1. #COVID19: China is reporting 889 new confirmed cases for Thursday & 118 new deaths.
China's official numbers are now 75,465 cases & 2236 deaths.
Do not @ me if you don't believe China's numbers. I block rude. pic.twitter.com/UheeGVWDTl— Helen Branswell (@HelenBranswell) February 21, 2020
Thanks to commentor (and nursing student) Goku for the following link. (The tweets I’d seen over the previous day or two were all alarmist / sketchily sourced, presumably because the Iranian government has a fairly effective Twitter clampdown… and there’s a parlimentary election today.) From Univ-Minnesota’s Center for Infectious Disease Research and Policy:
… Following a report yesterday of its first two cases, both fatal, Iran’s health ministry today reported three more. Two are in Qom, the same city where the first two cases were confirmed, and one is in Arak, located about 92 miles southwest of that city.
All three patients are Iranian citizens, and the ministry’s machine-translated statement said the patient in Arak is a doctor. It said health officials have proposed limiting visits to Qom’s holy shrine and other pilgrimage sites. Among other measures, the health ministry has also advised canceling seminars and conferences in Qom.
A health official was quoted in Iran’s state news agency as saying the patients whose illnesses and deaths were announced yesterday had not had any contact with foreigners or people who had traveled to China, Al Jazeera reported today. It added that an advisor to Iran’s health ministry said testing is under way on suspected cases in several other cities, and that the state news agency reported that two people with suspected infections have been quarantined in Babol, located in northern Iran…
South Korea seems to be lighting up, reporting 52 new #COVID19 cases. Total now 156.
For context: On Tuesday they had 31 cases.
39/52 new cases are from a growing cluster in a religious community in Daegu. 1 seems to have contracted it in hospital. 12 still under investigation. pic.twitter.com/AksOOKyseE— Helen Branswell (@HelenBranswell) February 21, 2020
On the face of it, the declining number of new #COVID19 cases China is reporting daily should be reassuring. But questions about changes in how China is counting cases is creating concern among infectious diseases experts. https://t.co/fsqVPClrIE
— Helen Branswell (@HelenBranswell) February 20, 2020
The State Department and a Trump official wanted 14 patients with coronavirus to fly home with the rest of the cruise passengers. The CDC objected, lost & demanded to be taken off the news release. @ByLenaSun @LennyMBernstein @ShibaniMahtani @JoelAchenbach https://t.co/kLD8WDfEDD
— Laura Helmuth (@laurahelmuth) February 20, 2020
"This is the time to open up your pandemic plans and see that things are in order.” Hospitals across the US prepare for coronavirus outbreak to become global pandemic https://t.co/tP9ZXhukG2
— Jeffrey Duchin (@DocJeffD) February 21, 2020
A statement against conspiracy theories, and in support of the efforts of Chinese scientists and public health professionals fighting #COVID19 – with a link to a petition you can sign toohttps://t.co/FT0PrQMmR8
— Bill Hanage (@BillHanage) February 20, 2020
I spoke to @cyranoski @nature about testing for #SARSCoV2 #COVID19 #coronavirus and whether there are uninfected "carriers" (SPOILER ALERT: I doubt it).
Also featuring @MackayIM and @michaelmina_lab https://t.co/s4WfRkyyX0
— Dr. Angela Rasmussen (@angie_rasmussen) February 20, 2020
Dr. Rasmussen also has a long twitter thread, starting here, about the misleading term “asymptomatic”.
Not if you washed with soap. #coronaviruses are enveloped viruses, meaning they are coated with a membrane derived from the host cell. That membrane is disrupted by detergent, which inactivates the virus.
— Dr. Angela Rasmussen (@angie_rasmussen) February 20, 2020
Also reassuring (for anyone who needs it), thread from a specialist on why COVID-19 is not a ‘bioweapon‘:
I've written before that #COVID19 has no evidence of genetic engineering and the "bioweapon" theory has no grounds. See, for example https://t.co/aR5NfTJzYq. In this thread I wanted to directly address the theory of escape from lab in Wuhan. 1/21
— Trevor Bedford (@trvrb) February 20, 2020
I'll go through each piece of data in turn, but my summary is that the data are fully consistent with a zoonotic origin, but is highly unlikely in the lab escape scenario (and vanishingly unlikely in the bioweapon scenario). 4/21
— Trevor Bedford (@trvrb) February 20, 2020
The Diamond Princess fiasco. #COVID19https://t.co/HWKAKtAsdv
— Helen Branswell (@HelenBranswell) February 20, 2020
Could be worse…
Coronavirus: S'pore confirms first patient with both Covid-19 and dengue, all warded with her quarantined at Ng Teng Fong https://t.co/V2JMjGu7Ia
— The Straits Times (@STcom) February 20, 2020
WereBear
Trump officials override the CDC.
All while they aren’t inspecting food any more.
Something’s going to happen, and it won’t be good!
Cermet
Regardless of the real numbers of new cases, China has done an amazing job containing the virus, to date. A monster police state has managed to mostly control the country and people’s movement (surprize.) Asumming (I am more just hoping) spring causes a massive down tip in new cases, then these horrific controls by the chinese are buying the world time and is, for us, a massive gift that the chinese people are paying for everyone else.
Still, the data does not take into account the possible effects of smoking (long term) and air pollution in possibly increasing the death toll BUT the fact that not one person under age ten has died (no long term exposure to second hand smoke or air pollution) might be a factor in this illness’s greater death rate compared to the common flu. (aside: there is zero medical proof that this is true but does make one wonder.)
Maybe smokers, who are over fifty, should take note … .
JPL
Why the overrule? I know that trump has been downplaying the seriousness, but such a risk could cause a massive outbreak.
YY_Sima Qian
I am not too concerned about the change back in definition of confirmation. It’s not like those who are symptomatic but are testing negative or not yet tested go back to the wild. They are still categorized as suspect cases, and are at least quarantined. Those with severe symptoms and considered highly probable treated under COVID-19 protocols. It just means a slight delay as patients enter the suspect pool, before being confirmed. Not a problem as long as testing is not a bottle neck. This is evidenced by the rise of daily increase in new suspect cases, as well as an uptick in the total stock of suspect cases in China.
Yesterday was a bit discouraging all around, with further confusion caused by one time jumps from China’s penitentiary system. There are now five outbreak hot zones reported among Chinese prisons, three in Hubei, one in Zhejiang, and one in Shandong. One of the prisons in Hubei, and the one in Shandong, reported just over 200 cases each! Total of nearly 500 cases across the five prisons, more than half of all of reported new cases in China yesterday. Apparently, the data from the prison system is not connected to the national epidemic tracking system, and that data needed to be manually keyed in. Vector was probably correction officers/staff, visitors and new inmates. The fact that four prisons reported on the same day suggests that the Chinese authorities may have been aware of outbreak at least a few days ago, and quietly started a blanket survey of the situation. The warden of the prison with the larger outbreak in Hubei has already been removed, as has what appears to be the entire chain of command of the penitentiary system in Shandong. We shall see in the next couple of days if there are further hitherto unreported outbreaks in other correctional facilities in China. From an epidemic spread and containment perspective, prisons are rather similar to cruise ships. Only worse, since the correction officers and staff are not quarantined in the facilities, unlike the crew of the Diamond Princess.
This also begs the questions of what other parts of the China system are not hooked up to the national epidemic data tracking systems. Members of the People’s Liberation Army and People’s Armed Police? I doubt China will ever release data on the spread among military and paramilitary personnel. How about sanitariums and drug rehabilitation facilities? What about the detention/”re-education” sites in Xinjiang housing tens, if not hundreds, of thousands of Uighurs? Again, I doubt China will ever release the figures there. From epidemiology perspective, these detention camps are even worse than prisons. My understanding is that the detainees in such camps in Xinjiang are generally allowed weekend furloughs back home. The worst case scenario is that these people are stuck in a petri dish Monday through Friday, housed 6 – 10 per dorm room, but can bring the infection back to their communities on weekends… At least there relative few reported cases in Xinjiang (72 as of today, 43 active), and none in the Uighur heartlands such as Kashgar, Korla and Hotan, where most of the “re-education” camps are found. It helps that the population density in Xinjiang is low, and cities and settlements far from each other. Kind of like Utah, an only order magnitude larger.
Only 1 confirmed case has ever been found in Tibet, since cured. However, there appears to be a mini-hot zone in the predominantly Tibetan and sparsely populated Dawu County, in western Sichuan. For about a week, the county was showing several new cases a day, though it seems to have really slowed. More concerning is if the epidemic spreads to the neighboring Sertar County (1 confirmed case to date), specifically the Larung Gar Monastery, where tens of thousands of monks and students congregate in crowded conditions, and with poor sanitation. These are very remote places, but very difficult to contain the spread within the community if it reaches critical mass.
The good news is that, aside from the newly (hopefully one time) reported prison hot zones, which actually represent backlogs of cases, and which should be easy to contain, daily increase in new confirmed cases continue to fall everywhere in China, including Hubei and Wuhan. The number of active cases are starting to fall quickly, at more than 1K per day (> 2700 in the last couple of days). Even in Wuhan the number of active cases is decreasing at > 500 per day. Perhaps the overworked medical workers will start to get a breather. However, we do not know if the number of active severe/critical cases is decreasing, as those are the ones that tie up most of the health care resources.
News out of Japan and South Korea are very concerning. Feels like the outbreaks there are starting to exceed the authorities’ abilities to track and contain. China just donated a batch of test kits to Japan yesterday.
Cases continue to tick up in Hong Kong, Singapore and Taiwan. Not at a rapid pace, but clear evidence of community transmission, and cases that cannot be traced to their origins. Given the long incubation period and asymptomatic but contagious carriers, what is not being captured?
Finally, just how bad is it in Iran? None of the cases in Qom have connection to China? How large of an outbreak is already happening underneath the surface?
Princess
There is a new case in Canada which can be most plausibly traced back to Iran. This is concerning because we still don’t know how the transmission in Iran occurred.
Not sure Spring itself (=warmth) is going to kill the virus because it seems to be thriving in Singapore, which is hot.
Mary G
@YY_Sima Qian: Thank you for this update.
Rusty
Emma
That video on the Diamond Princess is so sad. The Japanese government pretty much indicated that everyone on board was expendable and not worth wasting resources on. No infectious disease specialists until Iwata’s team was finally allowed entry. We all know Trump and his cronies are fools, but the Japanese government definitely deserve their share of the blame in increasing the risk of global pandemic, especially if any of those tested-negative people going home was a false negative, or if the virus is simply incubating.
Bill Arnold
@JPL:
The airplane had a plastic partition inside which the patients were kept, to hopefully block droplet sprays. Still a stupid risk though; the patients could have been made to stay in China for a couple of weeks, and then would have caused no risk to the US population on return, and there were probably asymptomatic cases. (They’d be immune after recovery so no reinfection.) It could be that they’re convinced that they can manage the risk to keep it below the epidemic threshold. Unwarranted confidence IMO, if so.
opiejeanne
Thanks, AL for continuing to post updates on this issue.
Stumbled across this interview this morning. Haven’t listened to it yet.
https://www.chcradio.com/episode.php?id=524
lurker dean
yes, thanks for the updates, AL.
lee
I have no idea on the reliability of this reporting but I did run across this article today.
This might be why the numbers are going down:
“At the same time, he issued a warning to local party cadres: If one more case were to be found in a household, he said, that district’s party secretary would be held accountable.”
eachother
Thank you Anne Laurie. Important, interesting information.
In an epidemic, countries have more urgent health care requirements than accurate counts on columns. It is when the shades are pulled down and whole numbers are twisted into absurdities that BS becomes detectable.
When describing deaths from a virus Time and Ro* variables it may be more like: 1+1+ 2weeks x Ro (of 2.5 possibly) and it does not = 2
In other words, Iran yesterday reported only 2 cases, and immediately reported both dead. How long did they live while shedding infection? How many did they infect? Just skip the ‘how many did they contact’ column. They had contacts. A surprising number as described in many individual case reports. Today, the regional reality is more clear. The numbers are changing rapidly and what this epidemic may already be is hypothesis.
Marty Zweig said, “The trend is your friend.” The early trend of this virus is known. And what it is indicating is not friendly.
*Ro -reproduction number. The average number of people who will catch the disease from a single infected person.