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The radio was telling me that initial figures were that an infected person was going on to infect between 1.5 and 2.5 people. Then they got all coy and said the figures were not reliable.
 
Given that it takes 12 days to confirm a suspected case with samples being sent to non-Hubei laboratories, all the evidence seems to suggest underrecording of actual numbers.

This, along with climate change and hunger, the hugest challenge imagineable.

The local government was short on every level, original investigation, notification and measures taken.

www.scmp.com

Wuhan mayor under pressure to resign over response to virus outbreak

Zhou Xianwang tells state broadcaster the government’s ‘warnings were not sufficient’ in interview that prompts online backlash.
www.scmp.com www.scmp.com

I can only cry, I am very upset.
 
8ball said:
I think it's very speculative and a little doomy to say 'easily' for this kind of virus.
Click to expand...
Don't worry, gene sequencing and editing will be cheap enough for the home hobbiest in the near future and then any sufficiently motivated individual can figure out how to make such mutations very easily indeed.
 
weltweit said:
The radio was telling me that initial figures were that an infected person was going on to infect between 1.5 and 2.5 people. Then they got all coy and said the figures were not reliable.
Click to expand...

Well it is a preliminary figure that is bound to be taken with a pinch of salt. I believe someone already mentioned it here before, and the International Health Regulations Emergency Committee mentioned it in their Thursday statement:

www.who.int

Statement on the meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus 2019 (n-CoV) on 23 January 2020

The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the outbreak of novel coronavirus 2019 in the People’s Republic of China, with exportations currently reported in the Republic of Korea, Japan, Thailand...
www.who.int www.who.int

Human-to-human transmission is occurring and a preliminary R0 estimate of 1.4-2.5 was presented. Amplification has occurred in one health care facility. Of confirmed cases, 25% are reported to be severe. The source is still unknown (most likely an animal reservoir) and the extent of human-to-human transmission is still not clear.
Click to expand...

I havent seen too much reporting of something else they said. This is the panel whose advice is used to decide whether to trigger PHEIC (Public Health Emergency of International Concern) and yet I get the impression they dont think this system is actually fit for purpose:

In the face of an evolving epidemiological situation and the restrictive binary nature of declaring a PHEIC or not, WHO should consider a more nuanced system, which would allow an intermediate level of alert. Such a system would better reflect the severity of an outbreak, its impact, and the required measures, and would facilitate improved international coordination, including research efforts for developing medical counter measures.
Click to expand...

Not surprising given the crude nature of the system. A system which I think was partly brought in in the first place because of failures in the response to SARS, but they have struggled with decisions in the past in ways that confused people, eg they did not declare a PHEIC for MERS.

XaCa7yT.gif
 
cupid_stunt said:
www.businessinsider.com

Wuhan, China, is scrambling to build a hospital in just 6 days to treat coronavirus patients as its health system gets overwhelmed

Wuhan is in lockdown over the deadly virus, and doctors say existing hospitals are severely overwhelmed.
www.businessinsider.com www.businessinsider.com

Fucking hell, they can't even repair potholes in 6 months around here!
Click to expand...

If there was an outbreak big enough to cause London to be sealed off, I reckon they'd be able to put together a prefab hospital pretty quickly, or at least a warehouse for sick people that they'd call a hospital.
 
weltweit said:
The radio was telling me that initial figures were that an infected person was going on to infect between 1.5 and 2.5 people. Then they got all coy and said the figures were not reliable.
Click to expand...
I listened to the R4 sciencey show last night, rational people saying informed things about preparation and risk. Conclusion - China has been forward thinking and we shouldn't lay awake at night worrying.

It was immediately followed by the news which was all doom and gloom :rolleyes:
 
Reno said:
Not that amazing. They are forced to do that because their existing health care system and infrastructure is severely lacking.
Click to expand...
Hi Reno what I was meaning is amazing is the speed at which they are are constructing this new hospital. I don't know about their healthcare system.
 
Daily mirror helping spread the fear with picture of man lying in a Wuhan st. He's probably had a heart attack and no one went to help. Ambulance crew in hazards suits dealt with him.
 
So what we're saying is that they've quarantined a city of 11 million people and stopped public transport in another 11 cities for something that is as bad as the common cold?

Must be a nightmare over there when there's flu going about.
 
emanymton said:
So I've been ill for the last week and I work with someone who was in China over Christmas and got back a couple of weeks ago. :hmm:
Click to expand...

Well its perfectly understandable for the mind to ponder such possibilities. More so if the person who was in China was visibly ill at work.

The most reassuring things I can say are that there are many other things around at the moment that are making people ill. And the 14 cases mentioned in the media that have been tested here but came back negative. Presumably these cases were flagged because they came from certain places within a certain window of time and then showed certain symptoms. A scenario much risker than yours, and so theoretically more likely some of them would test positive, but they were negative.

More generally I am interested in the topic of the extent to which official/news/public perceptions about the current spread of a particular novel infection may lag behind the reality. And I dont like false certainty, so I dont like to rule out the possibility that someone here may have already had this illness. And even at the best of times the picture is a little murky, our sense of the picture far from complete. So I often end up with a 'never say never' stance. But even if we had a perfect view, our ability to make correctly balanced risk assessments and judgements is a bit limited, prone to under or overreaction, and quite an array of different psychological coping strategies.
 
tommers said:
So what we're saying is that they've quarantined a city of 11 million people and stopped public transport in another 11 cities for something that is as bad as the common cold?

Must be a nightmare over there when there's flu going about.
Click to expand...

No. Disease severity not well understood yet. Spectrum of possibilities. As bad as the common cold at one end, something more dangerous that needs a real response at the other. Given that SARS and MERS fell on the latter end of things and were the previous new coronavirus outbreaks that humans have experience of responding to, complacency about this one would at this stage be an unwise approach.

Still, it is certainly the case that overreaction can carry its own human cost, and if its all for nothing then such moves will be called into question with the benefit of hindsight. I still prefer it to the classic public health message mistakes where 'panic prevention' (and avoiding economic damage) is used to justify too much suppression of information that the public have a right to know in order to empower themselves.
 
tommers said:
So what we're saying is that they've quarantined a city of 11 million people and stopped public transport in another 11 cities for something that is as bad as the common cold?

Must be a nightmare over there when there's flu going about.
Click to expand...
The common cold doesn’t kill 3% of the people who catch it, which is the current estimate. Even for the flu the mortality rate is far lower. If hundreds of thousands are affected, do the maths.
 
Reno said:
The common cold doesn’t kill 3% of the people who catch it, which is the current estimate. Even for the flu the mortality rate is far lower. If hundreds of thousands are affected, do the maths.
Click to expand...

Its not an estimate that carries much weight, its too early for a good estimate.

Underreporting of symptomatic cases and inability to estimate level of asymptomatic cases are some of the reasons why the number isnt very useful.

For example, some MERS studies gave ranges of 12.5%-25% for asymptomatic cases.

And on the other side of the equation, of the known cases already counted, some of those that will die havent died yet and so are not included in the current number of deaths.
 
Big Chinese organisations in Europe have been instructed to halt most travel to the PRC and central command have ordered them to invoke epidemic contingency plans for staff wrt staff illness and sanitation ( distribution of hand sterliser etc) in their gaffs. Not joking here either, I know people who work for them.
 
weltweit said:
The radio was telling me that initial figures were that an infected person was going on to infect between 1.5 and 2.5 people. Then they got all coy and said the figures were not reliable.
Click to expand...

There is also bound to be talk of the super-spreaders (also known as super shedders for the presumed increased viral load they shed), because that does seem to be an actual thing. Its shown up in the past such as with SARS, on occasions when a particular person and location is tied to an outbreak and they end up being able to trace a whole chain of resulting infections. I expect such phenomenon are presumed to occur in other sorts of outbreaks that never end up being contained as well, such as influenzas that end up being pandemics/epidemics and then the 'normal' flu in 'normal' flu seasons.

I havent checked the UK press for any coronavirus super-spreader stories yet, but I've already seen one on the CNN website. Wuhan virus 'super spreader' alarms disease detectives

So yeah, that average figures for how many people an infected person goes on to infect proably dont give a fair picture, as some individuals can do way more than their fair share of spreading.

As for various 'horse has already bolted' sentiments I have expressed in recent days, I feel like qualifying them again. If this new coronavirus has a similar levels of ease with which it spreads as SARS or MERS, then eventual containment is still a goal. The horse has bolted but it can be brought back eventually, at least to the extent that this coronavirus does not end up as a permanent fixture around the world and in the human population at large. If its much better at sustaining human to human transmission than that, then its a whole different kettle of fish. Its a bit like the difference between H5N1 bird flu and H1N1 2009 swine flu. They both had the ability to go from animal to human, and then for some human to human transmission. But so far the concerning bird flu strains didnt become amazing at doing the human to human spread, so it was possible to contain the outbreaks. But the swine flu had no such limitations and so containment was not plausible, and we had a pandemic.
 
Supine said:
Amazing how detailed science can go so quickly on an emerging disease. Great link :)
Click to expand...

Thanks. Things have improved in that area, timely information sharing and reports, for sure.

It does get a bit depressing seeing how slow progress can actually be when it comes to the understanding of disease mechanisms and possible treatments. Anyone who has nerded out in the past on a bunch of diseases likely wont be surprised to see various cytokine storm things in the report. And the same old crude attempts to mitigate - yes, bloody corticosteroids again. The old 'well they are powerful anti-inflammatories and some of the damage is being done by inflammation response so lets try them'. But oh dear, current evidence from SARS and MERS patients tended to show no changes in mortality when corticosteroids were used, but rather delayed viral clearance. Anyway this isnt just me ranting, its all mentioned in that same report. Its just when they call for urgent study into this topic as a result it just makes me sad to see the same old themes and drug families coming up in the same unresolved way and same old context over and over again.
 
elbows said:
There is also bound to be talk of the super-spreaders (also known as super shedders for the presumed increased viral load they shed), because that does seem to be an actual thing. Its shown up in the past such as with SARS, on occasions when a particular person and location is tied to an outbreak and they end up being able to trace a whole chain of resulting infections. I expect such phenomenon are presumed to occur in other sorts of outbreaks that never end up being contained as well, such as influenzas that end up being pandemics/epidemics and then the 'normal' flu in 'normal' flu seasons.

I havent checked the UK press for any coronavirus super-spreader stories yet, but I've already seen one on the CNN website. Wuhan virus 'super spreader' alarms disease detectives

So yeah, that average figures for how many people an infected person goes on to infect proably dont give a fair picture, as some individuals can do way more than their fair share of spreading.

As for various 'horse has already bolted' sentiments I have expressed in recent days, I feel like qualifying them again. If this new coronavirus has a similar levels of ease with which it spreads as SARS or MERS, then eventual containment is still a goal. The horse has bolted but it can be brought back eventually, at least to the extent that this coronavirus does not end up as a permanent fixture around the world and in the human population at large. If its much better at sustaining human to human transmission than that, then its a whole different kettle of fish. Its a bit like the difference between H5N1 bird flu and H1N1 2009 swine flu. They both had the ability to go from animal to human, and then for some human to human transmission. But so far the concerning bird flu strains didnt become amazing at doing the human to human spread, so it was possible to contain the outbreaks. But the swine flu had no such limitations and so containment was not plausible, and we had a pandemic.
Click to expand...

I suspect some element of this phenomenon is down to circumstance more than any fundamental difference in “shedding”.
 
8ball said:
I suspect some element of this phenomenon is down to circumstance more than any fundamental difference in “shedding”.
Click to expand...

Yes a lot of factors are implicated. Some are down to environmental and contact circumstances. Symptoms that are not present in a lot of people, but make spread more likely when they are, are implcated. As is the related possibility of coinfection with something else that causes the symptom. eg runny nose not common with SARS, but a case who did have that seemed better at spreading it to other people.

A bunch of this stuff is explored here: Super-spreaders in infectious diseases
 
A friend of mine from Wuhan who is studying overseas told me that she hasn't heard from her family in several days and they aren't answering her calls - bear in mind this is at the equivalent of Christmas time.

There's some stuff doing the rounds on Wechat of a doctor in Wuhan sobbing on a voice message that they the hospital is overloaded with 40,000 people and there are only a few dozen doctors and they don't have the resources to cope with it. Sounds absolutely awful, and it looks like a real panic is spreading now. Even some articles published by state media are saying it is "far more serious than you imagine."

Another friend of mine who lives in a city in Guangdong province says that shopping malls, parks, cinemas, libraries, public transport, schools and many workplaces have all been shut down. Her city isn't named as one which is under lock down as transport in and out is still possible, but it seems like similar drastic measures are being taken outside of the cities in Hubei reported as being sealed off.

However, I can't work out if it is now a case that officials are trying to show that they have done absolutely everything they can to stop the spread and may be overreacting and spreading panic. Authorities in Wuhan initially covered up reports, harassed journalists for "spreading rumours" no matter how accurate, Internet censors deleted reports on social media, and they denied that the virus could spread human to human. As a result the city of Wuhan went ahead with a massive outdoor New Year's banquet with 200,000 people in attendance.

At that time, local officials had an incentive to cover up mistakes. Now the Central Government is warning that heads will roll if there's more cover ups (however, the same central government has spent the last 8 years centralising power in one man, tightening control on social media, cracking down on lawyers and NGOs, and fixated on spreading 'positive energy' by repressing bad news and punishing those who report it) , then the incentive has changed to being seen to be doing absolutely everything to control it. So it's totally possible that these extreme measures are in overreaction.

Also, I've never seen so much open dissent and anger on my Wechat, too much for the censors to manage I guess. People seem confused and frustrated about the mixed messages - one post says "some people [thinly veiled reference to government officials] are really very strange, if you say it's serious they say you're spreading rumours, if you say it's not serious they again say that's misinformation, all common people can do is take all precautions."

Bear in mind this is the second major disease outbreak in the last year, in both cases the problem was aggravated by cover ups and bad circulation of information. The first didn't spread to humans but killed so many pigs that it caused a big increase in the price of pork, the most staple meat in the Chinese diet.

The psychological impact of this happening at New Years is akin to "Christmas is cancelled'. But actually even that doesn't quite capture it. The mass migration of Chinese from the countryside to cities in the last couple of decades is unprecedented in human history, and Spring Festival is for hundreds of millions of people the one time of year where they can be reunited with their relatives who they may live very far away from and work gruelling hours with few holidays. It's a real tragedy and coming on top of a struggling economy and unrest in Hong Kong, could be the big watershed moment in which the illusions of the "great rejuvenation of the Chinese people" and the Xi Jinping era are shattered. Another post I saw in a group chat said "rise of the East and decline of the west, we must wait longer for this day" which tells you something about the ideological and political impact of this.
 
There's now 18 cities in 'lock-down' affecting 56 million people, fuck that must be scary for everyone. :(

The nationwide death toll has jumped to 41, the government said Saturday, after 15 more people died in Wuhan.

Confirmed infections also surged to 1,287, up from 830 reported 24 hours earlier. Most of the deaths and overall cases have been in Hubei.
Click to expand...

www.channelnewsasia.com

China deploys army medics to overwhelmed virus epicentre

WUHAN: The Chinese army deployed medical specialists Saturday (Jan 25) to the epicentre of a spiralling viral outbreak that has killed 41 people and spread around the world, as millions spent their normally festive Lunar New Year holiday under lockdown.The country's most important celebration ha
www.channelnewsasia.com www.channelnewsasia.com
 
cupid_stunt said:
There's now 18 cities in 'lock-down' affecting 56 million people, fuck that must be scary for everyone. :(



www.channelnewsasia.com

China deploys army medics to overwhelmed virus epicentre

WUHAN: The Chinese army deployed medical specialists Saturday (Jan 25) to the epicentre of a spiralling viral outbreak that has killed 41 people and spread around the world, as millions spent their normally festive Lunar New Year holiday under lockdown.The country's most important celebration ha
www.channelnewsasia.com www.channelnewsasia.com
Click to expand...


More than 18, that's 18 which people can basically not leave but many cities in Guangdong are also basically under lock down but aren't stopping people from leaving now.

This looks absolutely disastrous, in Wuhan there is a shortage of supplies to deal with the crisis, apparently part of the reason is that workplaces are closed for the holidays and also as a precaution against the disease, and logistics networks have also been shut down. The rush to contain the virus has led to a breakdown in supply chains. Just read that a doctor in Wuhan died from a heart attack due to the stress of dealing with so many patients, fuck..
 
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