A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data
By John P.A. Ioannidis
March 17, 2020
The current coronavirus disease, Covid-19, has been called a once-in-a-century pandemic. But it may also be a once-in-a-century evidence fiasco.
At a time when everyone needs better information, from disease modelers and governments to people quarantined or just social distancing, we lack reliable evidence on how many people have been infected with SARS-CoV-2 or who continue to become infected. Better information is needed to guide decisions and actions of monumental significance and to monitor their impact.
Draconian countermeasures have been adopted in many countries. If the pandemic dissipates — either on its own or because of these measures — short-term extreme social distancing and lockdowns may be bearable. How long, though, should measures like these be continued if the pandemic churns across the globe unabated? How can policymakers tell if they are doing more good than harm?
Vaccines or affordable treatments take many months (or even years) to develop and test properly. Given such timelines, the consequences of long-term lockdowns are entirely unknown.
We know enough now to act decisively against Covid-19. Social distancing is a good place to start
The data collected so far on how many people are infected and how the epidemic is evolving are utterly unreliable. Given the limited testing to date, some deaths and probably the vast majority of infections due to SARS-CoV-2 are being missed. We don’t know if we are failing to capture infections by a factor of three or 300. Three months after the outbreak emerged, most countries, including the U.S., lack the ability to test a large number of people and no countries have reliable data on the prevalence of the virus in a representative random sample of the general population.
This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19. Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror — and are meaningless. Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.
The one situation where an entire, closed population was tested was the Diamond Princess cruise ship and its quarantine passengers. The case fatality rate there was 1.0%, but this was a largely elderly population, in which the death rate from Covid-19 is much higher.
Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%. But since this estimate is based on extremely thin data — there were just seven deaths among the 700 infected passengers and crew — the real death rate could stretch from five times lower (0.025%) to five times higher (0.625%). It is also possible that some of the passengers who were infected might die later, and that tourists may have different frequencies of chronic diseases — a risk factor for worse outcomes with SARS-CoV-2 infection — than the general population. Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%.
Coronavirus model shows individual hospitals what to expect in the coming weeks
That huge range markedly affects how severe the pandemic is and what should be done. A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.
Could the Covid-19 case fatality rate be that low? No, some say, pointing to the high rate in elderly people. However, even some so-called mild or common-cold-type coronaviruses that have been known for decades can have case fatality rates as high as 8% when they infect elderly people in nursing homes. In fact, such “mild” coronaviruses infect tens of millions of people every year, and account for 3% to 11% of those hospitalized in the U.S. with lower respiratory infections each winter.
These “mild” coronaviruses may be implicated in several thousands of deaths every year worldwide, though the vast majority of them are not documented with precise testing. Instead, they are lost as noise among 60 million deaths from various causes every year.
Although successful surveillance systems have long existed for influenza, the disease is confirmed by a laboratory in a tiny minority of cases. In the U.S., for example, so far this season 1,073,976 specimens have been tested and 222,552 (20.7%) have tested positive for influenza. In the same period, the estimated number of influenza-like illnesses is between 36,000,000 and 51,000,000, with an estimated 22,000 to 55,000 flu deaths.
Note the uncertainty about influenza-like illness deaths: a 2.5-fold range, corresponding to tens of thousands of deaths. Every year, some of these deaths are due to influenza and some to other viruses, like common-cold coronaviruses.
In an autopsy series that tested for respiratory viruses in specimens from 57 elderly persons who died during the 2016 to 2017 influenza season, influenza viruses were detected in 18% of the specimens, while any kind of respiratory virus was found in 47%. In some people who die from viral respiratory pathogens, more than one virus is found upon autopsy and bacteria are often superimposed. A positive test for coronavirus does not mean necessarily that this virus is always primarily responsible for a patient’s demise.
If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths. This sounds like a huge number, but it is buried within the noise of the estimate of deaths from “influenza-like illness.” If we had not known about a new virus out there, and had not checked individuals with PCR tests, the number of total deaths due to “influenza-like illness” would not seem unusual this year. At most, we might have casually noted that flu this season seems to be a bit worse than average. The media coverage would have been less than for an NBA game between the two most indifferent teams.
…
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It is a wise statement. The question always is “who benefits” from scaring the population?. For a start: traders on Wall Street, the mass media, politicians…
Short sellers on Wall Street, in particular. I bet they are cleaning up right now.
Massive QE from Fed and ECB.
Loan guarantees to “help” small businesses just kneecapped by shutting down entire economies means banks can issue credit at ZERO risk.
Banks create money from nowhere when they issue credit, this injects “wealth” into the system ( and above all into the banks ).
The virus is real enough, and so is seasonal flu deaths. But the root cause of man made “crisis” is the need to flood the banks with more public funds.
As Obama’s boy said: never waste a good crisis.
I don’t think that endless QE is zero risk when economic output falls sharply. Asset values collapse, and real goods become scarce and pricey. Let that run too long, and you have hyperinflation.
Greg March 19, 2020 at 4:32 am
The President has always been a sharp critic of the Federal Reserve. The Fed had interest rates set far above that of other competitive countries, until now. He may not be opposed to some QE, right now, unfortunately. I don’t like it; why not take the money out of some massive, massive Black Budget somewhere, and give it back to the taxpayer and small business owner, for shutting down main street over influenza.
But at least Pres Trump might refinance the national debt at the lowest rates ever. 😀 Something good might come of this.
Do you think the governor of California is involved?
He just created an economic crisis based on statistics showing the amount tested and showing positive as an indicator of speed infectious spread.
It’s not. It’s first an indication of speed of increased testing. Which is in recent days exacerbated by –what the governour should know–>the earlier defective CDC test equipment.
But the governor …is an idiot? Crook? I think more likely he has statistical idiots around him.
Charles,
We surely do need more data. However, this statement caught my eye before even finishing your post: “We don’t know if we are failing to capture infections by a factor of three or 300.”
This is obviously an enormous over-statement, most locations have a firm grasp on non-coronavirus-related deaths. Additionally, I suspect (but don’t know for certain) most suspicious deaths are tested for the virus.
caught your eye and then you didn’t read it … infections not deaths …
O disagree. It’s a fair assessment of the state of uncertainty. Two orders of magnitude. Why not three?
” I suspect (but don’t know for certain) most suspicious deaths are tested for the virus.”
A reasonable suspicion, but probably untrue at the moment because many countries with active contagions (including the US) simply don’t seem to have enough test kits available to test all suspicious deaths. Keep in mind that “suspicious deaths” would possibly include each and every fatal case of seasonal flu plus many cases of microbial pneumonia, emphysema and dozens of other conditions. Also, AFAICS, there are apparently a number of different tests being used in different countries. And we seem to have little or no idea as to the rates of false positive or false negative for any of the tests much less all of them. Neither do there seem to be well defined criteria for assigning cause of death where the deceased had both corona virus and some other affliction.
I think Ioannidis is correct. The data we have is so poor that it is impossible to determine whether we are dealing with a relatively minor affliction or a serious disease that most of us will catch and a significant number will die from. We do have the example of the last great pandemic — the “Spanish Flu” of a century ago, and right at the moment we have little choice but to assume that this could be similar in many respects — including a very limited ability to deal with it.
Are we over-reacting? Hopefully. But under-reacting could be pretty grim.
What seems constantly unspoken is the substitution effect. Dying of covid instead of the heart disease that was going to get grandad this year or next. Thousands die every day in America of old age related issues. The delta between extra covid deaths and the reduction of background existing rates should be part of the discussion long before we can judge Cuomo’s or Newsom’s divergent responses.
Hey Zack. Let’s hope you are that “casual” and objective when your time comes to be old and frail, which it surely will.
I’m 64, and while not frail, I have my aches and pains. I’d rather take my own chances, with my own regime of hand-washing 30 times a day, and betting on being tell the difference between a cough from food or drink going down the wrong pipe and someone that sounds sick.
This is all just about protecting the Boomers, afte all.
Ah! … trying to inject a dose of sanity into an atmosphere of global hysteria.
A noble effort, but you’re likely to be either ignored or torn to shreds.
Excuse me while I go and buy some more toilet paper.
Ah, yes, OCD-TP (Obsessive/compulsive disorder toiletus paperus). Seems to be spreading at a 1000 times the rate of Sars-CoV-2. Results in a basement full of 400 rolls of toilet paper that is abandoned when the stores have stock available again, left to mice and rats to party and build condos in. Makes for a bunch of “Hoarders” episodes, and the rats and mice love you. Fascinating how mental illness just springs forth, isn’t? 🙂
PS If you have a source for TP, do NOT tell. Riots start that way!!!
You neglect scatophobia in your catalogue of mental derangements.
I’m not sure fear of scat qualifies as irrational, except in CA, WA, and parts of New York and Texas. I guess it’s a matter of geography as to what is insane.
We knew a lovely married couple that, by every guideline we could imagine, was so visibly virtuous that for role models, they were perfection. We travelled in Europe for three weeks with them. Her hair styling was immaculate, no matter the weather. At dining times, a silver platter would magically appear in his hands, for the proper serving of nibbles.
We plebs surmised that they had perfected the clean life to the extent that they had no needs for bodily waste. Their eating was precisely planned so that its nutrition was exactly extracted, no waste remaining, no need for toilets or their paper.
We worked shifts, following them to see if they did indeed go to powder rooms. We never saw their perfection compromised this way, but we might have been less than perfect observers. Thus, we never did confirm a human anatomy with the completely closed anus. I tried seduction of the one of opposite my gender, attempting to gain a closer view in nudity, but the moral barrier was also honed and I was repulsed, but in a seamlessly smooth non-hurtful way. She was a virgin, her children adopted, because of the unclean aspects of coarse copulation.
Some years later, by chance we met again. The perfection, the virtue, the lack of need for toilets paper, had persisted. She had moved on in her chosen career and was now an IPCC lead author. He had grown his money laundering and subsidy skimming business and invented a way to count money with no chance of transmitting diseases. A truly inspirational couple for our times! Geoff S
Geoff,
Winking Poop Emoji
Why is TP such a concern ? A reasonably clean rag and soap and water actually work better
How can they get a mortality rate….without testing every person….and then testing them again and again
…computer games
when they do test..they find a lot more people are exposed than they thought…and the death rate is a lot lower because of that
For influenza they have done controlled studies with testing whole population samples to understand the key statistics. While that helps narrow the uncertainty, it is limited to the particular populations being tested. For this virus they have extrapolated from those numbers – who knows how accurate that is?
“the official 3.4% rate from the World Health Organization … are meaningless.”
And you counter with 1% results from cruise ship data and don’t bother to bother telling us the actual age distribution and forget to mention they were locked down to prevent new infections.
Mean while, deaths in the US mount.
7500 deaths per day from all causes. Over 20, 000 deaths estimated from influenza this year. Try to stay calm
It’s not about the deaths.
China has twice the hospital beds as the USA,
and they had to build a couple thousand extra beds.
IT is NOT about the deaths. NOT ABOUT THE DEATHS
Here in Korea we maybe have 5x the number of hospital beds per capita that the USA has.
What did we have to do to handle the SURGE?
well first a few things to note.
1. This SURGE comes ON TOP OF the normal flu.
2. The infection spreads fast as fuck. In the documented cases we have
of individuals going into work, we see > 50% of co workers getting it in some cases.
3. The government commandeered 7000 locations to turn them into
treatment centers for the mildly affected.
4. Korean Civil defense already had this all war gamed in December 2019. YUP
in December a tabletop simulation of a pandemic was conducted by Civil defense officials ( this is like what war gamers do)
Both Singapore and Korea PLAN for these types of emergencies. HK too.
If you plan, there is no panic. if you fail to plan, the public response of necessity will be
A) denial
B) Panic
let me repeat that. if you fail to Plan, your public will choose Denial or Panic.
Anyway, my mobile Alarm went off twice this morning. That means 2 more cases located 5 minutes from me. It gives me the location where the infected person was.
I won’t be going to that office building today. Later today the civil defense team
will show up. That building will be sealed. people who work in that building
will be tested. 99.5% of them will test negative. The building will be cleaned.
life will go on.
as planned.
But in a situation like the USA where there was no plan, no war gaming, no simulation
you get
A) Denial.
B) Panic
In short, You HAVE TO deny it. and other folks have to Panic. neither of these is a free
choice. It’s in your human programming
cause you didn’t prepare or plan.
“Anyway, my mobile Alarm went off twice this morning. That means 2 more cases located 5 minutes from me. It gives me the location where the infected person was.”
Wow, you are further gone than anyone could have imagined…..Talk about paranoia and insane responses..
PS We know you despise America, love South Korea (which makes one of those terrifying nationalists) and rarely have anything worthy of note to say. Thanks for never changing from that lovable, angry, bitter person you remain.
Contact tracing is not paranoia. It was the old orthodoxy. Using modern technology to mitigate exposure and provide a more rapid response during an outbreak enhances a proven protocol that helped eradicate smallpox worldwide.
Phil: Then why do we not have trackers for influenza, measles, HIV/AIDS, whooping cough, etc? These are nasty illnesses and I can’t see how anyone could leave home not knowing where these are. Not if SarsCoV2 scars them enough to need a tracker. Where’s the modern technology for all those other scary, possibly fatal diseases???
Trackers:
Influenza – many different types -reasonably managed with seasonal flu vaccine
measles and whooping cough – managed with vaccines
HIV/AIDS – disease WAS tracked in early phases:
Risk network structure in the early epidemic phase of HIV transmission in Colorado Springs; J J Potterat, L Phillips-Plummer, S Q Muth, R B Rothenberg, D E Woodhouse, T S Maldonado-Long, H P Zimmerman, J B Muth
https://sti.bmj.com/content/sextrans/78/suppl_1/i159.full.pdf
The main driver for the current disease appears to be that it is highly contagious. Contact tracing is used for two purposes: (a) tracking highly contagious diseases for which there is no vaccine (vaccinating populations offers a means of disease control that makes tracking unnecessary) and (b) identifying individuals that need to be vaccinated (smallpox).
A agree with you 100% Sheri. All your comments on this thread. Despite a new vaccine every year, Influenza kills 50,000 yearly, in the US alone. 100,000’s world-wide Every year.
Why aren’t we shutting down the economy for that?
What the world should be doing is locking down Care Homes and using appropriate measures to prevent spread in hospitals (like we do for other diseases), until this new virus runs it’s course, while letting the rest of the population operate normally. This is what we do with Influenza, a much more lethal virus.
Huh?
I would rather KNOW that the market around the corner had a case before I leave to do my shopping rather than showing up to find it closed?
insane? Paranoid?
Nope
PREPARED WITH KNOWLEDGE.
go to the other market
Holly it is not about the deaths
its about hospitals not being able to cope
https://www.mirror.co.uk/news/world-news/coronavirus-patients-apocalypse-ward-gasp-21723273
Do you have EVIDENCE that “flu kills”?
Quite right, it’s not about death. It’s about beds.
That’s what I thought. But the Lancet claims that 80% of those in China who needed oxygen died, and almost all of those who needed ventilators died; at least in the population whose data they were able to study. I presume the 80% who needed oxygen and later died progressed to needing ventilators.
So if the Lancet is correct, by the time most people really need a hospital bed, they’re probably doomed.
Again, thanks for the sane comment, Steven Mosher.
Thoroughly considered plans led humanity in July 1914. We never seem to be able to understand the consequences of our grand schemes.
Now world economy collapses due to plans intended to stop airborne Ebola or TB.
How do you avoid the common cold? Simple, avoid contact, avoid probable vectors, avoid close contact, Sometimes I am happy to be a lonely introvert.
That’s just the US.
Most expert analyses indicate anywhere from 50% to 70% total infection rates in the US – around 214 million. If even just 1% die, that is 2.14 million dead. That would be more than three times the number of dead Americans from the 1918 flu pandemic, and more than all the dead in all the wars the US has fought since it was founded in 1776.
If it turns out to be 3.4 % fatality rate, that comes to around 8 million dead.
yes it is the oldest skeptical trick in the book
The numbers are meaningless!
and then a few paragraphs later they are relying on data of THEIR choosing
Some people have a ‘glass half-full’ attitude. Others think the glass is shattered and there are splinters in the foot.
should be ‘half-full’
Fixed.
w.
Steven Mosher March 18, 2020 at 7:52 pm
Oh, please. He didn’t say “The numbers are meaningless”. He specified exactly WHICH numbers he thinks are meaningless, and he specified exactly WHY he thinks they are meaningless.
He then specified numbers that he thinks are meaningful, and he specified why.
And that is not a “trick” either old or new. The only one trying to trick us at present is YOU.
Now, if you don’t like his reasons, quote the ones you don’t like and tell us why.
Because this kind of comment is just unadulterated meaningless accusatory handwaving, and it is far beneath you. You want to object? QUOTE HIS EXACT WORDS AND TELL US WHY THEY ARE WRONG.
You may indeed be right and he may be wrong … but you gotta show it, not just claim without a scrap of evidence that he is trying “tricks”.
w.
Oh I HAVE TO SHOW IT, but he can merely claim it?
“This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19. Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror — and are meaningless. Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.”
“Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. ”
WRONG.
This is NOT HOW TESTING was done in China or Korea or Singapore.
lets take china.
1. You went to a fever clinic. they are ALL OVER THE PLACE because of SARS episode years
ago.
2. You were tested for the Flu ( if negative)
3. you were tested for bacterial pnumonia ( if negative)
4. you were given a CT scan, if you had glass opacity you were
5. tested via PCR for COIVID
IF you were positive you were quarantined.
Next
There was contact tracing.
1. Your phone data was accessed to see where you went, CCTV etc.
2. your family, close contacts were tested,
A total of 683,281 close contacts were traced, and 9,144 close contacts are still in medical observation. So if you were a close contact YOU GET TESTED. and not just once.
You get observed and isolate until you are cleared.
“”Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. ”
WRONG WRONG WRONG
in Korea we have tested close to 300K people. 99% plus are negative
It is NOT TRUE that those tested for COVID are those with severe symptoms
FFS, if I wanted to pay 132 bucks I could go to the drive through and get tested.
1. When a case develops, the contacts are TRACED.
2. Folks who have been in contact are Tested, more than once.
For example, if someone in your building gets it, BOOM, everyone within a few floors
of the case will get tracked and tested. Like I said 99%+ test negative.
“Because this kind of comment is just unadulterated meaningless accusatory handwaving, and it is far beneath you. You want to object? QUOTE HIS EXACT WORDS AND TELL US WHY THEY ARE WRONG.”
‘This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19. Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror — and are meaningless. Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.”
Now, He is Wrong about testing.
He never looked
You never looked
He is not witnessing this shit first hand
he doesnt know a single chinese person who went through testing
he doesnt know a single co worker in china who was tested
he has No idea what was actually done
He has no experience with testing in Korea
So the question YOU should have asked is
“This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19. Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror — and are meaningless. Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.”
IS THAT TRUE?
NOPE
does he give evidence?
NOPE
Did I object to that very paragraph?
YUP
Does quoting the whole thing help you?
NOPE
Steven, as someone on the spot, do you think the figures released by China and S Korea are reasonably reliable? Political spin is a problem everywhere of course.
Steven Mosher
March 19, 2020 at 12:50 am
——————————
What you said few days ago:
“1. the math is never right. there will ALWAYS be objections and uncertainties
2. you do the best you can to make a transparent projection, noting uncertain”
——
Your above comment in this blog post wholly non compatible with this stand of you of few days ago.
Which is which Steven?
Aren’t you being selective?
cheers
Good information about testing in China and Korea.
It tells that in the West we don’t know how to handle fast spreading diseases while those procedures are unknown.
“Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. ”
WRONG.
This is NOT HOW TESTING was done in China or Korea or Singapore.
lets take china
In the piece you pulled from OP WHERE did the author claim that applied to China, Korea and Singapore? Regardless, how many people with systems simply go home, feel sh@tty and recover?
Steven Mosher, …….. testify, TESTIFY.
Tell us about all those great n’ wonderful government paid “testing lab” employees that issue actual, factual reports on …. “the yearly death rate due to cigarette smoke related lung cancer”.
Me thinks their “reporting” is as trustworthy as yours is.
“YUP”, …… you all are being paid to “do a job, ….. and by damn that is what you are doing.
I never thought I would see the day that I agreed with Mr Mosher.
There are an awful lot of Americans in denial about how serious this is for not only the people that get it, but also for all the other patients requiring Intensive care once the system is overloaded.
Wim Röst said on March 19, 2020 at 3:05 am:
Actually it is disheartening that we aren’t doing contact tracing. Contact tracing was (the past tense is unfortunate) the orthodoxy that the West preached when conquering infectious diseases like smallpox. That is exactly how smallpox was eradicated by the WHO. It was the West who developed these epidemiological protocols. Now, at a news conference this morning in the US, we are told that it isn’t necessary to test people without symptoms.
The belief that models and modeling are a substitute for testing and contact tracing is the new orthodoxy. Testing and contact tracing permit the economy to continue without shutting it down. The economic damage done by the new orthodoxy does not seem to make any difference today.
Phil: “Now, at a news conference this morning in the US, we are told that it isn’t necessary to test people without symptoms.”
WR: this probably means:
“We don’t want to know the truth” or
“We still don’t have enough test kits / people who can handle that”
As in Europe nobody knew how to react on the virus, in the US there has been an incredible fail about the test kits. I still don’t understand why the US hasn’t bought the test kits abroad when their own system of test kits failed.
Wim Röst said on March 19, 2020 at 1:05 pm:
The U.S. Air Force Makes a Heroic Coronavirus Airlift Across the Atlantic
https://pjmedia.com/trending/u-s-air-force-flew-half-a-million-coronavirus-test-swabs-from-italy-to-tennessee/:
I love your caustic comments which are so often on target. The whole point is that we do not have sufficient reliable data. But we can’t wait. leadership requires making decisions on available information. The issue is the cost of being wrong. Action without significant downside is a no-brainer.
“Steven, as someone on the spot, do you think the figures released by China and S Korea are reasonably reliable? Political spin is a problem everywhere of course.”
Korean numbers are perfect. The daily reports drill down to individual cluster, naming the building, the business, the number of people tested.
For example. We had a call center infected. That location is announced to everyone
everyone is tested (207 employees) and last night they reported 4 more positives bringing the total to 139
https://youtu.be/_wCNcDxFNjQ?t=134
And you can go back in time and watch the case evolve. NOTE that they dont simply test
people with symptoms.
” In Seoul, 50 cases have confirmed at call center in Gurogu and investigation is underway. 46 except contact of family among confirmed cases have worked at 11th call center. 207 employers are under investigation.”
“There have been 90 cases confirmed at the call center located in Guro-gu, Seoul since 8 March. The epidemiological investigation and contact tracing are underway. 77 cases were known to work on the 11th floor. 553 other employees of the same company are currently under self-quarantine even though they work on different floors. Diagnostic test will be conducted as well if necessary.”
“A current total of 99 confirmed cases have been reported from a call center in Guro-gu since the 8th of March. Epidemiological investigation and contact tracing are underway. Out of 208 workers at the call center on the 11th floor, 80 cases are confirmed. Self-quarantine measures have been taken by 553 workers who work on 7th through 9th floors of the same building.”
“A current total of 109 confirmed cases have been reported from the call center located in Guro-gu, Seoul since 8 March. Epidemiological investigation and contact tracing are underway. There is 1 newly confirmed case from an office located on the 10th floor of the same building as the call center on the 11th floor. Diagnostic tests have been conducted for the residents of the studio apartments located on 13-18th floors. All of the 186 tests conducted so far have turned out negative.”
“A current total of 115 confirmed cases have been reported from a call center in Guro-gu since the 8th of March. There is no additional confirmed cases at the building, while 6 newly confirmed cases from family and acquaintance of cases. Also, Through the religious events in Bucheon, Gyeonggi province where confirmed case from the 11th floor call center visited, 9 cases have confirmed to date. The further investigation is ongoing.”
9 more cases were confirmed at the call center located in Guro-gu, which brings the total number of confirmed cases there to 124. Also, 13 confirmed cases have been reported from Saeng Myeong Su Church located in Bucheon, Gyeonggi province. One of the confirmed cases from the 11th floor of the call center attended the service at the church. Further epidemiological investigation and contact tracing are underway.
“From Guro-gu call center in Seoul, 4 additional cases (2 from the 11th floor, 2 contacts) were confirmed. The current total is 139 confirmed cases since 8 March.”
More examples
“From Bundang Jesaeng Hospital in Gyeonggi Province, 4 additional cases were confirmed. The current total of 35 confirmed cases since 5 March (20 staff, 5 patients in inpatient care, 2 discharged patients, 4 guardians of patients, 4 contacts outside the hospital). The 144 staff members who were found to have visited the hospital’s Wing no. 81 (where many confirmed cases emerged) were tested, 3 of whom tested positive.”
“In Daegu, 46 cases have confirmed at Hanmaum Apartment from 13 February and investigation is underway. 80 tenant out of 140 are tested negative and 14 people are under testing. In Gyeonggi province, 13 cases are confirmed at Bundang medical center, and all 6 hospitalized and discharged patients were admitted to the same ward. The contact tracing is still investigation. “
Thank you Steve. We need this type of information, me thinks. It sounds like there is a plan and it’s understood and methodical.
Steven,
Thank you for replying to Willis. Having the foundational facts for your conclusions DOES make a big difference. It helps other folks think about what you are saying and helps people decide if they agree or disagree. So I disagree with your statement:
‘Does quoting the whole thing help you?
NOPE’
Please keep us informed with how Korea is handling the situation – I think it helps us make better decisions here, and that’s what we all need now.
“Please keep us informed with how Korea is handling the situation – I think it helps us make better decisions here, and that’s what we all need now.”
1. Testing, and rushing a 20 minute test to market
2. Tracing. A full 80% of infections have been traced back to a travel source,
Tracing CONTINUES on the 20%
3. Testing ALL contacts and all people who entered the building
4. Isolating people until they are cleared.
5. Hygeine reinforced by constant PSAs
6. Social distancing reinforced by constant PSAs.
7. twice daily, unemotional nonpolitical briefings By Civil defense Officials.
8. Politicans shutting up and letting civil defense do their job.
9. DETAILED information on all infections: date and place.
10 orderly rationing of masks, so health workers come first.
11 One phone for everyone to call.
There is no shut down of the economy
Wim Röst
March 19, 2020 at 3:05 am
Good information about testing in China and Korea.
It tells that in the West we don’t know how to handle fast spreading diseases while those procedures are unknown.
while those procedures are unknown.
————————————-
First, I think your point made in your comment, in my consideration is wrong, supposedly.
There is a difference in proposition of terminology and meaning.
“fast spreading diseases ”
is not the same as
“faster spreading disease”
In consideration of relativistic reality.
A disease is fast spreading in consideration of detection, which in consideration of a novel or new one it means that it has being there successfully infecting or propagating
more infection prior to detection, and still remaining even after that very difficult to really properly detect it’s proper further wide spreading, with a single simple straightforward testing method. (aka fast/faster than us)
Faster it will mean a kinda of faster spreading infection than similar ones of same class or subclass, regardless and not in consideration of detection.
(faster/faster than it’s kind,)
This will seem weird, but in this context, fast may mean soft, when faster definitely does not mean softer, if you get my point.
(where fast means slower and faster means slow)
I know, looks weird and sounds weird… 🙂
But I think that is the way approach for a proper clear transparent way to asses and inform the actual meaning
of the condition, regardless what term one or the other chooses, either fast, faster, slow or slower, it got to be clear and transparent in consideration of the point made.
Kinda of messy, yes, but otherwise chaos can be the king of the day.
And it seems like the proper Western developed countries are in a ramp-up for more and expanded better detecting methods, aka a better information about such fast spreading infection…
cheers
whiten March 20, 2020 at 8:31 am: “It tells that in the West we don’t know how to handle fast spreading diseases while those procedures are unknown.
while those procedures are unknown.”
WR: Misquotation
Wim Röst
March 20, 2020 at 9:23 am
———-
Thanks Wim Röst.
Just for clarity.
My comment to you, was about the “fast”, and what it may imply.
I can’t tell, what you meant there with it, more scary or less scary, or whatever.
And these “procedures” are very well known, and as far as I can tell, is the West developed world first engaging openly and fully, as it supposes to.
Maybe WHO not there yet or much happy about it, as as it seems WHO not much interested at the huge cost of doing otherwise than WHO is doing, fulling the fire and the flames (of insanity);
the huge unjustifiable damage of the draconian measures, which happen to be non acceptable even in the worst case scenario as a solution to this problem,
which happens to be global.
that WHO so much “cherishes” at.
If such procedures are a little late, maybe you know now who to ask why that happens to be the case!
cheers
Following is a comment by Julian from the original paper at
https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/
“Why is this article’s main source of data the Diamond Princess when we have a much, much larger data set in South Korea? As of March 15th, South Korea had tested 248,000 people, and confirmed 8,162 cases, and recorded 75 deaths. That represents a case fatality ratio of 0.9%. If governments should base their policy decisions on a range of reasonable possibilities, it seems like the South Korea example, where they have conducted the most testing, should be the benchmark – not the Diamond Princess.”
OK Julian, here it is:
The Center for Disease Control and Prevention, Headquarters for Disease Control and Prevention (Eun-Kyung Jung, Head of Headquarters), as of March 20, 00:00:.
https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030
In South Korea as of 0:00, 20 March 2020:
A total of 316,664 were tested and 8,652 cases have been confirmed (3%), of which 2,233 cases have been discharged from isolation (1%). Newly confirmed cases are 87.
6325 patients remain in isolation (2%), 94 have died (0.03% of those tested, and 1.1% of confirmed cases).
15,525 are being tested and a total of 292,487 tested negative (97% of those with test results to date).
In South Korea only 3% of all those tested to date were positive for the SARS-CoV-2 virus – this suggests a strong level of containment.
On the Diamond Princess Cruise Ship by 20Feb2020:
Data source: https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v2.full.pdf
There were 634 cases (21% of the 3063 tested), of which 328 (11%) were asymptomatic, out of 3663 passengers and crew.
On the cruise ship Diamond Princess 21% of those tested were positive for the SARS-CoV-2 virus – this suggests a poor level of containment.
The cruise ship stats also reflect the very old age of the average passenger. There were 1231 people over age 70 (34% of the total population).
By 1Mar2020 there were 7 deaths, all over age 70 (2.4% mortality of the 288 over 70’s who tested positive for the virus)
Whiten March 20, 2020 at 10:18 am :”My comment to you, was about the “fast”, and what it may imply. I can’t tell, what you meant there with it, more scary or less scary, or whatever.”
WR: “The new coronavirus “spreads too efficiently” to disappear like SARS did, said Fauci”
Source: A coronavirus recurrence is “conceivable” next season but its impact would be more modest, says Anthony Fauci – From CNN Health’s Arman Azad
Summary for above
https://wattsupwiththat.com/2020/03/18/the-danger-of-making-coronavirus-decisions-without-reliable-data/#comment-2942582
CORONAVIRUS – STRONG CONTAINMENT (3% INFECTED) VS POOR CONTAINMENT (21% INFECTED) – 1% FATALITIES OF THOSE INFECTED.
South Korea – Strong Containment – 3% (8652) of tested group population (316,664) infected, of which 1.1% (94) died to date.
Diamond Princess Cruise Ship – Poor Containment – 21% (634) of tested group population (3063) infected, of which 1.1% (7) died to date.
Ahh the old alarmist trick assuming all their data is pure and golden 😉
No, Steven, that’s called “human nature” and is practiced by all. Only the totally blind or the not human believe otherwise. The skeptics/people who understand math and science all know that unless ALL the UNALTERED data is included, plus a graph or numbers of any alterations, the graph is slanted. Only the faithful AGWites believe otherwise. True skepics KNOW for a fact everyone picks their data, again unless ALL the data is provided in RAW form. Something the AGWites simply do not provide. Got it?????
He stated “The one situation where an entire, closed population was tested was the Diamond Princess cruise ship and its quarantine passengers.” The death rate was equal or less than 1% and the population trended older.
What other populations have provided better data? How is this a trick and not a reliable yardstick?
Its a reliable yardstick to a similar situation.
A) medical staff prepared
B) medical facility not overwhelmed.
What he misses is that the issue is NOT THE DEATH RATE.
It’s the risk of swamping the health system
Its the UNCERTAINTY that’s the problem
So how do you act when the data is unreliable?
A) you shut down ALL inbound traffic. Check Singapore and Taiwan for this
B) you test like crazy.
C) When you find a case, you track and expand testing to contacts .
D) You isolate the infected and those who were in contact
E) You practice social distancing
basically, you do : Diamond princess, Korea, Singapore, Taiwan, Honk Kong
Oh, I agree about A-E and think that is the approach we should start switching to asap.
I disagree that it’s a yardstick only for ship bound people. It’s a measure of a highly infectious environment and indicates something close to an upward boundary.
Locked down on Diamond Princess only meant we had a closed system and a handful of cases on board after leaving Hong Kong grew to nearly 700 or 17% of the 3400 on board.
90% of those on board were tested , where else do we have test numbers of that ratio in a controlled environment ?
“forget to mention they were locked down “. That is the main point but exactly wrong. The first passenger tested positive on Feb 1. The boat left the dock Jan 20. Assuming immediate lock down, the community had 10 days unrestricted circulation. A perfect giant floating petri dish with a 10 day incubation period. To be clear, the first positive case go off the boat at day 7 but the virus had already spread to other passengers by that time. 7 deaths so far reported in 3700 or 1 in 528. So (1 / 528)100=.1893% chance of death if exposed in a small, close contact community. Those are the numbers, age adjustments aside. The number of infections and deaths certainly would have been higher if the time were extended but how much time best describes a small, close contact community? Another number worth noting, 712 people were infected of which 330 had no symptoms. Because I did not stay at a Holiday Inn last night, I wonder what a real infectious disease researcher would have to say about this?
Spot on! And decisions aren’t even “being made”, I think, – they appear to be “making themselves”!! The world has gone crazy. We are being told by the media and by politicians that we are facing an unprecedented crisis. Beloved customs like handshakes, hugs and kisses are forbidden despite their great human and cultural significance. Schools closed, travel banned, social functions impossible, work and trade to cease.
But manifestly, pandemics are not “unprecedented”. Plagues and pestilence have been with us since times immemorial. And humankind always just courageously ploughed on, working and behaving as usual. These days we know more than ever about the true nature of viruses – and yet, we are all running round like headless chickens. We know the virus cannot now be contained. But I fully agree with sensible measures to slow down its spread – so that health services are not overwhelmed. That is all we need to do.
Covid 19 isn’t even particularly dangerous. The statistical facts (as pointed out by Willis) from the saga of the cruise ship Diamond Princess are illuminating – and should be studied by all. So what if older folks stand a 2% higher chance of dying this year?? That can hardly be called an unprecedented crisis. I am 85 and certainly lose no sleep because of that.
We should learn from history – and simply ignore this pandemic. Our reactions against the illness are plain stupid – and are far more deleterious to the economy than the illness on its own could ever be.
Ah – the clue to this post is your age. I’m not quite so old, but do remember testing times, whereas so many of today’s ‘flake generation have had everything they want or need laid out before them and have been brought up in a world where nanny always knows best and consequently they haven’t got a bloody clue how to deal with this. Just over 100 years ago young men where dying in trenches, desperately fighting for the freedoms that they don’t even realise they have- and here we are with wild hysteria over a particularly nasty virus that’s forcing them to give up their Avocado toast for a while…
“But I fully agree with sensible measures to slow down its spread – so that health services are not overwhelmed. That is all we need to do.”
The sensible thing to do would be to tell the vulnerable to isolate themselves and encourage the illness to spread through the 80% or so who are unaffected as quickly as possible. Then their herd immunity will protect the vulnerable. Flattening the curve just increases and extends everyone’s suffering
I am sure that you believe what you are saying, but I suggest that you read this.
https://www.dailymail.co.uk/news/article-8124901/Young-people-dying-coronavirus-despite-elderly-people-worst-affected.html
And then tell us which are the vulnerable, as it looks like anyone over 50 is rather vulnerable.
One group who are very vulnerable are Medical workers, over 2000 in Italy now have the virus and they are the ones looking after all the other ill people with the Flu, Heart attcks, Strokes, Car accident victims etc etc.
Those youngsters need to be tested for TB. Latent TB is prevalent among Europe’s immigrant population (535 per 100,000 of those screened in N Italy). TB symptoms are the same as those for this illness. Lung damage is the same.
If not immigrants with latent TB, it could be virus infection coupled with vaping illness. Same symptoms, same morbidity.
https://www.today.com/health/what-are-symptoms-vaping-illness-doctors-warn-about-e-cigarettes-t162468
Andy Espersen – March 18, 2020 at 7:41 pm
“ The world has gone crazy. We are being told by the media and by politicians that we are facing an unprecedented crisis. ”
Coronavirus – the “prevention” will surely prove to be far worse than the “contagion”.
Did the cruise ship cohort take tablets like chloroquine for their Asia trip? I always used to, when I went to West China for business, for malaria avoidance. Do we know if it works for this ailment, qualitatitively or quantitatively? This is but one of the missing data stories that supports this Ioannidis essay.
We need less emotion and more scientific rigor in the official responses to this viral episode; but we have seen emotion already contaminating science in global warming etc. That contamination is a disease in itself, doing much harm. Geoff S
Too late for scientific rigor. Fearmongering and panic have been chosen as the recommended response and are fully entrenched. The words “previously unknown” gave a carte blanche to the media and politicians to cause extreme, insane panic by writing science fiction, not news stories. It “could get bad” now is “it will get bad”, even in the scientific circles. People live in a fantasy world where everything hits worse case scenario even if it doesn’t. I think that’s curable. Maybe using the herd immunity theory, but even then, panic is the preferred response of humans. It’s probably hopeless at this point.
Yeah the world is nuts. I am isolating myself but I am an introvert anyway so no cost. But although not panicking, as a widower without a main squeeze my love life has ground to a halt. Oh well everyone has to pay a price .
Again, the Holiday Inn is shut down but I think its safe to assume Chloroquine was not a popular drug between Yokohama and Hong Kong in the middle of winter. Maybe Dramamine though.
Might have been drinking a lot of G&Ts, though.
This is incredibly distorted. Those who ignore this threat will suffer and so will those in contact with them. What flu epidemic since 1918 caused hospitals to overflow as in Wuhan, or doctors to triage people dying of pneumonia because they lacked ventilators? Or does the author just consider these accounts as “fake news”? Short of the giant shutdowns that the author condemns, what force on earth would keep the infection rate to 1%? In the country that has tested most thoroughly, South Korea, which controlled the virus by tracking down every case, the death/recovery ratio is 0.5%, with the hospitals not overwhelmed and providing high quality care. In the US an infection that was allowed to grow freely will infect 70% of the population in weeks, killing over a million people. But it would also totally overwhelm US hospitals which have one quarter of the beds per capita as S. Korea, leading to much higher death rates as people die at home.
CORONAVIRUS / 101 >>>1. Does not like heat, sun or humidity. The more heat, sun and humidity the shorter the virus’s half life. >>>2. Tylenol and ibuprofen have no positive effect on the virus or your body if infected. They are a comfort measure not a treatment measure. >>>3. This new virus is not heat-resistant and will be killed by a temperature of just 26/27C (79F) degrees. It hates the Sun. >>>4. If someone sneezes with it, it takes about 10 feet before it drops to the ground and is no longer airborne. >>>5. If it drops on a metal surface it will live for at least 12 hours – so if you come into contact with any metal surface – wash your hands as soon as you can with a bacterial soap. >>>6. On fabric it can survive for 6-12 hours. Normal laundry detergent will kill it. >>>7. Drinking warm water is effective for all viruses. Try not to drink liquids with ice. >>>8. Wash your hands frequently as the virus can only live on your hands for 5-10 minutes, but – a lot can happen during that time – you can rub your eyes, pick your nose unwittingly and so on.
– hand sanitizers or antimicrobial soap will not help.
– Water, suds and friction will wipe the virus away. >>>9. You can also gargle as a prevention. A simple solution of salt in warm water will suffice. >>>10. Can’t emphasis enough – drink plenty of water! Everyone should ensure their mouth & throat are moist, never dry. Take a few sips of water every 15 minutes at least. Why? Even if the virus gets into your mouth, drinking water or other liquids will wash them down through your throat and into the stomach. Once there, your stomach acid will kill all the virus. If you don’t drink enough water more regularly, the virus can enter your windpipe and into the lungs. >>>11. To build immunity, eat your veggies, raw, lightly steamed or lacto-fermented; there are healing properties in the raw lacto-ferments. Cut down on meat [harder for the body to digest and unless carefully raised, may have added poisons]. >>>Accumulate Health!
What are your qualifications for handing out medical advice?
What are your objections to his points? It’s not his qualifications that count. Unless you ask every skeptic of anything “what are your qualifications” which puts you on the side of believing only people with letters after their names. How do letters after your name make you the bearer of truth? (Hint: It doesn’t……)
Why do I ask about qualifications? Because most of that post consisted of stuff that has been going round the internet and has been debunked by the relevant experts.
Susan: you wrote: “Because most of that post consisted of stuff that has been going round the internet and has been debunked by the relevant experts.”
This one sentence is a lazy and careless emotional and useless act of panic. Other than your appeal to authority you offer no clear and cogent response, no specificity. Was everything wrong, some of it, one point?
I understand your point that no one’s advice, even if it was sourced by an authority should be taken unless you agree to it, so let me ask you since you broad stroked “stuff” as being debunked;
Are you qualified to decide which, if any, claims are in fact debunked claims?
I disagree. Posting “medical” recommendations is not something that anyone other than authoritative sources should be doing. Especially in a manner that’s intended to represent expertise. While knowledgeable people know not to trust such postings (including most on this website), not all do.
What medical advice are you talking about?
Are you going to tell parents not to tell their kids to drink water and wash their hands? List one piece of medical advice that was given? Please try not to rewrite a strawman case out of things and then attack things that were not written. That we can all agree on.
Mario, the list was a series of recommendations and statements. There was no reference as to source or support. While many appeared to be common sense, some were actions that may or may not be advisable. To be truly useful, such points need verifiability. Basically, quality staff work, if you’ve ever worked in a large organization.
“many appeared to be common sense, some were actions that may or may not be advisable. ”
Well the first part is true… so why the panic over helping spread what is pretty much good common sense? What specific actions justify the blanket strawman attack on spreading common sense around?
Because some were medical advice, with no provenance. There is too much bad information on the web. I’m just suggesting a way to improve posts on WUWT, and as you’ve read in this string alone, I’m hardly the first, or the only. And I noted your preference to avoid drugs you don’t need. I strongly agree. I just returned from 19 days on a cruise ship out of Sydney. As too often happens to me, the long flight over caused my sinuses to act up, which often results in an infection. It was not much fun worrying about that, while also reading all the news of the Wuhan Flu. Luckily no infection so far. Tomorrow I’ll have been home for a week in self isolation, just in case the half empty plane and airports were a problem.
Well: I truly hope you are OK and stay fine sir.
Could you pull out one example of bad medical advice for all of our benefit? That would make our several back and forth emails worth all of these words!
Mario, copied is the list.
1. Is questionable, and Politifact views it as false. I disagree that it is false, just unproven.
3. As with 1., only more so. I wish it were true. I live where daytime temperatures are already reaching 80.
5. From what I’ve read from government sources, any soap is fine, and antibacterial soap doesn’t kill the virus. What you need to do is wash OFF the virus.
7. While this may be true, some level of support is needed. Nowhere else have I seen or heard such a fact.
8. Are you confident hand sanitizers don’t work. From all I’ve read from safe sources, alcohol based sanitizers, if used correctly, do work.
As to some of the recommendations, I recall discussion of there being a difference between impact if the virus is breathed into the lungs as the initial invasion, versus getting into your body before the lungs. It was thought the latter allowed the body to start resisting whereas if it hit the lungs first it overwhelmed resistance. More recently I’ve read more about 2 versions of the virus. Have these views been shown wrong?
CORONAVIRUS / 101 >>>1. Does not like heat, sun or humidity. The more heat, sun and humidity the shorter the virus’s half life. >>>2. Tylenol and ibuprofen have no positive effect on the virus or your body if infected. They are a comfort measure not a treatment measure. >>>3. This new virus is not heat-resistant and will be killed by a temperature of just 26/27C (79F) degrees. It hates the Sun. >>>4. If someone sneezes with it, it takes about 10 feet before it drops to the ground and is no longer airborne. >>>5. If it drops on a metal surface it will live for at least 12 hours – so if you come into contact with any metal surface – wash your hands as soon as you can with a bacterial soap. >>>6. On fabric it can survive for 6-12 hours. Normal laundry detergent will kill it. >>>7. Drinking warm water is effective for all viruses. Try not to drink liquids with ice. >>>8. Wash your hands frequently as the virus can only live on your hands for 5-10 minutes, but – a lot can happen during that time – you can rub your eyes, pick your nose unwittingly and so on.
– hand sanitizers or antimicrobial soap will not help.
– Water, suds and friction will wipe the virus away. >>>9. You can also gargle as a prevention. A simple solution of salt in warm water will suffice. >>>10. Can’t emphasis enough – drink plenty of water! Everyone should ensure their mouth & throat are moist, never dry. Take a few sips of water every 15 minutes at least. Why? Even if the virus gets into your mouth, drinking water or other liquids will wash them down through your throat and into the stomach. Once there, your stomach acid will kill all the virus. If you don’t drink enough water more regularly, the virus can enter your windpipe and into the lungs. >>>11. To build immunity, eat your veggies, raw, lightly steamed or lacto-fermented; there are healing properties in the raw lacto-ferments. Cut down on meat [harder for the body to digest and unless carefully raised, may have added poisons]. >>>Accumulate Health!
I’ve had to post this as a reply to myself because I don’t get a reply option on the posts I wanted to respond to.
I do have some claim to qualification to speak on medical subjects: I am a veterinary surgeon of over 40 years experience and viruses in humans or animals share the same characteristics. I have also spent 40 years listening to rubbish from clients, what used to be called ‘old wives’ tales’, often generated by breeders to excuse flaws in their product (Burmese cats always snuffle, distemper vaccine gives Pugs eye problems…).
The suggestions that drinking warm water will kill viruses or that frequent drinking will wash the virus into the stomach are such nonsense that no-one in their right mind would credit this post. The virus is in your respiratory system: when you drink the respiratory system is closed off to prevent water getting in and water hot enough to kill viruses would also scald your mouth and throat!
Suasan:
A dry throat will not have good protection,(makes it difficult for mucus to do its job). Drinking warm fluids does a few things to protect your throat, and is much better than drinking cold fluids). Warmth also brings more blood to the area… blood carries the stuff that can combat the invaders. As well, it is correct that constant drinking and eating small amounts washes down the infection. Think about what you do when you wash your hands. Your throat is a dual gateway and in fact can cross contaminate so you’re confused about the complexity of the system and argue only for argument sake.
@ur momisugly Old Retired Guy
“ Posting “medical” recommendations is not something that anyone other than authoritative sources should be doing.”
Old Retired Guy, it is apparent that you are ignorant of the fact that the majority of people offering “medical” recommendations do so based on a “consensus of opinions”, …… whereas there are quite a few ailment specific “authoritative sources”, educated or otherwise, that have actually “experienced” the effect they are recommending. AKA: peptic ulcers, …… marijuana for pain relief, ….. etc., etc.
Correct. In his world, telling someone not to sneeze directly onto other people’s faces and to wash your hands very very well is medical advice and we should refrain from such medical advice. I am exaggerating to show make the point.
Old Retired Guy – March 19, 2020 at 6:31 pm
But, …. But, ….. but, …… Old Retired Guy, it appears you are afraid of living and scared of dying.
Why else would you post the above RECOMMENDATIONS, …… after claiming that ….. “ Posting “medical” recommendations is not something that anyone other than authoritative sources should be doing.”
Are you claiming to be an “authoritative source”?
Samuel, apparently you can’t understand my post. I copied the list as a reference so readers could see the points of the original poster that I was saying were questionable. I spend a lot of money each year with a longevity doctor, and with tests due to family history of pancreatic cancer. Not afraid of dying, but want to live a good life. Don’t like bad information posing as authoritative.
You’re not correct. Nutrition is not medical advice. And that nutrition advice is solid and reasonable anyway. Anyone who disagrees can call it debunked. But your attack was basically telling someone they are full of bunk. Not a very nice thing to do to someone, especially when it’s really just you disagreeing. Take a bit of a chill.
Apparently this community has a number of persons with limited cognitive skills. I didn’t question all the list of statements made. I suggested references as to some of the points should have been provided.And I said many we’re just common sense, which is fine. But a number went beyond that. And I provided the list you asked for. I’m done responding to questions about my common sense suggestions.
“Tylenol and ibuprofen have no positive effect on the virus or your body if infected. They are a comfort measure not a treatment measure”
They actually have a negative effect and are basically iatrogenic poison: Tylenol depletes glutathione, the most abundant and important antioxidant in the lungs, and ibuprofen increases ACE2 expression in the lungs.
icisil: Not sure of the accuracy of your claim. I will note that people in severe pain really do not care about any of what you wrote. There are no “natural” pain killers that work as well.
If you’re using it for fever, fever is part of how your body kills the virus. If it’s going up quite high (over 102 or 103), and you are at home where you are supposed to be, cooling rags or a cool bath may bring it down. When I was young, my mom rarely used anything other than cooling to bring fevers down. Why everyone panics and pops a pill, I do not know. Now, if the fever is going up rapidly or is very high, you should be seeing a medical professional, not sitting at home anyway. Again, ask your doctor if you’re not sure. (That’s a CYA statement, of course.)
If you search for ibuprofen + ACE2 and acetaminophen + glutathione you can verify it yourself.
My brother uses something natural and loves it. Can’t remember, but if I heard the name I’d recognize it.
icisil: I did look it up. I can find many contradictory studies and statements on this. I will print them out, tack them to the wall and throw a dart.
Instead, why don’t you post some links to some of those contradictory studies? I’d like to see them.
Not Tylenol per se, but acetaminophen, paracetamol
This is the sort of hygiene advice of competent 1950s nurse or military/naval person responsible for hygiene. The days when Cleanliness was next to Godliness . The days when cleaning was part of hygiene regime not a beauty one.
If one reads about the life of a nurse pre ant-biotics it was non stop cleaning because infection had to be prevented. Hot water, scrubbing brushes, carbolic soap, bleach, ammonia, open windows, caustic soap and boil washes were the order of the day. It may be iseful to compare spread of disease via air conditioning within a building and open windows.
I would suggest that there has been three major flu epidemics 1918, 1957 and 1968/69 plus others in the 1970s; consequently what should we prepare for ?
locked down in the same ship with shared dining and air … not locked in their rooms … and they were free to mingle for days before anyone realized the corona was onboard … if you want to counter his statement why don’t you go read the report … or better yet find the post on THIS SITE that breaks it down for you … a better use of your time and spreading fear porn …
Global warming tries to justify extreme measures to fight an invisible enemy. There is no way to know how the battle is going. Now we are justifying extreme measures to fight another invisible enemy. Without massive testing, there is no way to know how the battle is going. An exercise in national suicide justified by models that cannot be validated. God help us all.
this is the same “math” they used to tell us we will all be dead in 10 years from CO2 use … its a bad use of statistics with the usual garbage in useless garbage out …
If I were to admit I’ve had on and off sneezing fits, runny nose, and watery eyes since Sunday, yet all gone by Wednesday.
Now what ??, I’m 57 years old and I think I survived ??
I am trying to stay away from people for the next two weeks in case I’m a carrier, how long might I carry it, assuming I’ve got IT ??
Your symptoms , of runny nose , sneezing ,watery eyes are very rare for the Cov-19 virus.
Highly unlikely you are infected , so be very careful as you dont have any immunity and may still catch it
And also if you don’t get the symptoms, you’ve obviously been exposed to it before at some time. Just like everyone else.
Hi, James,
Given, that you still live in the north Midwest of the U.S., it is very likely just tree pollen or another allergen.
Heh. This spring, in the Northern Hemisphere, no one will come down with a cold or the flu or have pollen allergies.
And no one will wonder how that could be.
#(;))
Take care, back there,
Janice
P.S. Glad you are feeling better, now.
Thanks for the thoughts Janice.
Also had a “jaw ache”, I was thinking wisdom tooth, then thinking, are dentists even working ??
All better now.
Take care.
In Washington State, dentists were completing work already initiated and emergencies. Otherwise they are not open.
🙂
The symptoms of the coronavirus do not include sneezing, a runny nose, and watery eyes. They are a dry cough accompanied by a fever with or without shortness of breath.
You are probably afflicted with the common cold.
I had a dry cough and a fever of 101F. I asked my local hospital their opinion. I was told to stay home, but call back if my symptoms worsen, and they would test me then. My symptoms lessened on their own. I may be one of the majority of survivors who were not counted. If case numbers are not known, mortality rate is not known.
SR
Has same symptoms as TB.
The real tragedy is what we are doing to our economy and our population without any regard to the consequences, which are far worse even in terms of health than what is likely to be the outcome from coronavirus. Millions of jobs lost, mostly by low-income people, homelessness, loss of health insurance, increase in mental illness and suicides, and on and on. Why is this being done with no weighing of relative risks and harms? Because in today’s age of hyper-media and social media, politicians are so cowardly they will do anything to avoid being accused of doing nothing. And the result is what we see happening right now, the destruction of an economy to avoid at most a few thousand deaths. Why was the reaction so different to swine flu? And almost certainly this suppress at all costs strategy will not work, the moment we let up the virus will pop right back up. Better to take reasonable mitigation steps but not destroy millions of lives. See #thecureisworsethanthedisease where I am providing people with a variety of articles, like this one, in hopes that we can at least have a dialogue about what the right approach is.
Kevin,
How do you know there has been no weighting of relative risks and harms? I suspect that there has
been but no-one is prepared to come out and present the results of the “death panels”. Do you think
and politician is going to step and say they have decided to let people grandparents die in order to save
the a few jobs. Or say the opposite? They are just going to present the results and not the calculations.
It is not a few jobs!!
Wed. afternoon:
Washington State claims 67 deaths. These account for most of the total in North America. 58% of the U.S. deaths. Why?
This virus was in a nursing home of 120 elderly with prior health problems. How and why hasn’t been told. When deaths spiked above the normal (3 to 7 per month) someone finally noticed.
What they now know is this: “Staff members who worked while sick at multiple long-term care facilities contributed to the spread of COVID-19 among vulnerable elderly in the Seattle area, “ – – report by the CDC.
Political officials still haven’t got a clue about what is going on, but continue to make decisions as though that one facility and rotating staff was a template for all of society.
I’d list some of the damage, but it is too sad.
At this point, the one thing the medical experts and politicians “know”, is that if left to rapidly spread it will overwhelm local medical systems. That’s the point of drastic action to slow the spread. No doctor/nurse wants that, as it puts them at much greater personal risk. And no politician wants videos of people dying in hallways at the hospitals.
And this will be a similar model that will be used to reign in the CAGW debacle that is also quietly raging throughout parts of the world still. Many jurisdictions have already passed Climate Emergency measures, which when given the same status as a Health Emergency, this will be how they try and implement their measures and agenda and reign in our carbon based energy supplies.
WHO would have thought 3 months ago things would have come to this state we find ourselves in, and it isn’t a stretch to imagine that within 10 years or less, pretty much the same measures could be used against us in all our consumption and energy usage required for human survival. No meat, no nat gas to heat to your house, no gas or diesel for the car or truck, and energy rationed while prices double and triple. Electricity has already doubled in many jurisdictions due to ineffective solutions such as solar and wind. All the more reason to at least vote for 4 more years of reasonable sanity with a Republican administration no matter what comes of this present Wuhan Coronavirus that is now a global pandemic. It is imperative that the USA continue to be a shining beacon of hope for civilization.
Absolutely spot on. I have no doubt whatsoever that this is a trial for that very purpose or at least many are viewing it as such. Dangerous times. Be alert for those who would abuse power.
“I have no doubt whatsoever that this is a trial for that very purpose or at least many are viewing it as such. ”
This disease is the biggest threat to globalism since WWI ended the last big globalist experiment. Certainly the usual suspects are trying to exploit it as another ‘global problem that needs global solutions!’ but a world where countries are closing borders and turning against their neighbours is not one where they’re going to care much about ‘climate change’.
If anything, it’s demonstrated how utterly useless global institutions and big governments are when there’s a serious problem to deal with.
https://www.reddit.com/r/ConservativeNewsWeb/comments/fkwica/hello_world_before_economy_totally_disintegrates/
Well, wouldn’t that be interesting!
Worth noting that 17% of the Diamond Princess passengers and crew were infected with Covid 19. If this translates to the entire US population, the impacts will be significant, and deeply felt. Where was the 1% figure derived from?
700 diagnosed with the virus resulting in 7 elderly dead. I am in my 70’s and am not worried about this apparently mild corona virus flu, as many more hundreds of thousands of flu victims have already passed away this flu season. Seasonal flu normally kills between 250,000 and 700,000 people per year.
Why the heck did the moderator nix my comment to you?! I’ll try again. Anyway, the 1% relates to the 7 elderly Diamond Princess passengers who died out of the 700 who were diagnosed with the corona virus.
using the Diamond Princess is an exceedingly bad idea.
think bristlecone pine
The issue is with R0.
In both SARS and MERS R0 is hetergeneous. What’s that mean?
with SARS in 73% of cases R0 was less than 1. it didnt spread
in 6% of the cases the R0 was > 8
SuperSpreading is a NORMAL feature . So if you find a case ( like the diamond princess)
where it doesnt spread, that tells you NOTHING about the average R0
because R0 is not a normal distribution.
in MERS 89% of the cases led to NO secondary cases, and 1 case (<2%) led to 84 secondary cases
First of all, the current virus everyone is talking about is a SARS virus. The official name is SARS-CoV-2. So, when you say SARS, it is important to be clear which SARS virus you are talking about or whether you mean all different types of SARS virus.
Also, what is the point of your post and does it have anything to do with the SARS-CoV-2 death rate? Please explain.
The issue is trying to infer anything from the diamond princess.
Willis tried to Infer a R0
And others try to infer CFR from the data.
Thanks for this information about the importance of ‘superspreaders’. It tells why ‘testing and testing and testing’ is that important. It also tells why ‘social distancing’ might be enough for 70% or more of the cases not to spread. Unfortunately for this virus we don’t have the exact data needed.
Unlimited traffic causes the SPREAD of cases. In just one or two weeks traffic produces a map like this, even with limited testing: https://web.archive.org/web/20200316151410/https://www.rivm.nl/nieuws/actuele-informatie-over-coronavirus
Local hotspots can be contained if testing and tracking is ubiquitous and constant. But to diminish the number of hotspots after an ‘explosion of cases’ and to prevent a further spread a containment like in France is a good first step, to be followed by intense tracking and by the containment of remaining cases. Traffic by persons from countries that did not follow the same method has to be prohibited or extremely controlled (quarantine) until there is a vaccin. There are many asymptomatic cases able to spread the virus.
It is helpful when governments prevent further impoverishment of poor people during such an effort. Poor people don’t have money for the next month. Those measures could take away much of the panic and problems in the society. A certain flow of money to all affected people will keep the economy going, also for firms that depend on people with less or just a little bit of money.
Let me just say that I knew the hype meter was being turned to an “11” when I looked at the Johns Hopkins corona virus map that is so popular, along with all the similar ones. You look at all the red circles overlaid on the countries and they are REALLY BIG. This would lead one to think that “oh my gosh the whole country was infected and massive deaths”.
If these circles were realistic, they would show it as a proportion of the overall population. Even China with 81,000 cases right now works out to far less than 1 infection per 10,000, and should be a single pixel at best. Most other countries have a small fraction of even that. So effectively if the maps were giving us a realistic picture they would be effectively blank. Ironically when you zoom in, the pictures become more accurate – the circle size stays about the same, but the area represented is much smaller. So if you could actually view the map at full zoomed in aspect it would provide an accurate perception. Of course all the media uses the fully zoomed out picture which satisfies their desire to create panic.
When talking with people about this, I try to have them keep it in perspective – on average 150,000 people die every day on this planet, Here we are panicking over 8,100 worldwide deaths in several months. It’s not even a blip on the death line…9 million people will have died in these two months, so under 0.1%. I know it’s a much more complicated subject, but there is no balance – every unexpected death is treated like it was a mass casualty incident, every negative anecdote is promoted like it’s the rule, and every wild guess (oops I mean “computer model”) is treated like it’s gospel. The more outlandish, the more promotion.
I only hope that everyone gets tired of the press crying “wolf, no wait a pack of wolves, no wait there are wolves everywhere”. Maybe somehow we can revolt against the media and force them to come back to reality.
If the underlying math is fractal, how can it be modeled reasonably? Radioactive fallout is fractal: there are “hotspots” that can’t be predicted. Epidemics also have “hotspots,” like the assisted living facility in Washington state that is responsible for about 30% of the deaths in the US. It is going to be economically ruinous to subject the entire country to blanket measures when only massive testing can identify the “hotspots.” The rest of the country (and the economy) need not be subjected to this insanity.
When one does not learn the lessons of history, then one is condemned to repeat them. Miami was quarantined in 1899 for a yellow fever outbreak. The measures taken then are instructive for their wastefulness and futility. Houses were burned down. Economic activity was curtailed. Patients were sometimes “treated” with whiskey and turpentine enemas. Within a year, the Reed Commission, chaired by Walter Reed, M.D. showed that a mosquito was the vector that carried the disease. All the ideas about how the disease was transmitted were incorrect. The result of this research (which cost the life of one of the researchers) was the building of the Panama Canal.
The economic effect of the Covid-19 shock is going to be felt for a long time. The government’s actions constitute a mathematical step function. The result is going to be economic instability that may last for a decade or so. There needs to be more regard for limiting the economic costs of these actions. The lethality of this virus may be overstated.
Yellow Fever at Miami: The Epidemic of 1899 by William M. Straight, MD
http://digitalcollections.fiu.edu/tequesta/files/1995/95_1_02.pdf
THE ETIOLOGY OF YELLOW FEVER.-A PRELIMINARY NOTE. By WALTER REED, M. D., SURGEON, U. S. A.; JAMES CARROLL, M. D.; A. AGRAMONTE, M. D., AND JESSE W. LAZEAR, M. D., ACTING ASSISTANT SURGEON, U. S. A.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2329228/pdf/pubhealthpap00031-0042.pdf
In war the side that waits for definitive data has been conquered already.
There is this myth that it is not possible to act and one should not act until one is sure.
No one in business or the military operates on this premise: it is all calculated risk in a fog of almost total ignorance. The ability to rapidly reverse or modify a plan as data is acquired is the hallmark of a successful entrepreneur or general. In politics it’s called ‘making a U turn’ and is of course derided.
We don’t know, and we probably wont know for years, how transmissible or how lethal or what the effects of various policy reactions will be: Furthermore with most of the West in lock step, we won’t know ever if alternative policies would have worked better.
Governments are poor at this: More people died from being relocated, at Fukushima, than would have died if they had stayed put, for example.
But this is not an argument to do nothing.
Cut the governments a little slack. Only time will tell who second guessed correctly.
Since we are giving opinions, mine is that more people are seriously hurt by OVER reaction than by calm measured reaction. Example is fire in crowded place. Most survivors are the ones who looked around and didn’t follow the crowd where lots of deaths due to stampeding.
We are easier to conquer when running around.
Moderator, could you please inform me why you are not allowing my comment to Gordon Saul.
I have huge respect for Dr. Ioannidis, but I think he’s much too optimistic, this time.
Based on the Diamond Princess experience, about half of those who contract the disease will show symptoms. But “projecting the Diamond Princess mortality rate onto the age structure of the U.S. population” means assuming that:
1. the fact that the Diamond Princess patients were mostly older patients means their fatality rate was much higher than we should expect from the general population; and
2. the fact that the Diamond Princess patients all got excellent, no-expense-spared care, did not reduce their fatality rates per age cohort below what we can expect from the general population.
The 1st assumption seems reasonable, but the 2nd assumption does not. There’s no way that the United States can replicate the level of care that Diamond Princess patients got, in the general population, if tens of millions of U.S. citizens are ill simultaneously — and many other countries would be even less able to cope with an epidemic of such scale.
JHU is reportingThe U.S. COVID-19 death count is now up to 150, and the number of confirmed cases is up to 9,345. They’re also reporting 106 U.S. recoveries. So we’re seeing a 1.56% U.S. fatality rate so far — but some of those 9,345 will also die.
I hope that Dr. Ioannidis is correct that the final death rate will be well below 1%, and that the ultimate infection rate will be only 1%. But I do not share his confidence in the former, and I think the latter is wildly optimistic. If the current apparent† exponential growth rate (doubling about every three days) does not slow, the USA will exceed one million confirmed cases in less than three weeks.
† I dearly hope that at least part of the current exponential rise in confirmed U.S. cases is because of the increase in testing capability. But even if it is, there’s no question that this disease is spreading extraordinarily rapidly. The fact that so many people have no symptoms, combined with the fact that this pandemic is very easily transmitted, make it very, very difficult to control.
Do the math for the USA: if the number of COVID-19 cases were to continue to double every three days, it would take only 3 × log2(150,000,000) ≈ 81 days to infect about half of the U.S. population.
If 1% of them die, that’s 1.5 million U.S. deaths, most of them in the same month. To put that in perspective, in a typical month, about 230,000 U.S. citizens die (all causes combined). If 1% of COVID-19 patients die, and we don’t slow its spread, this disease could plausibly cause a temporary >600% increase in the overall U.S. death rate. That would not be “buried within the noise of the estimate of deaths from ‘influenza-like illness.'”
Those are the kind of numbers we might be looking at, in a business-as-usual scenario, if we don’t drive down the infection rate, and if effective treatments are not found. (It would not be unprecedented, either; it is believed that the 1918 flu pandemic killed about 2% – and that’s not the percentage of those infected, it is the percentage of the entire world population.)
Perhaps effective treatments will be found. There are some reports of success treating the disease with existing antivirals and/or chloroquine. If those reports are confirmed, then the death rate might fall sharply. Those eggs have not hatched, and should not be counted, but here are a few articles about possible treatments:
a. https://wattsupwiththat.com/2020/03/17/an-effective-treatment-for-coronavirus-covid-19-has-been-found-in-a-common-anti-malarial-drug/
b. https://www.physiciansweekly.com/cocktail-of-flu-hiv/
c. https://www.thailandmedical.news/news/coronavirus-drug-research-german-researchers-identify-japanese-drug,-camostat-mesylate-that-could-be-repurposed-to-treat-covid-19
d. https://www.news.com.au/lifestyle/health/health-problems/coronavirus-australia-queensland-researchers-find-cure-want-drug-trial/news-story/93e7656da0cff4fc4d2c5e51706accb5
Be careful out there, folks. Nearly half of the people who have the disease feel fine. So the healthy-looking person whose hand you shake might be one of them — or you might be one of them. Be like these guys: don’t take chances: