Ricochet is the best place on the internet to discuss the issues of the day, either through commenting on posts or writing your own for our active and dynamic community in a fully moderated environment. In addition, the Ricochet Audio Network offers over 50 original podcasts with new episodes released every day.
I’d Like to Pass on the Corona
I haven’t seen a post on Ricochet talking specifically about the coronavirus, now known as 2019-nCoV or COVID-19, since Rodin’s post on the 7th. Let me take this opportunity to provide a short update from the other side of the world in Yokohama, Japan. While it’s not China, and not as bad off as China, the way this outbreak is progressing, Yokohama is now, as I’ll explain below, another front in the COVID-19 outbreak. Although I was in the Navy and spent time working in Emergency Management, now I’m just a plain ex-pat enjoying my retirement overseas, so most of what I’ll relate here comes from personal observations and local news sources.
Even with the occasional friction that occurs between China and Japan, Japan remains a favored destination for Chinese travelers. Before the outbreak kicked off, there were tons of Chinese tourists at popular locations across Japan every day. The last time I visited Kyoto a couple of years ago, the big tourist sites, buses, and sidewalks were packed as I had never seen them before. The famous shopping area in Tokyo called Ginza was crowded every day with tour buses and tourists, and while not all of them were Chinese, a vast majority appeared to be. However, starting at about the beginning of this month, Japan’s tourist locations saw traffic dry up. A store owner at Asakusa, one of the most popular sites in Tokyo, just mentioned on a news program that the number of tourists is way down, about 10 percent of normal, or a drop of 90 percent. One of the bigger duty-free stores called Laox, which sells electronics and electrical goods, is decreasing its workforce by 20 percent due to the outbreak.
Although it’s a different scale than China, the number of people in Japan infected with COVID-19 continues to slowly increase, as of today at 63, which I believe is the second highest after China. The first reported case of Japanese who tested positive with COVID-19, but had not visited Wuhan, was a bus driver who had driven a tour group of Chinese from Wuhan a few weeks ago. Soon afterward, a tour guide that had worked on one of his routes was also confirmed to have it. Whether the guide caught it from tourists from China or the driver hasn’t been reported, although this was a big question in the news a couple of weeks ago.
There’s another group of infected people that show the difficulty of limiting the infections, especially since news of the outbreak wasn’t reported early enough. There is a group of Tokyo taxi drivers that tested positive for the coronavirus, and when I first heard about it, I guessed that they must have caught it from a passenger. However, it’s been verified that they caught it from someone on a dinner boat ride they took a month ago, on 18 January. (This is before the outbreak became serious news.)
They were on the boat as part of a company “new year party,” known in Japanese as a shinnenkai (新年会). Many Japanese companies, families, and friends participate in end-of-year parties, known as bonenkai (忘年会, which means “forget the year party”) or new year parties. One of the people working on the dinner boat looks to have caught COVID-19 from someone else who came into contact with a person who had visited Wuhan. Of all of the people on the boat, 2 employees and 9 of the passengers have COVID-19. Did these people spread it before they were tested? How many of the other passengers might not be showing any symptoms but be carriers of the disease? While the public health officials have leads to investigate this incident and try to contain it, there are a couple of other small outbreaks at different locations, in Wakayama and Aichi, where they don’t know how the outbreak started.
Note that the number of infected people in Japan doesn’t include everyone in the country. There’s a cruise liner called the Diamond Princess that has spent many days over the last week or so sitting pierside in Yokohama, about a mile from where I used to work. It spent some time initially at anchor in Tokyo Bay before going pierside, and went to sea outside Tokyo Bay at least once during that time, probably to empty its sewage tanks. Allowing it to moor seems compassionate for the welfare of the crew and passengers. This is much better treatment than what another cruise liner, the Westerdam, has faced in Southeast Asia, since it was refused entrance to a few countries before being accepted by Cambodia. The Japanese are testing people on the ship who show symptoms of COVID-19 and taking those who are verified to have the disease to local hospitals. The total number on the ship who have tested positive was just reported as 454 by NHK news. This number is being reported separate from the total infected in Japan, although the infected people from the ship are being treated ashore in Japanese medical facilities.
It would undoubtedly stink to be stuck onboard the ship, waiting for the quarantine period to end, where you’re not allowed off the ship unless you’re confirmed to have the disease. I’ve been wondering whether, by staying onboard that ship, the infection may have been able to spread to more passengers. If the ventilation system on that cruise liner is anything like the ones on the Navy ships I’ve served on, I wouldn’t be surprised if the disease were to spread to other rooms. However, in response to these concerns, the cruise line company provided a letter containing information from a director at the CDC to all its passengers that there’s no evidence that the disease can spread via shipboard ventilation systems.
That said, there have been more incidents than I knew of where people on cruise liners suffered from virus outbreaks. A trip on a cruise liner sounds appealing, but the information at this site doesn’t make one seem enticing.
The first evacuation of American citizens was from Wuhan early this month. The next evacuation I know of involves American citizens on the Diamond Princess. There were originally around 400 Americans on it. The US government-chartered a couple of passenger jets to evacuate Americans who didn’t show signs of the disease to a couple of military bases in the US. According to this news page, around 330 of them departed this morning, so they should have arrived stateside by now. The news also reported that a few other nations, including Australia, Canada, Italy, and Hong Kong, are planning to do the same thing in the next few days. Other passengers who aren’t infected will have completed the 14-day quarantine in a few days, so those who aren’t infected should be able to get off of the ship soon.
As for personal protective equipment, the Japanese are well-known for wearing face masks when out in public. However, many of the face masks that they sell here are made in China, so the disruptions in China have caused the supply to run very low here. Japanese domestic manufacturers of masks are upping their production, but I don’t think they’ll make up for the shortfall anytime soon. Alcohol-based hand disinfectants are in the same situation, which is too bad since alcohol appears to be the ideal way to kill the virus.
China being a few hundred miles away, the outbreak has been a significant news item on all the news shows and newspapers since it became clear it would be big. I feel fortunate to speak Japanese well enough to understand much of the discussion from the subject matter experts that are brought in for interviews. The information provided has been detailed and dispassionate. Japan is not immune to the desire to avoid discussing embarrassing news, but in this case, the broadcasters seem to be pretty open to most aspects of this problem. Some of the daytime “wide shows” provide a lot of information on what’s going on, with questioners addressing different perspectives and bringing up things that cannot be easily answered.
Even though this is Japan, land of electronic screens, the hosts use huge boards the size of whiteboards, filled with information with details including maps, charts, tables, pictures, as well as comments from experts. These help to make complicated issues more accessible for the layman to understand, while also mentioning details that experts need. In comparison to Japanese commentators, I’m embarrassed when I see the type of coverage shown on American news programs, and how meager it is in comparison. My Navy and EM time have taught me to seek out the details, so I’m also not interested in how someone feels about the problem, I want to know more about various aspects of the problem.
Some of the Japanese experts I’ve seen on local television have said that this outbreak probably won’t die out until May, in which case it will probably get worse before it gets better. The Japanese are cutting down activities here, including such annual major public events as the celebration of the Emperor’s birthday at the Imperial Palace, which was scheduled for this coming Sunday but has been canceled. I expect to see more of this, and my family is limiting how much we go out, a form of voluntary quarantine that serves to lessen risk. They’ve already started talking about possible impacts on the Tokyo Olympics, but the jury is still out on that.
Thankfully, we’re not in China, where more people than the entire population of Japan are currently quarantined. Under the current situation, stopping flights to and from China, as the US and several airlines have already done, seems to have been a prudent move. Hopefully, that’s as far as the restrictions will have to go.
I’ll end this here, let me know if you have questions.
Published in Foreign Policy
Thank you very much for this report.
Thanks very much for the info.
My daughter is studying in Singapore right now, and her college over there is doing its classes over the internet, so she’s sitting in her apartment watching lectures on her laptop. Her weekend trips to Malaysia, Thailand, etc have been cancelled. They’re doing temperature checks to get into public buildings.
She’s not having fun.
I wonder how all this will turn out…
It’s obvious that people are dying of this but do you have any feedback on how sick the survivors get. Also can a person survive without extensive medical help?
This caught my eye. Generally, I’ve been trained, alcohol based products like hand sanitizers are generally about one notch above zero when it comes to killing viruses. Tell me more.
Thanks for the very interesting perspective.
A question about the quarantined ship: what percentage of those who got the virus are passengers versus crew? I understand that the passengers are quarantined to their cabins, but the crew cannot be. People keep getting sick. Is the crew spreading it?
Also, the news today carries a story about a Japanese couple who came down with the virus after returning to Japan from a Hawaiian vacation. Yet another point source for contagion.
We spent last week at a USAF pilot reunion. Most of the former AF pilots are now airline pilots, and there was lots of unhappiness among the FedEx pilots that they are still flying into China.
Main feed! Main feed! I thoroughly enjoyed your beautifully written article. I’m reminded of the earliest days of the Newseum in Virginia, where I spent a few hours reading the front- page coverage of Jimmy Stewart’s death in newspapers around the world.
FYI @rodin has also written several informative updates about the spread of the virus outside China that could add to your perspective. Please keep posting, and stay well! I’ll keep you and your family in my prayers.
Caveat – I’m not a doctor, I’m only repeating what I’ve seen on the news.
So far, it doesn’t appear to be an instant death sentence, the majority of people who’ve got it so far have survived. Some get really sick, with the worst coming down with pneumonia, but for many others the symptoms are like a flu. For comparison, although this outbreak is still pretty early, at this point in time, it doesn’t seem worse than SARS. The factor that is most troubling is the long period when someone can transmit the virus to others. COVID-19 appears transferable to others soon after one has been infected, even when the person shows no symptoms, and this period so far seems to last for a couple of weeks. That’s why the quarantine period is 2 weeks.
I had heard the same thing, so I’ve always walked past them. However, the expert medical advisor who’s been on several programs, and who teaches at a Japanese medical college, repeatedly says that alcohol breaks down the membrane that surrounds the COVID-19 virus tissue, killing it. I’m using my own, plain English, words, so don’t place any faith in my terminology.
I invite anyone with actual medical training to verify this.
I haven’t seen a breakdown of crew versus passengers. About ten percent of the total complement onboard the ship have been confirmed as infected.
I’m also interested in how the virus spread. There were plenty of interactions of crew and passengers up until they told everyone to stay in their rooms, so that’s the most likely cause. Not everyone shows symptoms at the same time, and the Japanese have only been testing people after they’ve shown symptoms. I think they’re also supposed to test everyone at the end of the quarantine period before they let them go, so we may see a big batch of infected people at that time.
I’m taking classes at a Japanese university, and they happen to be on break right now. As you gather, the Japanese have a different academic schedule for universities and colleges. The spring college semester starts in early April and runs until the end of July, while the fall semester starts late September and ends the end of January. It totally ruins the Christmas and New Years holiday period knowing that final exams or term papers are due soon. Conversely, not having to travel by train right now is a good thing. However, I don’t know of many universities here that are prepared to do what your daughter’s college can do. Here’s hoping it passes quickly.
Thanks, I hadn’t seen his 15 Feb update.
Good report. I heard the Tokyo Marathon was canceled.
One correction:
The makers of Purell are pruning their marketing strategy after the Food and Drug Administration slapped the company with a warning letter that told it to knock off unproven claims that the hand sanitizer can prevent diseases like Ebola, norovirus and MRSA.
Soap and water works.
Yeah, that’s pretty much what I knew was coming.
This whole thing intensifies my great dislike for those air dryers in public restrooms, especially the ones that have a sign on them, something like “40 trees went into the pulp needed to produce the paper towels you would have used.”
To make those infernal things even worse is that some will re-coat your hands almost as much as if you hadn’t washed them at all. And those 40 trees you saved weren’t majestic denizens of the forest primeval. They were grown on pulpwood tree farms, mainly in the SE U.S., much as we grow corn here in the West. And in so growing, and pulping, and being used, they bind up tons and tons of CO2 – instead of releasing how much carbon to generate the electricity to run that stupid blower. But I digress . . .
The CDC says alcohol based hand sanitizer also works.
The CDC’s Show Me the Science which includes information on handwashing, hand sanitizers, and their efficacy for various pathogens
Efficacy of various disinfectants against SARS coronavirus; a 2005 paper
Inactivation of SARS coronavirus by means of povidone-iodine, physical conditions and chemical reagents; a 2006 paper
Basically, for the relevant viruses, 70% ethanol is fine. Stock up on the 151 rum, or talk to your local moonshiner.
One point of clarification: All recommendations to use soap and water are supported across the medical community. However, the medical expert’s recommendation to use an alcohol-based hand-sanitizer was that it worked against this virus, which probably means coronaviruses in general. The CDC, NCBI, and for the layman, this post at Yahoo, note the effectiveness of alcohol. I was a skeptic, but I’m sold.
As for the Tokyo Marathon, Tokyo cancelled the participation of the over 10,000 regular runners, but plan to still hold it for around 200 Olympic-level runners, since it’s a qualifying event for the Olympics. What will happen with the Olympics remains to be seen. If this outbreak is anything like SARS, it won’t die down for a few months. While that may not impact the Olympics itself, how could one hold all of the qualifying events when the virus is most virulent?
For anyone still following this post, here are some details from today’s lunchtime news (18 February, Japan time):
This CDC webpage has links to the latest details, notably their situation reports and dashboards.
Well, there ya go.
Povidone-iodine, eh? I have a supply. We here could have very clean – and very red hands! It’s great stuff!
I live in Tokyo (Ota-ku) and suffice it to say that I am not amused — I’m with Sen. Tom Cotton on this one.
For clarification, I’ve lived off-and-on in Tokyo on several stints of various lengths since 1988 — all told, across a 30-year span, cumulatively I’ve logged about 18 years here, with this current stint having started in April 2016; I count myself extremely fortunate that I wasn’t here during the disastrous events of March 2011, and I just missed the Aum Shinrikyo-instigated subway attacks of 1995.
Getting back to my allusion to Sen. Cotton, while I’m “with” him in the sense that I see this outbreak as stemming from bioweaponry research, I see human error as the proximate cause — nothing derived from deliberate malice and planning; but the effect nonetheless may be Chernobyl-esque.
Pause to let that sink in.
So I’m lining up immediate-exit options; will update folks (here and elsewhere) over the coming 1-2 weeks.
One addendum: What strikes me as supremely irresponsible of the Japanese government is that it is not declaring that it is pulling/re-directing all resources (human, material, financial) presently/nominally committed to Olympics preparation, and prioritizing their deployment if and as appropriate with a focus on addressing the virus crisis; if taking such a step has a knock-on effect of jeopardizing the scheduling for the Olympics, well, cross that proverbial bridge at the requisite time.
Sure, I might have a significant misapprehension about whether the Olympics preparations — running in parallel with the effort to combat the virus — have any genuine and substantive impact on resource availability vis-a-vis this public health emergency, but my hunch is that there is much that can and should be diverted from the Summer Games readiness effort in order to minimize various strains on the work of protecting the public and hopefully extirpating this contagion.
This, of all times, is when the powers that be in Japan need to face up to the imperative of trade-offs and the potentially deadly folly of multitasking (not to mention fretting over sunk costs) — and I’m not confident that they’ll do that facing-up…
I also first came to Japan in ’88, although I was in Okinawa then. I was Yokohama when both Aum Shinrikyo and 3/11 happened. I didn’t experience the fears in 2011 that caused many expats to evacuate. I was doing emergency management for the US Navy then, and I had other sources of information that told me it wasn’t that bad.
As for this coronavirus, DNA-editing technology makes anything seem possible. However, this version of the coronavirus appears to be similar to the SARS coronavirus outbreak of 17 years ago. SARS was reported to have originated from one of China’s wet markets, a conclusion that was scientifically-recognized outside of China. For the time being, until other reliable evidence comes along to disprove it, I’m sticking with Occam’s Razor and accepting that this originated from a wet market. In agreement with you, I also think that human error, as well as other failings exacerbated by China’s police state atmosphere, allowed it to spread out of control.
While I understand your concerns, I’m not sure that this outbreak warrants an evacuation from Japan. First, Japan seems to be handling it pretty well (NOT perfectly, but they’re human, too). More importantly, this virus doesn’t currently appear to be very deadly. Outside of China, somewhere around 1,000 people are confirmed to be infected, but the last time I looked, the number who have died of it is still in the single digits. One other thing to keep in mind regarding evacuation: many of the people who have gotten infected appear to have gotten it while in public transportation–passengers and crew on the Diamond Princess, a tour bus, and a dinner-cruise boat. And while I haven’t heard of anyone confirmed to have caught it while on an airplane, that seems as likely to spread the virus as the other forms of conveyance.