Day 46: COVID-19 “In the Wild”

 

95 countries now in the “club”. The screen grab above doesn’t even include all of the countries with 100+ cases. The total official count now exceeds 100,000. Iran’s epidemic appears to be very much out of control, and note how may cases elsewhere are known to be sourced in Iran. There are suspicions that the death count reported from Iran may be low. There are now believed to be two main strains of COVID-19 — types L and S– with L being more severe and S less so. There may be more as, like influenza, this virus mutates.

Cruise ships continue to be featured in this pandemic. There is a cruise ship on the Nile River in Egypt that has 12 persons on board with COVID-19. This doesn’t seem comparable to the behemoth ships like the Diamond and Grand Princess, but the passenger capacity is less than 100. The pandemic is going to slam tourism hard, hard, hard. There was a report of a crowd of Reunion islanders who greeted a Princess cruise ship demanding that passengers be tested before being allowed to disembark. Of course there was neither plan nor capability to do so. And so police controlled the crowd while passengers boarded buses for their onshore excursion. The island population is under 1,000,000 and is frequently visited by tourists both by air and sea. Tourism is a big industry there, so the cruise ship greeting was not what local officials planned.

The US is now up to 12 deaths from COVID-19 (NBC is reporting 14). All but 1 were in Washington state in the Seattle area. Half were associated with a single long term care facility. 

A new term (to me) is being discussed on the World Health Organization website: Infomedics.

Infodemics are an excessive amount of information about a problem, which makes it difficult to identify a solution. Infodemics can spread misinformation, disinformation and rumors during a health emergency. Infodemics can hamper an effective public health response and create confusion and distrust among people.

And, you guessed it, WHO has a plan: EPI-WIN.

Working with the World Economic Forum, EPI-WIN has established networks with the key business sectors and public enterprises likely to be impacted by COVID-19 and future epidemics. These have been grouped into networks of Healthcare & Health Workers, Travel & Tourism, Food & Agriculture and International Mass Gatherings. Within each network, there are multi-national enterprises, professional associations and UN specialized bodies representing sectors that employ tens of millions of people and account for many billions of dollars in economic activity.

Keep Calm and Carry On, indeed.

[Note: Links to all my COVID-19 posts can be found here.]

Worldometers.com news update below. Reporting both March 5 & 6 as updates made to March 5 since last post:

March 6 (GMT):

  • 47 new cases and 1 new death in the UK, including: [source]
    – First Birmingham coronavirus case [source]
    5 new cases in Scotland, bringing the total to 11: Tayside, Ayrshire and Arran, Forth Valley, Greater Glasgow and Clyde, Grampian, Fife and Lothian [source]
    – 2 British Airways baggage handlers [source]
  • 4 new cases in Portugal: 3 are in the hospital center of São João, in Porto and “have an epidemiological link to previous cases”, which indicates that the source of the infection is in Italy. The other case, for which no information was provided, is receiving treatment in a health care in Lisbon. [source]
  • 154 new cases and 2 new deaths in France [source]
  • 33 new cases in Germany [source]
  • 1 new case in Bahrain [source]
  • 1 new case in the Dominican Republic (second case in the country): a Canadian tourist who was staying at a hotel in Bayahibe [source]
  • 6 new cases in Russia [source]
  • 46 new cases and 1st death in the Netherlands: an 86-year-year old man in Rotterdam whose source of infection is unknown [source] [source]
  • 100 new cases in Spain [source]
  • 18 new cases in Switzerland [source]
  • 2 new cases in San Marino [source]
  • 1st case in Peru: a 25-year-old man who was in Spain, France and the Czech Republic [source]
  • 1 new case in Brazil (first in Bahia): a 34-year-old woman, resident of Feira de Santana, who was in Italy and returned to Brazil on Feb. 25 [source] [source]
  • 3 new cases in Denmark [source]
  • 13 new cases in Singapore (largest single-day increase) [source]
  • 14 new cases in Greece (Zakynthos): part of the travel group who returned from the Holy Land in Israel. 3 from this group are in serious condition [source]
  • 12 new cases in Egypt on a Nile cruise ship heading to the southern city of Luxor from Aswan [source]
  • 2 new cases in Romania:
    – a 51-year-old woman who came in contact with the Suceava case. She will be admitted to Craiova. [source]
    – a young classmate of the 16-year-old boy who was diagnosed with coronavirus previously. The young woman has been transferred to the Victor Babes hospital in Timisoara [source]
  • 1st case in Slovakia: a patient aged 52 from a small, unspecified town in Slovakia, who has been hospitalized at the infectology clinic of the University Hospital in Bratislava. No recent travel history abroad, but his son – who does not show any symptoms of the virus – has been to Venice, Italy [source] [source]
  • 63 new cases and 2 new deaths in Spain [source]
  • 59 new cases in Belgium: total more than doubled since yesterday [source]
  • Total number of COVID-19 cases worldwide tops 100,000
  • 1,234 new cases and 16 new deaths in Iran [source]
  • 28 new cases in Malaysia [source]
  • 2 new cases in Iceland [source]
  • 1 new case and 3 new recoveries in Taiwan [source]
  • 5 new cases in Estonia [source]
  • 7 new cases in Sweden: 5 in Skåne and 2 in Västra Götaland. Total now tops 100 [source]
    • Stockholm region: 59
    • Västra Götaland region: 14
    • Region of Skåne: 14
    • Region of Värmland: 5
    • Region Uppsala: 4
    • Region Jönköping County: 3
    • Region Örebro county: 1
    • Region Gävleborg: 1
  • 2 new cases in Indonesia [source]
  • 1st case in Cameroon: a 58 years old French man who entered the country from France on Feb. 24 [source]
  • 1st case in Serbia: a 43-year-old man who traveled to Budapest [source] [source]
  • 1st case in Vatican City [source]
  • 1 new case in India: a person who has travelled to Thailand and Malaysia [source]
  • 1 new case in Pakistan [source]
  • 4 new cases in Austria [source]
  • 3 new cases in Finland [source]
  • 17 new cases in Japan
  • 309 new cases and 1 death in South Korea [source] [source]
  • 2 new cases in Norway (Bærum, Viken County). Total now tops 100 [source]
  • 2 new cases in the Philippines: a 48-year-old male Filipino with travel history to Japan and a 62-year-old male Filipino with no overseas travel history [source]
  • 12 new cases in Canada, including:
    1 in Ontario:
    a person who traveled to Las Vegas for an international conference [source]
    8 in British Columbia
    : 1 has no travel history, 2 had recently returned from Iran, 4 are linked to a previously confirmed case, 1 is connected to University Canada West where a presumptive case is being investigated [source]
    1 in Alberta: a woman in her 50s from the Calgary area who had been on board of the Grand Princess cruise ship, which is currently quarantined off the coast of California awaiting tests for all passengers and crew [source]
  • 12 new cases and 2 new deaths in the United States, including:
    2 new deaths in King County, Washington state.
    2 new cases in Washington state
    – first 2 cases in Colorado
    (Summit County): 1 is a 30-year old man who had traveled to Italy in February and was in contact with a confirmed case outside of Colorado.[source]
    – first 3 cases in Maryland
    (Montgomery County): they had all recently traveled overseas. [source]
  • 1st case in Bhutan: a 76-year old American tourist who arrived in Bhutan on March 2 via India. [source]
  • 143 new cases (126 in Hubei), 30 new deaths (29 in Hubei) and 1,681 new discharges occurred in China on March 5, as reported by the National Health Commission (NHC) of China. [source]

March 5:

  • 1 new case in Argentina: a 23-year old man who had recently traveled to Italy [source]
  • 1st case in Costa Rica: a woman who had traveled to Italy and Tunisia [source]
  • 1 new case in Chile: a Cook County resident in his 20s who flew into O’Hare after traveling from Italy where he caught the illness [source]’
  • 2 new cases in Hungary: including a man in Debrecen who works in Milan, Italy [source]
  • 1 new case in New Zealand: the partner of a previously confirmed case [source]’
  • 63 new cases and 1 new death in the United States, including at least:
    1st case in Colorado [source]’
    – 1 case in Middlesex County, Massachusetts
    fifth case in Illinois a person who returned from Italy. He’s in isolation at Rush. [source]’
    second case in New Jersey: a 32-year-old man from Fort Lee [source]’
    – 2 cases in Harris County, Texas: both are travel-related to Egypt [source]’
    1 new death in King County (Washington state): a woman in her 90s
    – a resident of Sonoma County (second case there) who traveled internationally on the Grand Princess ship from San Francisco to Mexico [source]
    4 in Los Angeles County, California [source]
    the 1st cases in San Francisco, California [source]’
    11 in New York State: 3 are in serious condition and are treated in intensive care units [source] New cases include a man in his 40s and a woman in her 80s [source]
    – the 1st case in Nevada
    [source]
    – 1 in Tennessee (Williamson County) [source]
    – a Facebook worker in Seattle [source]
    – the 1st case in New Jersey: a man in his 30s hospitalized in Bergen County [source]
  • 138 new cases and 3 new deaths in France, including the first 3 cases in Corsica [source][source]
  • 7 new cases in Ireland: including the first in Cork, with no recent history of travel, who is being treated in an intensive care unit. [source]
  • 1 new death in Iran today is of a senior Iranian politician, Hossein Sheikholeslam, Iran’s former ambassador to Syria and former advisor to current Foreign Minister Mohammad Javad Zarif. He was 67 years old [source]
  • 5 new cases in Brazil [source]
  • 1 new case in Luxembourg: a person who had recently returned from Northern Italy [source]
  • 283 new cases in Germany [source]
  • First 7 cases in Palestine, West Bank. 5 new cases in addition to the first 2 reported earlier. Palestinian Authority closes Bethlehem churches and mosques for two weeks [source] [source]
  • 1st death in the UK, an older patient with pre-existing conditions. [source]
  • 769 new cases and 41 new deaths in Italy, which becomes the country with the largest daily increase in cases and deaths in the world. [source]
    Among the 3,296 active cases, 1,790 (54%) are hospitalized, 331 of which (representing 11% of active cases) are in intensive care.
    Among the 562 closed cases, 414 (74%) have recovered, 148 (26%) have died.
  • 42 new cases in Sweden, bringing the total number of cases in the country to 94. [source]
  • 5 new cases in Slovenia [source]
  • 5 new cases in Denmark including former Danish footballer Thomas Kahlenberg [source]
  • 28 new cases in the UK [source]
  • 2 new cases in Israel [source]
  • 3 new cases and 1 new death in Iraq: a 65-year-old person in Baghdad [source] [source] [source]
  • 1 new case in Israel [source]
  • 2 new cases and 1 new recovery in Canada (Ontario) [source]
  • 3 new cases in Ecuador: all linked to the first confirmed case [source]
  • 1 new case in Oman: a man who had recently traveled to Milan, Italy [source]
  • Diamond Princess cruise ship: The Ministry of Health, Labor and Welfare has corrected the number of cases from 706 to 696. After examining the results of the virus test, it was reported that some people were counted twice. [source]
  • 4 new cases in the Czech Republic [source]
  • 1 new case in Lebanon: a Lebanese woman coming from Britain [source]
  • 3 new cases in Portugal: two males, aged between 40 and 50, admitted to São João Hospital in Porto, and a man in Lisbon who had recently traveled to Italy [source]
  • 44 new cases in the Netherlands [source]
  • 26 new cases and 1st death in Switzerland: a 74-year-old woman who had been hospitalized since March 3. The woman suffered from a chronic illness. Source of infection still unclear. [source][source]
  • 54 new cases and 1 death in Spain [source]
  • 33 new cases in Japan, including 8 in Tokyo and 8 in Aichi
  • 5 new cases in the Republic of San Marino bringing the total to 21: 15 are hospitalized, 3 are in serious condition. [source]
  • 1 new case in India (Ghaziabad) [source]
  • 22 new cases in Greece [source]
  • 1 new case in Canada (Québec) [source]
  • 5 new cases and 2 new recoveries in Singapore [source]
  • 3 new cases in Saudi Arabia [source]
  • 1st case in South Africa: a 38-year-old man who had traveled to Italy with his wife. They were part of a group of 10 who arrived back in South Africa on March 1. [source]
  • 9 new cases in Iceland [source]
  • 1 new case in Egypt, bringing the total to 3 [source]
  • 3 new cases and 3 new recoveries in Bahrain [source]
  • 5 new cases in Malaysia [source]
  • 27 new cases in Belgium [source]
  • 6 new case in Georgia: a person who had recently visited Italy. [source]
  • 3 new cases in Azebaijan: they had all visited Iran. [source]
  • 3 new case in Estonia: including a resident of Tallinn who had been on the same flight from Bergamo, Italy, to Riga as the second confirmed case. [source]
  • 1 new case in Slovenia: a person who was in contact with the first case. [source]
  • 591 new cases and 15 new deaths in Iran
  • 5 new cases in Finland: 3 in the Helsinki and Uusimaa hospital district, 1 is in Pirkanmaa and 1 in Kanta-Häme. The case in Kanta-Häme is a child in Hämeenlinna who had returned from northern Italy with their family on Tuesday. [source]
  • 3 new cases in Scotland (UK) [source]
  • 1 new case in Russia: an Italian citizen [source]
  • 1st case in Bosnia and Herzegovina: a middle-aged man and his child who recently visited Italy. His wife tested negative. He is in stable condition, hospitalized in isolation in Banja Luka. School children who have had contact with the infected child will now be tested. [source]
  • 1 new case in Morocco: a Moroccan woman who recently returned to Casablanca from Italy. [source]
  • 2 new cases in Kuwait [source] [source]
  • 11 new cases in Norway [source]
  • 15 new cases in Austria [source]
  • 4 new cases in Thailand [source]
    – a 29 year-old Italian man who arrived in Thailand on March 1
    – a 42 year-old Thai male office worker who returned from Italy
    – a 22 year-old Chinese male student who was screened with symptoms while in transit at Bangkok’s Suvarnabhumi Airport while traveling from Iran to China.
    – a 20 year-old Thai male student who arrived from Iran on Feb. 27
  • 467 new cases, 7 new deaths, and 47 new recoveries in South Korea [source] [source]
  • 139 new cases (134 in Hubei), 31 new deaths (all in Hubei) and 2,189 new discharges occurred in China on March 4, as reported by the National Health Commission (NHC) of China. [source]

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  1. Gumby Mark (R-Meth Lab of Demo… Coolidge
    Gumby Mark (R-Meth Lab of Demo…
    @GumbyMark

    We had the first case in our city three days ago.  Now all 6 emergency responders who took the person to the hospital are in isolation.  How is this supposed to work when the number of cases starts ramping up?

    • #1
  2. Dr. Bastiat Member
    Dr. Bastiat
    @drbastiat

    I can’t thank you enough for all this info.  Your ongoing work on this topic is VERY much appreciated.

    • #2
  3. Kozak Member
    Kozak
    @Kozak

     

    The nurses statement just blew my mind.

    • #3
  4. Kozak Member
    Kozak
    @Kozak

    About 6 weeks too late.

     

     

    • #4
  5. Rodin Member
    Rodin
    @Rodin

    Gumby Mark (R-Meth Lab of Demo… (View Comment):

    We had the first case in our city three days ago. Now all 6 emergency responders who took the person to the hospital are in isolation. How is this supposed to work when the number of cases starts ramping up?

    I assume this is a reference to the Sunnyvale, CA man who was administered CPR (but died)?

    The rule is going to have to be protect the health care and first responders first. This is like the airline safety instructions: “If you are traveling with a small child and the air masks deploy (for cabin decompression) place your mask on before assisting the child.”

    • #5
  6. Kozak Member
    Kozak
    @Kozak

    Gumby Mark (R-Meth Lab of Demo… (View Comment):

    We had the first case in our city three days ago. Now all 6 emergency responders who took the person to the hospital are in isolation. How is this supposed to work when the number of cases starts ramping up?

    Poorly. Very poorly.

    • #6
  7. Valiuth Member
    Valiuth
    @Valiuth

    Seems China has curbed the spread of the disease (at least according to these numbers), even if we assume the numbers coming out of China are massaged to be more favorable if it was running rampant and uncontrolled do you think they could really hide it given the numbers already reported? I think even they would have trouble keeping it under wraps. 

    However Iran seems to be devolving fast, and it is a large country (not stupid large like China but it does have like 60 million people if I recall) so there is a lot of potential for spread there. 

    Things still going okay, I would say. We are starting to see economic effects, but I think that was to be expected and are reasonable. People really should be cutting back on travel especially in enclosed spaces like cruise ships. I mean seriously, those things are ideal for spreading things like COVID-19. I think at this point it would be nice for the CDC to post some positive accomplishments just to help morale. Cause the whole testing kit follies is just embarrassing. 

     

    • #7
  8. Valiuth Member
    Valiuth
    @Valiuth

    Gumby Mark (R-Meth Lab of Demo… (View Comment):

    We had the first case in our city three days ago. Now all 6 emergency responders who took the person to the hospital are in isolation. How is this supposed to work when the number of cases starts ramping up?

    Well ideally they will only be in isolation a short time because you will be able to test them for the virus. It should be detectable even prior to symptoms. If they are negative they can go back to work. If it gets real bad maybe you just have them on partial isolation. ie. They still work and interact with hospital staff and respond to COVID-19 emergencies , but stay away from others. With constant testing to screen for infection. I mean if it gets that bad then there is almost no reason to isolate medical staff away anymore. They will all come in contact with the disease at some point. You just want to isolate them from uninfected civilians. Lets hope it doesn’t come to that. for now we can hopefully afford excessive caution. 

    • #8
  9. MarciN Member
    MarciN
    @MarciN

    A positive-outcome story in the WSJ today, “The Company That Fought the Coronavirus and Won“:

    STOCKDORF, Germany—The chief executive of a little-known local auto supplier had received an alarming email: One of his employees—who had just visited the company’s headquarters, shaking hands with management, including him—had tested positive for the novel coronavirus.

    This was how Europe’s first major Covid-19 outbreak started, but more impressive was how it ended. In slightly more than a month, the outbreak was successfully contained, and all 16 infected are now free of the pathogen.

    Company executives and health officials used detective work, rapid testing and isolation to limit the spread. The quick response is an example of how to contain a virus that remains little understood and has killed about 3,200 people world-wide, some 3% of all those known to be infected.

    “Managing a health crisis like this is something completely different than an economic crisis,” said Holger Engelmann, CEO of the company, Webasto SE, which makes sunroofs, electric-car chargers and air-conditioning systems. “It’s personal.”

    Before Mr. Engelmann opened that email Jan. 27, the virus seemed far away. “Then, all of a sudden, the virus was so close,” he told The Wall Street Journal.

    A Chinese employee had visited the company’s headquarters in the sleepy town of Stockdorf, near Munich, to attend a training seminar. She didn’t exhibit any symptoms in Germany as she met different co-workers, including Mr. Engelmann, who shook her hand. . . .

    The employee told the radio station that he went straight to the doctor and tested positive for the virus later that day.

    “At that point, we knew that something was about to hit us,” Mr. Engelmann said. He summoned a conference call and set up a crisis committee that Monday.

    The group included 17 active members and a shadow committee of the same size—the B-team in case executives on the front line fell ill. He also requested that Bavaria’s Infectious Diseases Task Force, a team of doctors and virologists, come to Stockdorf the next day and test the committee members.

    When the crisis committee reported to work Tuesday, they were met by Dr. Martin Hoch, leader of Bavaria’s disease task force, and three of his team, dressed in protective clothing and wearing face masks.

    They took DNA swabs from the executives and began the arduous detective task of identifying everyone who had had contact with the Chinese woman or any of the Stockdorf employees who had contracted the virus.

    The committee members all tested negative. . . .

    [continued in comment 10]

    • #9
  10. MarciN Member
    MarciN
    @MarciN

    [continued from comment 9]

    Around 1,500 employees at the Stockdorf headquarters were ordered to work from home that Tuesday. By the end of the day, three more Stockdorf employees, who had attended the training with the Chinese associate, tested positive.

    By then, little-known Webasto had become front-page news in and beyond Germany. Company officials decided to extend the home-office mandate for a week through Feb. 2.

    Initially, Bavarian health officials didn’t think it was necessary to shut down Webasto’s offices, but Mr. Engelmann ordered the closure to protect employees against the virus—an account confirmed by Bavarian officials.

    “The decision of the Webasto management to shut down and keep people home was a decisive factor in containing the spread of the virus,” Dr. Hoch said. “That allowed us to isolate those who had contact very early. We identified about 230 people.”

    Anyone who tested positive was treated at a hospital in Munich, even if their symptoms were mild.

    “It was clearly our policy to treat each case in hospital,” so as to keep a close check on the development of the unfamiliar disease, said Dr. Andreas Zapf, director of the Bavarian State Agency for Health and Food Security.

    On Feb. 3, the day Webasto had hoped to reopen its offices, Mr. Engelmann extended the shutdown for most of the 1,500 employees for another nine days. By now, seven Webasto employees had tested positive and around 122 examined in the previous week tested negative. All of the infections led back to the training seminar in January. The company extended the shutdown another week, keeping the office closed for a total of 14 days, the virus incubation period. . . .

    Next door, at Webasto, lights are burning in the offices again. This week, the company reported that the last employee had left the hospital, virus-free.

    The virus has since spread across Europe—and returned to Bavaria—from a separate outbreak in Italy, whose origin remains obscure. Still, Mr. Engelmann and his associates, in conjunction with the local health officials, managed to stop the Webasto outbreak within the company before it could infect the community.

    By Feb. 14, the number of infections had peaked at 16, including nine Webasto employees in Germany, five of their relatives, and two company employees in China. A month after the first infection was discovered, the staff at Mr. Zapf’s agency are still studying the Webasto case to better understand which coronavirus patients can be kept at home and who should be treated in a hospital in the future.

    “We are trying to slow this thing down considerably,” said Dr. Zapf. “We want to slow it down and buy ourselves time to develop a vaccine.”

    This occurred because of the availability of the test. Why we did not have these tests up and running sooner is the question that will occupy historians.

    • #10
  11. MarciN Member
    MarciN
    @MarciN

    Dr. Bastiat (View Comment):

    I can’t thank you enough for all this info. Your ongoing work on this topic is VERY much appreciated.

    I second this. Thank you very very much.

    • #11
  12. DrewInWisconsin, Influencer Member
    DrewInWisconsin, Influencer
    @DrewInWisconsin

    https://thehill.com/policy/healthcare/486231-health-experts-warn-coronavirus-mortality-rate-likely-to-drop

    U.S. health officials have been quick to point out the concerns over the WHO’s estimated mortality rate after Ghebreyesus said Tuesday that it was about 3.4 percent.

    President Trump himself on Wednesday forcefully questioned the WHO estimate, saying during a phone interview on Sean Hannity‘s Fox News show that his “hunch” was that it was much lower.

    “I think the 3.4 percent is really a false number, and this is just my hunch, but based on a lot of conversations with a lot of people that do this because a lot of people will have this and it’s very mild. They’ll get better very rapidly, they don’t even see a doctor, they don’t even call a doctor. You never hear about these people,” Trump said.

    U.S. health officials have acknowledged that the WHO is right to say the virus appears deadlier than the seasonal flu, even if they may disagree with the estimated mortality rate.

    “The best estimates now of the overall mortality rate for COVID-19 is somewhere between 0.1 percent and 1 percent. That’s lower than you’ve heard probably in many reports,” Assistant Secretary of Health Brett Giroir said Thursday during an appearance on Capitol Hill.

    “This is likely more severe in its mortality rate than a typical flu season, but it’s certainly within the range. So we don’t want people to go crazy,” he added.

     

     

    • #12
  13. DrewInWisconsin, Influencer Member
    DrewInWisconsin, Influencer
    @DrewInWisconsin

    See also: https://pjmedia.com/news-and-politics/covid-19-and-mortality-trump-and-who-are-both-right/

    (Behind a pay wall, but here’s the important part)

    We have a couple of examples that, if not quite perfect Petri dishes, are at least informative, well-controlled populations: the Diamond Princess cruise ship, and South Korea.

    A cruise ship is honestly the perfect environment in which to spread a virus, . . . So you would expect a pretty significant proportion of the passengers and crew of the Diamond Princess to get sick, and they did, with 704 sick among 3711 passengers and crew. That’s about 19 percent — call it one in five. Of those, there were six deaths, yielding a case-fatality of about 0.008 – 0.8 percent.

    Then there’s South Korea, where there are 6593 confirmed cases and 40 deaths (as of 6 March 2020 at 03:33 EST). The case-fatality rate there is about 0.006 — 0.6 percent.

    Now, on one hand, these are sort of small samples, but on the other hand, they both have special characteristics that make them interesting. The Diamond Princess was about as well isolated and densely packed an exposed population as you could find. While I’m sure they tried to minimize exposures on the ship once they were aware of COVID-19, there’s only so much you can do. But because of that isolation, they were also able to identify cases rapidly and rather specifically.

    . . . South Korea has an utterly closed border with North Korea, and it’s their only land border. It’s one of the most densely populated countries in the world, amazingly so in the Seoul area. So it’s not too far wrong to think of it as a really, really big cruise ship. When the first cases were identified, the South Korean government began aggressively testing and isolating.

    Both the Diamond Princess and South Korea share two characteristics, then: isolated populations, close observation, and aggressive testing. This suggests that mildly-symptomatic patients are being identified more readily. Even then, however, the number of identified cases is still probably significantly less than the actual number of cases. After all, if you’re really asymptomatic, why would you see a doctor? And a mild case of COVID-19 is really just like having a cold or flu — fever and cough.

    The real result here is that in two isolated populations, we’re finding that the real observed case-fatality rate is much lower than the 3.4 percent case-fatality rate the WHO reported.

    • #13
  14. DrewInWisconsin, Influencer Member
    DrewInWisconsin, Influencer
    @DrewInWisconsin

    MarciN (View Comment):
    Dr. Andreas Zapf, director of the Bavarian State Agency for Health and Food Security.

    Dr. Zapf? He’s a Dingbat!

    (Typography humor, please ignore.)

    • #14
  15. Rodin Member
    Rodin
    @Rodin

    MarciN (View Comment):
    This occurred because of the availability of the test. Why we did not have these tests up and running sooner is the big questions for historians. It’s been appalling to watch this failure in this country, the most advanced society the world has ever known.

    I do not assume there is “the” test. If someone has a link to a description of the various testing methods and their efficacy it would be instructive. We have heard about “false negatives” which imply that there are limits to the accuracy of at least some testing methods. The disease has a progression from infection to symptoms (which is the body forming antibodies) to post “recovery” contagion potential. What test can accurately detect the presence of COVID-19 and where in the respiratory system at a given point in the disease progression is unclear to me. I would like more information.

    • #15
  16. MarciN Member
    MarciN
    @MarciN

    DrewInWisconsin, Influencer (View Comment):

    MarciN (View Comment):
    Dr. Andreas Zapf, director of the Bavarian State Agency for Health and Food Security.

    Dr. Zapf? He’s a Dingbat!

    (Typography humor, please ignore.)

    I love typography humor. Funny typos are what keep sleepy editors awake and laughing. :-) 

    • #16
  17. Gumby Mark (R-Meth Lab of Demo… Coolidge
    Gumby Mark (R-Meth Lab of Demo…
    @GumbyMark

    Rodin (View Comment):

    Gumby Mark (R-Meth Lab of Demo… (View Comment):

    We had the first case in our city three days ago. Now all 6 emergency responders who took the person to the hospital are in isolation. How is this supposed to work when the number of cases starts ramping up?

    I assume this is a reference to the Sunnyvale, CA man who was administered CPR (but died)?

    The rule is going to have to be protect the health care and first responders first. This is like the airline safety instructions: “If you are traveling with a small child and the air masks deploy (for cabin decompression) place your mask on before assisting the child.”

    This is in Scottsdale AZ.  Just reported today.

    • #17
  18. Gumby Mark (R-Meth Lab of Demo… Coolidge
    Gumby Mark (R-Meth Lab of Demo…
    @GumbyMark

    DrewInWisconsin, Influencer (View Comment):

    See also: https://pjmedia.com/news-and-politics/covid-19-and-mortality-trump-and-who-are-both-right/

    (Behind a pay wall, but here’s the important part)

    We have a couple of examples that, if not quite perfect Petri dishes, are at least informative, well-controlled populations: the Diamond Princess cruise ship, and South Korea.

    A cruise ship is honestly the perfect environment in which to spread a virus, . . . So you would expect a pretty significant proportion of the passengers and crew of the Diamond Princess to get sick, and they did, with 704 sick among 3711 passengers and crew. That’s about 19 percent — call it one in five. Of those, there were six deaths, yielding a case-fatality of about 0.008 – 0.8 percent.

    Then there’s South Korea, where there are 6593 confirmed cases and 40 deaths (as of 6 March 2020 at 03:33 EST). The case-fatality rate there is about 0.006 — 0.6 percent.

    Now, on one hand, these are sort of small samples, but on the other hand, they both have special characteristics that make them interesting. The Diamond Princess was about as well isolated and densely packed an exposed population as you could find. While I’m sure they tried to minimize exposures on the ship once they were aware of COVID-19, there’s only so much you can do. But because of that isolation, they were also able to identify cases rapidly and rather specifically.

    . . . South Korea has an utterly closed border with North Korea, and it’s their only land border. It’s one of the most densely populated countries in the world, amazingly so in the Seoul area. So it’s not too far wrong to think of it as a really, really big cruise ship. When the first cases were identified, the South Korean government began aggressively testing and isolating.

    Both the Diamond Princess and South Korea share two characteristics, then: isolated populations, close observation, and aggressive testing. This suggests that mildly-symptomatic patients are being identified more readily. Even then, however, the number of identified cases is still probably significantly less than the actual number of cases. After all, if you’re really asymptomatic, why would you see a doctor? And a mild case of COVID-19 is really just like having a cold or flu — fever and cough.

    The real result here is that in two isolated populations, we’re finding that the real observed case-fatality rate is much lower than the 3.4 percent case-fatality rate the WHO reported.

    I understand the math on the fatality rate.  The question is if there is only a fraction of that infection rate in a much larger population (say 330 million) what is the capacity of the health care system to handle and provide treatment?  Rodin’s report as of today says there are 6 dead and 34 seriously ill from the cruise ship.  So, if we assume none of the other 444 cases are hospitalized, that’s still about a 6% hospitalization rate.  That’s a big problem if this scales up.

    • #18
  19. Roderic Coolidge
    Roderic
    @rhfabian

    The number infected in the US appears to be doubling every 3 or 4 days, just as it did at the beginning of the epidemic in China.  At this rate we’ll have 10,000 infected by the end of the month, 100,000 infected by mid April.

    I don’t think this squares with the government’s assessment that we are at “low risk” for infection.  

    There’s a potential for having a worse time of it here than they are having in China.  For one thing we don’t weld people’s doors shut to enforce quarantines, and Americans are more likely to buck authority. 

    • #19
  20. DrewInWisconsin, Influencer Member
    DrewInWisconsin, Influencer
    @DrewInWisconsin

    Roderic (View Comment):

    The number infected in the US appears to be doubling every 3 or 4 days, just as it did at the beginning of the epidemic in China. At this rate we’ll have 10,000 infected by the end of the month, 100,000 infected by mid April.

    That’s only if you assume that it will keep going up.

    There’s a potential for having a worse time of it here than they are having in China. For one thing we don’t weld people’s doors shut to enforce quarantines, and Americans are more likely to buck authority.

    But we are also less densely packed, and a bit more . . . shall we say, . . . “sanitary.”

    • #20
  21. Unsk Member
    Unsk
    @Unsk

    The nurse’s statement posted by Kozak should be a huge wake up call.

    It should be very apparent by now that even with protective gear health care workers can get very sick when treating Corona Virus patients. That is a huge problem, but it is a problem that has been known for weeks. We should not be trying to treat these Corona Virus patients in our regular hospital facilities because they will likely just infect almost the entirety of those facilities because there are just too many ways this disease can spread and our health care workers have neither the equipment nor the training to prevent that. That will result in a hellacious healthcare disaster.  We should have been building specialized separate facilities that limit the exposure to healthcare workers for weeks now. Damn the cost.

    I afraid President Trump is blowing it. Yesterday from some reports he didn’t answer a question about the availability of test kits.

    The CDC promised by today that 1 million  test kits would be available, but I don’t think anyone seriously thinks that is going to happen.  We need those test kits right now and that is just the beginning. South Korea is testing 10,000 patients a day and we have only done a few hundred tests?  That is why that nurse  couldn’t be tested- there are simply way too few test kits. That is a disgusting national disgrace. With the FDA and the CDC, as  Trump done repeatedly with other rogue bureaucrats before, he is trying to  work with them to get them to do their job, but our Federal Bureaucracy through a series of very Progressive Supreme Court cases has been so overly  protected  from oversight and accountability that is now almost totally unresponsive, which the FDA and CDC has been in these case even in the face of this pandemic which could cost untold lives through their negligence. Trump has to very publicly come down very hard today if they do not meet the test kits goals or he will be blamed for their immense negligence.   Our health care worker’s lives are going to be at risk which very  quickly, though the union’s powers,  could shut down the entire system if the health care workers are not reasonably protected.

    It seems apparent that the Corona Virus Task Force is not familiar with the concept of “worst case scenario” or has not considered the very high probability that a very bad scenario even if it is not the worst case  could happen with this pandemic. The Task Force seems more interested in managing daily messaging than preparing the country, and has not considered that very soon if the appropriate preparatory steps have not been taken, no amount of messaging will prevent a debilitating panic and a national disaster on a monumental scale.

    • #21
  22. Rodin Member
    Rodin
    @Rodin

    Gumby Mark (R-Meth Lab of Demo… (View Comment):
    The question is if there is only a fraction of that infection rate in a much larger population (say 330 million) what is the capacity of the health care system to handle and provide treatment?

    Precisely. Let’s assume that the “real” fatality rate is only 0.8% for those receiving first world health care. Let’s also assume an infection rate of 1.6% (a modest doubling of the supposed low fatality rate). In the United States that would project to 5,280,000 cases with 42,240 deaths. Our health system could deal with so long as it is spaced out. But if it isn’t spaced out and it breaks our health system, then the direct fatality rate goes up and there are indirect fatalities associated with lack of care for other diseases and trauma.

    • #22
  23. DrewInWisconsin, Influencer Member
    DrewInWisconsin, Influencer
    @DrewInWisconsin

    Because of my own tendency to be anxious, I am focusing on a couple related things:

    First, that because we aren’t doing as much testing as other places, and because symptoms are often indistinguishable from the common cold, we probably have a lot more cases in the U.S. than we realize.

    But second, that also probably means that the fatality rate is far lower than the current estimates.

    It might be a case where this is a coronavirus that spreads more easily, but isn’t especially more dangerous.

    I’m clinging to that.

    My biggest worry is the fallout from unnecessary panicking. My income depends on schools in Wisconsin and Minnesota staying open. Should we see a lot of cases springing up in Wisconsin or Minnesota, I could see schools closing for the rest of the school year, which would pretty much reduce me to poverty. That’s what gives me the most anxiety.

    • #23
  24. OmegaPaladin Moderator
    OmegaPaladin
    @OmegaPaladin

    If this continues, we need to move from using completely disposable protective gear to masks like asbestos remediation workers wear.   I’ve done PPE design on a budget before professionally

    • #24
  25. MarciN Member
    MarciN
    @MarciN

    DrewInWisconsin, Influencer (View Comment):

    Roderic (View Comment):

    The number infected in the US appears to be doubling every 3 or 4 days, just as it did at the beginning of the epidemic in China. At this rate we’ll have 10,000 infected by the end of the month, 100,000 infected by mid April.

    That’s only if you assume that it will keep going up.

    There’s a potential for having a worse time of it here than they are having in China. For one thing we don’t weld people’s doors shut to enforce quarantines, and Americans are more likely to buck authority.

    But we are also less densely packed, and a bit more . . . shall we say, . . . “sanitary.”

    I’m putting all of my hope in an early spring. Whenever contagious infections have gotten loose in the schools my kids attended, the principals or superintendents would wisely shut them down for a week or two and air out the buildings. In spring, the infections stopped coming. February was always the worst. By the middle of March, things started to improve on their own. 

    I think once we start getting into the warm humid spring temperatures, get outside more, get more exercise, the virus will find fewer hosts. Exercise will boost our circulation and immune systems and our lungs’ ability to get rid of congestion, which is the breeding ground for pneumonia. Congestion is the enemy of hardworking surgeons, and they deploy their heartless Nurse Ratchets to the post-surgical wards to get their patients up and walking around a little bit as a way to fend off pneumonia settling into the base of the lungs–I’m quoting the nurse who forced me to get up and out of bed the day after surgery. :-) 

    I’ve been checking the weather for the most affected countries–Wuhan, Milan, Seoul–and their weather looks a lot like ours right now. As we move into warm spring temperatures–and all indications are that spring will be early this year, despite this weekend’s snowstorm–we will watch this bug go into dormancy, at least for a while. That will give us time to get the treatment remdesivir medicine and the vaccines through trials, production, and distribution. By next fall, I hope. 

    • #25
  26. MarciN Member
    MarciN
    @MarciN

    Unsk (View Comment):
    That is a huge problem, but it is a problem that has been known for weeks.

    Correction: for years, since the Ebola outbreak in 2014. 

    • #26
  27. MarciN Member
    MarciN
    @MarciN

    Unsk (View Comment):
    It seems apparent that the Corona Virus Task Force is not familiar with the concept of “worst case scenario” or has not considered the very high probability that a very bad scenario even if it is not the worst case could happen with this pandemic. The Task Force seems more interested in managing daily messaging than preparing the country, and has not considered that very soon if the appropriate preparatory steps have not been taken, no amount of messaging will prevent a debilitating panic and a national disaster on a monumental scale.

    We can’t blame them. This neglect in procedures and equipment has been known since the Ebola and Zika scares. The current group of people are politely not saying that the situation was abysmal when they inherited it.

    This informative article about the research on the Zika virus that is being conducted at the University of Texas Medical Branch at Galveston provides some insight into explanations as to how and why this new corona virus is spreading so far and wide and fast (Dina Fine Maron, “How Zika Spiraled out of Control,” Scientific American, May 24, 2016). Apparently it is an improbable “perfect-storm” scenario of events that come together.

     

    • #27
  28. Unsk Member
    Unsk
    @Unsk

    “But we are also less densely packed, and a bit more . . . shall we say, . . . “sanitary.””

    Drew,  there are a number of possible reasons why China is uniquely susceptible to this virus ranging from as you mentioned the incredibly poor sanitary habits of the Chinese peasantry, to the enormously high number of heavy smokers, to the incredibly  bad air quality, to even a possible high susceptibility of those of Northern Chinese ancestry to SARS like diseases by one Chinese University study.  It would be great, that if they possibilities were all true,  which we don’t know, so that America’s susceptibility  would be significantly less to this Corona Virus. It has even been speculated by some scientists this Virus is already mutating into a more virulent “L” strain and a less virulent “S” strain  and perhaps that this rapid mutation of about two mutations a month will eventually mutate this disease into a near oblivion or a less dangerous disease.

    All that said, we cannot count on those things being true or happening. We need to prepare for the worst case. A case like what is happening right now in South Korea, which is far from the worst case,  would be devastating.  The downstream effects would be enormous with many dead, millions thrown out of work and millions more ruined financially.  We have to do all that we can  to stop this disease dead in it’s tracks and wishing and hoping things will get better probably ain’t gonna cut it.

    • #28
  29. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    As far as I am concerend, the CDC has proven it cannot do its job. Another part of the administrative state that fails when needed, just like the FBI, CIA and DOJ

    • #29
  30. DrewInWisconsin, Influencer Member
    DrewInWisconsin, Influencer
    @DrewInWisconsin

    Unsk (View Comment):
    We have to do all that we can to stop this disease dead in it’s tracks and wishing and hoping things will get better probably ain’t gonna cut it. 

    Well, I don’t work in that field, so aside from personal hygiene, there’s little I can do to stop it. Hope is all I have. Let me have that, at least.

    • #30
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