The SARS-CoV-2/COVID-19 coronavirus

[MKSheppard]

The signal to noise ratio in this thread is rather high with Shep and TRR doing their thing

You haven't seen signal/to noise ratio until you get asked "do you believe in god" after you try to bring this to the attention of your boss, since our department will be viewed as a supply of warm bodies and vehicles if this thing goes bad.

[Jub]

The signal to noise ratio in this thread is rather high with Shep and TRR doing their thing

You haven't seen signal/to noise ratio until you get asked "do you believe in god" after you try to bring this to the attention of your boss, since our department will be viewed as a supply of warm bodies and vehicles if this thing goes bad.

You've been given a slap on the wrist and asked to tone it down in this thread already, so maybe instead of seeing how many unique posts you can make in the thread take a second, make one post, and let most of us do our best to pretend you were banned years ago.

[MKSheppard]

Jaerius:

Linky poo

The U.S. Federal Reserve has begun quarantining physical dollars that it repatriates from Asia before recirculating them in the U.S. financial system as a precautionary measure against spreading the virus, a Fed spokesperson told Reuters.

She said regional Fed banks that help manage the money supply will set aside shipments of dollars from Asia for seven to 10 days before processing and redistributing them to financial institutions. The policy, first reported by Reuters, was implemented on Feb. 21, the official said.

[FireNexus]

If it exists, there's porn of it. In some ways, humans are depressingly predictable creatures.

In my younger days, well past any possible statute of limitations, I received a contraband shipment disguised as a DVD case for this movie:

http://www.adultfilmdatabase.com/video/70804/insexts/

Not safe for work, if the link hadn’t give it away. But opening that package was the hardest I ever laughed in my whole life. My only regret wasn’t not actually containing the DVD.

[Grand Moff Yenchin]

-----------------------
On another front closer to home. Toilet seems to get sold out. I think the reasoning is in case the Australian government asks us to self isolate for 14 days, people are stocking up. The shelves were empty when I went to Coles to do my regular morning shopping. Fortunately I got plenty left, but might pay to buy some in case I have to self isolate myself when I get back. You never know.

Hopefully it's not too late to let you know that NT News provided eight blank pages a couple days ago for loo paper :

https://www.news.com.au/finance/busines ... ae1e5cb049

But seriously I don't quite understand the toilet paper panic. Over here in Taiwan and HK it was due to rumours of paper pulp being used to make face masks. Now it has become like some sort of rite of passage for affected areas.

[The Romulan Republic]

This is apparently originally sourced from a Communist Party outlet in China, so take it with a grain of salt if you like, though I'm not sure what incentive they'd have to lie here:

https://news.com.au/lifestyle/health/he ... 2d2b9305ca

Chinese doctors say autopsies of coronavirus victims suggest the deadly illness is “like a combination of SARS and AIDS” that can cause “irreversible” lung damage even if the patient recovers.

The grim finding was reported on by Communist Party mouthpiece the Global Times on Friday, after a paper by Wuhan doctors published in the Journal of Forensic Medicine earlier in the week went viral on Chinese social media.

“The influence of COVID-19 on the human body is like a combination of SARS and AIDS as it damages both the lungs and immune systems,” Peng Zhiyong, director of the intensive care unit of the Zhongnan Hospital of Wuhan University in Wuhan, told the Global Times.

Dr Peng was commenting on the paper by Liu Liang, a forensic specialist from the Tongji Medical College at Huazhong University of Science and Technology, whose team had conducted nine autopsies of coronavirus patients as of February 24.

“The autopsy results Liu shared inspired me a lot. Based on the results, I think the most important thing now is to take measures at an early stage of the disease to protect patients’ lungs from irreversible fibrosis,” Dr Peng told the outlet.

Pulmonary fibrosis is permanent scarring of the lung tissue that can leave the patient chronically out of breath. The paper described an autopsy conducted on an 85-year-old man. It said there was apparent damage to the patient’s lungs.

Excess production of mucus spilt out of the alveoli — tiny air sacs in the lungs that absorb oxygen — indicating COVID-19 “causes an inflammation response that damages deep airways and pulmonary alveoli”.

According to the Global Times, the paper said the patient exhibited similar pathological changes to those caused by SARS and MERS. Fibrosis was “not as serious as was seen in SARS patients, but an exudative reaction was more apparent, possibly due to the short course of his disease”.

The paper did not say that all coronavirus patients will suffer permanent fibrosis.

An earlier study published in The Lancet which examined the CT scans of 81 patients with COVID-19 in Wuhan found the imagery “indicated the appearance of interstitial changes, suggesting the development of fibrosis”.

“However, since the natural history of COVID-19 pneumonia is yet to be fully explored, it is too early to label these lung changes as irreversible fibrosis,” the researchers wrote.

It comes as a group of Chinese scientists warn that the virus has mutated into a more aggressive strain. In a new study published in the National Science Review, researchers suggested that after COVID-19 crossed into humans, the original strain evolved into a second type and both of these are now circulating.

More than 95,000 cases of the disease have been confirmed worldwide and over 3000 people have died, including two in Australia, where there are currently 50 confirmed cases.

So, the majority of the human race may have permanent lung damage by the end of the year. This just keeps getting better and better.

Also, a new, more aggressive strain.

[Broomstick]

Its interesting. Actemra is an immunosuppressant which are used in autoimmune diseases. They basically plan to use it to treat the complications. Now from autopsies of patients, there is quite strong inflammatory response which damages the lungs. This broad principle of using medications to suppress inflammation while treating someone for an infection, even though this medication itself can suppress the immune system isn't new.

Not new, but it can be tricky to manage between suppressing the inflammation and not leaving the patient vulnerable to other infectious agents. Still, it makes sense and seems a logical fit between the specifics of the inflammation reaction and what the medication does.

There's also the matter of costs. A typical dose, based on a quick google, is between $500-1000 USD. Prices in other places are almost certainly different but apparently this is more expensive than aspirin. Also, as a humanized monoclonal antibody I'm not sure how production works or how easily it could be ramped up to meet increased demand.

[Broomstick]

Basically everything mr friendly guy posts can seemingly be summed up as:

"A Westerner said/did something bad! This proves the West is the source of all evil, and therefore everything China's government does is okay!'

TRR you are wrong.

Keep in mind that I probably side with you/defend you more than most.

Your latest interpretation of his recent post is off-base and I'm assuming colored by personal bias. Please take a deep breath and reflect on that.

[Broomstick]

So, on the local level, state, city and other such healthcare organizations are going to feel the pinch for those 14 day quarantines.

And individual citizens will, in many cases, be financially ruined for a 14 day quarantine in a hospital.

Unable to work, they could lose their jobs, be ruined by enormous medical bills, and wind up homeless. Yesterday local TV was interviewing people and more than one expressed that very fear. For many, the fear isn't a serious illness, it's being ruined by loss of income and loss of home.

Yeah, America sucks at times.

[The Romulan Republic]

Basically everything mr friendly guy posts can seemingly be summed up as:

"A Westerner said/did something bad! This proves the West is the source of all evil, and therefore everything China's government does is okay!'

TRR you are wrong.

Keep in mind that I probably side with you/defend you more than most.

Your latest interpretation of his recent post is off-base and I'm assuming colored by personal bias. Please take a deep breath and reflect on that.

Okay, that was not an accurate characterization of that specific post, I'll admit.

My response was due to frustration over how he seems to turn every post, one way or another, into a defense of China's dictatorship/attack on the West. In particular, this line:

Nevertheless, this statement is pretty disgusting. It ranks up there with the New Antisemitic Times describing China as having "historical reputation as an incubator of deadly diseases," (page 3 of this thread). I sure hope RT or Chinese news have a field day with this, but I don't hold up much hope from the latter.

Which is pretty disjointed from the content of the rest of his post, and seems to have been tacked on just for the sake of further bashing of Western media/praising of Russian/Chinese state media.

I'll admit I am biased when it comes to his posts (though no more so than most of the board is biased against mine), because when someone pulls a particular move often enough, you start to expect it from them. But, you're right, I should be more accurate regardless. My apologies.

[madd0ct0r]

Two new cases in Vietnam, and a story.

Case 18 caught it in Korea. He had flown back on a flight from Daegu. The entire flight was quarantined on arrival but so far only he is ill.

Case 17. Fucking hell. 26 year old Steel mill heiress, went to visit her sister in France. Her sister had caught it. So they naturally travelled Paris and Milan, London. Flew back from London to Hanoi, lied when asked where she's been, did social things around Hanoi, eventually got so sick she went to hospital.
But being rich and ignoring how rules apply to her, she went to a luxurious private hospital, rather than the quarantine one. That hospital and staff is now in quarantine. The news is playing it down but the entire story is accidentally evidenced on her Instagram. Lots of photos of her with a mask and Wheely suitcase with "stay safe", and "protect yourself first" as captions.

The plane she flew in on was full of tourist s who have spread across the country
https://news.trust.org/item/20200306164447-x50r7/

Single handedly, this rich selfish idiot has probably started 2nd wave of infection in Vietnam and at least three cities.

[Ralin]

So, the majority of the human race may have permanent lung damage by the end of the year.

What?

I feel like I'm missing a step here.

[The Romulan Republic]

So, the majority of the human race may have permanent lung damage by the end of the year.

What?

I feel like I'm missing a step here.

Well, the worst case projections for Coronavirus a while back had somewhere between 30 and 70% of the Earth's population catching it, IIRC. Sure, it might not be that bad. But that's what I was referencing.

[mr friendly guy]

Trump the Tariffman has met his kryptonite, and I don't mean his marriages. Its coronavirus.

https://markets.businessinsider.com/new ... 1028973176

The Trump administration has taken steps to ease punitive tariffs against certain medical items from China.
The steps came against a backdrop of escalating concerns about a coronavirus outbreak in the US.
The administration has offered tariff relief for more than 100 of medical items from China, including face masks, sanitization products, isolation gowns and more.

Unfortunately China doesn't have that much to spare in terms of masks. China is reporting that despite 110 million masks a day there is still a supply deficit. That's due to factories going back online and workers needing masks. China and its private citizens has already donated masks to South Korea, Japan , Iran, you know, those countries that helped China when this started when their mask production was a "mere" 20 million a day. So I expect some priorities to go to those others first before selling them to the US.

Edit - further information on the mask shortfall
https://medium.com/syncedreview/100m-ma ... f33c5105b9

[MKSheppard]

Re the Mask Shortage:

March 5th:

http://www.koreaherald.com/view.php?ud=20200305000730

The South Korean government said Thursday it will take full control of face masks distributed via public channels, and ban local companies from exporting them to cope with the severe supply shortage amid rising cases of coronavirus.

“To distribute face masks swiftly and fairly to all citizens, the government has decided to fundamentally manage the entire process of production, logistics and distribution,” the Ministry of Economy and Finance and other agencies monitoring the COVID-19 outbreak said in a joint press release.

Exports of masks will be fully banned, replacing the previous measure of allowing maximum 10 percent outbound shipments of the total output here.

Can't find a source, but the South Koreans also banned the export of mask precursor materials such as fibers, etc.

[MKSheppard]

Morning Roundup:

Sources: The NBA has sent a memo to its franchises explaining that, due to coronavirus outbreak, teams should be preparing to play games without fans in attendance and identifying “essential staff” present for these games -- should it be necessary.

Shams Charania Shams Charania (@ShamsCharania) March 7, 2020

They’re pulling asymptomatic nurses off of quarantine early so the can take care of patients.

Link

Ms. Shepler said that after quarantining some workers who were exposed to coronavirus patients, the hospital determined that the extent of the quarantine was unrealistic because it left shortages in a needed work force. They brought nurses back who were asymptomatic — an approach deemed reasonable by the C.D.C., she said — and are testing them twice a shift. They are also required to wear masks while treating patients.

LINK

eBay is banning the sale of a number of items related to the novel coronavirus outbreak after rising prices raised concerns about price gouging.

The online auction giant says that "effective immediately" it will "block new listings and start to remove listings" that offer "masks including N95/N100 and surgical masks." Hand sanitizers and disinfecting wipes will also be banned.

Random Commentary:

Look at the AIPAC conference news I posted yesterday where there were two infected at the conference, and about 2/3 of Congress attended the conference.

Now extrapolate average age of a Congresscritter against COVID fatality statistics by age group, since we're seeing COVID rip through Iranian elected officials like a hot knife through butter:

#coronavirus strikes the Iranian parliament again, killing another Iranian official. Fatemeh Rahbar died today of #COVID?19. She was a newly elected member of Parliament, she had also served as an MP in the past. She is the first female official to be killed by #coronavirus.

Contract job offers are going out for nurses (from another forum):

Nurse i know just sent me a text with a job offer they tried to get her to do a contract on

Kirkland,WA $5160 a week for Coronavirus response assignment 8-13 week agreement

LINK

Liz Specht
@LizSpecht

I think most people aren’t aware of the risk of systemic healthcare failure due to #COVID19 because they simply haven’t run the numbers yet. Let’s talk math.

Let’s conservatively assume that there are 2,000 current cases in the US today, March 6th. This is about 8x the number of confirmed (lab-diagnosed) cases. We know there is substantial under-Dx due to lack of test kits; I’ll address implications later of under-/over-estimate.

We can expect that we’ll continue to see a doubling of cases every 6 days (this is a typical doubling time across several epidemiological studies). Here I mean *actual* cases. Confirmed cases may appear to rise faster in the short term due to new test kit rollouts.

We’re looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on. Exponentials are hard to grasp, but this is how they go.

As the healthcare system begins to saturate under this case load, it will become increasingly hard to detect, track, and contain new transmission chains. In absence of extreme interventions, this likely won’t slow significantly until hitting >>1% of susceptible population.

What does a case load of this size mean for healthcare system? We’ll examine just two factors — hospital beds and masks — among many, many other things that will be impacted.

The US has about 2.8 hospital beds per 1000 people. With a population of 330M, this is ~1M beds. At any given time, 65% of those beds are already occupied. That leaves about 330k beds available nationwide (perhaps a bit fewer this time of year with regular flu season, etc).

Let’s trust Italy’s numbers and assume that about 10% of cases are serious enough to require hospitalization. (Keep in mind that for many patients, hospitalization lasts for *weeks* — in other words, turnover will be *very* slow as beds fill with COVID19 patients).

By this estimate, by about May 8th, all open hospital beds in the US will be filled. (This says nothing, of course, about whether these beds are suitable for isolation of patients with a highly infectious virus.)

If we’re wrong by a factor of two regarding the fraction of severe cases, that only changes the timeline of bed saturation by 6 days in either direction. If 20% of cases require hospitalization, we run out of beds by ~May 2nd.

If only 5% of cases require it, we can make it until ~May 14th. 2.5% gets us to May 20th. This, of course, assumes that there is no uptick in demand for beds from *other* (non-COVID19) causes, which seems like a dubious assumption.

As healthcare system becomes increasingly burdened, Rx shortages, etc, people w/ chronic conditions that are normally well-managed may find themselves slipping into severe states of medical distress requiring intensive care & hospitalization. But let’s ignore that for now.

Alright, so that’s beds. Now masks. Feds say we have a national stockpile of 12M N95 masks and 30M surgical masks (which are not ideal, but better than nothing).

There are about 18M healthcare workers in the US. Let’s assume only 6M HCW are working on any given day. (This is likely an underestimate as most people work most days of the week, but again, I’m playing conservative at every turn.)

As COVID19 cases saturate virtually every state and county, which seems likely to happen any day now, it will soon be irresponsible for all HCWs to not wear a mask. These HCWs would burn through N95 stockpile in 2 days if each HCW only got ONE mask per day.

One per day would be neither sanitary nor pragmatic, though this is indeed what we saw in Wuhan, with HCWs collapsing on their shift from dehydration because they were trying to avoid changing their PPE suits as they cannot be reused.

How quickly could we ramp up production of new masks? Not very fast at all. The vast majority are manufactured overseas, almost all in China. Even when manufactured here in US, the raw materials are predominantly from overseas... again, predominantly from China.

Keep in mind that all countries globally will be going through the exact same crises and shortages simultaneously. We can’t force trade in our favor.

Now consider how these 2 factors – bed and mask shortages – compound each other’s severity. Full hospitals + few masks + HCWs running around between beds without proper PPE = very bad mix.

HCWs are already getting infected even w/ access to full PPE. In the face of PPE limitations this severe, it’s only a matter of time. HCWs will start dropping from the workforce for weeks at a time, leading to a shortage of HCWs that then further compounds both issues above.

We could go on and on about thousands of factors – # of ventilators, or even simple things like saline drip bags. You see where this is going.

Importantly, I cannot stress this enough: even if I’m wrong – even VERY wrong – about core assumptions like % of severe cases or current case #, it only changes the timeline by days or weeks. This is how exponential growth in an immunologically naïve population works.

Undeserved panic does no one any good. But neither does ill-informed complacency. It’s wrong to assuage the public by saying “only 2% will die.” People aren’t adequately grasping the national and global systemic burden wrought by this swift-moving of a disease.

I’m an engineer. This is what my mind does all day: I run back-of-the-envelope calculations to try to estimate order-of-magnitude impacts. I’ve been on high alarm about this disease since ~Jan 19 after reading clinical indicators in the first papers emerging from Wuhan.

Nothing in the last 6 weeks has dampened my alarm in the slightest. To the contrary, we’re seeing abject refusal of many countries to adequately respond or prepare. Of course some of these estimates will be wrong, even substantially wrong.

But I have no reason to think they’ll be orders-of-magnitude wrong. Even if your personal risk of death is very, very low, don’t mock decisions like canceling events or closing workplaces as undue “panic”.

These measures are the bare minimum we should be doing to try to shift the peak – to slow the rise in cases so that healthcare systems are less overwhelmed. Each day that we can delay an extra case is a big win for the HC system.

And yes, you really should prepare to buckle down for a bit. All services and supply chains will be impacted. Why risk the stress of being ill-prepared?

Worst case, I’m massively wrong and you now have a huge bag of rice and black beans to burn through over the next few months and enough Robitussin to trip out.

One more thought: you’ve probably seen multiple respected epidemiologists have estimated that 20-70% of world will be infected within the next year. If you use 6-day doubling rate I mentioned above, we land at ~2-6 billion infected by sometime in July of this year.

Obviously I think the doubling time will start to slow once a sizeable fraction of the population has been infected, simply because of herd immunity and a smaller susceptible population.

But take the scenarios above (full beds, no PPE, etc, at just 1% of the US population infected) and stretch them out over just a couple extra months.

That timeline roughly fits with consensus end-game numbers from these highly esteemed epidemiologists. Again, we’re talking about discrepancies of mere days or weeks one direction or another, but not disagreements in the overall magnitude of the challenge.

This is not some hypothetical, fear-mongering, worst-case scenario. This is reality, as far as anyone can tell with the current available data.

That’s all for now. Standard disclaimers apply: I’m a PhD biologist but *not* an epidemiologist. Thoughts my own. Yadda yadda. Stay safe out there. /end

From ARFCOM:

"Well at least this answers the age old question whether the gov would tell us if an asteroid was approaching."

Standford U cancels classes.

STANFORD, Calif. (KRON) Stanford University has canceled all in-class courses for the remainder of the winter quarter due to coronavirus concerns, the university announced Friday.

For the final two weeks of the winter quarter, classes will not meet in person but will move to online formats.

Large group events will also be canceled or adjusted.

The university says it is actively monitoring the local and global health situation and is taking precautionary measures in an effort to help limit the spread of COVID-19.

People related to Iran are wondering what's going on with DHS/Immigration at US ports of entry on twitter:

My mom’s friend just came back from Iran. At LAX she asked if she needed to be tested for corona virus. They asked her if she had a fever. She said no. So they let her pass through. Hearing many other similar stories about people coming from Iran.

Arash Karami Arash Karami (@thekarami) March 6, 2020

TOP. MEN.

Nevermind that up to maybe 40% of COVID cases may be asymptomatic. We've only known this datapoint since what, a month or more ago?

COIVID survival rates on various surfaces (LINK

At "Normal" Temp 68-86°F (20-30°C)

Aluminum - 2-8 hours
Metals - 5 days
Wood - 4 days
Paper - 3 hour to 5 days depending on initial load/amount of virions
Glass - 4 days to 5 days
Plastics - 4 - 9 days (longer the higher the viral load/contamination)
Silicone Rubber - 5 Days
Latex Gloves - 8 hours
Disposable Gown (Tyvek) - 1 hour to 2 Days depending on initial level of contamination
Ceramics - 5 days
Teflon - 5 days

...

Here are the best disinfectants (in order of paper above)

3log₁₀ is 99.9%, 4log₁₀ is 99.99%, 5 log₁₀ is 99.999%, etc.

Ethanol 4.0 log₁₀ to > 5.9 log₁₀ after 30 seconds 70% to 95% respectively (other biologicals survive longer with 90%+ alcohol, NOT nCoV-19)

2-Propanol > 3.3 log₁₀ in 30 seconds

BZK/Benzalkonium chloride 0 - 4.0 log₁₀ after 10 Minutes

Sodium Hypochlorate (Bleach) - 0.21% (2100 ppm concentration) > 4.0 log₁₀ after 30 seconds

Sodium Hypochlorate (Bleach) - <=0.01% (<100 ppm concentration) 0.3 - 2.8 log₁₀ 10 Minutes

Formaldehyde - above 0.7% concentration > 3.0 log₁₀ in 10 Minutes

Glutardialdehyde - 0.5% to 2.5% > 4.0 log₁₀ after 2-5 Minutes

Povidone iodine > 4.0 log₁₀ after 15 seconds

Kent County, WA has just purchased a brand new Econolodge hotel and converted it for use as a quarantine hospital via painting over the sign. LINK

Americans buy more ammo

Alex Horsman, the marketing manager at Ammo.com, said of the surge, "We know certain things impact ammo sales, mostly political events or economic instability when people feel their rights may end up infringed, but this is our first experience with a virus leading to such a boost in sales." Horsman continued, "But it makes sense. A lot of our customers like to be prepared. And for many of them, it's not just facemasks and TheraFlu. It's knowing that no matter what happens, they can keep themselves and their families safe."

When it comes to actual sales, Ammo.com's increase varied among calibers and brands. Calibers that saw the largest increase include:

40 cal (S&W) ammo: 410%
223 ammo: 194%
7.62x39 ammo: 114%
9mm ammo: 101%
12 gauge shotgun shells: 95%
5.56x45 ammo: 69%
380 ACP (Auto) ammo: 43%
45 Auto (ACP) ammo: 35%
308 Winchester ammo: 32%
22 Long Rifle (LR) ammo: 29%

Top sales increases in brands went to MBI ammo with a 179% increase and Federal ammo at 176%. Other significant growth included:

Fiocchi ammo: 122%
Remington ammo: 116%
Winchester ammo: 107%
PMC ammo: 101%
Tula ammo: 90%
Hornady ammo: 79%
Wolf ammo: 79%
Sellier & Bellot ammo: 20%

Sales also varied by state, with North Carolina and Georgia coming in with the largest increase (179% and 169% respectively). These were closely followed by Pennsylvania (140%) and Texas (128%). Other states that saw a big boom are:

Florida: 76%
Illinois: 67%
New York: 48%
Ohio: 40%

Can China's COVID-19 strategy work elsewhere?
Kai Kupferschmidt, Jon Cohen
Science 06 Mar 2020:
Vol. 367, Issue 6482, pp. 1061-1062
DOI: 10.1126/science.367.6482.1061

Chinese hospitals overflowing with COVID-19 patients a few weeks ago now have empty beds. Trials of experimental drugs can't find enough eligible patients. And the number of new cases reported each day in China is dropping precipitously.

These are some of the startling observations in a report released on 28 February by a team of 12 Chinese and 13 foreign scientists who toured five cities in China to study the state of the COVID-19 epidemic and the effectiveness of the country's response. Even some on the team, organized jointly by the World Health Organization (WHO) and the Chinese government, say they were surprised. “I thought there was no way those numbers could be real,” says epidemiologist Tim Eckmanns of the Robert Koch Institute in Berlin.

But the report is unequivocal. “China's bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic,” it says. To Bruce Aylward, a Canadian WHO epidemiologist who led the mission and briefed journalists in Beijing and Geneva last week, the effort was a huge success. “Hundreds of thousands of people in China did not get COVID-19 because of this aggressive response,” he says.

Aylward and other members of the task force say the rest of the world should learn from China. But critics say the report failed to acknowledge the human rights costs of the most severe measures imposed by China's authoritarian government: massive lockdowns and electronic surveillance of millions of people. “I think there are very good reasons for countries to hesitate using these kinds of extreme measures,” says Lawrence Gostin, a global health law scholar at Georgetown University. Many also worry that a resurgence of the disease will occur after the country lifts some of its strictest control measures and restarts its economy, which has taken a huge hit.

The report comes at a critical time in what many epidemiologists now consider a nascent pandemic. The number of affected countries is rising rapidly—it stood at 72 as Science went to press, according to WHO. Alarmingly, in many of these countries, the virus has quickly gained a foothold and started to spread in communities.

But cases have plummeted in China. On 10 February, the first day of the mission, the country reported 2478 new cases. Two weeks later, when the foreign experts packed their bags, the daily number of new cases had dropped to 409. (On 3 March it had dropped further to 129 new cases, compared with 1848 in the rest of the world.) China's epidemic appears to have peaked in late January, according to the report.

Members of the team traveled to Beijing, Shenzhen, Guangzhou, Chengdu, and the hardest hit city, Wuhan. They visited hospitals, laboratories, companies, live animal markets, train stations, and local government offices. “Everywhere you went, anyone you spoke to, there was a sense of responsibility and collective action—and there's a war footing to get things done,” Aylward says.

As part of the effort, Chinese scientists have compiled a massive data set that gives the best available picture of the disease. The mission report says about 80% of infected people had mild to moderate disease, marked by fever and a dry cough; 13.8% had severe symptoms; and 6.1% had life-threatening episodes of respiratory failure, septic shock, or organ failure. The case fatality rate was highest for people over age 80 (21.9%), and people who had heart disease, diabetes, or hypertension, but 3.8% overall. Children made up a mere 2.4% of the cases, and almost none was severely ill. People with mild and moderate illness took 2 weeks on average to recover.

The report highlights how China achieved what many public health experts thought was impossible: containing the spread of a widely circulating respiratory virus. “China has rolled out perhaps the most ambitious, agile, and aggressive disease containment effort in history,” the report notes. The most dramatic—and controversial—measure was the lockdown of Wuhan and nearby cities in Hubei province, putting at least 50 million people under a mandatory quarantine since 23 January. That has “effectively prevented further exportation of infected individuals to the rest of the country,” the report concludes. Most of China did not face such severe measures: People were asked, but not required, to quarantine themselves if they felt ill, and neighborhood leaders monitored their movements.

Chinese authorities also built two dedicated hospitals in Wuhan in about 1 week, sent health care workers from all over China to Hubei, and launched an unprecedented effort to trace contacts of confirmed cases. In Wuhan alone, more than 1800 teams traced tens of thousands of contacts. Aggressive “social distancing” measures implemented in the entire country included canceling sporting events and shuttering theaters, schools, and businesses. Anyone who went outdoors had to wear a mask.

Two widely used mobile phone apps, AliPay and WeChat—which in recent years have replaced cash in China—have helped enforce the restrictions, because they allow the government to keep track of people's movements and even stop people with confirmed infections from traveling. “Every person has sort of a traffic light system,” says mission member Gabriel Leung, dean of the Li Ka Shing Faculty of Medicine at the University of Hong Kong. Color codes on mobile phone screens—in which green, yellow, or red designate a person's health status—let guards at train stations and other checkpoints know who to let through.

“As a consequence of all of these measures, public life is very reduced,” the report notes. But the measures did work. In the end, infected people rarely spread the virus to anyone except members of their own household, Leung says. Once all the people living together were exposed, the virus had nowhere else to go and chains of transmission ended. “That's how the epidemic truly came under control,” Leung says.

It's debatable how much of this could be done elsewhere. “China is unique in that it has a political system that can gain public compliance with extreme measures,” Gostin says. The country also has an extraordinary ability to do labor-intensive, large-scale projects quickly, says Jeremy Konyndyk, a senior policy fellow at the Center for Global Development: “No one else in the world really can do what China just did.”

Nor should they, says lawyer Alexandra Phelan, a China specialist at Georgetown's Center for Global Health Science and Security. “There are plenty of things that would work to stop an outbreak that we would consider abhorrent in a just and free society,” Phelan says.

The report urges China “to more clearly communicate key data and developments internationally.” But it is mum on the coercive nature of China's control measures and the toll they have exacted. “The one thing that's completely glossed over is the whole human rights dimension,” says Devi Sridhar, a global public health specialist at the University of Edinburgh. Instead, the report praises the “deep commitment of the Chinese people to collective action in the face of this common threat.”

“To me, as somebody who has spent a lot of time in China, it comes across as incredibly naﶥ—and if not naﶥ, then willfully blind to some of the approaches being taken,” Phelan says. Singapore and Hong Kong may be better examples to follow, Konyndyk says: “There has been a similar degree of rigor and discipline but applied in a much less draconian manner.” Jennifer Nuzzo of the Johns Hopkins University Bloomberg School of Public Health also wonders what effects China's strategy had on, for instance, the treatment of cancer or HIV patients, whose care may have been interrupted. “I think it's important when evaluating the impact of these approaches to consider secondary, tertiary consequences,” she says.

And the benefit may be short-lived. “There's no question they suppressed the outbreak,” says Mike Osterholm, head of the Center for Infectious Disease Research and Policy at the University of Minnesota, Twin Cities. Reducing the peak number of cases buys a health system time to deal with later ones, public health experts say. But once the restrictions are lifted, “It'll come roaring right back,” Osterholm predicts.

Aylward and the other visiting scientists on the team were well aware of the “reality of different political systems,” he says, but they spoke with hundreds of people around the country and “everyone agreed with the approach.” He hopes China's successes so far will encourage other countries to act quickly. “We're getting new reports daily of new outbreaks in new areas, and people have a sense of, ‘Oh, we can't do anything,’” Aylward says. “Well, sorry. There are really practical things you can do to be ready to be able to respond to this, and that's where the focus will need to be.”

#BREAKING. @US_EUCOM can confirm its first U.S. military #COVID19 case in Naples, Italy. Official updates will continue to be provided. @USNavyEurope

— U.S European Command (@US_EUCOM) March 7, 2020

[chimericoncogene]

Apart from the relatively draconian Wuhan quarantine, AFAIK, measures taken in Hong Kong and Singapore should not have differed markedly from those taken in most of China. And Wuhan is still like ~80% plus of cases worldwide, so that's why it was singled out for special treatment.

Basically, what happened was that the governments declared a massive work shutdown (all bureaucrats ordered to work from home for ~four weeks, and private corporations/nonessentials exhorted to do the same). Parks, swimming pools, post offices (that was silly, IMO), private country clubs... those sorts of things got shut down, and kids have been basically confined to their homes for one month and counting. Sick people were exhorted to self-quarantine and remain at home, and everyone was advised to cut down on unnecessary travel. Parks and stuff have begun reopening, and bureaucrats are going back to work now.

The economy tanked, of course.

At the same time, the governments shut down travel to Wuhan, then shut down flights across China, then shut down travel to mainland China entirely. Then Japan and Korea. Now Italy's northern provinces are on a self-quarantine recommendation list.

Like the article says: the doors can't stay closed forever. The economy won't take it.

https://medium.com/syncedreview/100m-ma ... f33c5105b9

Now that time has been bought for increased production of medical supplies (still 100 million masks a day short, for what it's worth), more effective treatment, and organized responses.

But the outbreak has just begun. We won't know whose response was optimal until the final reports are written and published - heck, maybe not even then. Even if the US screws up its disease response, or reacts lackadaisically, its economy might still come out on top vis-a-vis China, which cratered its economy with aggressive disease control. In the medium-term, that might actually result in more lives saved in the US and result in a better overall outcome. We'll see.

[FaxModem1]

The Independent

China hotel collapse: 70 people trapped in building used for coronavirus quarantine
More than two dozen people pulled from rubble so far

Andy Gregory
1 hour ago
A hotel being used as a coronavirus quarantine centre in China has collapsed, leaving 70 people trapped.

The five-storey building in Fujian province was being used to house and observe people who had come into contact with Covid-19 patients when it collapsed at around 7:30pm local time.


Some 38 people have so far been rescued from the wreckage of the Xinjia Express Hotel in Quanzhou, local officials announced four hours later.




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:: Follow live updates on the coronavirus here ::
Nearly 150 firefighters are thought to be engaged in the rescue operation. Footage shared to social media shows emergency service workers clambering among the rubble and using powerful torches to search for survivors.


“I was just having dinner and I suddenly heard a loud bang and thought it was an explosion,” South China Morning Post (SCMP) reported a man who lived in the building opposite as telling state-affiliated media.


“It was not until I ran to my balcony that I saw that the entire hotel building had collapsed.”

The hotel is one of two buildings being used as a quarantine centre in the city’s Licheng district, after opening as a hotel in June 2018, according to SCMP.

Bad timing.

[Broomstick]

They’re pulling asymptomatic nurses off of quarantine early so the can take care of patients.

Well, yeah - if you quarantine every medical person with even the tiniest risk of exposure there's no one left to provide health care.

Look at the AIPAC conference news I posted yesterday where there were two infected at the conference, and about 2/3 of Congress attended the conference.

Now extrapolate average age of a Congresscritter against COVID fatality statistics by age group, since we're seeing COVID rip through Iranian elected officials like a hot knife through butter:

So... Mother Nature is imposing term limits?

We’re looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on. Exponentials are hard to grasp, but this is how they go.

Yep, that's the real problem we'll be facing soon - not the death rate, but simply so many people sick simultaneously.

As healthcare system becomes increasingly burdened, Rx shortages, etc, people w/ chronic conditions that are normally well-managed may find themselves slipping into severe states of medical distress requiring intensive care & hospitalization.

Makes me glad I recently had a physical, dental work caught up, new glasses ordered, refilled my asthma prescription.... It's not that we're all gonna starve, but choice of things like food and toilet paper might be restricted, shelves might be empty at times, etc. Don't let anything run out. Don't go berserk - this is not going to end civilization - but top off your supplies and keep them that way. Be ready for shortages.

Shortages of medical care might become the most critical problem. We're going to lose people not just to this new virus but simply because the medical system will be overwhelmed and some things will be missed/not get done.

“Hundreds of thousands of people in China did not get COVID-19 because of this aggressive response,” he says.

Aylward and other members of the task force say the rest of the world should learn from China. But critics say the report failed to acknowledge the human rights costs of the most severe measures imposed by China's authoritarian government: massive lockdowns and electronic surveillance of millions of people.

Human rights only matter to the living.

Of course, he downside of saying "this is an extreme circumstance that requires extreme measures" is the problem of getting those measure removed after the emergency is over.

[Broomstick]

Single handedly, this rich selfish idiot has probably started 2nd wave of infection in Vietnam and at least three cities.

Yep. Selfish idiot being a selfish idiot. And rich selfish idiots can spread shit faster and farther.

Expect to see more of this.

Yes, I also find it infuriating.

[Broomstick]

The Independent

China hotel collapse: 70 people trapped in building used for coronavirus quarantine
More than two dozen people pulled from rubble so far

Bad timing.

Yeah.

But you know there's at least one person lying the rubble saying "fuck my life". Seriously, that totally sucks.

Any idea yet why this building collapsed?

[mr friendly guy]

https://www.businessinsider.com.au/pres ... ?r=US&IR=T

One slide in a leaked presentation for US hospitals reveals that they're preparing for millions of hospitalizations as the outbreak unfolds
LYDIA RAMSEY
MAR 7, 2020, 10:08 AM

Hospitals are confronting the rising threat of the novel coronavirus in the US.
The spread of the coronavirus outbreak in the US could push the healthcare system to its limits.
In a February webinar presentation hosted by the American Hospital Association, an expert laid out “best guess” estimates about how many Americans could be impacted.
He projected that there could be as many as 96 million cases in the US, 4.8 million hospitalizations, and 480,000 deaths associated with the novel coronavirus.
Visit Business Insider’s homepage for more stories.
Hospitals are bracing for millions of Americans to be hospitalized as part of the novel coronavirus outbreak.

The American Hospital Association, which represents thousands of hospitals and health systems, hosted a webinar in February with its member hospitals and health systems. Business Insider obtained a copy of the slides presented.

The presentation, titled “What healthcare leaders need to know: Preparing for the COVID-19” happened February 26, with representatives from the National Ebola Training and Education Centre.

As part of the presentation to hospitals, Dr. James Lawler, a professor at the University of Nebraska Medical Centre gave his “best guess” estimates of how much the virus might spread in the US.

Lawler’s estimates include:

4.8 million hospitalizations associated with the novel coronavirus
96 million cases overall in the US
480,000 deaths
Overall, the slide points out that hospitals should prepare for an impact to the system that’s 10 times a severe flu season.
Here’s the slide:

(obviously you have to click on the link to see the slide)

The slide does not give a particular time frame.

The slide represents “his interpretation of the data available. It’s possible that forecast will change as more information becomes available,” a spokesman for Nebraska Medicine told Business Insider in an email.

The American Hospital Association said the webinar reflects the views of the experts who spoke on it, not its own.

“The AHA regularly hosts webinars and conference calls that include a variety of voices and opinions that seek to provide relevant information to professionals at hospitals and health systems that are on the front lines of preparing for and protecting their patients and communities,” a spokeswoman for the AHA told Business Insider in an emailed statement. “The slides you shared reflect the various perspectives of field experts and should not be attributed to the AHA.”

In particular, the slide points out that hospitals should prepare for an impact to the system that’s 10 times a severe flu season.

The numbers are frightening. But some journalist suggest we should just give everyone coronavirus and get it over and done with.

[mr friendly guy]

https://www.bloomberg.com/amp/news/arti ... y-corriere

Italy set to implement China style quarantine measures. And by implement I mean expand already existing measures.

Italy to Lock Down Milan Region in Bid to Contain Coronavirus Outbreak
By Alberto Brambilla and John Follain
March 7, 2020, 2:41 PM EST
Updated on March 7, 2020, 4:46 PM EST
Measures include a virtual ban on entry, exit in Lombardy
Several other northern areas are targeted in draft decree

The Italian government is set to dramatically restrict movement and activity for a quarter of its population, or about 16 million people, according to a draft decree seen by Bloomberg.

The decision to lock down the Milan region and several other northern areas is the latest step in the effort to contain Europe’s worst coronavirus outbreak. It comes as cases surged to 5,883 on Saturday with 233 deaths, and as Nicola Zingaretti, the leader of one of the two major government parties, announced he had contracted the illness.

The measures, set to come into force Sunday and last until April 3, will stop anyone from entering or exiting the most-affected areas, while movement inside will be allowed only for “non-deferrable” business or health reasons, the draft said. Skiing, public events, religious ceremonies and work meetings will be suspended, while schools, museums, swimming pools and theaters will close.

Bars and restaurants will have to make sure patrons keep at least a meter apart or they’ll be shut. The draft specifies that failing to respect the measures is a criminal offense, and might lead to imprisonment. Police and the army will be responsible for ensuring that containment measures are respected.

The restrictions will apply across Lombardy and in 11 provinces around cities including Venice, Modena, Parma, Rimini and Treviso.

Italy’s Democratic Party Head Tests Positive for Coronavirus

A second draft decree with new containment rules for the rest of the country, also seen by Bloomberg, recommends citizens avoid travel outside their hometowns unless absolutely necessary, and restricts public events. The government is set to approve both decrees in a meeting Saturday evening.

With Italy’s economy already at risk of recession before the outbreak, the crisis has all but paralyzed business activity in Lombardy -- which accounts for a fifth of the country’s gross domestic product -- and the rest of the north, Italy’s economic engine.

The Italian government is set to dramatically restrict movement and activity for a quarter of its population, or about 16 million people, according to a draft decree seen by Bloomberg.

The decision to lock down the Milan region and several other northern areas is the latest step in the effort to contain Europe’s worst coronavirus outbreak. It comes as cases surged to 5,883 on Saturday with 233 deaths, and as Nicola Zingaretti, the leader of one of the two major government parties, announced he had contracted the illness.

The measures, set to come into force Sunday and last until April 3, will stop anyone from entering or exiting the most-affected areas, while movement inside will be allowed only for “non-deferrable” business or health reasons, the draft said. Skiing, public events, religious ceremonies and work meetings will be suspended, while schools, museums, swimming pools and theaters will close.

Bars and restaurants will have to make sure patrons keep at least a meter apart or they’ll be shut. The draft specifies that failing to respect the measures is a criminal offense, and might lead to imprisonment. Police and the army will be responsible for ensuring that containment measures are respected.

The restrictions will apply across Lombardy and in 11 provinces around cities including Venice, Modena, Parma, Rimini and Treviso.

Italy’s Democratic Party Head Tests Positive for Coronavirus

A second draft decree with new containment rules for the rest of the country, also seen by Bloomberg, recommends citizens avoid travel outside their hometowns unless absolutely necessary, and restricts public events. The government is set to approve both decrees in a meeting Saturday evening.

With Italy’s economy already at risk of recession before the outbreak, the crisis has all but paralyzed business activity in Lombardy -- which accounts for a fifth of the country’s gross domestic product -- and the rest of the north, Italy’s economic engine.

Quick, someone needs to tell the human rights crowd. Italy are clearly violating the corona virii right to have freedom of movement.

[mr friendly guy]

A chinese epidemiologist volunteered for an injection of an untested vaccine, which is pretty risky IMO. Test it on animals first. But wait, how is Western Media going to spin this one.

https://www.vice.com/en_au/article/v74p ... us-vaccine

Chen Wei is a world-renowned epidemiologist and a major-general in China’s People’s Liberation Army. She was at the forefront of the fight against Ebola and SARS and since mid-January, she has been stationed at the epicenter of the coronavirus outbreak in Wuhan.

On Tuesday, the 54-year-old, along with six members of her team, proved their loyalty to the Communist Party by injecting themselves with a vaccine that hasn’t even been tested on animals, in an apparent bid to show how well China is doing in combatting coronavirus.

Chen and her research team have been working for over a month at the Wuhan Institute of Virology, a laboratory with the highest biosafety classification. As well as rushing to develop a vaccine, Chen’s team has been working on treatments including plasma therapy and repurposing a nasal spray that is designed to boost immunity to the virus.

Chen spoke with China’s state-run television station for a report broadcast Tuesday claiming to have made a major breakthrough in the development of a vaccine.

“We are doing all we can to put the recombinant vaccine that we are developing into clinical application," Chen said. “We must strive to bring the vaccine we are working on to clinical trial and application, providing strong technical support for winning this battle.”

You cannot make this shit up from the Western media. She did it to prove her loyalty to the CCP.

Now before someone goes, this never occurs in the West. Well.... I kind of live in Western Australia where this actually did happen. A doctor was so confident in their hypothesis, they tested it on themselves.

https://en.wikipedia.org/wiki/Barry_Marshall

Barry Marshall hypothesised that stomach ulcers was caused a bacteria (one we now know as Helicobacter Pylori) whereas previously it was thought stress was the cause. So he cultured the bacteria and swallowed it, and lo behold he developed stomach ulcers. The treatment of course was antibiotics, so it already existed. Marshall went on a win a nobel prize in medicine.

[MKSheppard]

Quick, someone needs to tell the human rights crowd. Italy are clearly violating the corona virii right to have freedom of movement.

So.....if we extrapolate from Italy's first case on 20 February, this means that it's about 16 days from first case to the implementation of crisis measures to limit spreading.

South Korea had their first death on 20 February, and they've locked down the area around Deagu to limit the spread.

So....

Since Washington State's first case was on 28 February, lockdown will become a plausible potentiality around 15 March (one week from now, approximately).