The armchair quarterbacking on Twitter of the #2019nCoV response is … a lot.
Outbreaks are chaotic, exhausting & frightening. Fog of war conditions. Good to keep that in mind.— Helen Branswell (@HelenBranswell) January 26, 2020
On last night’s thread, commentor Starfish recommended Dr. Tara C. Smith’s twitter feed. Dr. Smith has some very helpful information:
/4 If you feel you need to "do something," 1) make sure you're vaccinated for influenza so if a case comes to your area, you're one fewer febrile person to be tested and potentially isolated.
— Dr. Tara C. Smith (@aetiology) January 25, 2020
/6 3) you'll see some disagreement among scientists. That's ok; were still working it out. Again, there will be lots of uncertainty from limited data in the early weeks.
4) lots of good people to follow from suggestions in this thread. https://t.co/okW6Wnpf3y /fin
— Dr. Tara C. Smith (@aetiology) January 25, 2020
IMO, at this particular moment, the situation appears to be pretty good. There’s no widespread panic, the news media seems to have acquired some immunity to the OMG WE’RE ALL GONNA DIE conspiracies that flared around SARS and the last global Ebola outbreak, and the governments involved appear to be reacting, if not flawlessly, at least reasonably. Murphy the Trickster God willing, we’ll be watching similar reports for the next few weeks / months…
This medic in China was infected while treating patients with the new coronavirus.
The death toll has jumped to 81, with Chinese authorities saying there are now more than 2,700 confirmed cases. pic.twitter.com/p63MMZsfEy
— Al Jazeera English (@AJEnglish) January 27, 2020
Within a month of the discovery of the Wuhan coronavirus, the @CDCgov has generated an assay for the virus and made the protocol publicly available to the world. This is an outstanding example of the importance of publicly funded scientific infrastructure! https://t.co/W6krZbVfaS
— Russ Poldrack (@russpoldrack) January 26, 2020
The additional genomes released in the last two days provide further evidence for a single animal-human spill-over event 7-10 weeks ago. Here is our updated report. https://t.co/bbp9CfMJez
— Richard Neher (@richardneher) January 26, 2020
Bad time to be in Wuhan, terrible time to be a health professional working in Wuhan, nowhere near time to start worrying about how your pets will survive once the new plague reduces major U.S. cities to wastelands.
Videos circulating on Chinese social media show doctors straining to handle the enormous workload and hospital corridors loaded with patients, some of whom appear to already be dead.
Here are the latest updates on the Wuhan coronavirus outbreak. https://t.co/thOFNwafla
— The New York Times (@nytimes) January 27, 2020
With WHO chief on his way to Beijing, might the coronavirus outbreak be decalred an emergency of international concern?
So far, the virus has been exported to 12 countries. https://t.co/K0U7eF0F2K
— Elizabeth Law 思敏 (@lizzlaw_) January 27, 2020
Key Shanghai companies in epidemic prevention industries, including medical equipment, pharmaceuticals and protective gear, have been urged to cancel the Spring Festival holiday and continue production to contribute to the fight against the #Coronavirus pic.twitter.com/oZjVMd8hRR
— Global Times (@globaltimesnews) January 27, 2020
"50 million people are quarantined" is one of those things that tells you less about the disease and more about the political machine responding to the disease.
— Adia Benton (@Ethnography911) January 26, 2020
Thought-provoking article on the Wuhan quarantine from a medical specialist in the Washington Post:
… China is in a real bind. If Beijing doesn’t act — or delays reporting on the situation, as officials did for five long months during the SARS (severe acute respiratory syndrome) epidemic of 2002-2003 — then the virus will spread quickly and, if it proves especially lethal, could kill many more people than it already has. China will also incur international blame, economic sanctions or worse. Doing nothing is not an option in an era when information, fear and gossip travel at the speed of electrons and the public invariably demands action from leaders.
On the other hand, by taking the draconian step of closing down densely populated urban areas, China can hope only to diminish the coronavirus’s spread, knowing full well that some additional infections, or many, will inevitably occur. It takes just a few cases to spread outside the Chinese quarantine zone before critics say it has failed. As Lawrence O. Gostin, a public health law professor at Georgetown, has, for example, already said, “It’s very unlikely to stop the progressive spread.”
It’s possible that this coronavirus may not be highly contagious, and it may not be all that deadly. We also do not know yet how many people have mild coronavirus infections but have not come to medical attention, especially because the illness begins with mild to moderate respiratory tract symptoms, similar to those of the common cold, including coughing, fever, sniffles and congestion. Based on data from other coronaviruses, experts believe the incubation period for this new coronavirus is about five days (the range runs from two to 14 days), but we do not yet know how efficiently this coronavirus spreads from infected person to healthy person. And because antibodies for coronavirus do not tend to remain in the body all that long, it is possible for someone to contract a “cold” with coronavirus and then, four months later, catch the virus again…
Even open societies such as the United States have stringent laws regarding quarantine during epidemics, but they are rarely used because they are so poorly tolerated by citizens. Nevertheless, Americans have a long history of misapplying the quarantine. Russian Jewish immigrants in New York City in 1892, San Francisco’s Chinatown in 1900, and more recently gay men and Haitians in the early years of the AIDS epidemic were all stigmatized, isolated and blamed for the spread of contagious diseases. In many instances, some of these “undesirable” groups were inappropriately quarantined; their health needs were routinely ignored; and some even contracted deadly diseases while in isolation…
… When the public trusts leaders and health authorities, it is easier to establish wide-scale cooperation, clear lines of communication and appropriate, humane health care. Civic-minded, community-wide, voluntary disease containment and mitigation efforts — such as those adopted in Mexico City during the 2009 H1N1 influenza pandemic, when officials inspired buy-in from the public to enact bans on social gatherings, school closures, isolation of the ill and at-home quarantines for those suspected of having contact with sick people — have been shown to work well. That is certainly the prescription I would write, and it’s not one that extreme measures are likely to engender.
Microbes, as agents of illness and death, are the ultimate social leveler. They bind us and, when transmitted through a filter of fear, have the power to divide. China has deemed this contagious disease to be too dangerous, or poorly understood, to take any chances with the public’s health. But the country also has a moral imperative to provide safe and compassionate medical care for those confirmed or suspected to be infected by the coronavirus…
Martin
We’re going through various alerts here. The Orange County case is about a mile from me. There’s a connection to my daughters school, who has issued guidance for students. We’re having internal conversations where I work for what we should do if a case arrives there (more likely when – we have people traveling to China daily).
I don’t see any sign of panic. Concern, sure. You can’t buy a face mask locally to save your life, but with a large asian community, that kind of happens at the drop of a hat. It’s hardly unusual.
OCIAC has always served as the skeleton for communication around the county. Their focus is on terrorism and such, but they’ve done a good job of connecting all of the first response groups in the county and the hospitals and universities work closely with them. We did have a bioterrorism case a couple blocks from me some years back, which helped get these different agencies talking to one another, involved evacuations, school closures, etc. I’m pretty confident that if cases here spread, that the county will be able to mount a reasonable response. People here really don’t panic. They didn’t panic when they were told the neighbor had anthrax and C4 in his house. I don’t expect they’ll panic here.
Juice Box
The 2012 Ebola panic was whipped along by Fox News as another one of Obama’s failures. Subsequent outbreaks were ignored by the media.
different-church-lady
We’ve probably reached a point in society where social media viral misinformation is getting more people killed than any one physical virus.
Martin
Some additional thoughts – based on the Johns Hopkins data a few things stand out to me.
Martin
@different-church-lady: Well, that’s certainly true with the anti-vaxxer movement.
JPL
@Martin: Thank you. That was informative.
Matt McIrvin
@Martin:
Mostly, that indicates that the people known to have gotten sick haven’t recovered yet. I’ve been seeing some “mortality rate is 60% and they’re all lying to us” takes on Twitter and it’s important to stress that the numbers don’t imply anything one way or the other.
Barbara
@Matt McIrvin: Of course, the mortality rate in that scenario assumes that they have identified every case, when it is equally likely that only really serious cases are being identified, at least in the first instance. Looking at the flu mortality rate by reference to flu cases that turn into hospital admissions would probably be comparably devastating.
HeartlandLiberal
Seriously, we have become a society so manipulated by a news infotainment structure that runs 24×7, and lives for the excitement of the stories that get views, that is why the media fails at reporting on our politics, they want a horse race, report breathlessly on latest polls, but never bother actually reporting on the positions and facts about the candidates.
FWIW, shouldn’t everyone be freaking out over the flu? Just look at the numbers! OMG, we are all going to die!!!!!!!!!!
Influenza killed about 80,000 people in the 2017-2018 season, according to figures released by the Centers for Disease Control and Prevention. The previous high for a regular flu season, based on analyses dating back more than three decades, was 56,000 deaths.
Citizen_X
@Juice Box: Exactly. The media is not panicking because Democrats aren’t in power. The next pandemic that happens during a Dem administration, Fox and the Republicans (and some stupid Dems) are going to whip up as much fear as possible. CNN and other media will bark along idiotically with the other dogs.
Fair Economist
@Martin: The Lancet article found a 15% death rate in the first 41 patients. That’s a pretty hard number because they’ve been in treatment long enough for their cases to resolve. That means the death rate is 15%*(chance of hospitalization). We don’t know that second number, but this was early in the outbreak, so the chance of hospitalization has to be pretty high and so the lethality is certainly far more than the flu. My rough estimate is about 3-4% (based on modeling indicating only about 1 in 4 is getting tested), coincidentally about the same as the crude estimate.
Neither statement is sustainable at this point. Every estimate of infectiousness so far has it more contagious than the flu (“highly contagious” according to WebMD) and, per the above, it’s far more deadly than any flu other than perhaps the original Spanish. This isn’t a “we’re all gonna die” disease but it’s a huge risk, probably the most dangerous new disease in a century.
Barbara
Here is an article that puts the new virus in perspective compared to seasonal influenza, as well as measles and some other diseases that we take for granted. Among other things, it notes that the death of 5,000 in the Congo from measles (or, I would add, the recent measles epidemic in American Samoa), has not led to any kind of panic or lessened the resistance of anti-vaxxers. And fyi, this is a very good source of information about a whole host of health related issues. Source
cain
I’m going to flying to Europe and going to be there for about ten days. So I hope nothing happens. It’s the airport that I’m mostly worried about.
Martin
@Fair Economist: Again, that’s of diagnosed patients. One of the problems with the flu is that so many people get it, treat it at home, and recover, and they never get counted in.
The reports I’ve seen is that most fatalities have been elderly, suggesting that either this is transmitted at a higher rate among the elderly (unlikely) or that many other people got the virus, napped and ate chicken soup for a week, and went back to work, figuring it was just a regular flu.
As awareness goes, you get people going to the doctor with more mild symptoms worried that they have the virus so you get better reporting on who has it, but in some places you get the reverse because they don’t trust the health agencies. See parts of Africa were people believe the ebola vaccine is really a US plot to give them ebola, or Pakistanis who believe that certain vaccines are a way for the government to investigate them.
After a while your sample sizes get large enough that you can do proper statistical analysis and project how many cases there likely are and get a better fatality rate, but unless The Lancet author knows how to identify the number of undiagnosed cases, you have to assume they have a very unrepresentative sample of cases. There’s nothing improper about reporting a mortality rate just among severe cases, etc. We do that for cancers, with mortality rates tracked for stage 1-4 cancers.
But people shouldn’t assume they have 50/50 chance of dying if they come in contact with the virus. That’s highly unlikely to be the case and will just cause them to panic.
EmbraceYourInnerCrone
@Barbara: Thank you. Measles is the one that makes me want to kick anti-vaxxers in the shins. Measles is so contagious that if you are not vaccinated, you can walk in a room 2 hours after someone with the disease sneezed and left, and potentially contract the measles from the air the person sneezed in.
I think the R0 of measles (in an un-vaccinated population) is 12 to 18. In 2018 it still killed 140,000 people worldwide, which is better than 1980, when the death toll from measles was over 4 million.
Emma
Just FYI, since I’ve seen tweets from the Global Times on these posts a few times now, the Global Times is the batshit-crazy right-wing mouthpiece of the CCP. The People’s Daily, or Xinhua, is still the CCP’s mouthpiece, but think of it as CNN vs. Fox News.