> Doctors there were running "naked" as they knew they were set to be infected given the shortage of protective gear. They still worked there nonetheless.
That is so rough, especially since some healthcare workers are now among the dead: specifically, I saw that Li Wenliang had died.
> "Doctors there were running "naked" as they knew they were set to be infected given the shortage of protective gear. They still worked there nonetheless."
The absolute definition of heroes. It blows my mind to imagine ever having that sort of selfless dedication to helping others. For all the crappy things in the world these days, it's stuff like this that gives me hope for humanity.
> Doctors there were running "naked" as they knew they were set to be infected given the shortage of protective gear. They still worked there nonetheless.
This was one of the most tragic things in that article.
The doctors, nurses, and health workers are the front line soldiers in this fight against the virus. And they don’t have the protective gear that they need to stay safe, and to keep the population safe, as well as the rest of the world.
I hope they can fight the infection, and survive, and live to fight another day. We need them!
In the 2019 television series, they were miners conscripted into service on the disaster. And in the show they actually did work literally naked due to the heat.
My wife is mainland Chinese, and she has been saying that it a worse than what the government is saying. Also, since Li Wenliang died, well, frankly a lot of people are pissed at the CCP.
Anyway, I feel like it’ll be an epidemic ( it already is, I believe ) in China, and be much better controlled outside of China.
Unfortunately my wife is also stuck in Chongqing; Taiwan is essentially closing up its borders and we don’t know if she’ll be able to move here to Taiwan to live with me. At least not until things blow over ( I assume summer time ).
I live in Taiwan and they’ve been very good at containing this, afaik. Just this morning they released a map of Taiwan with nav-points where all the cruise ship people were at in Taiwan before they went on the ship, and released information on what to do if you experience certain symptoms. 13 people have been diagnosed and quarantined.
I don’t understand what it is that the Chinese authorities are supposedly misreporting?
The mortality rate of 2% is consistent with the number of cases and deaths reported by other countries.
Is it that there are a large number of undiagnosed cases? That is kind of a given and is probably also the case in other countries.
The timespan between first case and until it gets reported to who and quarantines start is less than a month. To me that seems very fast (but I am just a layperson).
My wife, when she went to the hospital to be diagnosed, said that they had a separate room for those that were diagnosed with having the Wuhan virus, and a separate room for those that did not.
She saw several people in that room, and yet over the next few days, only one new case was reported from that hospital.
I don’t know if this is due to unconfirmed or bad diagnosis, but this is just yet another red flag in a country full of red flags.
As for my wife, she only had a respiratory infection and got medicine for it. She’s better now, but now her mother is sick -.-
Presumably they could be under-reporting the number of infections and the number of deaths, to keep the mortality rate consistent.
I don't know why they would do that, but they are accused of doing this kind of thing frequently.
If they sat on the news of the virus for an extended period they might have known the mortality rate they needed to align with long before the rest us.
The main reason now is that the confirmation method of infection is still under debate and improvement. The current method is nucleic acid detection, which only has about 50% accuracy, so obviously a huge number of people out there cannot be diagnosed, and they won't be added to the official number.
And there are also rumors out there saying the lack of medical resources. Sick people couldn't get proper medical treatment and dying at home or somewhere. Because they didn't get diagnosed before they die, so the number won't be added to the official number. Don't know if it's true or how many people are dying there, but sure it's terrifying.
About misreporting, they did do it back in January, mainly because they want to control the panic as they always do, (and probably they didn't know it's gonna be this bad), but it should be much better now (I hope).
Chinese authorities at some level -- it's not clear that this was CCP or local Wuhan decisionmakers -- clearly tried to shut down initial reports of the outbreak, as evidenced by Dr. Li Wenliang's detention and citation.
As a new disease, with the first cases possibly being acquired as early as late November 2019, it wasn't until mid to late January 2020 that city and national authorities appeared to start taking the outbreak seriously.
I'm not aware of other novel outbreaks outside of China and how quickly those have attracted notice, though there's the case of the 1976 initial outbreak of Legionaire's Disease, reported within a week of first outbreak (though the disease was both fast-acting and rapidly lethal for many victims). However epidemiologists also realised that there had been previous, unrecognised outbreaks, dating to the 1950s. See:
The case of HIV/AIDS in the US and elsehwere would be a case of a disease with ascribed social and moral assocations, for which early responses were very much delayed, on of several examples of stigma associated with the disease:
https://en.wikipedia.org/wiki/Discrimination_against_people_...
(The fact that SARS, MERS, and 2019-nCoV all appear to have emerged during November may be significant.)
Point being:
- China are slow to detect, report, and respond to new contagious epidemics. Notably so in the case of SARS, and less so, but still, with 2019-nCoV.
- Other countries, including the US, have had similar failures.
- Early unofficial public disclosure of 2019-nCoV was prosecuted by Chinese authorities, though at what direction is unclear.
- Trust between the people and the government is somewhat frayed.
- There are also numerous actors with incentives to make the most of any missteps of the government, or to inflate distrust.
Several of those groups have legitimate gripes against the Chinese government, and I've seen reports associated with Falun Gong, Hong Kong, and Taiwan specifically. I've not seen any associated with Tibet or Uygher populations. And there are various rabble-rousing actors elsewhere, doomers, and conspiracists (generally of the nutcake variety).
This ... clouds information. Many of the criticisms are legimate, some are not, and sorting fact from fiction (both between and within reports) is challenging. China are in the position where both locked-down and unfettered communications are potentially harmful -- the first for preventing accurate information from being available to both public and government, the latter for allowing agents provacateurs to rumourmonger, exaggerate bad news, and spread active disinforation. This is strong shades of attacks the West has seen over the past several years (within the US, UK, EU, and elsewhere), some of it from China itself.
As a reminder, don't mix this rate with case fatality (or lethality) rate, which is counted on ended cases and is about 30%. This is your real chance when you're infected.
The question I'm still not sure is: of those who were infected, how many have been discharged from the hospital already? What was their mean recovery time?
> Also, since Li Wenliang died, well, frankly a lot of people are pissed at the CCP.
This is a pretty irrational reaction if you ask me, the CCP is actually the more open, quasi-democratic side of Chinese government and politics. There are loose 'factions' as part of the CCP that are cautiously pushing for more openness, and the Chinese should be aware of them and be supportive. Frustration and anger are not helpful.
If they screw up other measures, like hygiene for the sick and food delivery to 50 million people they can multiply the death rate.
Modern theory of Spanish flu[1] is that the flu itself was not that deadly. Combination of influenza with bacteria in the lungs caused most of the deaths. It was the World War I with lots of wounded in the same place, bad hygiene conditions, many with scarred lungs from poison gas and civilians suffering from malnutrition.
> However, it is possible that — as in 1918 — a similar pattern of viral damage followed by bacterial invasion could unfold, say the authors. Preparations for diagnosing, treating and preventing bacterial pneumonia should be among highest priorities in influenza pandemic planning, they write. "We are encouraged by the fact that pandemic planners are already considering and implementing some of these actions," says Dr. Fauci.
Spanish flu killed very many people in regions that did not directly participate in WWI, so civilians (as opposed to recruits sent overseas) should not be affected by the war; e.g. India, Indonesia, etc.
The half a million people who died of the Spanish flu in USA did not die because lots of wounded in the same place and scarred lungs from poison gas.
In the US roughly half present of the population died. It killed roughly ~5% of the world's population.
btw. I did not say WWII was the single cause for high mortality. Hygiene, malnutrition etc. contributed. And the virus itself had higher mortality rate than usual, but not as much as previously thought.
There are very little details on how the bodies are being disposed of. Does the virus become dormant at a certain temperature ranges? How does it fare with irradiation? These are the kinds of experiments that need to be run.
Honestly if there is truth to this article it is reassuring. I've been scouring the darker corners of the internet obsessively for every seemingly reputable bit of data under the assumption that virtually anything official out of China could not be trusted.
This doctor is working on the absolute worst of cases and even they, it seems, have a high overall probability of survival. Also good to see some figures on the progression of the virus - 5-10 days of incubation, 1 week before symptoms either improve or worsen, then one more week before severe cases recover or die.
Regardless, we should all be paying attention to the quarantined cruise ships. In a few weeks or so we'll have much a more accurate mortality rate. I feel for those people but perhaps there is some comfort in knowing that their losses will not be without value.
We had a SARS outbreak in Taiwan since we trusted the statement from Chinese government back then. This time we assume coronavirus can do person to person transmission and blocked travel to WuHan back when CCP and WHO were downplaying its ability to spread. That's how we have less cases than Japan, Korea and Hong Kong now.
Recently Taiwanese people in WuHan asked for evacuation. CCP denied our request at first, then they allowed but the plane had to be operated by them. We requested to fly children, elderly and people with medical condition first, instead they flew wealthy businessmen with good connection to CCP and their China spouses. Three people on that plane exhibit symptoms at customs and one of them is confirmed infected with coronavirus. Now we have to quarantine all 200+ people boarded.
> That's how we have less cases than Japan, Korea and Hong Kong now.
There could be other reasons for this, no? I mean, specifically in Japan's case, a huge cluster of that is from cruise ships. That seems more like a [bad] luck thing rather than the result of proactive action.
Also, I think we should make the distinction between "cases" and "confirmed cases". I'm in Singapore and one of the reasons given why Singapore has so many confirmed cases (3rd most) is that the Government is relentless about tracking infections.
Maybe that's just a positive spin. Either way, I think there's a lot of reasons to take these early numbers with a grain of salt.
> We requested to fly children, elderly and people with medical condition first, instead they flew wealthy businessmen with good connection to CCP and their China spouses.
> I've been scouring the darker corners of the internet obsessively for every seemingly reputable bit of data under the assumption that virtually anything official out of China could not be trusted.
I do the same. If you can read Chinese, I strongly recommend you read Sina Weibo, a micro-blogging social media in China, or Toutiao. Read them quickly before posts are inevitably deleted by the censors. There are some truly harrowing stories of ordinary people being refused treatment and left to die at home.
Well, isn't that the very definition of anecdotal data? Not saying these cases didn't happen. But to use them to build a model of the Corona virus epidemic doesn't fly, IMHO. I for my part stick to WHO data.
One general point so. That WHO has now a te dedicated to counter false rumours and theories on the internet is telling. And HN would be best served if we, educated, critical thinking people, would stick in that with the experts. Who are the WHO.
I mentioned this in another thread as well but I recommend watching MedCram's video series on nCov. They have been doing daily videos since late January, [0] really good no nonsense information.
In particular, if this gets really out of hand in the west, we may not have enough oxygen facilities to support patients anywhere. Most hospitals are not equipped to provide high volume oxygen to thousands of people at a time.
Regarding sources, I came across this article in the Sinocism newsletter from Bill Bishop. I only subscribe to the free version, but during the coronavirus crisis he's been making the full version free. It's a pretty broad survey of both Chinese and English language sources, usually with an economic and political focus. It's at sinocism.com.
You're right, and this could very well be a propaganda piece, but it somehow comes off as genuine. There are activists in China who recognize the severity, understand the grasp of the party, and still desperately attempt to reach out - including the selfless doctor who died yesterday, and a number of activists who have already been disappeared. No doubt the number of such people has been increasing exponentially and the only antidote to authoritarian control is numbers. It's plausible that enough Chinese sympathetic to dissemination of such critical information have gathered such that an article like this may be genuine.
Moreover, while many terrible rumors ostensibly from educated and/or directly witnessing sources from the dregs of the web have turned out to be true, these sources are even less reliable than the CCP, given the propensity of netizens for exaggerating and/or deliberately spreading falsehoods. Which is to say reports out of China may not be that much less reliable than much of what is floating around and at this point, as ridiculous as I know it sounds, I'm almost willing to relax my suspicion and cling to slivers of hope.
The undesputed facts so far are grim. 80-90% of the Chinese GDP has been shut down, we still don't know with certainty just how contagious or dangerous the virus actually is, but it is obviously more virulent than any of the previous viruses from the Corona family, and if for whatever reason containment fails for an extended period of time in a region, you can expect severe social hardship. How long can China continue to operate at 10% capacity?
It is only prudent in my opinion to make at least minimal preparations now with 1-2 months of food and water before panic potentially sets in and stores are emptied. There is still a high probability that the virus will be sufficiently contained and minimally deadly, but this also is shaping up to possibly be the biggest threat faced by civilization in centuries, exceeding the Spanish Flu of the early 1900s. I'm about halfway through Gallaher's report linked in these comments (very thankful for it) and I hope I'm wrong, but even his numbers are understandably prefaced with uncertainty.
Even though this is true, Caixin has been allowed some leniency, especially in reporting this outbreak. Some reports have been very distinct from the official reporting, although it appears that some articles have also been retracted.
In times of a crisis like this, some signal will get through.
Caixin is the best Chinese news source in normal times, and at this time all Chinese news is more free to report on the virus. As someone very critical of the CCP, I'd say Caixin's reporting here is as authoritative as anywhere.
That was a good read. This is what should be shared.
The entire world is going into a freaking panic over this. And they’re spewing out nonsense that the China government is lying, and their numbers cannot be trusted. Which doesn’t really help the situation, and it clouds the scientific understanding of this incident.
Then the 2 moronic scientific papers that were published whipped everyone up into a frenzy.
(1) The German paper said that people can transmit it asymptomatically, which means this is some kind of Frankenstein virus that can transmit over 14 days, and infect others when not showing any symptoms.
(2) The Indian paper that suggested that this virus was man-made, and thus fueled the conspiracy theories about it being a bio weapon. And this fed more fuel to the fire for #1.
Two scientific papers that were both terribly wrong!
And what was the result? It created mass panic.
So there you have it. Fake news that created real mass panic in the real world.
Some good highlights from this transcription were:
* This is like SARS, but less deadly. Yes, it is infectious and contagious, but it is also less deadly than SARS.
* The virus will likely burn out in May, because it doesn’t do well in warm and humid weathers. So Australia with its hot wildfires will be spared. Go take a vacation in the hot and dry outback of Australia everyone. You’ll be fine out there.
* The 2.2 reproductive R0 number is a perfect theoretical scenario, but it will likely not happen in this case, since China mandated the quarantine. And the entire country is a ghost town, with people wearing face masks in public, and avoiding any outdoor activities. This should help to slow the spread, and kill off the virus, like how SARS mysteriously disappeared.
So, governments around the world, need to be vigilant, and do what they can to contain the spread of the virus, but we should be ok. There is no need to panic right now. The fear is worse than the disease.
The leaders of the world needs to step forward and make regular public health announcements about this. And to calm the public down, and stick to known scientific facts and evidence.
Unfortunately, we have morons as our elected leaders.
He's the expert, and I'm not. But I can do math. Influenza this year in the US: 19M infected and 10K fatalities. If you posit 1% mortality rate for coronavirus like he argues, that's 20 times more deadly. And it's twice that in China, it's unclear if that's a statistical anomaly or a structural feature of some difference in how things are tested/reported in China.
So I'm not going to just shrug and say it's no big deal. It could be. I'm a programmer, I know powers of 2 intimately. We're at 2^15 and doubling every 5 days. If that keeps up for a month we'll be at 1M infected and 16K dead. From there it's another 50 days to 1B infected and 1-2M dead. I'm keeping an eye on that, if it doesn't slow down before 2^20 (1M) then I've already planned to bug out with my loved ones to the mountains of Panama for a couple months until this blows over.
I think it won't come to that, but I'm keeping an eye on the progression and doubling rate. The thing with exponential growth is it always ends. The question here is does it end in time?
OPs article does have merit, as far as giving a first-person account of treating the virus and quarantine procedures, but you'll learn a lot more about the virus itself if you follow the research.
“ nCoV2019 has a furin-sensitive motif at the traditional S1/S2 border fo the spike protein, i.e. RRAR, that was lacking in SARS (which depends on cathepsin cleavage a few amino acids downstream). nCoV2019 lacks the secondary minimal furin cleavage site, i.e. RNTR, that is found in SARS. Therefore, the endoproteolytic cleavage pattern is expected to be different between nCoV2019 and SARS.
Prediction of O-glycosylation sites reveals a cluster of Serine residues, just before and after the RRAR cleavage site, with a high propensity to form a “mini-mucin” patch at that site. It is positioned to protect the putative fusion peptide region in the native or pre-fusion Swiss-Model projection of the probable nCoV2019 structure.”
Not sure how to ‘follow the research’ when the first page has 12 proper nouns/terms I’ve never encountered...
I've noticed the English language media has been big on facts and events, but generally provide little context besides the usual unhelpful short quotes.
Great article all around, worth reading as it's one of the only I've seen that are actually talking about disease progression and timeline. Some key info from the article:
----
Caixin: Based on your clinical experience, what's the disease progression of the new coronavirus?
Peng: Lately I've been spending the daytime seeing patients in the ICU, then doing some research in the evenings. I just wrote a thesis. I drew on data from 138 cases that South Central Hospital had from Jan 7 to Jan 28 and attempted to summarise some patterns of the novel coronavirus.
A lot of viruses will die off on their own after a certain amount of time. We call these self-limited diseases.
I've observed that the breakout period of the novel coronavirus tends to be three weeks, from the onset of symptoms to developing difficulties breathing. Basically going from mild to severe symptoms takes about a week. There are all sorts of mild symptoms: feebleness, shortness of breath, some people have fevers, some don't. Based on studies of our 138 cases, the most common symptoms in the first stage are fever (98.6 per cent of cases), feebleness (69.6 per cent), cough (59.4 per cent), muscle pains (34.8 per cent), difficulties breathing (31.2%), while less common symptoms include headaches, dizziness, stomach pain, diarrhea, nausea, vomiting.
But some patients who enter the second week will suddenly get worse. At this stage, people should go to the hospital. The elderly with underlying conditions may develop complications; some may need machine-assisted respiration. When the body's other organs start to fail, that's when it becomes severe, while those with strong immune systems see their symptoms decrease in severity at this stage and gradually recover. So the second week is what determines whether the illness becomes critical.
The third week determines whether critical illness leads to death. Some in critical condition who receive treatment can raise their level of lymphocytes, a type of white blood cell, and see an improvement in their immune systems, and have been brought back, so to speak. But those whose lymphocyte numbers continue to decline, those whose immune systems are destroyed in the end, experience multiple organ failure and die.
For most, the illness is over in two weeks, whereas for those for whom the illness becomes severe, if they can survive three weeks, they're good. Those that can't will die in three weeks.
The cases that the interview alluded to have already been published in JAMA: Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China https://jamanetwork.com/journals/jama/fullarticle/2761044
Note Dr. Peng in the interview is one of the authors of the JAMA article.
Should add their discussion of cytokine storms in healthy people, which appears to have a more rapid timeline
> Some experts argue that the virus triggers a cytokine storm, which ravages the stronger immune system of young adults
> Based on my observations, a third of patients exhibited inflammation in their whole body. It was not necessarily limited to young adults. The mechanism of a cytokine storm is about whole-body inflammation, which leads to a failure of multiple organs and quickly evolves into the terminal stage. In some fast-progressing cases, it took two to three days to progress from whole-body inflammation to the life-threatening stage.
the 1918 flu pandemic caused a cytokine storm, which is hypothesized to have caused so many otherwise healthy people to die. if there's cytokine activity that's another parallel to the Spanish flu.
I find it so strange that even people who should know better say yeah there is 30k cases and 600 deaths so only 2% die. They should look at the clinical progression of the disease, if it takes 2 weeks from hospitalization to death - how many cases where there 2 weeks ago: those were the people that died.
Yeah, and people who know better say anything different than that? Or what exactly don't you like about official WHO numbers based on global data that pretty much alines with Chinese ones?
EDIT: What makes you think highly educated people just doing epidemics didn't have that ideas alrwady and didn't base their numbers on that?
Beyond the actual mortality rate or possible sequelae (which seemed to occur in post-SARS survivors), the real danger lies in what the actual percentage of cases requiring hospitalization due to severity of pneumonia is (serious + critical condition). Some believe it to be a much higher percentage of the total # of cases than something like the flu, meaning if the infection spreads as much as the normal flu, we may see a shortage of ICU beds and respirators.
The corollary of this is that you don't even have to be infected with the coronavirus to die because of it. This coronavirus acts as figurative denial of service attack against hospitals. Anybody with a medical emergency is going to have an incresed risk of mortality if hospitals are swamped with an epidemic.
> is it obvious from the symptoms whether they have novel coronavirus, or just the regular flu?
There are test kits but China has very few of them compared to the mass of patients who have flu-like symptoms. So... from what I heard we dont really know.
From what I read, the coronavirus reduces lymphocytes and that is what ultimately causes the serious symptoms. For people who can keep their white counts up, they don’t get so sick.
Edit: my thought is that maybe they could use blood counts to separate it from the flu
If one is to run tests, it would much easier to use the actual nCoV diagnostic panel. The question was whether differential diagnosis for nCoV based on (early-stage) symptoms exists, which to my knowledge it doesn’t yet.
I don’t think it’s correct that most do. I think most people have mild symptoms. I’ve seen statistics that up to half of the people that end up in the hospital die, though.
This was the most valuable piece of info for me, which I shared among my social circle:
Doctor observed that three weeks seemed to determine the difference between life and death.
- Patients with stronger immune systems would start to recover in a couple of weeks
- Second week, some cases would take a turn for the worse.
- In the third week, keeping some of these acute patients alive might require extraordinary intervention. For this group, the death rate seems to be 4 per cent to 5 per cent.
Readit News
That is so rough, especially since some healthcare workers are now among the dead: specifically, I saw that Li Wenliang had died.
https://www.straitstimes.com/asia/east-asia/chinese-doctor-w...
The absolute definition of heroes. It blows my mind to imagine ever having that sort of selfless dedication to helping others. For all the crappy things in the world these days, it's stuff like this that gives me hope for humanity.
This was one of the most tragic things in that article.
The doctors, nurses, and health workers are the front line soldiers in this fight against the virus. And they don’t have the protective gear that they need to stay safe, and to keep the population safe, as well as the rest of the world.
I hope they can fight the infection, and survive, and live to fight another day. We need them!
I'm not an authority on the subject, but I was under the impression that those were soldiers and conscripts and they were ordered to go.
Anyway, I feel like it’ll be an epidemic ( it already is, I believe ) in China, and be much better controlled outside of China.
Unfortunately my wife is also stuck in Chongqing; Taiwan is essentially closing up its borders and we don’t know if she’ll be able to move here to Taiwan to live with me. At least not until things blow over ( I assume summer time ).
I live in Taiwan and they’ve been very good at containing this, afaik. Just this morning they released a map of Taiwan with nav-points where all the cruise ship people were at in Taiwan before they went on the ship, and released information on what to do if you experience certain symptoms. 13 people have been diagnosed and quarantined.
The mortality rate of 2% is consistent with the number of cases and deaths reported by other countries.
Is it that there are a large number of undiagnosed cases? That is kind of a given and is probably also the case in other countries.
The timespan between first case and until it gets reported to who and quarantines start is less than a month. To me that seems very fast (but I am just a layperson).
My wife, when she went to the hospital to be diagnosed, said that they had a separate room for those that were diagnosed with having the Wuhan virus, and a separate room for those that did not.
She saw several people in that room, and yet over the next few days, only one new case was reported from that hospital.
I don’t know if this is due to unconfirmed or bad diagnosis, but this is just yet another red flag in a country full of red flags.
As for my wife, she only had a respiratory infection and got medicine for it. She’s better now, but now her mother is sick -.-
I don't know why they would do that, but they are accused of doing this kind of thing frequently.
If they sat on the news of the virus for an extended period they might have known the mortality rate they needed to align with long before the rest us.
And there are also rumors out there saying the lack of medical resources. Sick people couldn't get proper medical treatment and dying at home or somewhere. Because they didn't get diagnosed before they die, so the number won't be added to the official number. Don't know if it's true or how many people are dying there, but sure it's terrifying.
About misreporting, they did do it back in January, mainly because they want to control the panic as they always do, (and probably they didn't know it's gonna be this bad), but it should be much better now (I hope).
As a new disease, with the first cases possibly being acquired as early as late November 2019, it wasn't until mid to late January 2020 that city and national authorities appeared to start taking the outbreak seriously.
I'm not aware of other novel outbreaks outside of China and how quickly those have attracted notice, though there's the case of the 1976 initial outbreak of Legionaire's Disease, reported within a week of first outbreak (though the disease was both fast-acting and rapidly lethal for many victims). However epidemiologists also realised that there had been previous, unrecognised outbreaks, dating to the 1950s. See:
https://en.wikipedia.org/wiki/1976_Philadelphia_Legionnaires...
The case of HIV/AIDS in the US and elsehwere would be a case of a disease with ascribed social and moral assocations, for which early responses were very much delayed, on of several examples of stigma associated with the disease: https://en.wikipedia.org/wiki/Discrimination_against_people_...
Reponse to the 2012 MERS outbreak appears to have been swift -- in November of 2012: https://en.wikipedia.org/wiki/2012_Middle_East_respiratory_s...
The 2003 SARS epidemic, also emerging in China, also first emerged in November, but was not internationally reported until the following March:
https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...
(The fact that SARS, MERS, and 2019-nCoV all appear to have emerged during November may be significant.)
Point being:
- China are slow to detect, report, and respond to new contagious epidemics. Notably so in the case of SARS, and less so, but still, with 2019-nCoV.
- Other countries, including the US, have had similar failures.
- Early unofficial public disclosure of 2019-nCoV was prosecuted by Chinese authorities, though at what direction is unclear.
- Trust between the people and the government is somewhat frayed.
- There are also numerous actors with incentives to make the most of any missteps of the government, or to inflate distrust.
Several of those groups have legitimate gripes against the Chinese government, and I've seen reports associated with Falun Gong, Hong Kong, and Taiwan specifically. I've not seen any associated with Tibet or Uygher populations. And there are various rabble-rousing actors elsewhere, doomers, and conspiracists (generally of the nutcake variety).
This ... clouds information. Many of the criticisms are legimate, some are not, and sorting fact from fiction (both between and within reports) is challenging. China are in the position where both locked-down and unfettered communications are potentially harmful -- the first for preventing accurate information from being available to both public and government, the latter for allowing agents provacateurs to rumourmonger, exaggerate bad news, and spread active disinforation. This is strong shades of attacks the West has seen over the past several years (within the US, UK, EU, and elsewhere), some of it from China itself.
How China responds will be interesting.
https://twitter.com/evdefender/status/1223887384892313600
As a reminder, don't mix this rate with case fatality (or lethality) rate, which is counted on ended cases and is about 30%. This is your real chance when you're infected.
Go to WeChat Pay -> Health
The numbers are updated each day.
Which could just be the common conspiracy theory suspicions of parts of a population...
Dead Comment
This is a pretty irrational reaction if you ask me, the CCP is actually the more open, quasi-democratic side of Chinese government and politics. There are loose 'factions' as part of the CCP that are cautiously pushing for more openness, and the Chinese should be aware of them and be supportive. Frustration and anger are not helpful.
Dead Comment
Modern theory of Spanish flu[1] is that the flu itself was not that deadly. Combination of influenza with bacteria in the lungs caused most of the deaths. It was the World War I with lots of wounded in the same place, bad hygiene conditions, many with scarred lungs from poison gas and civilians suffering from malnutrition.
[1]: Bacterial Pneumonia Caused Most Deaths in 1918 Influenza Pandemic - Implications for Future Pandemic Planning https://www.nih.gov/news-events/news-releases/bacterial-pneu...
> However, it is possible that — as in 1918 — a similar pattern of viral damage followed by bacterial invasion could unfold, say the authors. Preparations for diagnosing, treating and preventing bacterial pneumonia should be among highest priorities in influenza pandemic planning, they write. "We are encouraged by the fact that pandemic planners are already considering and implementing some of these actions," says Dr. Fauci.
The half a million people who died of the Spanish flu in USA did not die because lots of wounded in the same place and scarred lungs from poison gas.
btw. I did not say WWII was the single cause for high mortality. Hygiene, malnutrition etc. contributed. And the virus itself had higher mortality rate than usual, but not as much as previously thought.
https://www.news.com.au/lifestyle/health/health-problems/chi...
This doctor is working on the absolute worst of cases and even they, it seems, have a high overall probability of survival. Also good to see some figures on the progression of the virus - 5-10 days of incubation, 1 week before symptoms either improve or worsen, then one more week before severe cases recover or die.
Regardless, we should all be paying attention to the quarantined cruise ships. In a few weeks or so we'll have much a more accurate mortality rate. I feel for those people but perhaps there is some comfort in knowing that their losses will not be without value.
There could be other reasons for this, no? I mean, specifically in Japan's case, a huge cluster of that is from cruise ships. That seems more like a [bad] luck thing rather than the result of proactive action.
Also, I think we should make the distinction between "cases" and "confirmed cases". I'm in Singapore and one of the reasons given why Singapore has so many confirmed cases (3rd most) is that the Government is relentless about tracking infections.
Maybe that's just a positive spin. Either way, I think there's a lot of reasons to take these early numbers with a grain of salt.
Wow, that’s disgusting.
I do the same. If you can read Chinese, I strongly recommend you read Sina Weibo, a micro-blogging social media in China, or Toutiao. Read them quickly before posts are inevitably deleted by the censors. There are some truly harrowing stories of ordinary people being refused treatment and left to die at home.
I have closed friend work there and speak highly about the integrtity of their reporting and the content I am reading seems aligned to that.
Also, do you have any opinion on this:
https://i.redd.it/88osl54prjf41.png
One general point so. That WHO has now a te dedicated to counter false rumours and theories on the internet is telling. And HN would be best served if we, educated, critical thinking people, would stick in that with the experts. Who are the WHO.
https://www.youtube.com/watch?v=9vMXSkKLg2I
The danger here is that the healthcare system gets overwhelmed by the high percentage of patients requiring intensive care.
Moreover, while many terrible rumors ostensibly from educated and/or directly witnessing sources from the dregs of the web have turned out to be true, these sources are even less reliable than the CCP, given the propensity of netizens for exaggerating and/or deliberately spreading falsehoods. Which is to say reports out of China may not be that much less reliable than much of what is floating around and at this point, as ridiculous as I know it sounds, I'm almost willing to relax my suspicion and cling to slivers of hope.
The undesputed facts so far are grim. 80-90% of the Chinese GDP has been shut down, we still don't know with certainty just how contagious or dangerous the virus actually is, but it is obviously more virulent than any of the previous viruses from the Corona family, and if for whatever reason containment fails for an extended period of time in a region, you can expect severe social hardship. How long can China continue to operate at 10% capacity?
It is only prudent in my opinion to make at least minimal preparations now with 1-2 months of food and water before panic potentially sets in and stores are emptied. There is still a high probability that the virus will be sufficiently contained and minimally deadly, but this also is shaping up to possibly be the biggest threat faced by civilization in centuries, exceeding the Spanish Flu of the early 1900s. I'm about halfway through Gallaher's report linked in these comments (very thankful for it) and I hope I'm wrong, but even his numbers are understandably prefaced with uncertainty.
In times of a crisis like this, some signal will get through.
https://www.fwdeveryone.com/t/puzmZFQGRTiiquwLa6tT-g/confere...
The entire world is going into a freaking panic over this. And they’re spewing out nonsense that the China government is lying, and their numbers cannot be trusted. Which doesn’t really help the situation, and it clouds the scientific understanding of this incident.
Then the 2 moronic scientific papers that were published whipped everyone up into a frenzy.
(1) The German paper said that people can transmit it asymptomatically, which means this is some kind of Frankenstein virus that can transmit over 14 days, and infect others when not showing any symptoms.
(2) The Indian paper that suggested that this virus was man-made, and thus fueled the conspiracy theories about it being a bio weapon. And this fed more fuel to the fire for #1.
Two scientific papers that were both terribly wrong!
And what was the result? It created mass panic.
So there you have it. Fake news that created real mass panic in the real world.
Some good highlights from this transcription were:
* This is like SARS, but less deadly. Yes, it is infectious and contagious, but it is also less deadly than SARS.
* The virus will likely burn out in May, because it doesn’t do well in warm and humid weathers. So Australia with its hot wildfires will be spared. Go take a vacation in the hot and dry outback of Australia everyone. You’ll be fine out there.
* The 2.2 reproductive R0 number is a perfect theoretical scenario, but it will likely not happen in this case, since China mandated the quarantine. And the entire country is a ghost town, with people wearing face masks in public, and avoiding any outdoor activities. This should help to slow the spread, and kill off the virus, like how SARS mysteriously disappeared.
So, governments around the world, need to be vigilant, and do what they can to contain the spread of the virus, but we should be ok. There is no need to panic right now. The fear is worse than the disease.
The leaders of the world needs to step forward and make regular public health announcements about this. And to calm the public down, and stick to known scientific facts and evidence.
Unfortunately, we have morons as our elected leaders.
So I'm not going to just shrug and say it's no big deal. It could be. I'm a programmer, I know powers of 2 intimately. We're at 2^15 and doubling every 5 days. If that keeps up for a month we'll be at 1M infected and 16K dead. From there it's another 50 days to 1B infected and 1-2M dead. I'm keeping an eye on that, if it doesn't slow down before 2^20 (1M) then I've already planned to bug out with my loved ones to the mountains of Panama for a couple months until this blows over.
I think it won't come to that, but I'm keeping an eye on the progression and doubling rate. The thing with exponential growth is it always ends. The question here is does it end in time?
There are other virology / epidemiology forums which may be of use, but I don't have these links at-hand.
For instance, the following link is a highly descriptive, accessible analysis of nCoV-2019: http://virological.org/t/analysis-of-wuhan-coronavirus-deja-...
OPs article does have merit, as far as giving a first-person account of treating the virus and quarantine procedures, but you'll learn a lot more about the virus itself if you follow the research.
“ nCoV2019 has a furin-sensitive motif at the traditional S1/S2 border fo the spike protein, i.e. RRAR, that was lacking in SARS (which depends on cathepsin cleavage a few amino acids downstream). nCoV2019 lacks the secondary minimal furin cleavage site, i.e. RNTR, that is found in SARS. Therefore, the endoproteolytic cleavage pattern is expected to be different between nCoV2019 and SARS.
Prediction of O-glycosylation sites reveals a cluster of Serine residues, just before and after the RRAR cleavage site, with a high propensity to form a “mini-mucin” patch at that site. It is positioned to protect the putative fusion peptide region in the native or pre-fusion Swiss-Model projection of the probable nCoV2019 structure.”
Not sure how to ‘follow the research’ when the first page has 12 proper nouns/terms I’ve never encountered...
Dead Comment
----
Caixin: Based on your clinical experience, what's the disease progression of the new coronavirus?
Peng: Lately I've been spending the daytime seeing patients in the ICU, then doing some research in the evenings. I just wrote a thesis. I drew on data from 138 cases that South Central Hospital had from Jan 7 to Jan 28 and attempted to summarise some patterns of the novel coronavirus.
A lot of viruses will die off on their own after a certain amount of time. We call these self-limited diseases.
I've observed that the breakout period of the novel coronavirus tends to be three weeks, from the onset of symptoms to developing difficulties breathing. Basically going from mild to severe symptoms takes about a week. There are all sorts of mild symptoms: feebleness, shortness of breath, some people have fevers, some don't. Based on studies of our 138 cases, the most common symptoms in the first stage are fever (98.6 per cent of cases), feebleness (69.6 per cent), cough (59.4 per cent), muscle pains (34.8 per cent), difficulties breathing (31.2%), while less common symptoms include headaches, dizziness, stomach pain, diarrhea, nausea, vomiting.
But some patients who enter the second week will suddenly get worse. At this stage, people should go to the hospital. The elderly with underlying conditions may develop complications; some may need machine-assisted respiration. When the body's other organs start to fail, that's when it becomes severe, while those with strong immune systems see their symptoms decrease in severity at this stage and gradually recover. So the second week is what determines whether the illness becomes critical.
The third week determines whether critical illness leads to death. Some in critical condition who receive treatment can raise their level of lymphocytes, a type of white blood cell, and see an improvement in their immune systems, and have been brought back, so to speak. But those whose lymphocyte numbers continue to decline, those whose immune systems are destroyed in the end, experience multiple organ failure and die.
For most, the illness is over in two weeks, whereas for those for whom the illness becomes severe, if they can survive three weeks, they're good. Those that can't will die in three weeks.
-----
Whole thing is worth reading.
Note Dr. Peng in the interview is one of the authors of the JAMA article.
> Some experts argue that the virus triggers a cytokine storm, which ravages the stronger immune system of young adults
> Based on my observations, a third of patients exhibited inflammation in their whole body. It was not necessarily limited to young adults. The mechanism of a cytokine storm is about whole-body inflammation, which leads to a failure of multiple organs and quickly evolves into the terminal stage. In some fast-progressing cases, it took two to three days to progress from whole-body inflammation to the life-threatening stage.
EDIT: What makes you think highly educated people just doing epidemics didn't have that ideas alrwady and didn't base their numbers on that?
That is, the tail end is clearly deadly -- but for the average case, are symptoms much worse than the yearly flu, or around the same?
There are test kits but China has very few of them compared to the mass of patients who have flu-like symptoms. So... from what I heard we dont really know.
Edit: my thought is that maybe they could use blood counts to separate it from the flu
Fevers of 5+ degrees F (lasting 3-5 days), chills, aches, chest pain, etc. And complications (eg pneumonia) are fairly common and can be deadly.
I would wager that most "flu" cases people self-report aren't actually the flu.
more like feeling like you've been hit by a truck for 2 weeks while you shiver in bed with a fever, coughing your lungs out, unable to function
https://www.cdc.gov/flu/about/burden/index.html
Deleted Comment
Doctor observed that three weeks seemed to determine the difference between life and death.
- Patients with stronger immune systems would start to recover in a couple of weeks
- Second week, some cases would take a turn for the worse.
- In the third week, keeping some of these acute patients alive might require extraordinary intervention. For this group, the death rate seems to be 4 per cent to 5 per cent.