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Coronavirus 2019n-CoV: Are You Paying Attention?
I have been watching the chart below:
The Coronavirus has been raging in China since sometime in December 2019. We’re now over 30,000 cases and over 500 deaths. What seems to be established at this point is that persons without symptoms can be a source of contagion and the exposure to symptoms period is about 13 days. They are still trying to calculate the N factor, which is how many people will get sick in the future for each person who gets sick now. Estimates are a factor between 2 and 4; so basically, they don’t know.
I feel for the Chinese people, but what I have my eye on is where else it is going. Look at the next two screengrabs:
Did you see it? Japan has the most cases outside of mainland China. In the first chart, it shows 46, in the second grabbed a couple of hours later it shows 86! Earlier it was reported that 10 of the “Japanese” cases are actually amongst 3,700 cruise ship passengers quarantined and anchored off Yokahama on the Japanese coast. Oh, joy for those cruisers who will now be onboard and going nowhere for two weeks. Has there been a jump in the number of passengers testing positive for Coronavirus? Similarly, a cruise ship is also quarantined in Civitavecchia on the Italian coast with an ill Chinese couple amongst the 6,000 passengers.
On the first chart, the scale makes the yellow line (outside of mainland China) almost flat. But when will that line start to emulate the rate of growth of the mainland China line? The US has taken action to limit this by quarantining persons coming from China and denying entry to passengers from China who are not US citizens or permanent residents. But we are two or more weeks behind asymptomatic contagion before these restrictions were put in place. So this is something to keep your eye on as February goes on.
Published in General
We have been keeping a close eye on it in the PIT with our man in Hong Kong reporting frequently.
Rod, I also have been following the epidemic on the Johns Hopkins site. I confess I don’t understand just what we’re seeing.
As an aside, I find it odd that today is the first day I’ve noticed the graph substantially differing from the aggregate infection count. It has generally reflected the count pretty well, and I’m surprised that the two aren’t synchronized now.
But the real puzzle to me is the concentration within China, and the apparent lack of transmission outside of China. Per this evening’s figures, fully 99% of the cases remain confined to China — 70% of those within Hubei province, presumably overwhelmingly within Wuhan itself.
The reported mortality rate from the disease within Hubei province is about 2.8%, more than ten times the mortality rate of the cases outside of Hubei. (In fact, essentially all coronavirus fatalities have occurred within Hubei province.) What does that mean? Is there something different about the virus inside Hubei? Has there been a major breakdown of care within Hubei? If the latter, do we have any idea what the real level of infection is in the city?
Given the peculiar concentration of the virus and the vast difference between figures reported from Wuhan versus elsewhere, I wonder how reliable any of the Chinese reporting is on the virus. I also wonder why it has remained so well-contained in the rest of the world.
It will be interesting to learn just what has gone wrong in public health care, epidemiological reporting, or both, once the crisis is over.
Sometimes the virulence of a new epidemic will decline after being transmitted through the initial series of hosts. Maybe not always, though. (I am not an epidemiologist, nor do I play one on TV.)
I’ve been watching closely. The explanation for the difference in mortality rates among Hubei, elsewhere in China, and other nations is obviously reporting, the only question is which variable is incorrect (if not both). I’m assuming that most other nations’ health services are on it, and the reporting is fairly accurate. Internal to China, I’m guessing that infections are under-reported in Hubei, with only those serious enough to show up for medical treatment being counted (if that), but deaths more or less accurate. The other Chinese provinces are the biggest question – are they more or less fully reporting infections, as with other countries, and therefore the death toll might possible be accurate. Or are they reporting only the most serious cases, in which case the deaths must be low, unless there’s some serious mutation that’s occurred (and occurred consistently in quite a few difference provinces – seems unlikely.)
The biggest problem is going to be when/if this gets loose in countries without an effective public health infrastructure. I’ve seen published worry pieces about Thailand, Cambodia, and Africa in general.
Strange things on the data again:
Japan now has only 25 cases with 61 of the 86 from the prior screen grab now be assigned to “Others”.
How does that work?
On a guess, they likely reassigned the patients from the cruise ship in Japan (where it’s moored) to Other. Probably due to political sensitivity in Japan, but then it doesn’t really make sense to put them in the totals for their home countries, since that would give the false impression of infections there. So Other.
Deaths are mainly among the elderly. Most of the people outside Hubei are travelers (business/pleasure/university) and I assume are less likely to be elderly.
Chinese reporting is historically unreliable and there is no reason yet to think that this epidemic is different. So the Chinese part of the graphs is likely to be GIGO.
The WHO is trying to keep Taiwan out of the loop. China engineered the selection of Ethiopian pol Tedros Adhanom as WHO director. So the WHO is ambivalent at best about best practices.
@henryracette
I would also think that since this is a respiratory infection, if someone who lives outside of China, and is therefore unaffected by the tremendous coal burning smog that has ravaged the lungs of those who live in Chinese cities, does come down with the disease, their lungs are in good shape and can rally against the infection.
My husband and I rarely come down with any type of infections. But in 2018, after spending about six weeks dealing with the heavy duty smoke from our region’s many wildfires gunking up our lungs, we were both as sick as dogs with some respiratory thing-ee it was hard for us to shake. Our malaise lasted a good three weeks. It was also the first time in my life of close to seven decades that I had ever been sick in September.
There are reports of bodies in the streets of Wuhan.
The NYT reports here (paywall, story quoted here and below)
The Daily Mail reports
All I want to know is if the zombies are coming. Because I’m woefully unprepared.
I feel people should not over analyze this kind of data. I doubt any real insights into the virus will be gained, and the most likely out come is building up a sense of hysteria about the situation. Things seem to be being handled in a reasonable manner so far. Again this doesn’t seem worse than the flu to me. Just more notorious for some reason.
The screenshots of the data put official Chinese lies on the same level with legitimate data coming out of less politically compromised health authorities in other countries. The non Chinese data definitely doesn’t justify hysteria. It looks as though there really is a serious epidemic in China, and so far it also looks like what China learned from SARS was not to be transparent but how to be non-transparent more effectively. That is an excellent way to incite hysteria elsewhere; whether this is what Xi wants is another question.
Agreed. That said, anticipating supply chain disruption is legitimate, and so is discussion of other aspects of the disease outbreak. For example:
Dr. Li subsequently died. Austin Bay, who wrote the quoted piece, notes:
China is getting hit hard by the coronavirus due to the combination of several factors:
Note a lot of these factors combined in the US during the 1918 Influenza. (1, 4. 5. 6 — in the form of military travel and enforced attendance at bond drives.)
The only places in the US that I see vulnerable to China-sized contagion are certain US cities with large homeless populations. They have conditions 1-5.
A lot of BART riders in the SF Bay Area have near daily exposure to homeless riders on the trains and in and around the stations.
There is a real economic impact of quarantining 500M people. Germany will definitely go into recession, because China will be buying fewer cars. The death rate is about 20X that of seasonal flu, which matters.
I recall a previous post by a Ricochetti on global warming, and one of the observations or analogies used, was to gauge the severity of a situation by observing how the flight attendants respond to in-air turbulence. Lots of people get nervous when flying when there are little bumps, but if you observe the flight attendants, and they are still serving drinks, smiling, doing their jobs, then it is fairly reasonable to assume all is well. When the flight attendants get into their jump seats and securely fasten their 3 point restraint systems, and have a serious look on their face, then it is a good time to start worrying. Likewise, the official reaction to this virus globally, points towards a very serious issue. The full body suits, the economic shutdown of China’s production, transportation, schools, festivals, movie theaters, the absolute quarantining of cruise ships, the immediate cremation of the dead. These are all steps that point to a situation that deserves sober consideration.
Xi Jinping appointed Premier Li Keqiang to head China’s response to the epidemic. Li is widely thought of as an ally of Xi’s predecessor Hu Jintiao… and as a rival whom Xi defeated in their struggle for power. Without knowing more than that, this makes me think that Xi wants somebody else holding the bag for this.
Everyone please take note of these words and similar ones along the lines of “Move along, there’s nothing to see here.” In a month’s time, use them to judge the credibility of the source.
“I would also think that since this is a respiratory infection, if someone who lives outside of China, and is therefore unaffected by the tremendous coal burning smog that has ravaged the lungs of those who live in Chinese cities, does come down with the disease, their lungs are in good shape and can rally against the infection.”
I have seen similar comments elsewhere. I hope this is true. Others have said that once the cold/flu season ends in the spring transmission may lessen greatly. I hope so. I don’t have much faith in our Obamacare damaged health care system’s ability to deal with a true pandemic, and due to the fact that 80% of pharmaceutical drugs are manufactured in China.
“The only places in the US that I see vulnerable to China-sized contagion are certain US cities with large homeless populations. They have conditions 1-5.”
NYC, LA and several other California cities like San Francisco have the most homeless. These cities also probably have the highest concentration of Chinese Nationals who may have come in contact with those with the disease. Here is LA, the Chinese are everywhere.
The fact that the Chinese statistics are unreliable doesn’t mean that there’s no cause for alarm. It means that the Chinese government has been lying about how bad things are. Among other things. Hint: they’re not lying to make things look worse than they really are. We know it’s worse than they’re saying, we just don’t know how much worse.
“The flu.”
The case fatality rate of the 1918 pandemic was probably between 10-20%. I have seen higher estimates than the Modeling Group’s based on the thinking that the critical difference between a potentially lethal case of flu in 1918 and today is our ability to provide life support to the critically ill. Respirators (thanks @drlorentz) are the limiting resource, though in a large scale pandemic medical staff availability would also be a factor. The flu itself was quite lethal in 1918; there were also a lot of secondary bacterial pneumonias. Guess who makes most of the antibiotics used in the US?
Sooner or later there will be an H1N1 outbreak (or a novel and lethal virus) and the year’s vaccine won’t work. The hope is that some means of producing an effective vaccine for an active epidemic followed by massive production of the vaccine will become possible before that happens.
Whenever the next health scare emerges (Ebola, H1N1, SARS, mad cow, heterosexual AIDS, etc) the first order of business for the layman is to google Michael Fumento and get his take. The guy is money in the bank.
In a nutshell, his take on Coronavirus: Those graphs will bend downward soon enough, chillax, get your flu shot, wear your seatbelt. We’re good.
After you do that, a useful question to ask yourself is: “who benefits from spreading FUD?”
“Guangzhou, the capital of China’s southwestern Guangdong Province and the country’s fifth largest city with nearly 15 million residents, has just joined the ranks of cities imposing a mandatory lockdown on all citizens, effectively trapping residents inside their homes, with only limited permission to venture into the outside world to buy essential supplies.
The decision means 3 provinces, 60 cities and 400 million people are now facing China’s most-strict level of lockdown as Beijing struggles to contain the coronavirus outbreak as the virus has already spread to more than 2 dozen countries.”
Yup. Just another version of the seasonal flu. Nothing to see here at all.
Move along Comrades.
I will repeat my comment of the other day: with everything going on in Hong Kong, this is a bad time for a distracting and disruptive Chinese epidemic and mobilization of government authority.
I’m keeping an eye on it, since I work for a Silicon Valley company that employs a lot of Chinese nationals. The company has ordered self-quarantine for anyone returning to China (14 days of working from home), and banned all travel to China (and discouraged any other international travel generally.) So they’re taking it seriously.
What’s interesting to me is that the regular old flu killed 61,000 people in the U.S. in 2017, and no one was particularly exercised. 34,200 were estimated killed by the flu last year, as well. I understand that this is a new thing, and so we know less about it, but I’m not going to freak out until there’s something to freak out about. @ontheleftcoast and I will compare notes, and if it is bad where we both are, we will freak out with alacrity, precision, and maximum efficiency.
I believe the standing joke is that breathing your air through a cigarette filter is healthier than breathing the air directly.
(We used to say that about Mexico city in the ’90s as well)
It’s important to have a plan.