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Day 32: COVID-19 Outside of China
Another big day, and maybe even bigger. The chart above is based on the Johns Hopkins website that was last updated 03:33 GMT. The Worldometers website was last updated about 3 hours later and totals 1526 cases; 155 more than the Johns Hopkins total. Most of this difference involves South Korea: 346 cases reported in the Worldometer database vs 204 in the John Hopkins database.
The US case count has jumped to 35.
Chris Martenson’s latest video is here. Key matters covered include reports of re-infection of “recovered” patients, and potential for persons declared “recovered” continuing to be infectious for a period after symptoms disappear. CDC guidance is focusing on persons having recently traveled to China and close contact with such persons, but will this guidance miss persons who have been unknowingly infected by persons who traveled to China or persons in close contact with China travelers? We’ll be watching the data.
Published in General
The most disturbing thing I got out of Martensons video was this…
“Only 3 states can test for coronavirus”
So are all suspected cases referred to the CDC? If not, that’s 47 states where we can’t make a diagnosis.
Here’s the current CDC flowchart for testing. Note the only criteria accepted are “travel to China” and “close contact with known infection”.
If we already have secondary spread occurring in the US how are we going to identify it?
My fear is the cats going to be well out of the bag before we even know whats going on.
This may be the Singapore conference he said was canceled.
https://www.inta.org/2020Annual/Pages/Home.aspx
Even in years when it’s held in the US, there are several thousand attendees from China.
I think we have to assume the cat is out of the bag. Most cases will not be definitively diagnosed because they will not involve severe/significant respiratory distress, their symptoms will not persist beyond a period of time to seek medical care, their interview with medical staff will not trigger testing, and/or their tests may present false negatives and there are no factors that result in re-testing. In short, they (and medical staff) will not have cause to believe they have anything but a bad cold or a form of flu for which they have not been vaccinated.
My guess is the best indicator of the size of the epidemic will be the ratio of severe cases/fatalities to total infections. In a population like Singapore which is relatively contained, good Western medicine, and aggressive monitoring, we make get a good ratio calculation fairly representative of the US. Let’s assume for the sake of argument it is 80-20 — for every 100 cases only 20 become critical, including death. If so then you look at the number of cases that are confirmed and critical. If they are more than 20% of the total cases said to be confirmed, then you are likely under-counting the number of actual cases.
I see S. Korea is up to 433 today. I think that ROK has honest reporting, so this shows how easy it is for 1 or 2 people to spread the disease. ROK is also unlike China and not a police state, so it gives us an idea how hard it is to control people. One person was told to go home and wait for test results, but instead went out shopping. He faces a possible fine ($2400), but no jail time. Compare with China which has cops breaking up Mahjong games with clubs, nailing doors shut, and dragging people off to “quarantine”.
As for people being infectious after recovery, it makes sense. People can be infectious before symptoms present themselves and some viruses are known to “hide” outside of the bloodstream (lymph nodes and such).
There are about 100,000 ICU beds in the US. During Flu season we have almost no empty ICU beds.
It won’t take much to overwhelm the system.
That was my point. If we don’t look aggressively we won’t find any cases until people start piling up in the ICU and someone finally tests them. From what I’ve read, we have tested about 500 patients. The UK for contrast has tested about 6,000 with a fraction of our population.
Here is a chart of the growth in cases in South Korea over the last few days:
North Korea is the big question. https://www.thedailybeast.com/north-koreas-secret-coronavirus-crisis-is-crazy-scary
Part of the problem is that our test is not that good and needs improvement. They are using clinical parameters because they want to try and extend the net to avoid any false negatives. False positives are bad, but here false negatives could be extremely deadly.
There is a lot of active work on therapy, and a group I work with is going to be turning their expertise on the human immune response to the flu virus and applying it to COVID-19.
From the Wall Street Journal today:
Have scientists been able to develop vaccines for MERS and SARS?
We could cheat and watch for people to Google symptoms. When we see that start to move, override their Google navigation to send them to a hospital. We can also have Google alert Alexa to activate the secret Ring lockdown task. Big Tech has our “6”.
This could go in a lot of directions: Use our browser, social media, and purchase histories to order Grubhub food deliveries and sent them with a note to stay home, do not grocery shop, do not go out to eat. Have special “this is what your neighbors are eating” Grubhub surprises. Make a game of staying home. Facebook could automatically “join” you to a Quarantine Fancier’s Group, with periscope sharing. Etc.
Again this morning, I’m not going to copy and paste everything, but I’ll keep up my tradition of doing updates on the PIT.
Numbers and commentary in this comment and following:
http://ricochet.com/652840/archives/pit-19-no-not-that-way/comment-page-1903/#comment-4708977
These are numbers outside of mainland China, right? Or do they exclude Hong Kong and Macau?
@saintaugustine, they include Hong Kong and Macau, exclude mainland China.
Insanity that the Israelis continued to allow tourism from Asia well into the pandemic
https://m.jpost.com/Israel-News/180-Israeli-students-quarantined-after-coronavirus-exposure-618455
https://m.jpost.com/International/Japan-summons-Israeli-ambassador-to-protest-travel-ban-618485
https://m.jpost.com/Israel-News/South-Koreans-refused-entry-to-Israel-over-coronavirus-fears-618419
Better we all die then be accused of being racist
Following
According to the SARS entry on Wikipedia, the official timeline for the SARS epidemic was November 2002 to July 2003.
We have a long way to go with this new corona virus.
There no vaccine available yet for the SARS virus. There’s no vaccine available yet for the MERS corona virus (2012) either.
What are current infection/rectory/death stats for SARS & MERS?
According to Wikipedia:
And for MERS:
The predicted death rate from COVID-19 is ~1% of those infected. But in reality you would have to examine all deaths from flu-type diseases (which are many) and (if possible) by testing tissue rule-in or run-out COVID-19, to have a definitive number.
Current data is all over the place. Singapore, which addressed its outbreak quickly, comprehensively and with Western medical capabilities has had zero (0) deaths (as yet) attributed to COVID-19 with 89 confirmed cases. Phillipines has had 1 death with only 3 confirmed case. Iran has had 5 deaths with 28 confirmed cases (as of the WHO report I am referencing). The mainland China data in that report has a death rate of 1.7%.
So COVID-19 on average is not as deadly as earlier MERS and SARS outbreaks. But death, per se, does not strain the health care system. Critical and serious cases, whether or not they result in death, do. And when you strain the health care system there are secondary effects and fatalities that arise from the inability to provide care in other types of medical emergencies and problems.
I believe that’s the deaths/infections rate, which is not the real death rate because there are so many new infections every day.
The death rate among cases that have had an outcome is much worse: deaths/(deaths+recoveries).
Among many really shocking things with this are several involving quarantined people being monitored from long before being symptomatic and perhaps even before becoming infected.
Contrast a normal flu where I get infected at day 1 (I am making up numbers and invite our MDs to edit), would be testable at day 3, start to feel off at day 5, start to feel really bad at day 7, realize I am not getting better at day 9, and see my doctor at day 10. Not unexpected that there is a nontrivial chance I may not recover.
With the asymptomatic people in quarantine, they are in a position to have treatment begin when a positive test comes in or at the first sign of symptoms. They are not going to have treatment begin days after severe symptoms. Yet there are nontrivial numbers of deaths of such people.
Some of them numbers for this morning.
The CoronaVirus Pandemic is getting very serious. The question needs to be asked “are we doing enough to prevent it’s spread?”.
“But death, per se, does not strain the health care system. Critical and serious cases, whether or not they result in death, do. And when you strain the health care system there are secondary effects and fatalities that arise from the inability to provide care in other types of medical emergencies and problems.”
Since it seems that people are contracting this virus asymptomatically, without showing symptoms, several points come to mind:
A. We need to protect our current health care system from contagion. In China, already thousands of health care workers have taken sick. It is not to hard to see that health care workers may refuse to work on CoronaVirus patients if they are not sufficiently protected. If there are no symptoms after contracting the disease, how are health care workers able to detect the disease and protect our medical facilities from contagion? The people most at risk it would seem are our health care workers because of their repeated contact with those who may have the disease but are not showing symptoms.
From that conclusion, one might conclude that we need to be building separate hospital facilities away from populated areas that minimize the contact between health care professionals and those infected while still providing adequate care. And that effort should be begin immediately with the greatest of speed because judging from the Chinese experience, the inability to treat patients led to greater contagion, more infection and death.
B. There are some reports that the normal masks were not that effective for protection against transmission. Proper masking would be a great help in the effort to protect health care workers. Fortunately, from Zerohedge:
• Earlier this month, we noted how Dyson patented a wearable air purifier that can also be used as headphones.
• Now Ao Air’s Atmos Faceware is the next generation of maks to block germs up to 50 times better than traditional masks currently on the market, reported AUT BioDesign Lab.
Last January 31, President Trump authorized the Public Emergency Act Public Health Emergency which gives him and HHS great powers to implement health care measures. He needs to use all his powers to speed production and placement of these masks to the Health Care system and the general public to stop this contagion.
C. Thirdly, Trump needs to focus great effort on the building of Pharmaceutical Drug Production facilities here as soon as possible including those that have shown to have had success fighting the Corona Virus. The drugs to fight this disease and other critical conditions are an absolute necessity.
If these measures are successfully implemented quickly the threat of panic that has already engulfed other countries China may be avoided here.
https://www.engadget.com/2017/05/10/o2o2-hands-on/
Dyson has 4 published applications:
https://patentscope.wipo.int/search/en/result.jsf?_vid=P12-K6ZTU5-16604
Not actual patents.
My daily brief analysis–here and in the next few comments.