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[elbows]

The following article is already getting a little old now, but still provides a useful look at a bunch of the clusters they have found in Singapore:

COVID-19: What we know about the 7 clusters in Singapore

SINGAPORE — Seven clusters of the coronavirus have been identified.

sg.news.yahoo.com

Japan meanwhile provides another example of problems detecting outbreaks in a timely fashion. A lot of the cases now testing positive in Tokyo are being linked to a party on a boat that took place almost one month ago. Will try to post relevant stories about this later.

 

[elbows]

The Westerdam cruise ship sounds like it could be a worry - after it was turned away by several other countries, Cambodia allowed the more than 1,000 passengers to disembark after determining that none of them were sick. The passengers dispersed, most of them flying back to their home countries, and then one of them tested positive for the virus. Officials are now talking about trying to track down everyone who got off the ship and put them in quarantine for 14 days.

And Cambodias PM, who has been in power since 1985, was shaking their hands for propaganda purposes when they got off the boat.

 

[elbows]

Yet more signs of lots of asymptomatic cases. Bad news for containment, likely very good news for overall mortality rate.

The US state department announced later that 14 of the 340 American evacuees were confirmed to have the virus in tests given before they boarded the planes. They were taken to the US because they did not have symptoms and were being isolated from other passengers on the planes, it said. It was not immediately clear whether the 14 were among the 99 new cases.

“Many people are testing positive on the ship, but that is because we are testing everyone onboard, regardless of their medical condition,” said Shigeru Omi, the chief director of the JapanCommunity Health Care Organisation. “And 70% of those testing positive are not showing any symptoms at all.”

2h ago 10:42

 

[elbows]

An early contender for understatement of the year:

“We are not entirely convinced that the quarantine procedures on that ship were 100% effective,” said Prof Dianne Stephens, deputy chief health officer for the Northern Territory (NT).

7h ago 06:24

 

[elbows]

Indonesia remains a concern.

 

[not-bono-ever]

Cant understand why anyone thought it was a good idea to leave people on that ship. It's a nightmare scenario.

its standard procedure with ships- run up the yellow flag and wait it out. this shi[p was at least allowed to dock for utilities etc - non passenger vessels usually hole up and drop anchor offshore. the crew of passenger vessels are still subject to a further 2 weeks quarantine after the last the the paying passengers have left the biulding

 

[elbows]

I'm not 100% sure, but it sounds like the first big change as a result of Japan recognising a new phase has happened - gone are the requirements to have travelled to certain places or had contact with known cases before Covid-19 is suspected:

Tokyo, Feb. 17 (Jiji Press)--Japan's health ministry on Monday advised people to consult dedicated coronavirus-related offices at public health centers or other relevant facilities if they run a fever of 37.5 degrees Celsius or over for at least four days.

Also asked to do so were people feeling lethargic or breathing difficulties severer than such conditions for influenza.

The recommendation was included in a set of guidelines announced the same day as rough indications for when a person should reach out to the consultation offices if they develop fever or other symptoms. The guidelines were compiled in response to a rapid increase in the number of people in the country contracting the new coronavirus originating in China, for whom infection routes are unknown.

People with Fever for 4 Days Asked to Seek Advice on Coronavirus

Tokyo, Feb. 17 (Jiji Press)--Japan's health ministry on Monday advised people to consult dedicated coronavirus…

www.nippon.com

 

[not-bono-ever]

The Westerdam cruise ship sounds like it could be a worry - after it was turned away by several other countries, Cambodia allowed the more than 1,000 passengers to disembark after determining that none of them were sick. The passengers dispersed, most of them flying back to their home countries, and then one of them tested positive for the virus. Officials are now talking about trying to track down everyone who got off the ship and put them in quarantine for 14 days.

i think i mentioned cambodia earlier on in the thread- they were purposefully not talking about the corona issue as a threat becuase of the sheer weight of chinese nationals that use cambodia for sex tourism R&R, gambling and low level money laundering. backpackers might provide a living for a few bars and flophouses but the chinese are the financial muscle thats keeps the hun sen dynasty bank accounts filled

 

[elbows]

Another story on the Japan change.

Japan issues coronavirus medical guidance as infections rise

Japan's health ministry issues guidance for when people with symptoms consistent with the new coronavirus should consult medical institutions, as the country steps up efforts to contain the outbreak.

english.kyodonews.net

Japan's health ministry issued guidance Monday for when people with symptoms consistent with the new coronavirus should consult medical institutions, as the country steps up efforts to contain its spread with more cases, even among medical staff, confirmed.

The ministry is now encouraging people who have had a temperature of 37.5 C or higher for four days, are feeling lethargic or are experiencing shortness of breath to contact by phone nationwide health-care centers in charge of responding to the outbreak.

The centers will then recommend medical institutions they should visit. The period is shorter at two days for the elderly and those with underlying conditions such as diabetes, as they are viewed as more vulnerable to the pneumonia-causing virus, the Ministry of Health, Labor and Welfare said.

The guidance is intended to give those worried about contracting the virus an idea of when and where to go to a doctor while a government panel of experts has said the country is at an early stage of infection.

Raising public concerns, the number of cases despite no recent record of coming into contact with people from virus-stricken regions in China or without symptoms has been increasing.

The social repercussions of the virus became more visible on Monday, with a birthday event this weekend at the Imperial Palace for Emperor Naruhito, who took the throne in May, canceled.

Tokyo Marathon organizers said the annual race in March will be scaled down.

In unveiling the medical guidance, health minister Katsunobu Kato said at a press conference that people with colds or influenza tend to see their health recover after three to four days on average while those infected with the virus do not.

Kato also asked individuals who have developed cold-like symptoms to keep track of their temperature and refrain from going to work or school.

 

[elbows]

All ramping up isn't it?

It certainly has not strayed far from the way that a 'default assumption, containment wont work, it will be a pandemic' reality would look. I might be reliant on countries that widen their criteria for suspecting (and therefore testing) cases in order to spot the wider community transmission outside China that would be required for me to consider this a pandemic. Thats a big part of the reason why I've gone on about Japan so much recently, though there are plenty of other places that might end up fulfilling that role first.

Although given the awkward stage we are still in, its a good idea to balance that sort of 'it looks like a pandemic' thinking with an example that had some worrying features and spread, but that did not lead to a pandemic. SARS in 2003 provides such an example, especially given that Canada ended up with around 250 cases and 43 deaths, and 29 countries/territories had cases.

 

[elbows]

OK just this one last Japan story from me for now, because it contains some useful info about the 'Jan 18th party boat' cluster in Tokyo.

And it also provides some context for why the changes I have discussed in recent posts have happened now:

The Tokyo Metropolitan Government says the virus may be spreading in the capital, as people not at the party -- including an office worker and a chauffeur -- were also confirmed infected, and is calling for measures to prevent transmission.

11 infected on Tokyo tour boat, likely transmitted coronavirus to non-passengers - The Mainichi

TOKYO -- A sudden spike in new coronavirus cases was confirmed among attendees at a New Year's party for independent taxi drivers held on a traditiona

mainichi.jp

 

[clicker]

Actually TopCat, I'm feeling a little better about it than I have done for a while. The small number of cases in the UK seemed to have petered out and it doesn't seem to have taken hold in other countries yet.

I am worried about Thailand Singapore India South Korea Hong Kong and Japan etc. I don't know how rigorous they are being in tracking down and isolating the cases that they have.

My young second cousin has been teaching English in South Korea for 2 years and currently sorting out a flight back to UK ( on the advice of the agency that found her the post. )

 

[elbows]

That may be in part because we arent looking for any cases that dont have such links, so we wont find any. That will only change by accident, ie stumbling into such a case, or because they change the criteria for suspecting Corvid-19.

It looks like I missed a comment from Neil Ferguson last week, which if accurate, means the UK did start an additional form of surveillance:

Earlier, Professor Neil Ferguson, from the MRC Centre for Global Infectious Disease Analysis at Imperial College, London, told the BBC Radio 4 Today programme the world was “in the early phases of a global pandemic at the moment” and the true number of UK cases is higher than eight.

He said: “The fact we have only recorded eight cases in the UK is because our surveillance is focused on travellers.

“We think probably we are picking up maybe one in three cases coming into the country at the current time.

“We will know more in the next few weeks.

“Surveillance has started across the UK in hospitals of pneumonia cases. That will give us a proper picture.”

Article is from the 12th Coronavirus: Scout leader at centre of UK cases ‘happy to be home’ and is mostly concerned with other coronavirus news from that day.

It is possible someone already mentioned the bit I put in bold on this thread, maybe even me, as I am not immune from information overload myself. But since signs of changing phases and surveillance is a recurring theme of mine in this thread, and I have mostly painted a picture where the UK was only looking for cases related to travel and contact of known cases, I feel the need to point out this quote which suggests I was out of date. Now I just need to find some confirmation of it from another source.

 

[Supine]

India considering an export ban on 12 medicines:

Coronavirus outbreak: Government mulls export ban on 12 essential drugs - Times of India

The eight-member expert committee constituted by the government to assess availability of medicines in the country has suggested imposing export restrictions on 12 drugs including antibiotics like chloramphenicol, neomycin, metronidazole, azythromicin, clindamycin; vitamin B1, B2 and B6; as well...

m-timesofindia-com.cdn.ampproject.org

 

[2hats]

WHO reports Covid-19 causes only mild disease in four out of five people who get it.

Coronavirus causes mild disease in four in five patients, says WHO

Covid-19 not as deadly as Sars, figures show, and children not affected in same way as adults

www.theguardian.com

“It appears that Covid-19 is not as deadly as other coronaviruses, including Sars and Mers,” said the WHO director general, Dr Tedros Adhanom Ghebreyesus, adding that officials were “starting to get a clearer picture of the outbreak”.

“More than 80% of patients have mild disease and will recover, 14% have severe disease including pneumonia and shortness of breath, 5% have critical disease including respiratory failure, septic shock and multi-organ failure, and 2% of cases are fatal,” Tedros said in Geneva. “The risk of death increases the older you are.”

He said children were not suffering from Covid-19 in the same way as adults, and more research was needed to find out why. There were still gaps in understanding that he hoped the WHO’s team of international experts would be able to work towards filling.

 

[Part-timah]

This is a report from the confirmed cases up to the 11th Feb. One thing of note is the mortality rate for those with identified additional conditions.

http://weekly.chinacdc.cn/fileCCDCW/journal/article/ccdcw/newcreate/COVID-19.pdf

 

[Cid]

My young second cousin has been teaching English in South Korea for 2 years and currently sorting out a flight back to UK ( on the advice of the agency that found her the post. )

Seems something of an overreaction... Or at least if it does start spreading uncontrolled in SK, I suspect the horse has already bolted worldwide. My contacts in Korea don't seem particularly more worried than we are here. Though also teaching is probably one of the worst professions to be in with regards to getting the latest illness. So there is that.

 

[Part-timah]

Seems something of an overreaction... Or at least if it does start spreading uncontrolled in SK, I suspect the horse has already bolted worldwide. My contacts in Korea don't seem particularly more worried than we are here. Though also teaching is probably one of the worst professions to be in with regards to getting the latest illness. So there is that.

If I had a solid support network and had confidence in SK health care system I probably would still come back TBH. I’d want to be around to help people that need it.

 

[sim667]

Partners sister lives in Hong Kong and there’s a massive shortage of bog roll and babywipes there because of corona virus. (Because of rumours and everyone panic buying, not because there’s an actual shortage)

 

[FridgeMagnet]

I have merged the UK pol threads on this as there was a lot of duplication (and also a request).

 

[Artaxerxes]

Fuck off great "wash you hands be aware of Coronavirus" on the mirrors at works bogs today

 

[Part-timah]

Fuck off great "wash you hands be aware of Coronavirus" on the mirrors at works bogs today

Sensible. Any spread needs to be slowed down along with everyday illness that good hygiene cam mitigate.

 

[elbows]

There is a WHO graph to help with that, which would make me a bit more optimistic if it told something approaching the full story, but sadly it does not. WHO decided to stick with lab-confirmed cases on their dashboard, so cases that have been counted due to the new approach to diagnosing cases in China are not included at all.

View attachment 198749
(from Operations Dashboard for ArcGIS )

The WHO have now switched to using the numbers from China that include cases that havent tested positive but were diagnosed clinically in Hubei province.

So it now has the spike in it like everyone elses.

 

[iona]

Yes, and so do the dental nurses, so it could be 2 or 3 masks per patient.

That just seems like a massive waste to me. Are they disposed of or sent back for re sterilising?

I've never known anyone change masks between every patient and it definitely isn't the norm (other than implants/oral surgery when you're using sterile ppe that comes in individual packs). Don't think I was even taught it as something you're supposed to do even though most people don't.
They're just made out of thin papery stuff, shipping them off to somehow be sterilised probably isn't much less wasteful than just binning a couple masks each per day tbh.

 

[Baronage-Phase]

The current mortality rate is above 2%. The table below is from the CDC to help judge the severity of a pandemic. The most severe level only requires 2%. Yes, many experts are predicting this figure will drop. All we can do now is work with the figures we have. Over the coming weeks we will have a better idea of the nature of covid-19.
View attachment 198548

Coronavirus has the same rate of mortality as the Spanish flu? 50 million died from that.

That is worrying.

 

[Baronage-Phase]

Reading about the Spanish Flu in Ireland ..1919.

The deadly trail of the Spanish Flu through Ireland in 1918

In 1918, the world faced an epidemic worse than the Black Death. The disease could not have arrived in Ireland at a worse time. The war meant that many doctors were at the front and there was no national health service. How well did the country cope? Robert Hume investigates

www.google.com

Many local boards of health recommended that schools be closed. But headteachers were slow to comply since the disease was described as “virulent but not dangerous”.

800000 caught the Spanish flu in Ireland. 23000 died.

My grandmother's parents both died from Spanish flu. They were young...early 30s.
Their children were split up and sent to different relatives all over Ireland. 2 ended up in Co. Clare which had the lowest incidence of deaths from flu.

 

[cupid_stunt]

I've never known anyone change masks between every patient and it definitely isn't the norm (other than implants/oral surgery when you're using sterile ppe that comes in individual packs). Don't think I was even taught it as something you're supposed to do even though most people don't.
They're just made out of thin papery stuff, shipping them off to somehow be sterilised probably isn't much less wasteful than just binning a couple masks each per day tbh.

Well that's odd, because my dentist & dental nurse always bin both gloves & masks after they have finished with me or my mother. Plus a British Dental Association spokesperson on the news explained they are single use, and must be changed between patients, which fits in with their press release about many practices will struggle with the rationing of just 2 boxes (i.e. 100 masks) per day.

There's also this report of a dentist being kicked-off the register for various failings, including not changing masks between patients.

Other cross-infection control failings included not routinely change his gloves and mask between patients and failing to ensure dental instruments and equipment were adequately cleaned.

 

[iona]

Well that's odd, because my dentist & dental nurse always bin both gloves & masks after they have finished with me or my mother. Plus a British Dental Association spokesperson on the news explained they are single use, and must be changed between patients, which fits in with their press release about many practices will struggle with the rationing of just 2 boxes (i.e. 100 masks) per day.

There's also this report of a dentist being kicked-off the register for various failings, including not changing masks between patients.

Yeah I'm sure some people do, it's not a standard universal thing like changing gloves between patients though ime.

 

[Virtual Blue]

phew...my parents escaped HK and now in the UK.

The struggle for bog roll was getting intense over there.

 

[elbows]

South Korea seems to be going down a similar path to Japan, with talk of a 'new phase' being reached.

S. Korea entering ‘new phase’ in virus fight

South Korea’s fight against the new coronavirus may be entering a new phase of local transmission, the head of the state disease control center said Tuesday, as the country identified a third case with an unclear infection route. “The situation here and abroad suggests we’re entering a new...

www.koreaherald.com

South Korea’s fight against the new coronavirus may be entering a new phase of local transmission, the head of the state disease control center said Tuesday, as the country identified a third case with an unclear infection route.

“The situation here and abroad suggests we’re entering a new phase,” Jung Eun-kyeong, head of the Korea Centers for Disease Control and Prevention, said in a press briefing.

“We have three cases yesterday and today with no overseas travel history. … As we expand screening and conduct more tests, there is a chance that we will see more of such cases,” the director said.

Its not mentioned in that article, but some machine translated stuff I read suggests they are also going to start routinely testing people who are hospitalised for pneumonia, to see if they are actually suffering from Covid-19.