Guest Post by Willis Eschenbach [Note updates at the end]
Since the earliest days of the current pandemic, Italy has been the scary member of the family that you absolutely don’t want to emulate, the one cousin that gets into really bad trouble. The Italians have the highest rate of deaths from the COVID-19 coronavirus, and their numbers continue to climb. Here’s the situation today.
Figure 1. Deaths from the COVID-19 coronavirus expressed as deaths per ten million of the country population. Percentages of the total population are shown at the right in blue. All countries are aligned at the date of their first reported death. Most recent daily chart and charts of previous days are available by going here and scrolling down.
Italy, with over six thousand dead, is up well into the blue range. This is the range of annual deaths from the flu in the US. If the US coronavirus patients were dying at the same rate as in Italy, we’d have 38,000 coronavirus deaths by now in addition to the same number of flu deaths …
As a result, there has been much debate about why the Italian death rate is so high. People have suggested that it’s because they have one of the older populations in Europe. Others have noted that they often live in extended families. Some say it’s high numbers of smokers and polluted air. And some have pointed to their social habits that involve touching, kissing cheeks, personal contact during church rituals, and the like.
But we haven’t had good data to take a hard look at the question, or at least I hadn’t seen any.
In the comments to my post entitled END THE AMERICAN LOCKDOWN, wherein I passionately advocate just exactly that, I was given a link by a web friend, Mary Ballon, hat tip to her. It’s a report by a Swiss medical doctor about the COVID-19 deaths in Italy, well worth reading.
And in that document, there’s a further link to an Italian Government report. It’s in Italian of course, I have it on good authority that’s what they actually speak over there, who knew? They reported on the statistics of a large sample of the Italian deaths (355 out of 2003 total deaths at the time of the report). I got it, and the numbers are very revealing.
Let me start with the age distribution of the 2,003 Italians who had died at the time of the report. Figure 2 shows that it’s almost entirely old people.
Figure 2. Age of 2,003 Italians who had COVID-19 at the time of death.
Out of the 2,003 deaths, seventeen were people under fifty, and only 5 people under thirty died, while almost two hundred deaths were of people over 90. I’d read that the people dying in Italy were old, but I didn’t realize quite how old they actually are …
One thing I learned on this voyage was that the Italians distinguished between dying FROM the virus on the one hand, and dying WITH the virus on the other. Once I looked at the state of health of the Italian victims, however, I could see why they had to do that. Figure 3 shows the generous apportionment of serious diseases and conditions among the unfortunates.
Figure 3. Numbers of diseases in the sample of 355 Italians who had COVID-19 at the time of their death.
WOW! Yeah, they all had COVID-19. But three-quarters of them also had hypertension, a third had diabetes, a third had ischemic heart disease, a quarter of them had atrial fibrillation tossing clots into the bloodstream, and so on down the list.
As you can see from Figure 3, some people must have had more than one other disease besides COVID-19. Figure 4 shows the breakdown of the number of other diseases per patient.
Figure 4. Other diseases (comorbidities) of a sample of 355 of the 2,003 Italians who had COVID-19 at the time of their death.
For me, this was the most surprising finding of the entire study. Of all 355 people who died, only three did not have any of the diseases listed above. Three!
Looking at all of this as a whole picture, I had a curious thought about who they were representing. I thought … consider the characteristics of the people who died:
- More of the patients were over 90 than were under 60.
- The average age was 79 years.
- All but three of them had at least one other disease, so basically all of them were already sick.
- Three-quarters of them had two other diseases, and half of them had three or more other diseases. Half!
My thought was … that’s not a sample of the people in the street. That’s not a sample of an Italian family.
That’s a sample of a totally different population.
I was forced to a curious conclusion, both discouraging and encouraging. It is that most of these diseases were probably not community-acquired. Instead, I would hazard a guess that most of them go by the curious name of “nosocomial” infections, viz:
nos·o·co·mi·al
/ˌnōzōˈkōmēəl/
adjective MEDICINE
(of a disease) originating in a hospital.
Here’s what I suspect. I think that the COVID-19 disease got established in a couple of areas in Italy well before anyone even knew the disease was there, perhaps even before the Chinese recognized it as a novel disease.
And in some fashion, it got into the medical system. Doesn’t matter how. But once there, it was spread invisibly to other patients, in particular the oldest and weakest of the patients. It went from patient to patient, from patient to visitor and back again, and it was also spread by everyone in the hospital from administrators to doctors and nurses to janitors. In many, perhaps most cases, they didn’t even know they were sick, but they were indeed infectious.
And that’s why the pattern of the Italian deaths is so curious, and their number is so much larger than the rest of the world. It’s not a cross-section of the general population. It’s a cross-section of people who were already quite sick, sick enough that they were already visiting doctors and having procedures or being bedridden in hospitals. It was 85-year-olds with three diseases.
And it’s also why the death rate in Italy is so high—these people were already very ill. I can see why the Italians are distinguishing between dying FROM the virus and dying WITH the virus.
DISCUSSION AND CONCLUSIONS
As I said, this is both discouraging and encouraging. It’s discouraging because getting the virus out of a modern medical facility and a dispersed medical system isn’t easy. Italy has a big job ahead. And it’s discouraging because it means that the medical personnel who are so needed for the fight are getting the disease as well. Very likely they won’t die from it, but they will be hors de combat for three weeks or so. No bueno.
On the other hand, it is encouraging in a couple of aspects.
First, it lets us know what we need to do to prevent the Italian outcome. We have to, must, keep the virus out the medical system.
- We need to seriously quarantine the sufferers away from other sick people.
- We need to set up testing facilities at all medical centers and test the medical personnel daily.
- In areas with a number of COVID-19 infections, we need to set up separate field hospitals. There are a number of commercial versions of these that are expandable by adding modules, and are pathogen-tight, with airlocks at the doors, HEPA exhaust filters and negative air pressure maintained throughout. We know how to do this stuff, we’ve just got to do it.
- We need to test in-hospital patients at the time of their arrival and continue to test them at intervals during their stay.
- We’ll have to be very careful with visitors to patients in the hospitals
It’s a big job, and we absolutely have to do it.
Second, it cautions us to not claim that everyone who tests positively for COVID-19 after death actually died FROM the disease. They may very well have died WITH the disease.
Finally, the other reason it’s encouraging that Italy’s infection is likely nosocomial is that it removes Italy as the mysterious bogeyman of the COVID-19 pandemic. In addition, it points to just what we have to do.
IF (and it’s a big if) we take the proper precautions to protect our vulnerable medical system and personnel, I don’t think that the US will get as high a death rate as Italy has today.
Note that this makes me seriously question the idea of “flattening the curve” … if you let the virus into your hospitals and medical system you’re toast, no matter how flat the curve is.
So let’s end this crazy American lockdown, there’s a whole raft of work to be done shoring up our medical sector to withstand the coming wave, and it can’t be done at home with our heads in the sand, hundreds of thousands of people not working, jobs disappearing daily, and our economy in a shambles …
My very best regards to all, stay well in these parlous times,
w.
As Usual: I ask that when you comment, QUOTE THE EXACT WORDS YOU’RE DISCUSSING. Knowing who and what you’re referring to avoids endless misunderstandings and arguments.
[UPDATE]: Just after publishing this, I was reading about loss of the senses of smell and taste being symptoms of coronavirus infection. In the article, I found this:
Hopkins says an Italian doctor shared that “he and many of his colleagues had lost their sense of smell while working in northern Italy dealing with COVID-19 patients.”
… “many of his colleagues”. Kinda support my theory of nosocomial infection in Italy.
[UPDATE 2]: In the news today, the headline Coronavirus: 4,824 Italian Health Workers Are Infected … one in ten of their coronavirus cases are health workers …
[UPDATE 3]: Here’s a graph showing just how different Italy is from the other countries with numbers of cases …
PS—Let me take this opportunity to provide a wider readership to a comment that my obstropulous (yes, it’s a real word) good friend Steve Mosher posted on my blog yesterday. He’s living in Korea and has been a close observer of just how they are succeeding in controlling the virus. He spells out the level and the details of what we have to do. His comment is below, my thanks to him.The key is changing the criteria for testing. Here [in Korea] we test and track.
An employee of a call center in Seoul, was infected.
Office had 207 people.
March 8th. he tested positive.
EVERY person in that office was tested. today 152 have tested positive, they tested floors above and below his floor. Today 3 more from the 11th floor were found and 1 contact.
They are now tracing the contact, and the contact’s contacts. All will be tested. The business was in a residential building. 553 of the people in that building were tested. floors 13-18
This little beastie lives on surfaces for up to 3 days. See that elevator button? the hand rail on the stairs? the bathroom door handle? the coffee cup that pretty girl behind the counter handed you? it’s there. Now in my building we have hand sanitizer by the elevator buttons. you get in the habit of not touching public pretty quickly. Trust me I am not a germ phobe, but the changes have been simple when they are reinforced.
Let me give you a little taste of the highly detailed info we get.
Info that is shared daily in one spot, I will include some of the earlier call center case snippits
“In Daegu, every person at high-risk facilities is being tested. 87 percent completed testing and 192 (0.8 percent) out of 25,493 were confirmed positive. From Daesil Covalescent Hospital in Dalseong-gun, 54 additional cases were confirmed, which brings the current total to 64. In-patients on 6th and 7th floors are under cohort-quarantine.”
“From Guro-gu call center in Seoul, 7 additional cases (11th floor = 2; contacts = 5) were confirmed. The current total is 146 confirmed cases since 8 March. (11th floor = 89; 10th floor = 1; 9th floor = 1; contacts = 54)”
“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.”
“Five additional confirmed cases have been reported from the call center located in Guro-gu, Seoul, amounting to a current total of 129 confirmed cases from the call center since 8 March. As of now, 14 confirmed cases in Gyeonggi Province has been traced to have come in contact with a confirmed patient who is a worker at the 11th floor call center at a religious gathering. Further investigation and tracing are underway.”
Test, Trace, Test more.
A random test in Iceland found 1% infected. 50% asymptomatic.
If the US persists in only testing the symptomatic you won’t squash this bug.
Our cases are going up in Seoul. So we will have 15 days of voluntary social distancing.
go to work
stay away from crowds
wash your hands
wear a mask
don’t touch your face
Thanks for this Willis.
It could be deadlier strain is in Italy, though I have no proof.
Hypertension seems to be smoking gun. The ACE2 inhibitor drugs to treat it could be a major culprit. This study suggests it.
https://www.sciencedaily.com/releases/2020/03/200323101354.htm
YACTS (Yet Another Covid Tracking Site)
This is for the US only, very good detailed state by state data (even history). Pretty much open source, downloadable raw data and API.
https://covidtracking.com/
Willis, I have come to the the conclusion that uk should let it rip! In the winter of 2014/15 we lost 35000 mostly over 65 ‘s to winter flu. The system was stretched but it did not drive uk to shut down. This relative pusseycat of a virus needs a clamp putting around it but as you intimate, the economy of shutdown is for the birds!
But the 35000 lost due to winter flu had a good crack at survival. GPs open normally, hospital beds available if you deteriorated, intensive care plus ventilator if needed.
Even then we had to ‘prepare’ the NHS for the winter flu season to ensure enough beds.
Now you propose, harshly I suggest, that if, say, 100,000 people needed to be hospitalized due to COVID19 then they should just die at home?
What kind of world do you want to live in and would you want your rules applied to you, your friends and loved ones?
ALL of the current disruption is to reduce the overload on health services around the world to give people a chance of survival if they become seriously ill.
Today, Prof David Spiegalhalter, a renowned statistician announced that he had found a significant fit between deaths due to coved 19 and expected mortality within the next 12 months which pretty much sums up the view that if your not so chipper over the age of 70 , do not get infected with coved 19 like viruses. In summary, most of the deaths from winter flu-like viruses are just deaths brought forward. If the UK health service refuses to prepare for such peaks this is no justification for shafting the whole economy. The alternative is sentimental claptrap.
“According to Professor Ricciardi, scientific advisor to Italy’s minister of health, another reason is that anyone who dies in Italy and who has the coronavirus will be listed as having died of the coronavirus. So, 80-year-olds who die of cancer or heart disease, but who tested positive for the coronavirus, are listed as having died from the coronavirus. Professor Ricciardi says, in the Daily Telegraph, that when the National Institute of Health re-evaluated the death certificates only 12% showed a direct causality from coronavirus whereas 88% of those who died had at least one, two or three underlying illnesses. A study published in JAMA (`Coronavirus Disease 2019 (Covid19) in Italy’) on 17th March 2020 showed that 87% of deaths in Italy occurred in patients over 70 years of age. All this inevitably pushes up the number of deaths in the country. It is surely dangerous to extrapolate from one country’s experience. It is, perhaps, surprising that more publicity hasn’t been given to these findings which seem to me extremely important. (If you remove just half of the Italian deaths from the global total the figure looks very different.) Yesterday, I said that I thought the Italian figures were wrong because they were putting down too many deaths as coronavirus”
up to date figures on all countries. Cases in Germany looks high.
https://www.worldometers.info/coronavirus/
figures for Germany jumped by a factor of five a few days ago. Both cases and deaths. This absolutely not possible clinically. Someone has a big fat jackboot on the scales.
There must be some major change in how they are counting or diagnosing cases there. Unlike China which had a similar jump but were quite clear and up front about the changes at the same time as they published data, I don’t see any notice about changes in Germany. Like France this happened just before Merkel issued new national rules she wants the regional “Land” state authorities to adopt.
figures for Germany jumped by a factor of five a few days ago. Both cases and deaths.
When was this?
More you test, more cases you find and count.
80 5940 30
79 1042 0
78 1144 0
77 1174 1
76 1043 4
75 733 3
day 80 is 20th March in ECDC data file. Probably figures from previous days fatalities.
The same day Baveria, Germany’s most populous state announced “lockdown”.
Or they got a fresh supply of tests.
The “diseases” mentioned in Fig 3 (apart from the corona itself) are pretty common in aged U.S. population, and not only in Italy, aren’t they? How many male citizens past 50 years of age have medication against hypertension and/or diabetes and/or heart disease?
Half of them, though, don’t have three, count’em three, other serious health problems.
w.
True.
But most of the men past forty seem to have at least one, and quite a few have two.
Plus the combo of diabetes + statins + blood pressure medication is not that uncommon in normal and otherwise healthy folks in U.S.?
Latest WHO statistics, 3/24/20:
The top twenty countries (out of 177) have 90.6% of the cases and 97.4% of the deaths.
The US has 11.8% of the CORVID-19 cases and 3.4% of the CORVID-19 deaths (593)).
CORVID-19 is NOT a global issue.
The lying, rabble-rousing, fact free, shit-stirring, fake news MSM propaganda machine obviously want the public to believe that a positive test for the Covid-19 virus is a sho’nuff painful, expensive hospital stay which one probably won’t survive.
And if all 46,500 cases showed up for treatment it would be disaster.
But 98% of those US positive cases are asymptomatic, i.e. they don’t produce a data point, no doctor, no hospital, no death.
So, 2% of 46,500 = 930. That’s not going to tax the medical system.
Much like the climate change scam models assuming RCP 8.5 for all their hysterical predictions or accelerating sea level rise that did not exist.
Nick,
It’s like the fake ‘climate crisis’ on steroids.
But 98% of those US positive cases are asymptomatic,
Have you any evidence for this? Most countries are reporting that about 50% may be asymptomatic.
Why am I suspicious of the flat mortality curve in China, a country with 1.4 billion inhabitants. Are the Chinese authorities calculating mortality differently than, say, the Italians?
Most likely the ChiCom regime is just lying, but infection and death rates might well have flattened out.
Hubei has almost as many people as the UK, in 89% the area.
“Why am I suspicious of the flat mortality curve in China, a country with 1.4 billion inhabitants. Are the Chinese authorities calculating mortality differently than, say, the Italians?”
Why are you suspicious? Dunno. But your suspicion is not evidence.
If you watch daily numbers from China at the most granular level ( city district) You’d have a
better understanding.
Folks in Beijing are dying as predicted. Every case is tracked, publically. All new cases are via
Import.
February. The huge spike in cases on 12 Feb. is due to aggregate reporting of cases for previous days on the 12th. Regardless, cases peaked at the latest 13 Feb.
https://www.worldometers.info/coronavirus/country/china/
https://www.worldometers.info/coronavirus/country/italy/
New infections in Italy peaked on 21 March, and although the cases on 24 and 25 March were higher than 23 March, they were LOWER than 22 March, and the 25th was lower than the 24th.
THANK YOU WILLIS, for your continued data-based articles and common sense commentary. I agree with you 100%.
People need to stop listening to the talking heads (most of the ‘authorities’ and the sensationalist media.)
I’m sure President Trump agrees with you, he will lead America, and the World, out of this crisis. He’s saying one more week, and then America is getting back to work, before this shutdown creates more deaths than Influenza and Covid-19 combined.
Please keep up your very important data collection and commentary, it is badly needed.
There is a strong possibility that a class of the most widely-prescribed hypertension medication in Italy (ACE inhibitors) may well increase the likelihood of worsening the symptoms because the medication may facilitate transport of the virus into the cell. I couldn’t find use data by country for ACE inhibitors, but that information would be interesting.
https://www.sciencemediacentre.org/expert-reaction-to-questions-about-high-blood-pressure-diabetes-and-ace-inhibitor-drugs-and-risk-of-covid-19-infection/
Yes, there does seem to be quite specific biochemical evidence of ACEi being a major aggravating factor.
Here is the original Swiss doctor’s letter in Lancet. They do note that angiotensin conversion blocking or inhibiting medications are used in treating the two main comorbidities, hypertension and diabetes. And the role of ACE-2 in coronavirus getting into cells has been known since the original SARS.
I had read elsewhere that obesity was one of the main comorbidities.
But putting that aside, in the US, and I would hazard a guess in many if not all industrialized countries, hypertension is the number of health condition effecting the populace.
Diabetes is number 3.
Hyperlipidemia is #2.
I am not gonna spend all afternoon double checking, but a quick look seems to indicate that about 22% of people in the US have hypertension. It is 12.5% of all adverse health conditions present in the populace.
Diabetes afflicts 7% of everyone in the US.
It is 5.4% of adverse health conditions in the US.
I think the prevalence of these conditions means that a lot of people dying with those conditions is not very usual for any cause or manner of death.
Typo…dang making a lot of them today, time to give it a rest.
“…hypertension is the number one health condition…”
and that in part is the pharmas push to sell more by dropping the recommended BP reading that was considere safe
ie moved a huuuge amt of people to enforced BP meds or loose their healthcover.
and the average over 50yr old is oft stated to be on at least 2 meds and often up to 5 as their norm.
and many I know are..if theyre good lil sheeples
I chose surgery for the A-Fib and while it stopped the flutter Im finding Im still having the odd fast heart and BP rises
a lot of those dying may well have had other issues
but
the corona was what pushed their systems into failure, and yes maybe the normal(nasty) flu we sent you from down sth would also do it…for some -not as many I suspect
Spains now the hotspot with massive death tolls per day.
and Africas just taking off, some there on Aids meds or antimalarials might survive better
be interesting to see the end results there.
I’m slowly trying to piece it together, but it’s not easy to find. Taiwan and Japan both prefer calcium channel blockers over ACEi and ARB, especially for the elderly. In both cases morbidities and deaths are low. Italy’s use of ACEi/ARB appears to be high (see my comment above); and their morbidities and deaths are high. I’ll post more as I find them.
Because ACE inhibitors frequently cause a dry cough in E Asians, Japan set their maximum doses for ACEi lower than those in the US and Europe.
Willis,
Regarding END THE LOCKDOWN!!, I agree if the economy collapses that will cause many deaths. Economic collapse leads to the tax base drying up. Municipalities will cut police forces, firefighters, local health services. There will be more homelessness. Financial difficulties lead to depression, divorce, kids not being able to pay for college.
Trump must balanced these factors against what the doctors are suggesting to end the spread.
Despair has been one of the main vectors for the opiate “crisis.” As another writer noted, the lockdown is worse than the virus itself and will surely lead to more deaths.
Maybe obstreperous Mr. Mosher can explain what test the Koreans are doing. The naso-pharyngeal swab is invasive and until recently it took around a week to get a result. Is the test simply a thermometer for a fever? No one is much doing this in the USA, but we should be.
That’s the “obstropulous Mr. Mosher”. He knows much more than I, but I have heard that the Koreans are using a combination of fast tests and slower more accurate tests.
w.
I had to look up that word, as my ear has always heard it as obstreperous.
I found that the way you are spelling it is a word, but it is a corruption of the word from old Latin:
“obstreperous
noisy, boisterous, or unruly, esp. in resisting or opposing
Origin of obstreperous
Classical Latin obstreperus from obstrepere, to roar at from ob- (see ob-) + strepere, to roar from Indo-European base an unverified form (s)trep-, to make a loud noise from source Old English thræft, strife
However,
“obstropulous
Adjective
(comparative more obstropulous, superlative most obstropulous)
(obsolete slang) obstreperous
Origin
Corruption of obstreperous.”
Thanks Nicholas. I was familiar with the word obstreperous but had not bothered looking up this new word.
“to roar from Indo-European base an unverified form (s)trep-, to make a loud noise from source Old English thræft, strife”
Probably the origin of “stroppy” .
I tried to look it up. I couldn’t find it. Thanks for enlightening me!
I also live in Korea and follow the news on this topic closely.
The Koreans are using many different tests. They often use a combination of a nasal swap, mouth swap and a some spit. In some systems, test results are available within hours.
Korea is also requiring passengers arriving from abroad to install an app and to report health condition twice a day.
https://www.nature.com/articles/d41586-020-00827-6
The tests in China and Korea take hours.
Korea will hopefully reduce this to 20 minutes
They were both prepared for this.
The issue is the test equipment platform. The US had selected a low volume platform.
They are switching now.
Definition of ’obstropulous’
obstropulous in British English
(əbˈstrɒpjʊləs)
adjective
humorous, dialect another name for obstreperous
Collins English Dictionary. Copyright © HarperCollins Publishers
Willis, great discussion about some important factors that impact mortality – age and comorbidity. There is another very important factor which likely explains a large amount of the variability in mortality rates across countries and another factor that may have some impact. The first is the testing itself. Mortality rate is the ratio of deaths to those infected, but we don’t know number infected for any setting except perhaps the closed experiment of the Diamond Princess cruise ship where 700 or so were infected and 8 died – mortality just over 1% among an older population. For all of the countries reporting the denominator of number infected is replaced by number of infections detected by testing. If countries tested far and wide they may well identified most if not all infections (no test is perfect) and then the mortality rate may be accurate. If, as in Italy you are caught with you pants down and only start reacting and testing when sick people show up in health facilities then you are missing possibly the majority of infections out in the community with minimal or no symptoms. This shrinks the denominator and provides an inflated mortality rate. If, like in Germany and those parts of China remote from Wuhan, you are forewarned and start testing early among well persons who might be at risk, you will capture a wider profile of infections and generate a much smaller death rate. The early testing and detection strategy also has its own artifact. By testing early and finding asymptomatic or minimally symptomatic cases you may give an artificially low death rate as some of those tested will ultimately become ill and some will die later (this is lead-time bias).
The second artifact in the data is case classification. If deaths are not classified the same in different jurisdictions then the same real death rate from the virus may appear different in different countries. It has been claimed that in Italy some of the deaths attributed in CoVID may actually have had other immediate causes but CoVID was blamed due to a positive test. An extreme example for illustration is if someone committed suicide but happened to test positive fo CoVID at autopsy it would give a very wrong impression to call that a CoVID death.
In reply to Willis’ comment:
“So let’s end this crazy American lockdown, there’s a whole raft of work to be done shoring up our medical sector to withstand the coming wave, and it can’t be done at home with our heads in the sand, hundreds of thousands of people not working, jobs disappearing daily, and our economy in a shambles …”
I totally agree, Willis.
We are between a rock and a hard place. This is going to be a difficult problem to solve. (Restart world economy and stop the spread of the virus and/or reduce its death rate)
Every develop country is looking at instant 30% unemployment, many companies facing extinction, and all countries/states needing to borrow money because of collapsing revenues, due to the economic effects of extreme isolation.
We are facing an economic existential problem, not an economic recession.
People have a high standard of living because they are employed by companies and live in countries that are not bankrupt.
People do not get economic limits, the connection between a country’s current GDP, how much they have already borrowed, and the maximum amount a country can borrow.
Mosh:
… but go to work! The current western : shut everything down , is going to be far worse than the virus. At least your commander in chief seems to get it. Europe is screwed if they carry on.
“I was reading about loss of the senses of smell and taste being symptoms of coronavirus infection.”
Didn’t these medical experts notice that they lose sense of smell when they get a common cold too? Much of think of as “taste” is in fact smell anyway.
Why now? The Chinese have been eating bats (or however this started) for 1000 years, why did this not happen before now? I suppose an animal virus mutated and got in to a person possibly by fluid contact.
I know I got viral bronchitis 4 years ago from kissing a woman who had been to Istanbul a month earlier and she had it but had no more symptoms. I was messed up for a week.
I know what you mean, John. These days, when I kiss a woman it messes me up for a week too …
w.
John, Your testimony naturally brings to mind the apropos candid lyrics from Burt Bacharach/Hal David’s song from their 1968 musical ‘Promises, Promises’ as titled by their last line here: What do you get when you kiss a girl? / You get enough germs to catch pneumonia. / After you do, she’ll never phone ya! / I’ll never fall in love again.
The novel mutation supposedly required the bat virus to hybridize with a pangolin virus. Entirely possible that that had never happened before, or did a long time ago, when there were fewer people and no jet travel, such that the new virus died out locally.
How a bat virus goes to pangolins and picks up a wicked spike/cleaver feature.
https://www.foxnews.com/science/the-coronavirus-did-not-escape-from-a-lab-heres-how-we-know
See the article for links to scientific papers. For those who do not follow links, here is the gist.
“A group of researchers compared the genome of this novel coronavirus with the seven other coronaviruses known to infect humans: SARS, MERS and SARS-CoV-2, which can cause severe disease; along with HKU1, NL63, OC43 and 229E, which typically cause just mild symptoms”
“[they] looked at the genetic template for the spike proteins that protrude from the surface of the virus. The coronavirus uses these spikes to grab the outer walls of its host’s cells and then enter those cells. They specifically looked at the gene sequences responsible for two key features of these spike proteins: the grabber, called the receptor-binding domain, that hooks onto host cells; and the so-called cleavage site that allows the virus to open and enter those cells.”
“That analysis showed that the “hook” part of the spike had evolved to target a receptor on the outside of human cells called ACE2, which is involved in blood pressure regulation. ”
“SARS-CoV-2 is very closely related to the virus that causes severe acute respiratory syndrome (SARS), which fanned across the globe nearly 20 years ago. Scientists have studied how SARS-CoV differs from SARS-CoV-2 — with several key letter changes in the genetic code.”
“The overall molecular structure of this virus is distinct from the known coronaviruses and instead most closely resembles viruses found in bats and pangolins that had been little studied and never known to cause humans any harm.”
“One scenario follows the origin stories for a few other recent coronaviruses that have wreaked havoc in human populations. In that scenario, we contracted the virus directly from an animal — civets in the case of SARS and camels in the case of Middle East respiratory syndrome (MERS). In the case of SARS-CoV-2, the researchers suggest that animal was a bat, which transmitted the virus to another intermediate animal (possibly a pangolin, some scientists have said) that brought the virus to humans. In that possible scenario, the genetic features that make the new coronavirus so effective at infecting human cells (its pathogenic powers) would have been in place before hopping to humans.”
“In the other scenario, those pathogenic features would have evolved only after the virus jumped from its animal host to humans. Some coronaviruses that originated in pangolins have a “hook structure” (that receptor binding domain) similar to that of SARS-CoV-2. In that way, a pangolin either directly or indirectly passed its virus onto a human host. Then, once inside a human host, the virus could have evolved to have its other stealth feature — the cleavage site that lets it easily break into human cells. Once it developed that capacity, the researchers said, the coronavirus would be even more capable of spreading between people.”
Scenario two has less probability of future outbreaks among humans, it says.
1.
So “inside” the human host, which is not a host yet because it has not developed a cleavage mechanism, and where without being able to reproduce even a single time, it mutates the necessary cleavage mechanism. Clever.
2.
So with no evolutionary advantage in the string of animal hosts, it developed a “so effective” means of infecting a human host.
That reads like the NIST report on the collapse of WTC7. About as convincing.
Thanks for the link and reading the papers. Now I know it’s BS and the only way these “features” were acquired was with a little outside help.
Maybe it was the Creator, just messing with us again or it was the Franco-Chinese P4 biotech lab recently built in Wuhan a few hundred meters from the market ( where they would have ready access to wide range mammal genes to play with , since Chinese eat everything which moves).
I bristle every time I see that phrase, and by the time I finish reading their “proof” I am damn near apoplectic! When you read the actual text, they don’t prove anything. The models indicated this configuration wouldn’t do what researchers thought it would do, so they wouldn’t pick this arrangement? That’s no proof! How do we know the Chinese researchers are using the same models as the researchers cited in this article use? What they’re really showing is, it’s not likely these researchers who constructed this model would have selected this configuration to build.
In any event, all this “proof” demonstrates is it may be unlikely the virus was genetically engineered (and they haven’t proved that), but that in no way even indicates this virus did not escape from a lab. Infectious disease researchers should spend more time researching diseases that occur “in the wild” than they do on genetically engineering Super-Bugs that could be used as bio-warfare weapons. Most likely scenario: this was another virus researchers were studying, who knows where they found it, or if it arose as a mutation of something else the researchers were studying, that did escape through carelessness, or even an unforeseen transmission through a route/vector that was left unguarded. I read one article that revealed workers in the lab would either steal research animals or “liberate” living specimens once an experiment ended that should have been destroyed, and sell them to make money, most likely in the wet market, or they could have had pre-arranged customers. And there is always the possibility that it was a willfully released disease that was under study in the laboratory.
Bottom line is, we may never know where this thing originated because the Chinese will not allow us to even enter their lab to investigate. Nor will they do the close examination themselves. More reason to hold the Chinese virus against them.
1000 years ago there was not 10,000 commercial airliners in the air at any given moment, and some 100,000 such flights, each with between one and several hundred people each, traveling between every two cities on the planet every day.
Hospitals are a notorious place to pick up nasty bugs. I seem to recall that all super-bugs are picked up at hospitals.
If you want to accept a large number of deaths, then end the lock down. Obviously slowing the infection rate allows the limited number of IC units to save the largest number of people.
Allowing firms that make IC units to do so is critical, and must continue.
All other non related social activity must cease.
That is of course logical.
How about people selling food and medicine and stuff like that?
There may be a few others who are involved in things that not everyone in the country can really go a few weeks without.
In fact there are millions of people who need to get to work if the people in the hospitals are stores are going to keep working.
Gas stations.
Mechanics.
What about plumbers?
Home stores and other places that sell stuff for when someones well breaks, or their heater goes off line?
Is everyone with a busted appliance supposed to wait a month to get it fixed?
It really does not work when you start thinking about it carefully.
And if everyone stays home…will the bad guys?
Is everyone going to go back to offices that have been robbed blind in a few weeks or months or whenever it is?
Do we wait until no one has the virus to end the lock down?
This is a disaster, and there is no good way out of the fustercluck.
I don’t know what state you are examining. I know in the states I am most familiar with pretty much everything on your list are considered essential services and are allowed to continue to operate. Restaurants are restricted to take out, but we continue to frequent our favorites to help keep them going. Utilities and those who maintain them and repair them continue to operate, as do the stores that supply construction supplies. Gas stations are still open, etc. If there are places in the US that have locked down those items as non-essential, then that is too much.
Once ICU is at capacity they can’t save any more people, except through improved treatment that reduces stay times.
Norway’s outbreak is interesting from this nosocomial point of view – it has been reported by NRK (the state broadcaster) that a doctor returning from a skiing trip in northern Italy examined a couple of hundred patients before having any symptoms – many of whom then developed the illness.
And weren’t something like 35 deaths in Washington state all from the same long term care home?
https://edition.cnn.com/2020/03/23/health/coronavirus-nurses-inside-washington-care-home/index.html
CNN of course uses PC “novel coronavirus”.
Spain, similar to Italy?
“MADRID: There are nearly 4,000 health workers infected with the coronavirus in Spain, more than one in ten of total confirmed cases, officials said on Monday (Mar 23) as the virus toll rose in Europe’s second-worst affected country.”
Sadly, quite possible, as Spain’s death toll rivals Italy’s …
w.
The critical point here:
“We need to seriously quarantine the sufferers away from other sick people.”
Absolutely correct. We used to have isolation hospitals in years gone by (when we weren’t so squeamish) especially for respiratory diseases. In my lifetime, there were TB isolation hospitals in the UK and we have to consider what facilities are actually needed to treat Covid-19 cases and whether they really need to be treated alongside the rest of the hospital population. If it just a case of palliative care respiratory assistance, this can be provided in many facilities – hotels for example, or – dare I say it – redundant cruise ships!
It may be too late in some hospitals, but on a town-by-town basis this should be started right now and given much higher priority than locking down entire countries.
My mother, a trained nurse, made the same point to me a few days ago. She trained in Manchester in the ’60s.
The term “isolation ward” comes to mind …
Congratulations for your coronavirus-tracking post! One of the most useful in town.
May I suggest you to keep Wuhan Province in any updated chart of deaths per 10 million inhabitants, since Wuhan is probably the best benchmark for countries in the same range of population (Italy, UK, Korea, etc).
Best regards,
J. Reibnitz
I am also given to understand that Northers Italy has many Chinese living and working there. That the traffic between Northern Italy and China is very high. Thus some of them may have been infected. Also this has been kept under the radar because China is very sensitive and a huge investment by China in Italy would be threatened.
There has been much discussion on intubation, but little in the way of statistics on effectivness or recovery rates when in that condition.
Toward the end of the head posting, Willis Eschenbach says “hundreds of thousands of people not working, jobs disappearing daily, and our economy in a shambles ..”
Here in Saskatchewan, one little province in Canada, with just under 1.2 million people in all, I’ve heard that roughly 10,000 “hospitality workers’, meaning restaurant and bar staff, have been laid off over this. Lots of those must be younger people with little chance of be able to do anything else but collect Employment Insurance (and likely some haven’t been in the workforce long enough to even qualify for that).
Maybe I’m being contrary to the conventional wisdom here, but, having made the decision to do this damage, how can authorities then complain about young people refusing to self isolate, actually carrying on a social life while laid off? They could have foreseen that idle people would socialize, undoing whatever edge they thought they had by arbitrarily tanking the economy!
Also, I note that the analysis suggesting that this virus has spread in Italy mainly via the healthcare system as such is quite intriguing. I wonder if anyone in authority is listening?
“hospitality workers”, I thought that meant the sex trade.