beginning of our exponential growth curve because our government has not closed the borders and allowed tens of thousands of people from early affected areas to cross the borders, without tests and without any even recommended isolations. They are still allowing children to go to school while simultaneously telling people not to congregate in any numbers. We are running out of test kits and our health services have very little ability to cope with potential numbers.
Aa aside that I’ve been a keen Willis-ite for some time and enjoy your data driven position.
Did you consider the current thesis that there are two strains of Covid-19 and that the Cruise Ship version could have been the milder one?
Yes we tend to become complacent about constant background risks and then get spun up about something new which is by the numbers anyway less dangerous. There’s also the perception that we’re at least somewhat in control of our traffic risks, while for COVID-19 people are demanding that somebody else “do something”.
Having this in a Presidential election year probably skews perceptions even further away from reality.
The numbers from the Diamond Princess are indeed not what I would have expected from all the other reporting.
From perusing the daily WHO reports, it seems South Korea has had the most effective response. Italy alas has not, and Spain is not too far behind.
https://www.dailymail.co.uk/news/article-7978695/Journey-cruise-ship-passenger-infected-coronavirus.html My initial thought was behavior and outings/ports of call may explain some of the data (when did he get it, when was he shedding, and when did he leave the ship). According to this article (anyone have anything that contradicts?). Patient zero was only on the ship five days and reported symptoms on the 6th day after he left (1/26). He did go on a bus ride with others. He may have gone back to his room feeling a little off, thus limiting exposure. He may not have infected people until about the last day of his trip. Incubation time unknown. Once people were confined to their rooms, the outbreak would have been limited due to quarantine.
Interesting discussion!
I also found that authorities determined patient zero had only been in contact with under 300 people and the first 61 infected were removed to hospital immediately. If exposure to infected people were limited, people were quarantined to rooms the infected had not accessed, and no infectious material got into ventilation, I can imagine this was not the perfect petrie dish but a dodged bullet. Some of this is really about assumptions and unknowns…
facts are a bit scarce at a time like this.
we know when it started and the populations of countries. we know the deaths,
the rest is modelling or sparse testing data.
According to the best guesses, the pinch point will be icu beds
According to the best guesses the people in the beds will be over 70 with previous problems
by now, we should know one thing. are the icu beds being filled with over 70’s covid patients ??
that is where i would be looking
Diamond Princess Cruise Ship
Data source: https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v2.full.pdf
Patient 1 was on board from 20-25Jan2020
By 20Feb2020 there were 634 cases, or which 328 were asymptomatic (3063 tested) out of 3663 passengers and crew.
Only 17% of the people were infected, and only half of those (8.4% showed symptoms.
There were 1231 people over age 70.
By 1Mar2020 there were 7 deaths, all over age 70 (0.6% mortality of those over 70)
Assume this was a fully uncontained situation, such that infection and death rates will be much less with good containment.
DIAMOND PRINCESS CRUISE SHIP
Data source: https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v2.full.pdf
ABSTRACT
Adjusting for delay from confirmation-to-death, we estimated case and infection fatality ratios
(CFR, IFR) for COVID-19 on the Diamond Princess ship as 2.3% (0.75%–5.3%) and 1.2%
(0.38–2.7%). Comparing deaths onboard with expected deaths based on naive CFR
estimates using China data, we estimate IFR and CFR in China to be 0.5% (95% CI: 0.2–
1.2%) and 1.1% (95% CI: 0.3–2.4%) respectively.
______________________________________
If I understand this paper correctly, projections from the ship’s total population averaged :
CFR – Case Fatality Ratio (those who died / those who showed symptoms) ~= 2.3%
IFR – Infection Fatality Ratio (those who died / those who were infected, including those who showed no symptoms) ~= 1.2%
The ship was placed in quarantine on or about 3Feb2020 but it appears that containment was not effective, since by 20Feb2020 there were ~634 infections of which ~half were asymptomatic.
“The quarantine hasn’t worked, and this ship has now become a source of infection,” said Dr. Nathalie MacDermott, an outbreak expert at King’s College London. “There’s no reason this should not have worked if it had been done properly.”
Deaths commenced 20Feb2020 and by 1March2020 totaled 7, 2.4% of the 288 total infected over age 70, and 5.6% of the 124 total who showed symptoms over age 70.
Total projected deaths for over-70’s who were on this ship is projected at 12 (5 more) with another 3 deaths projected for ages 60-69.
Need coffee…
Could be you’re thinking too much. You can say there are broadly 2 types of quarantines in play right now. The draconian Russian type that results in very few infections or deaths and the other type in play in most places that is soft voluntary quarantines that results in much higher infection and death rates.
The Princess ship instituted russian style quarantines and they did it quickly… which is the secondary key to success.
By comparison, Italy instituted draconian quarantines, but far too late.
My completely unscientific 2 cents. Cheers
According to WHO 712 caught the disease and 7 died. Roughly 1%
https://who.maps.arcgis.com/apps/opsdashboard/index.html#/c88e37cfc43b4ed3baf977d77e4a0667
First off, those who died and those who didn’t had some of the best care available. Quite a few still haven’t recovered and some are still critical. Some may have been connected to ECMO machines which completely take over most of the main functions of the body. The deaths would be far higher if the health services of the World were full. Which they will be very soon. Even basics like oxygen supply might struggle to keep up.
Next the assumption that those who didn’t catch the disease were never going to. The ship went into lock down ie, the kind of ‘panic’ that you’re concerned about. This wasn’t normal cruise ship precautions. Thus the spread of the virus slowed to a trickle but, because of the confinment of the ship, didn’t stop until they allowed people to leave. With no efforts to limit spread, it’s expected that 60-80% of populations would catch it (assuming no mutations and the more people who catch it, the more chances of that). In the UK alone the lower figure would be about half a million. Equal to an entire year of deaths from all causes. Ok, natural changes in behaviour might reduce that to 250,000.
Those deaths might not be statistically scary but in reality they’re terrifying. OK, the assumptions might be wrong, maybe high numbers don’t catch it but it’s too dangerous to test the theory.
How much intervention is necessary to stop the spread is a guess. The UK is reacting to the failure of early interventions, to stop rapid rise in cases. If only to build more ventilators, work out if antivirals and anti malaria pills help and get a bit closer to a vaccine. This isn’t panic, this it catchup.
Robert Turner, referring to this as a mere cold, or even the flu, runs completely ignorant of actual medicine. As for the car analogy, we utilize safety measures every single day in our vehicles, therefore most of us end up okay in the end. However, this doesn’t negate the number of deaths every year. The same concept is true with this virus, but which we currently possess no safety measures against it aside from avoiding it in the first place. This is why we need to practice some serious self-responsibility, and help out our neighbors when necessary. If we go about this the right way, then a normal summertime could still be a possibility for us here.
From a medical professional with whom I shared this article, he took issue with the “good news” of a 2% infection rate saying:
1: The virus has been spreading for months unchecked in US. Not weeks, which is the incubation period.
2: Ten times the people dying is the best possible scenario. If our efforts were to fail completely, 2% of 300 million is 6 million. This is the exact wrong time to diminish the severity.
“he took issue with the “good news” of a 2% infection rate saying:”
Pretty sure that’s not what was said. What was actually written was:
“For me, this is all good news. 83% of the people on the ship didn’t get it, despite perfect conditions for transmission. If you get it, you have about a 50/50 chance of showing no symptoms at all. And the fatality rate is lower than the earlier estimates of 2% or above.”
Meaning, this showed LESS fatality rate than the 2% initial estimates, which IS good news (assuming it’s not outside the range). Not to mention the fact that 83% did not get infected and of half of those infected were not effected (other than the real concern of being unknowing carriers).
Also, the medical professional’s math is off. Assuming the numbers from this study could be generalized as a worse case scenario of near universal exposure:
17% infection rate of 300 million is 51 million people infect.
With a fatality rate at 1.2% (range of 0.38%–2.7%) would be 612,000 deaths (193,000 to 1,337,000 taking both ends of the range).
Willis this is probably to far down the post for you to see. However, thought it worth a post
Without going into detail the way the specific immune system works might explain the apparent low rate of infection. the mighty macrophages break down foreign invading proteins into short lengths of the peptide chain of which the foreign antigen is composed. These shorter bits are presented to t-cells and trigger both antibody and killer t-cell responses. Thus a foreign antigen is broken down into bits and it these bits that produce the immune response. Because the corona virus is one of a family of similar viruses cross reactivity of the immune system to several similar viruses is possible. So it is possible that many of the passengers on the cruise ship may have been infected with similar, but not as pathogen viruses in the past and have sufficient immune cross reactivity to provide protection. That would explain why some older passengers do not show symptoms. The only way to examine this would be to check if the individual has been infected, nasal swabs and also check the patient for virus antibodies. Of course, that hasn’t been done so this is just speculation, but could have profound implications for assessing the amount of infection in the population as a whole
Tony, I follow my posts to the bitter end … and yes, cross-reactivity of our immune system from one corona-virus to another may indeed be in play.
w.
Does anyone know what was put on the death certificates of those that died that had tested positive for this corona virus?
Dang … I made it onto Instapundit here. First time ever.
WUWT ROOLZ!
w.
This drug Remdesivir was trialled in the treatment of those who fell ill on this particular ship
https://unredacted.co.uk/2020/03/15/experimental-antiviral-drug-saved-a-coronavirus-patient-in-critical-condition/
Excellent article in Science about how the Koreans have managed the epidemic … testing, contact tracing, isolation of those testing positive. My friend Steve Mosher, who for unknown reasons y’all love to hate, who is living in Seoul says they even have text alerts for new cases in your area.
Worth emulating.
w.
“If you get it, you have about a 50/50 chance of showing no symptoms at all.” WE
From the paper “(asymptomatic cases were either self-assessed or tested positive before symptom onset)”.
If I am reading this correctly they are using asymptomatic where perhaps they may mean pre-symptomatic, and given the long latency this seems reasonable.
Fixed Wireless Communications at 60GHz Unique Oxygen Absorption Properties.
“At 60GHz, the extremely high atmospheric absorption level is due primarily to the molecular composition of the atmosphere. Figure 3 illustrates the atmospheric attenuation characteristics for wavelengths from 3 cm to 0.3 mm. For millimeter waves, the primary absorption molecules are H2O, O2, CO2 and O3. Since the presence of O2 is fairly consistent at ground level, its effect on 60GHz radio propagation is easily modeled for margin budgeting purposes. In addition, the high level of attenuation from oxygen absorption makes even the worst weather-related attenuation insignificant, especially on the short paths where 60GHz systems operate. Even extremely heavy rainfall, 25mm/hr (5dB/KM), will make only a very small percentage contribution to aggregate attenuation in the 60GHz oxygen absorption region.”
https://www.rfglobalnet.com/doc/fixed-wireless-communications-at-60ghz-unique-0001
What happens to your body when your oxygen level is low?
“Hypoxemia occurs when levels of oxygen in the blood are lower than normal. If blood oxygen levels are too low, your body may not work properly. … Hypoxemia can cause mild problems such as headaches and shortness of breath. In severe cases, it can interfere with heart and brain function.”
https://my.clevelandclinic.org/health/diseases/17727-hypoxemia
Is 5G involved in the coronavirus outbreak?
“Since our original post on 31st January, ALL our predictions happened exactly as we said they would so we have updated the Article….”
https://australianhiphopdirectory.com/5g/
re: “Is 5G involved in the coronavirus outbreak?”
We went OVER this ground a few weeks back. The effect would be immaterial, non-measurable.
Of course, you’re well out-of-your-depth on this too.
BTW, NO ONE (including myself) could find ANY telecom wireless infrastructure equipment manufactured (yet) for 60 GHz (Q-band). There is some limited ‘demo’ class hardware available (WE discussed THIS too a few weeks back), but to discuss this with you any deeper, jmorpuss, would be both fruitless and futile.
Jim
And what’s your proclaim to fame ?? Please provide links … Without links all your doing is GASLIGHTING
https://wattsupwiththat.com/2020/03/14/the-11-gaslighting-characteristics-of-the-climate-debate/
re: “And what’s your proclaim to fame ??”
Succinctly?
“Time in type.” (If you have done any flying, you’ll know what that answer entails, means.)
BTW, the phrase is “claim to fame”, and its not fame (per se), its experience with the technology. It’s the ability to know what current state-of-the-art is, its having ‘worked’ nearly ALL aspects of wireless (from semiconductor fab to radio/cellular test bed, incl. new product development) for probably more years than you’ve drawn breath.
re: “Without links all your doing is GASLIGHTING”
Moron, find my previous comments, they include links.
BTW, it’s “you’re doing”, not ‘your doing’. Either “you know your s**t”, or “you know you’re s**t”; you want the former, you end up being the latter …
Jim
I think you are full of s**t, I’ve never seen you leave a link you silly old F**t, and remember life is like a mirror , What you put out you get back.
Willis, I shared your piece with friend snd he bounced back this link about Brit epidemic modeling:
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
You can forward this to Willis and have him give his take perhaps?
On Wed, Mar 18, 2020 at 3:58 PM James Brown wrote:
Good to see this data. Kind of debunks the young/old hypothesis. I take his point on proportion, but I would add that auto accidents are not exponentially increasing. If there was more certainty about how it’s spreading, then I think we could relax a bit more. But there’s not, and we’re not.
Assume I have bad luck and the post person delivers some mail to my home that is infected . Will heat kill the virus? If so what temp. and for how long, eg 120 degrees for 10 or more min. John
Just apply Fahrenheit 451 to the mail, total sterilization.
w.
Willis using the diamond princess is a bad idea.
This has to do with the characteristics of R0.
With these virus it appears that infectiousness is not ‘normally” distributed.
think super spreaders. some infected people (think diamond princess) will have R0 1000
https://icjournal.org/Synapse/Data/PDFData/0086IC/ic-48-147.pdf
So the ship is not the perfect natural experiment.
Thanks much for that, Steve. However, you haven’t run the analysis all the way through.
As your link points out, although the average R0 is some given number, in fact the distribution is highly skewed, with many people not passing on any infection, while some “superspreaders” infect many people.
Now, the Imperial College Group has estimated the R0 of coronavirus at 1.5 – 3.5, so I’ll use the midrange. I’ve used the average value of “k” for MERS, SARS, and Ebola, which is 0.12.
With these values, we get the following results for the number of people who infected 0,1,2, etc other people:
As a result, I’m not seeing why the distribution makes much difference. Yes, IF the coronavirus acts like those other viruses, for which we have no evidence but is certainly possible, some 408 people didn’t infect anyone. But on the other hand, nine people infected nine others, six infected ten others, five infected eleven each, and one infected 12 others.
And the average R0 is still whatever it was. Your paper is certainly important in terms of how to fight the virus. But in terms of the overall spread in a closed community, I’m just not seeing how it makes any difference.
I mean, suppose four infected people get on the ship. Each one infects two others. Net is eight people, and the average R0 is 2
Now, suppose three infect nobody, and the other is much more virulent, he infects eight people. And again, the average R0 is 2
Not seeing the difference. Eight people are infected with an average R0 of 2, regardless of the distribution.
Let me add that it assuredly makes a difference in how to FIGHT the virus. As the paper says:
Whis is very valuable information … but it doesn’t change the average R0 one bit. So I can’t see how it invalidates the Diamond Princess experiment.
Thanks again for a fascinating paper.
w.
“Whis is very valuable information … but it doesn’t change the average R0 one bit. So I can’t see how it invalidates the Diamond Princess experiment.”
No superspreader, your R0 will be lower
the reason you dont use the diamond princess to estimate a GLOBAL metric
is that there is no superspreader
SAME REASON why you dont use the patient 31 in Korea to estimate R0
https://graphics.reuters.com/CHINA-HEALTH-SOUTHKOREA-CLUSTERS/0100B5G33SB/index.htmlv
Thanks, Steve. You keep talking like there are regular spreaders and A solitary superspreader. That is NOT what your paper said. Look again at the distribution above. There is a range, and the range is continuous from zero-spreaders to superspreaders.
As a result, according to their numbers, there would be no less than 77 (range 61-105) people who infected more than five people (R0>5), and 50 (range 39 – 77) who infected more than 8 people (R0>8). Heck, there are an average of 12 (range 3 – 22) who infected more than 20.
So the idea that there are no “superspreaders” in a group of that size comes up hard against the claim by the authors of your link that it is a distribution from people that don’t infect anyone at one end to people that infect a whole bunch at the other end of the distribution.
w.
One more look. Again using the figures from you link, we would indeed expect there to be superspreaders. If we look at the max R0 from repeated runs, it has a mean of R0=51 ± 1, a standard deviation of 11, a max R0 of 97, and a minimum R0 of 27. So indeed, we’d absolutely expect to see superspreaders among the Diamond Princess passengers.
w.
One event that might suggest the existence of ‘super spreaders’ was the Biogen meeting in Boston:
“Seventy-seven of the 95 confirmed cases in Massachusetts have been linked to a meeting of executives with Biogen, a company based in Cambridge, next to Boston, that develops therapies for neurological diseases, state officials said.
An additional 12 people who have tested positive for the virus outside Massachusetts have been linked to the Feb. 26-27 meeting, including five in North Carolina, two in Indiana, and one each in New Jersey, Tennessee and Washington, D.C., officials said. Two tested positive in Europe, Biogen spokesman David Caouette said Wednesday.”
This was dated March 11 since then there have been further developments, two attendees at that meeting were at a family party in Princeton and several people at that party have tested positive. This includes four members of one family that have since died of the virus and one other is on life support. That one event seems to have been the source of a major cluster.
Willis, what happened today ? 16 new cases among passengers from the ship ? How long incubation will that be ?
We may still have a lot to learn !
There’s always more to learn … I fear we don’t have enough information about those 16 cases. Were they still in quarantine? How good was the quarantine? Were they interacting with the other passengers?
w.
Well, it’s not so much the death rate or % of possible contagion to other people (which is not that high with 2019-nCoV, about 2-4 people on average get it around the first infected) – it’s the fact that the virus doesn’t respond to any medication, so there is a high chance that the contagion *can* grow to be uncontrollable if left unchecked. Uncontrollable meaning that in a very short time span (possibly under three days) it can overwhelm the medical units and when that happens, the virus will start to put more pressure on the whole infrastructure in other places.
It spreads too covertly, the incubation period is way too long – if it was something like 2-4 days, it would be much easier to monitor and contain. But because it can be as long as two weeks, it can spread too much behind the scenes before first patient starts getting sick. There is also a very long recovery period for the patients who have had it, some staying bed ridden for a month or more.
This hits the infrastructure hard, as well as the whole economy as everything is connected.
There are drugs that are highly effective against this virus.
More detail
https://www.niid.go.jp/niid/en/2019-ncov-e/9407-covid-dp-fe-01.html
‘Based on the number of confirmed cases by onset date, there is clear evidence that substantial transmission of COVID-19 had been occurring prior to implementation of quarantine on the Diamond Princess on 5 February (see also febrile patient visits to the on-board clinic below). The decline in the number of confirmed cases, based on reported onset dates, implies that the quarantine intervention was effective in reducing transmission among passengers. Transmission toward the end of the quarantine period, which is scheduled to end for most passengers on 19 Feb, appears to have occurred mostly among crew or within passenger cabins. It should be noted that due to the nature of the ship, individual isolation of all those aboard was not possible. Sharing of cabins was necessary, and some crew had to continue to perform essential duties for the functioning of the vessel with passengers aboard.
Recent confirmations of asymptomatic cases can be explained by the systematic testing of passengers that began around 14 Feb. Although some of these cases may have been secondary cases within a given cabin, it is difficult to know when transmission occurred. They may have been infected before the quarantine began. Nevertheless, these asymptomatic cases have been disembarked and their cabinmates have been defined as close contacts with their 14-day isolation reset on the day the asymptomatic case was disembarked. The systematic testing of asymptomatic cases was useful in screening these persons before allowing them to disembark.”
Not a “perfect” experiment for determining R0
any more than a Church in Korea is
‘Buncha virus resistant old geezers, I guess …’
The fact that older people are less likely to either get infected or show symptoms from the virus is not surprising at all. In fact it is exactly what I would have expected. It only takes a cursory knowledge of immunology to figure out why this is the case. For non novel viruses, the disparity is even greater.
“Small Italian town of 3,300 people cuts coronavirus cases to zero after authorities forced the WHOLE population to have repeated tests”
https://www.dailymail.co.uk/health/article-8126899/Small-Italian-town-cuts-coronavirus-cases-zero-population-tested.html
“The 3,300 or so citizens of Vo’ Euganeo, just 30 miles (50km) from Venice, were all swabbed for COVID-19 in late February. Anyone who tested positive was immediately quarantined to stem the spread of the disease – even if they weren’t showing symptoms – local media reported.”
And the city isolated itself.
“Two weeks later, mass testing showed the infection rate had dropped by 12 times from three per cent of the population to just 0.25 per cent.”
“Half of those who carried the virus in Vo’ Euganeo had no symptoms, proving that people are capable of spreading the deadly virus without even knowing it. ”
That’s the background. Here is the relevant quote:
The article does not go into how they did the total lockdown, but it is clear that should be the next step. The country-border closures were too late (horse/barn door) to keep out the virus. Now that it is here, we need to isolate any green zones we can find, testing anyone coming in, and doing strict isolation on any positive vectors that are found. It’s like a war. All the other “war on X” was just talk. This one is real, including the devastation.
re: “Two weeks later, mass testing showed the infection rate had dropped by 12 times from three per cent of the population to just 0.25 per cent.”
Alternate interpretation: A ‘whole lot’ of false positives were recorded initially. (Or, later tests were inadequate for purpose.)
Somebody correct me, but if these tests are for antibodies in the blood (to Covid-19) THEN said anti-bodies would still be present in subsequent tests later when additional testing of the same subjects took place.
You raise good questions. What are the false-positive and the false-negative rates for the tests?
What different test kits are being used in different countries? Which test kits are better? Which methods give the quickest results?
https://en.wikipedia.org/wiki/COVID-19_testing
I don’t know what test they used in Italy. For the last 0.25%, “The town isolated these last few cases and has since reopened.”
Another Italian mayor said they couldn’t test “test everyone since it takes 8-9 hours to get a result.”
“Luca Zaia, the governor of the Veneto region told Italian media this week: “We tested everyone, even if the ‘experts’ told us this was a mistake: 3,000 tests. We found 66 positives, who we isolated for 14 days, and after that 6 of them were still positive.”
“The Veneto governor told newspaper Corriere della Sera that the region has the ability to carry out 20-25,000 swabs a day.”
re: “Corriere della Sera that the region has the ability to carry out 20-25,000 swabs a day.”
Yes … need more info; what is their “test protocol”? Is it the same as ours? The Chinese? How did they ‘ramp up’ so fast? Receiving test kits, analysis and technical support from the Chinese? More questions …
The RT-PCR test is for the genome of the virus not for the antibodies to it.
re: “The RT-PCR test is for the genome of the virus …”
This ‘testing’ is a murky area for me, and I’m sure I am not the only who does not know the specifics of the protocol and the ‘lab’ work involved.
OK the viral genome is a strand of RNA, think of it like a sequence of letters (made up of GCAU). Each virus has its own sequence with differences in certain region, if you find a unique sequence you can test for it. This what RT-PCR does, it amplifies that unique region (if present) to give a sufficient sample to test for. The sample preparation and amplification process takes a few hours but the samples have to be sent to a qualified lab and the results transmitted. So early in the process when only the CDC could do the test the turnaround was about 4 days.
Just wondered if we can deduce the pathogenicity of this virus from Willis’s investigations!
It’s a small number, but highly relevant to the cocoon environment.
Anyone got the courage?
Not sure what you’re calling “pathogenicity” …
w.
“At this point at least, it doesn’t appear that we are following the Italian trajectory. However … it’s still early days.”
It’s all about demographics with Italy-
https://www.msn.com/en-au/news/world/why-have-so-many-coronavirus-patients-died-in-italy/ar-BB11qA65
You can’t beat this pandemic by printing money and all staying home. Stop believing Gummint can sole every problem all the time and common sense says you don’t sacrifice the productive majority on the altar of the aged and frail minority-
https://www.msn.com/en-au/news/world/i-dont-know-how-im-going-to-pay-rent-next-month/ar-BB11ocim
https://www.msn.com/en-au/entertainment/celebrity/this-is-so-far-beyond-absurd-today-extra-host-sylvia-jeffreys-slams-panic-shoppers-and-reveals-her-sister-had-to-mail-her-baby-panadol-from-brisbane/ar-BB11pnmO
https://www.msn.com/en-au/lifestyle/familyandrelationships/a-viral-video-of-a-mum-crying-over-sold-out-diapers-at-walmart-reveals-the-devastating-effects-of-bulk-shopping/ar-BB11pOaJ
You don’t produce and distribute stuff or earn incomes doing that then no amount of line credits dumped in your bank account is going to help anyone. That will simply beget massive stagflation as the adept and agile scoop up the available real goods and onsell their surplus at higher prices fighting with each other in supermarkets over the spoils. That’s Econ101 stoopids.
You might want to compare death rate for the virus at different age groups against the average chance of dying at that age also, because 99% of people who die have pre-existing conditions and the gender breakdown of deaths worldwide from the virus also seems to be remarkably similar to the average chance of dying by gender at that age group.
The odds of dying in any given year between the ages of 70-90 range from 2.3% at the low end (70) up to 16% at the high end (90) and you have 1200 people in that age range. So if we say 1000 people from 70-79 with a yearly 3.5% mortality rate and 200 people between 80-89 with a 10% yearly mortality rate.
35+20= 55 deaths per year, so 7 deaths would be the average number of deaths over a 6 week period anyway and people who die from flu related and respiratory illnesses tend to die more in the winter flu season anyway.
https://www.ssa.gov/oact/STATS/table4c6.html
Has anyone actually worked out how many of those people would have died anyway, because looking at it the numbers and gender ratio seem very similar.
Of course, the teenagers were partying through the night, and making out every chance they could get. Versus the seniors who retired to their rooms after the 5 PM dinner to cuddle up with a good book (enlarged print, of course).
Hello mr Eschenbach.
Firstly thankyou for all the informative posts of yours I have read over the last few months. Even your little spat with Zoe Phin brought much amusement.
With regard to the current crisis I have long believed in the benfits of vitamin D in the fight against the flue bug.
While doing a bit of research on the internet……..I know, it appears that Iran’s population is defficient in vitamin D and zinc and the Italian population is defficient in vitamin D and zinc, both these countries have comparitively high mortality rates.
My concern is if people isolate during the summer, they may come out of isolation with vitamin D defficiency due to lack of sunlight.
I am currently trying to run small business in the UK and all my time is being taken up with that, however I am about to visit my 82 year old dad with some home made meals and vitamin D and zinc suppliments.
I would appreciate your response to my comments and once again, thankyou for your posts.
Hello Mr Eschenbach.
Firstly thankyou for all the very informative posts of yours that I have read on this site over the last few months.
Regarding the current crisis, I have long believed in the benefits of vitamin D in fighting of the flue bug. A little bit of research on the internet reveals that there may be a vitamin D and zinc defficiency in the population of Iran and also a zinc defficiency in the elderly population of Italy, both have high mortality rates…….. I know, internet research.
My concern is if there is a correlation, the advice to self isolate indoors during the summer months could well mean many people not getting enough sunlight and coming out of isolation defficient in vitamin D.
I am currently trying to run a small business in the UK and all my effort is taken up with that, however I am just off to visit my 82 year old dad with some home made meals and Vit D and zinc tablets.
I would appeciate your thoughts on my comment above and once again, thankyou.
Hello mr Eschenbach.
Firstly thankyou for all the informative posts of yours I have read over the last few months. Even your little spat with Zoe Phin brought much amusement.
With regard to the current crisis I have long believed in the benfits of vitamin D in the fight against the flue bug.
While doing a bit of research on the internet……..I know. It appears that Iran’s population is defficient in vitamin D and zinc and the north Italian population is defficient in vitamin D and zinc, both these countries have comparitively high mortality rates.
My concern is if people isolate during the summer, they may come out of isolation with vitamin D defficiency due to lack of sunlight.
I am currently trying to run small business in the UK and all my time is being taken up with that, however I am about to visit my 82 year old dad with some home made meals and vitamin D and zinc suppliments.
I would appreciate your response to my comments and once again, thankyou
thank you for substantiate my assertion: http://asiawithout.us/corwel.html
corona is here to judge our characters, not so much resistance to virus infection. for whatever inconvenience it has cause us, it could very well have prepared us for surviving the ultimate knock-out punch — the killer virus.
please just allow all the countries to develop the minimum immunity for future more serious virus attack, and possibly also wake up to what we are doing to the climate, which would not be so kind as our good friend corona.
Just spitballing based on the chart at:
https://docs.google.com/document/d/12YDytbAsZaruGlhFO7eTTgxSH_BuxJtwFmbhqpkPPSk/mobilebasic
and some of the background data at ourworldindata.com…
and if someone else has made this point I apologize for not seeing it….
I can’t speak for this ship, but officers often come from southern or eastern Europe while deck and passenger service crews come from the Phillipines, South America, Indonesia, etc.
Just thinking that if you bash one data set into the other there might be a case to be made that many of the younger cases were among a crew cohort from places with greater malaria exposure and perhaps previously dosed preemptively with antimalaria drugs.
Looking at the malaria deaths by 1000s at risk it’s fascinating the variation between countries that you might think should be similar. Either the reporting is weird, or some governments and some programs are doing a far better job than others.
Hat tip to Steve Mosher, who tweeted a link to this most interesting and detailed analysis of the Diamond Princess.
w.
Maybe the immune system was overreacted cytokine storm Thats maybe the reason that people in age 20,30,40 get so sick .
There should also be some cruise ships with flu outbreaks that could be used for comparison. Flu cases are mostly estimated as well it is not known how many people actually get infected each year.
I think this post has also been mentioned on the Mark Levin radio show — heard while I was a distance from my computer.
Maybe the “missing” cases never cam about because another Rx prevented them? A high blood pressure med or statin? Likely that a significant part of the 50+ crown on the ship were taking similar daily meds for one of these conditions?
Willis, Great post. However, the 50% asymptomatic ratio is probably off. You wrote:
“It is particularly valuable to know that about half the cases are asymptomatic.”
Accounting for right-censoring of the raw Diamond Princess data, this paper estimates the true asymptomatic proportion at 18%:
https://www.medrxiv.org/content/10.1101/2020.02.20.20025866v2
“We estimated the asymptomatic proportion at 17.9% (95% CrI: 15.5%-20.2%), with most of the infections occurring before the start of the 2-week quarantine.”
Another paper, CDC, dated March 23, 2020, cites the above link (“Estimating the Asymptomatic Proportion of 2019 Novel Coronavirus onboard the Princess Cruises Ship, 2020”) and also says
https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e3.htm?s_cid=mm6912e3_w
“Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020”
“SARS-CoV-2 RNA was identified on a variety of surfaces in cabins of both symptomatic and asymptomatic infected passengers up to 17 days after cabins were vacated on the Diamond Princess but before disinfection procedures had been conducted”
Why would the infection rates and symptomless infection rates be lower for people over 50 and even more so for people over 60? What viral event happened 50-60 years ago?
Hong Kong Flu.
This is pure speculation but if the pensioners in areas that were more significantly impacted by Hong Kong Flu are less impacted by Covid 19 then it might be worth looking in to. Maybe the antibodies for Covid 19 are similar to an earlier disease? I don’t have enough access to data to find anything beyond newspaper cuttings but I think Hong Kong, Switzerland and Britain got hit hard.
Andy
(Completely prepared to be shot down on this)
“Why would the infection rates and symptomless infection rates be lower for people over 50 and even more so for people over 60?” I don’t know.
But a possible answer to why are Chinese under-30s are less susceptible than over-30s is oral (OPV) polio vaccination, according to a study that a friend just sent me. Not sure where to find it online but here’s the title:
Can the Poliovirus Vaccine prevent or minimize coronavirus (COVID-19) infection?
Authors: Xie Qiyi, MD.,/MPH/Public Health Medicine/Epidemiologist
Communication: qxie810 at yahoo.com 858 525 5831
Chen Wei, MD.,/MPH/Epidemiologist