Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China

[FreeLancer]

Italy has locked down 50,000 people in 11 towns to combat the growing number of infections. Military and police establishing a cordon around the area and violators face jail time.


South Korea has authorized the highest level of public health containment measures but formal orders are still pending.

[iam4liberty]

What checkpoints look like and how they operate.  Lessons to be learned.

https://twitter.com/CarlHerberger/status/1231628241334566913?s=09

[LvsChant]

Wow. I'm guessing he flunked the temperature test?

[fritz_monroe]

Wow. I'm guessing he flunked the temperature test?

That looks like it was a drill, but still scary stuff.

[FreeLancer]

WSJ:  Italy Grapples With Worst Coronavirus Outbreak Outside Asia

The first economic effects hit Milan, the engine of Italy’s economy, which is just 40 miles from the outbreak’s epicenter. Trade shows, soccer matches and other public events were canceled. The mayor of Milan, Italy’s second-largest city with about 1.4 million residents, said the city’s schools will would be closed for a week.

Health officials struggled to explain how in just a few days Italy went from having just three cases, two of them Chinese tourists, to becoming by far Europe’s biggest outbreak. Italian authorities are trying to reconstruct how the outbreak started, a key step needed to track down all people who might be infected without yet showing symptoms.

One focus is an emergency room in a hospital in Codogno, the town south of Milan at the center of the outbreak. Codogno and nine other nearby towns in Lombardy were put under quarantine on Saturday. Italian Prime Minister Giuseppe Conte didn’t say how long the quarantine would last.

Authorities in the Austrian province of Tyrol temporarily stopped all train traffic coming from Italy on Sunday, holding two trains with around 500 passengers at the Brenner Pass on the Italian side of the border. They were acting on fears that a train had two people on board who may have been infected with the Covid-19 virus. The two passengers subsequently tested negative and their train was set to continue its trip, Austrian Interior Minister Karl Nehammer said.

The worrying thing about Italy is the new cases don't have clear connections to China.

[FreeLancer]

Guardian:  World is approaching coronavirus tipping point, experts say

Paul Hunter, professor in medicine at the University of East Anglia and an authority on the new coronavirus infection, echoed Tedros’s warning and said the time for containing the disease was running out.

“The director general of the WHO has recently spoken of a narrowing of the window of opportunity to control the current epidemic,” he said. “The tipping point after which our ability to prevent a global pandemic ends seems a lot closer after the past 24 hours.”

He said the surge in South Korean cases had been unprecedented so far in the epidemic, adding: “The identification of the large cluster of cases in Italy is a big worry for Europe and we can expect there to be quite a few more cases identified in the next few days.”

Hunter also said the situation in Iran could have major implications for the Middle East. “A further problem with the Iranian cases is wider armed conflicts in the region,” he said.

Dr Robin Thompson, junior research fellow in mathematical epidemiology at the University of Oxford, pointed out that case numbers in Italy had doubled between Friday and Saturday. “This is an important stage of the coronavirus outbreak,” he said. “Fast isolation of even mild cases in affected areas is important for preventing substantial person-to-person transmission in Europe. It is critical that public health guidelines are followed.”

Pakistan responded by closing its land border with Iran, while Afghanistan said it was suspending travel to Iran “to prevent the spread of the novel coronavirus and protect the public”. Turkey also closed its borders and said it would halt incoming flights, adding that all motorways and railways at the border would be shut on Sunday afternoon.

Jordan, meanwhile, will not allow entry to citizens of China, Iran and South Korea and other foreigners travelling from those countries in response to the deadly outbreak.

Warning that China’s virus epidemic was “still grim and complex,” the Chinese president, Xi Jinping, called on Sunday for more efforts to stop the outbreak, revive industry and prevent the disease from disrupting the spring planting of crops. Xi defended the ruling Communist party’s response as “timely and effective” in a video conference with officials in charge of anti-disease work, according to the Xinhua news agency.

It already happened, we're just realizing it this weekend, and tomorrow the hammer falls.

[FreeLancer]

WaPo:  South Korea orders temporary shutdown of messianic church linked to more than half the country’s coronavirus cases

More than half of South Korea’s covid-19 cases have been traced to a regional branch of the secretive Shincheonji Church of Jesus, formally known as the Temple of the Tabernacle of the Testimony.

Health authorities have identified a 61-year-old woman who attended a Shincheonji branch in the southern city of Daegu as patient zero for scores of cases within the church. The Korea Centers for Disease Control and Prevention said the woman initially refused doctors’ requests that she be tested for the virus on the grounds that she had not traveled abroad recently.

The church denied media reports that the woman assaulted nurses and created a commotion with fellow church members at the hospital.

Authorities have identified a pair of Sunday services she attended with 1,000 others this month as a hotbed for the coronavirus.

Woo Seoc-kyun, a representative of the Association of Physicians for Humanism, said “hatred against Shincheonji” does not help but hinders efforts to contain the virus. “The labeling effect will push them even deeper into hiding,” Woo was quoted as saying by the online news outlet Pressian.

In his internal message, published by South Korea’s Yonhap News Agency, church leader Lee called the mass infection “the devil’s deed to curb the rapid growth of Shincheonji.”

Well, isn't that special.

[bigbear]

https://www.theatlantic.com/technology/archive/2020/02/coronavirus-and-blindness-authoritarianism/606922/

Such a good article that runs that connects many of the poli-sci dots in China:  Hong Kong, tech surveillance, COVID, global trend to the 'strong man' leader.

Ironically, for all the talk of the technological side of Chinese authoritarianism, China’s use of technology to ratchet up surveillance and censorship may have made things worse, by making it less likely that Xi would even know what was going on in his own country.

Authoritarian blindness is a perennial problem, especially in large countries like China with centralized, top-down administration.

(This one's a bit off topic, but it builds support for the reasons behind the COVID spread.)

Since taking power in 2012, Xi has shifted back to traditional one-man rule, concentrating more and more power into his hands. He has deployed an ever-more suffocating system of surveillance, propaganda, and repression, while attempting to create a cult of personality reminiscent of the Mao era, except with apps instead of little red books.

Unlike books, though, apps can spy on people.

One hundred million or so people in China have been, ahem, persuaded to download a party-propaganda app named “Study Xi, Strong Nation,” which makes users watch inculcation videos and take quizzes in a gamified, points-based system. It also allegedly gives the government access to the complete contents of users’ phones. It almost doesn’t matter whether the app contains such backdoor access or not: Reasonable people will act as if it does and be wary in all of their communications. Xi has also expanded China’s system of cameras linked to facial-recognition databases, which may someday be able to identify people everywhere they go. Again, the actual workings of the system are secondary to their chilling effects: For ordinary people, the safe assumption is that if they are in the wrong place at the wrong time, the authorities will know.

Back to the OP... 

It’s not clear why Xi let things spin so far out of control. It might be that he brushed aside concerns from his aides until it was too late, but a stronger possibility is that he did not know the crucial details. Hubei authorities may have lied, not just to the public but also upward—to the central government. Just as Mao didn’t know about the massive crop failures, Xi may not have known that a novel coronavirus with sustained human-to-human transmission was brewing into a global pandemic until too late.

If people are too afraid to talk, and if punishing people for “rumors” becomes the norm, a doctor punished for spreading news of a disease in one province becomes just another day, rather than an indication of impending crisis. Later, under criticism, Xi would say he gave instructions for fighting the virus as early as January 7, implying that he knew about it all along. But how could he admit the alternative? This is his system.

Contrary to common belief, the killer digital app for authoritarianism isn’t listening in on people through increased surveillance, but listening to them as they express their honest opinions, especially complaints. An Orwellian surveillance-based system would be overwhelming and repressive, as it is now in China, but it would also be similar to losing sensation in parts of one’s body due to nerve injuries. Without the pain to warn the brain, the hand stays on the hot stove, unaware of the damage to the flesh until it’s too late.

Sounds like some jobs I've held too.

[FreeLancer]

A change in tone at CDC over the weekend: 

Risk Assessment

Outbreaks of novel virus infections among people are always of public health concern. The risk from these outbreaks depends on characteristics of the virus, including how well it spreads between people, the severity of resulting illness, and the medical or other measures available to control the impact of the virus (for example, vaccine or treatment medications). The fact that this disease has caused illness, including illness resulting in death, and sustained person-to-person spread is concerning. These factors meet two of the criteria of a pandemic. As community spread is detected in more and more countries, the world moves closer toward meeting the third criteria, worldwide spread of the new virus.

The potential public health threat posed by COVID-19 is high, both globally and to the United States.

But individual risk is dependent on exposure.

    For the general American public, who are unlikely to be exposed to this virus at this time, the immediate health risk from COVID-19 is considered low.
    Under current circumstances, certain people will have an increased risk of infection, for example healthcare workers caring for patients with COVID-19 and other close contacts of persons with COVID-19. CDC has developed guidance to help in the risk assessment and management of people with potential exposures to COVID-19.

However, it’s important to note that current global circumstances suggest it is likely that this virus will cause a pandemic. In that case, the risk assessment would be different.


What May Happen

More cases are likely to be identified in the coming days, including more cases in the United States. It’s also likely that person-to-person spread will continue to occur, including in the United States. Widespread transmission of COVID-19 in the United States would translate into large numbers of people needing medical care at the same time. Schools, childcare centers, workplaces, and other places for mass gatherings may experience more absenteeism. Public health and healthcare systems may become overloaded, with elevated rates of hospitalizations and deaths. Other critical infrastructure, such as law enforcement, emergency medical services, and transportation industry may also be affected. Health care providers and hospitals may be overwhelmed. At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions would be the most important response strategy.


CDC Response

Global efforts at this time are focused concurrently on containing spread of this virus and mitigating the impact of this virus. The federal government is working closely with state, local, tribal, and territorial partners, as well as public health partners, to respond to this public health threat. The public health response is multi-layered, with the goal of detecting and minimizing introductions of this virus in the United States so as to reduce the spread and the impact of this virus. CDC is operationalizing all of its pandemic preparedness and response plans, working on multiple fronts to meet these goals, including specific measures to prepare communities to respond local transmission of the virus that causes COVID-19. There is an abundance of pandemic guidance developed in anticipation of an influenza pandemic that is being repurposed and adapted for a COVID-19 pandemic.

WaPo:  White House preparing to ask Congress for more money to finance coronavirus response

Details remain in flux as the Trump administration continues to assess needs. The request could be sent to Capitol Hill in the next few days and could seek close to $1 billion, according to two of the people briefed on the planning. The preparation comes as efforts to contain the virus have failed in multiple countries and financial markets are becoming increasingly spooked about the snowballing economic impact.

[iam4liberty]

Boy, talk about a stressful situation for everyone involved.

https://nationalinterest.org/blog/buzz/watch-mother-cancer-patient-pleads-china-coronavirus-checkpoint-her-daughters-passage
WATCH: Mother of Cancer Patient Pleads At China Coronavirus Checkpoint For Her Daughter's Passage

“My daughter needs to go to [a] hospital in Jiujiang,” said Lu, a farmer. “She needs to have her treatment, but they won’t let us through.”

“Please, take my daughter. I don’t need to go past. … Please, just let my daughter go past,” she said.

[FreeLancer]

Don't think we're immune to such situations developing here in the US. 

Hospitals don't make money on empty beds so there's just barely enough spare capacity to handle the extra flu cases each season.  There were hospitals that maxed out their ventilator capacity during the 2009 Swine Flu that everyone mocks as over-hyped.  It wouldn't take much of an increase in real respiratory infections (plus the inevitable worried-well) to overwhelm hospitals forced to deal with the extra precautions COVID will require. 

[Stwood]

I've got most all of the extra medical that I ordered for this. Probably should of had it anyways. Masks, wipes, extra alcohol.

It's all here except for the extra alcohol I ordered.

Ordered N95 masks from Amazon on Feb 1st for 18.99
Curious, the price raised to almost 40.00 then went out of stock like most of the N95's. Now restocked, and 2 sellers are priced at 49.75 + shipping, and 70.00 + shipping.
And, ordered some fillin Augason products yesterday, and noticed most Augason were out of stock, and Walmart was out of stock on almost all of Augason.

[FreeLancer]

MMWR:  Update: Public Health Response to the Coronavirus Disease 2019 Outbreak — United States, February 24, 2020

Discussion

COVID-19 is a serious public health threat. Cases of COVID-19 have been diagnosed in the United States, primarily in travelers from China and quarantined repatriates, and also in two close contacts of COVID-19 patients. Currently, COVID-19 is not recognized to be spreading in U.S. communities. If sustained transmission in U.S. communities is identified, the U.S. response strategy will enhance implementation of actions to slow spread in communities (2,6). Implementation of basic precautions of infection control and prevention, including staying home when ill and practicing respiratory and hand hygiene will become increasingly important.

Community-level nonpharmaceutical intervention might include school dismissals and social distancing in other settings (e.g., postponement or cancellation of mass gatherings and telework and remote-meeting options in workplaces). These measures can be disruptive and might have societal and economic impact on individual persons and communities (6). However, studies have shown that early layered implementation of these interventions can reduce the community spread and impact of infectious pathogens such as pandemic influenza, even when specific pharmaceutical treatments and vaccines are not available (7,8). These measures might be critical to avert widespread COVID-19 transmission in U.S. communities (2,6). Mitigation measures implemented in China have included the closing of major transport hubs and preventing exit from certain cities with widespread transmission, cancellation of Chinese New Year celebrations, and prohibition of attendance at school and work (5). However, the impact of these measures in China has not yet been evaluated.

In the United States, the National Institutes of Health (NIH) and their collaborators are working on development of candidate vaccines and therapeutics for COVID-19. In China, multiple clinical trials of investigational therapeutics have been implemented, including two clinical trials of remdesivir, an investigational antiviral drug.§§ An NIH randomized controlled clinical trial of investigational therapeutics for hospitalized COVID-19 patients in the United States was approved by the Food and Drug Administration; the first investigational therapeutic to be studied is remdesivir.¶¶ In the absence of a vaccine or therapeutic, community mitigation measures are the primary method to respond to widespread transmission and supportive care is the current medical treatment.

COVID-19 symptoms are similar to those of influenza (e.g., fever, cough, and shortness of breath), and the current outbreak is occurring during a time of year when respiratory illnesses from influenza and other viruses, including other coronaviruses that cause the “common cold,” are highly prevalent. To prevent influenza and possible unnecessary evaluation for COVID-19, all persons aged ≥6 months should receive an annual influenza vaccine; vaccination is still available and effective in helping to prevent influenza (9). To decrease risk for respiratory disease, persons can practice recommended preventive measures.*** Persons ill with symptoms of COVID-19 who have had contact with a person with COVID-19 or recent travel to countries with apparent community spread††† should communicate with their health care provider. Before seeking medical care, they should consult with their provider to make arrangements to prevent possible transmission in the health care setting. In a medical emergency, they should inform emergency medical personnel about possible COVID-19 exposure.

Areas for additional COVID-19 investigation include 1) further clarifying the incubation period and duration of virus shedding, which have implications for duration of quarantine and other mitigation measures; 2) studying the relative importance of various modes of transmission, including the role of droplets, aerosols, and fomites; understanding these transmission modes has major implications for infection control and prevention, including the use of personal protective equipment; 3) determining the severity and case-fatality rate of COVD-19 among cases in the U.S. health care system, as well as more fully describing the spectrum of illness and risk factors for infection and severe disease; 4) determining the role of asymptomatic infection in ongoing transmission; and 5) assessing the immunologic response to infection to aid in the development of vaccines and therapeutics. Public health authorities are monitoring the situation closely. As more is learned about this novel virus and this outbreak, CDC will rapidly incorporate new knowledge into guidance for action.

11:30 a.m. ET Tuesday, Feb. 25, 2020:  CDC Media Telebriefing: Update on COVID-19 Media Advisory by Nancy Messonnier, M.D., Director, National Center for Immunization and Respiratory Diseases

“It’s not so much of a question of if this will happen anymore but rather more of a question of exactly when this will happen."

“We are asking the American public to prepare for the expectation that this might be bad.”

[Stwood]

“We are asking the American public to prepare for the expectation that this might be bad.”

I hope everyone does.

[FreeLancer]

On the legal precedent for quarantine....


WaPo:  The government can quarantine you for coronavirus, and there’s almost nothing you can do about it

The government’s powers to sequester people in the name of public health are rooted in the Constitution’s Commerce Clause, which allows Congress to regulate foreign and interstate commerce. Quarantine involves the temporary confinement of people who may have been exposed to a disease but haven’t developed symptoms. Isolation separates people who are infected with a disease until they are no longer contagious.

“It’s like a curfew or an evacuation order if a natural disaster occurs. Just like when a hurricane is bearing down, people are ordered to leave coastal areas because no one can save them,” said Scott Burris, director of the Center for Public Health Law Research at Temple University. “If we have a reasonable prospect of stopping or slowing this virus, even if we’re doing it with mittens on, the government can take emergency action.”

U.S. District Judge John F. Dooling rejected the petition and ordered Siegel to remain quarantined for the full 14 days.

“The judgment required is that of a public health officer and not of a lawyer used to insist on positive evidence to support action,” Dooling wrote. “Their task is to measure risk to the public and to seek for what can reassure and, not finding it, to proceed reasonably to make the public health secure. They deal in a terrible context and the consequences of mistaken indulgence can be irretrievably tragic.”

[David in MN]

Unfortunately the 2019-2020 flu shot is a sorta bad match (yet again) so it provides precious little protection.

https://www.cnn.com/2020/01/14/health/flu-vaccine-match/index.html

I have qualms about this math but it belies the point that be it normal flu or corona the best medical advice is to limit exposure and practice clean health stuff like hand washing and not rubbing your face.

It's sad but it seems we should be putting soup in the freezer and making sure the cough medicine is stocked. Not much more that the average guy/gal can do. Seems like we just extended flu season.

[FreeLancer]

Unfortunately the 2019-2020 flu shot is a sorta bad match (yet again) so it provides precious little protection.

Certainly nothing new, but the focus has always been to limit severe flu illnesses that require hospitalization.  Influenza disease is less severe in those who receive even the worst matched vaccine.

Minimizing one’s contact with the hospital system is more critical in times of limited medical capacity to treat severe respiratory infections, more so when facing harsh quarantine orders to minimize transmission.

[FreeLancer]

Good Australian documentary on the epidemic from the beginning:  https://youtu.be/ycrqXJYf1SU

[Morning Sunshine]

Good Australian documentary on the epidemic from the beginning:  https://youtu.be/ycrqXJYf1SU

I will give it a watch if I can find the time today.  I am starting to think my family is actually fighting the Flu instead of a respiratory cold like I thought.  Maybe not though - it seems to effect us each differently.  Some have had the absolute weakness and body aches, and others just extreme fatigue.  I just have not seen a "cold" last this long with my kids before, not the fatigue and fever part anyway.
Ans so many of our friends from our homeschool co-op and church and neighborhood are as well.

[FreeLancer]

Brazil confirms a coronavirus case, the first in Latin America.  Associated with travel to Italy.

[Morning Sunshine]

looks like Trump will be having a press conference tonight at 6pm, eastern I assume.

so now what everyone needs to ask themselves (not here, no debate on this please) - do I trust this president to tell me the truth about it?

hopefully he will also give sources that we can use to verify as well; I hate having to take anybody's word alone on things this important.

[surfivor]

On the legal precedent for quarantine....


WaPo:  The government can quarantine you for coronavirus, and there’s almost nothing you can do about it

Can the government deny you access to food and Potable water while under quarantine?
Is there a reasonable maximum time limit for a quarantine?

Spirko Thinks the virus in China it is due to that most Chinese are very heavy smokers and the air quality from industry in that country is horrible that they have respiratory problems to begin with

[FreeLancer]

Can the government deny you access to food and Potable water while under quarantine?
Is there a reasonable maximum time limit for a quarantine?

It is all based on the threat, like martial law.  Governments will resort to extraordinary measures, like in that Australian documentary where apartment building doors are being welded shut. 

Speaking of which, many are saying China may have throttled the spread within their borders with their massive quarantine and now are planning to block travel from the rest of the world to prevent reintroduction.

[Stwood]

Iran's deputy health minister tests positive
https://www.youtube.com/watch?v=VS0cRj3a0Qk

[mountainmoma]

The "regular" flu that has gone around this year, well first there is more than one of course, but at least one of them is pretty bad.   I had it in November and I dont ever remember being that sick for so long.  Not everyone gets it that bad, but the ones that do, it is weeks

[FreeLancer]

In the last 24 hours the number of new cases is higher outside of China than inside. Hard to know if that’s for real, as we’ve been given plenty of reasons to doubt Chinese transparency, but it suggests that maybe their draconian measures worked.

I can’t imagine another country being capable of pulling that off without pointing a lot of guns at their own citizens.

[Greekman]

Brazil confirms a coronavirus case, the first in Latin America.  Associated with travel to Italy.

Same thing in Greece...A lady that just arrived from Rome.
And the past few days there were more than 450 students taking a travel at Italy and those were allowed to return unscreened.

[Greekman]

The "regular" flu that has gone around this year, well first there is more than one of course, but at least one of them is pretty bad.   I had it in November and I dont ever remember being that sick for so long.  Not everyone gets it that bad, but the ones that do, it is weeks

thing i that people are more scared by the way the coronavirus is transmitted than by its milder symptoms/effects.
Just imagine another virus that requires a month to show symptoms on the affected.

[Hurricane]

What I can't seem to get a handle on is this: How does this virus compare to a typical influenza outbreak?
What percentage of those infected actually die?
What percent are down and out for a week or more? Again, compared to a typical flu.

Thanks!

[FreeLancer]

The data is incomplete so we don’t have exact comparisons to flu. Of the people who test positive for COVID, about 1 in 5 has serious symptoms.  At this point the fatality rate is over 2%, but likely will come down, while flu is 0.1%.

At the current numbers this is killing people at around the same rate as the 1918 flu.  Risk of death steadily increases over age 40, hardly any deaths under 20.