CDC Begins Passenger "Funneling" re 2019-nCov

[Response Ability]

I'm a SLF.

The first patient in the US has contracted the very fast moving 2019-nCoV. (A new SARS-like virus first seen in Wuhan, China)

The United States' CDC has begun "funneling" passengers entering the US from Wuhan, China. This entails re-ticketing US bound passengers from the Wuhan region so that they arrive into US airports that have bio-screening in operation. Currently KSFO, KJFK and KLAX are bio screening having screened over 1,000 passengers since Friday, Jan 17, 2020. To come online this week (Jan 21- 26) with the screenings are KATL and KORD. I took this info from a CDC telebriefing that is an mp3 recording publicly available at the CDC website (cdc.gov) via a big link on the right side of their home page. I don't have enough posts / membership time to post the direct link but perhaps you can figure it out cdc.gov/media/releases/2020/t0121-Telebriefing-Coronavirus.mp3 just ad the ht and the ww in front.

My understanding from the telebriefing is that no redirecting is involved in the "funneling." The CDC is proceeding aggressively and I welcome it. Other US government agencies are already involved. Globally things are moving fast. The tele briefing is being transcribed but until that is available, the mp3 recording is available. The actual tele briefing begins at 34:38 into the mp3 file. Our cherished media reporters were afforded a limited Q&A so you can hear one of their main sources. There's lotsa info in the tele briefing regarding the one patient, when and where he travelled, the care being given to him and his own, educated early reporting of his symptoms.

I imagine the employers have already started briefing crews.

[etudiant]

Although Wuhan is perhaps the largest switching point in China, it is not the primary departure point for international flights.
My guess is many passengers from Beijing or similar airports got there via a change of trains in Wuhan.
So the effort, although laudable, is far from airtight.

[triploss]

Although Wuhan is perhaps the largest switching point in China, it is not the primary departure point for international flights.
My guess is many passengers from Beijing or similar airports got there via a change of trains in Wuhan.
So the effort, although laudable, is far from airtight.
That seems far stretched. Wuhan is 4 hours from Beijing and Shanghai, and that's not counting the time needed to get to the airport from the train (adding another hour). Most people will have connecting itineraries from WUH via Beijing, Shanghai, HKG, or other airports. The number of people on US-bound itineraries taking the train through Wuhan to get to another airport will be miniscule compared to people on tickets originating on Wuhan.

[fdr]

So, the evolved corona virus has an expected incubation period of somewhat more than the flight time from A to B, by a week to two weeks. Screening will only detect that part of the population that is sick enough to be detectable, and not sick enough to have been incapacitated to the extent that boarding the flight would have been denied or not possible due to health of the patient.

Without immunisation, there is only one method to stop a spread of an aerosolised type virus, or one that is otherwise transmitted from contact, and that is to restrict contact for the period necessary to ensure symptoms can be identified.

FWIW, Elvis has already left the building, the screening is lipgloss, and is limited in efficacy. The preliminary R nought on this one is high enough to need prompt and substantial controls in order to stop spread in the population, being higher than the SARS or MERS rates, but this is early days. Movement interactions over the last few weeks will become key in attempting to put the genie back in the bottle, but screening itself is currently is not the panacea of defence.

The period of incubation to the point of being contagious will be a major factor in developing the strategy to limit the spread. So far the lethality of the latest outbreak is lower at present than MERS or SARS have been, but is still serious.

Masks and gloves, hand-washes, and minimising contact with others. go to cdc.gov for latest info.

[Beamr]

Latest news are that Wuhan is "closed" by authorities by canceling planes and trains leaving the city, and suspending buses, subways and ferries within it.
Source: NYT

Someone is taking this very very seriously.

Looking at WUH departures, almost everything is cancelled.

[PAXfips]

Transcript of aboves "telebriefing" https://www.cdc.gov/media/releases/2020/t0121-Telebriefing-Coronavirus.html

Also news (on TV, so no link now) is that the city Huanggang (next to Wuhan) is now considering a travel
ban as well - or already put it in place.

[Beamr]

Now reported Huanqqang is closed and Eizhou has closed railway stations. This closure now actually affects approx 20 million people, so the local health and safety authorities must be very scary (and possibly know a lot more than is released).

[fdr]

Now reported Huanqqang is closed and Eizhou has closed railway stations. This closure now actually affects approx 20 million people, so the local health and safety authorities must be very scary (and possibly know a lot more than is released).

As all should be.

Was given an unconfirmed report of the death of the father of a friend who transited in the area, and died of symptoms consistent with the outbreak. That transit was outside of Wuhan, and the death was in a 3rd country. Not confirmed, but the source is medical and usually reliable. This event is not included in the reported deaths outside of China as far as I am aware. I hope that it wasn't the latest strain, but if it was, then there is an unreported vector already well outside of Wuhan. That report was enough for me to add hepa masks and additional gloves to the bio-protection that we already carry. If you are using masks, the simple surgical masks lose effectiveness when wet, from your own breath, in about 15 minutes, they don't work all day. Your own personal hygiene is a major part of contamination, we touch our own face many times every minute, and each time is an opportunity to transfer droplets from anything else we have touched.

Will be glad to be wrong.

[Ian W]

Meanwhile in other news...

While the impact of flu varies, it places a substantial burden on the health of people in the United States each year. CDC estimates that influenza has resulted in between 9 million – 45 million illnesses, between 140,000 – 810,000 hospitalizations and between 12,000 – 61,000 deaths annually since 2010.

Disease Burden of Influenza | CDC (https://www.cdc.gov/flu/about/burden/index.html)

Better the devil you know?

[Response Ability]

An update from China re 2019-nCoV in China. 6:47pm, 23 Jan, 2020

scmp.com/news/china/article/3047319/wuhan-coronavirus-full-blown-community-epidemic-chinese-health --- Add the https and www in front.

"A full-blown community epidemic" in Wuhan, a city of 11 million. Bigger than NYC.

Guan Yi, director of the State Key Laboratory of Emerging Infectious Diseases at Hong Kong University said, "Although a travel ban had been introduced in the city on Thursday morning, the “golden time” to contain the virus had passed, as most of the people travelling home for the Lunar New Year holiday had already left. They might have been in contact with patients in the community and still in the incubation stage when they left Wuhan. They are probably virus carriers on the move.”

[tdracer]

The US person who was infected is being treated in a hospital a few miles from where I live. The good news is the guy was paying attention - although he felt fine on the flight home, he started feeling ill a couple days later and immediately sought treatment. Even then, they've identified nearly 40 people who he had close contact with before he realized he was sick.
This could be bad...

[unworry]

This dashboard is updated regularly, for those tracking the global incidence
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

And if you are interested in the genomic analysis of the distribution and mutations of the virus
https://nextstrain.org/ncov?c=num_date

[etudiant]

A more extensive coverage is provided by FluTrackers ( https://flutrackers.com/forum/index.php ). The most recent updates are linked on the right.
The site is the best currently available to the general public, afaik.
Given the unprecedented measures taken by the Chinese government, including quarantining 50MM people in the heart of the country, there is sure to be massive fallout.
It would not be surprising to see much more intrusive scrutiny of travelers for health issues, essentially an HSA to supplement the TSA.

[Flight Alloy]

Does anyone have any info about flight LQ877, departed Wuhan for Siem Reap on JAN26 01:17 CST? It shows valid ADS-B data but doesn't show on airport arrivals site. I thought all flights out of WUH were suspended, curious this one is the only one to fly out today?

[givemewings]

And given there are those who deliberately sought to deceive the health screening checks (posts shared on Weibo and translated by Mandarin speakers) it may spread even quicker.

Shanghai and Hong Kong have closed major theme parks such as Disneyland and Ocean Park to prevent further spreading due to crowds.

[crankyanker]

Per the Associated Press the U.S. consulate in Wuhan will be evacuating Americans to San Francisco on Tuesday (at their own cost of course). Peugeot (PSA) is placing its employees in Wuhan under quarantine and evacuating them with the French government working on plans for other French citizens. I believe the Russian government is taking (or planning) similar actions. Canada is reporting their first case, a man who flew Wuhan-Guangzhou-Toronto.

[Radgirl]

It is sad that a totalitarian state that totally controls its population still allows wet markets. If we continue to eat exotic animals in the Far East and bushmeat in Africa, we will continue to see these issues. Totally avoidable.

Now the first world has to pick up the pieces.

[etudiant]

The reports from China now indicate that the patients who have caught the virus are infectious to others within as little as a day, whereas symptoms such as fever do not develop for at least several days to a week.
That very much calls into question the effectiveness of the airport screening as currently implemented. Imho, it seems likely that the few early international cases will soon have considerable company.
Unless there is a cure found fairly soon, we should expect much harsher travel restrictions.
.

[Less Hair]

How about a travel ban?

[etudiant]

How about a travel ban?

Quite possibly in the cards, but too late to be effective if the virus is indeed as contagious as some researchers believe, with an R0 of greater than 3.

[Less Hair]

Now we evacuate all the Westerners to their home countries to spread the virus, two weeks unnoticed each, there as well?

[etudiant]

Now we evacuate all the Westerners to their home countries to spread the virus, two weeks unnoticed each, there as well?
It might be a useful precaution to keep them all in quarantine for a couple of weeks before bringing them home.
However, there is not enough fear as yet to allow even minor inconveniences to be imposed. Very likely we will regret this missed opportunity.

[Rated De]

As the thug regime demonstrated during SARS their data isn't worth much.
Among reports now circulating (leaking) are that the deaths are being reported as "respiratory failure/ pneumonia"

Assuming that the mortality rate is lower than SARS, based on Chinese "information" is wishful thinking..

[givemewings]

It might be a useful precaution to keep them all in quarantine for a couple of weeks before bringing them home.


From what I read France and several other countries plan to do this. Evac from Wuhan/Hubei to an intermediate location for a quarantine, then once cleared onward to home. I suppose the main concern is transmission from infected to non infected during evacuation flights...

[etudiant]

As the thug regime demonstrated during SARS their data isn't worth much.
Among reports now circulating (leaking) are that the deaths are being reported as "respiratory failure/ pneumonia"

Assuming that the mortality rate is lower than SARS, based on Chinese "information" is wishful thinking..

At this point, no numerical data is reliable, as the caregivers are themselves overwhelmed and likely too busy to do much paperwork
However, the Hubei province government's ratio of fatalities to recoveries reported for the sickest patients is worsening, with 76 deaths versus 44 recoveries as of Jan 26th.
So the prognosis for those worst hit is poor.

[Airbubba]

Per the Associated Press the U.S. consulate in Wuhan will be evacuating Americans to San Francisco on Tuesday (at their own cost of course).

Looks like San Francisco is no longer a sanctuary city for the virus and the evac flight will route through ANC to ONT.

https://cimg8.ibsrv.net/gimg/pprune.org-vbulletin/590x654/wuhan_7332f525f7ce365a669de33de39f281955828055.jpg

[fdr]

If the nCoV is infectious while in an asymptomatic condition which is at least a 50/50 proposition, and anecdotally probable, then screening by temp probes remotely is lip gloss. The only manners to control this is by isolation, at least long enough to ensure that there is no chance of transmission to the protected population, or to develop immunity through achieving promptly a vaccine, or, to focus on personal protection and follow up therapeutic treatment of symptoms as they develop.

Of these options, we have lost the opportunity to stop the spread. The current figures ex JHU appear to be well underreporting total cases, consider that the likely spread is around an order of magnitude higher than reported to date. (If the amount of Wuhan-ians (Wuhan-ettes?) that are getting onto planes and then showing symptoms around the world, some 60 so far all happened to be at the same market/restaurant/beerfest/square dance/legionnaires convention, then their numbers make sense, otherwise, the spread was much higher in Wuhan at the start of the program, or people who fly happen to be more susceptible to the virus. Whatever. Or the reservoir numbers were already huge.

Good news so far is that of those that travelled overseas, there appears to be a very low mortality rate, and that suggests that discounting attenuation, that reasonable medical symptomatic treatment may be effective. That is just hinted at and is a best hope case.

In our region, shelves have already emptied of all N95 masks and hand sanitiser. That is a good thing, it at least suggests that at least the public are taking the issue seriously even if the govt's haven't. However, the use of masks even in the medical profession is just dismal, look at any images of people taking the time to put on a mask, and then lowering under their nose, while standing around other people. Watch if they take any care to avoid touching the mask, or taking any care with the mask being contaminated... Disposal of masks is also reminiscent of the condoms around Rome. So.... you get out of the bad place (supermarket etc...) and then just outside of the car you drop the pesky mask on the ground. How? Were the hands in gloves? Were the hands cleaned after being contaminated by removing the masks before touching the car door handle? (thanks for leaving a potential viral load in the carpark BTW, well done sir/ma'am). Personal protection is not that hard, but it takes deliberate steps to be effective. If the individual is not deliberate, then there is little point in bothering, in which case, take solace in the current anecdotal effectiveness of therapy at least outside of China. The images of dead bodies in the hallways of the local hospital suggest that the glastnost of the Chinese govt is open only to an extent.

Time for a holiday, at home, away from all others, and away from schools.

[Longtimer]

Re N95 masks, these masks come in different sizes and you need to be fit tested, shown how to use them etc. for them to be very effective. .For example, the fit around the bridge of the nose is critical as if this is not adjusted correctly, the gap will allow particles to enter the mask.

[Twitter]

Hopefully the evacuation aircraft will operate with recirc fan off, amongst the other precautions.

[fdr]

Hopefully the evacuation aircraft will operate with recirc fan off, amongst the other precautions.

To get serious about it, the crew involved need protection for the flight, including in the slip accomodation, and then on return they need to be placed into quarantine as well, preferably separate to the great unwashed passengers. The aircraft then also needs to be held out of service for the maximum latency of the virus on a surface, HEPA filters changed out, and tested for residual virus load prior to returning to service. None of that is being done at present with the aircraft plying their trade around the region, into other ports etc, so the likelihood of stopping the spread of a virus that has a current contagious phase while the host is asymptomatic is pretty low.

If there is any bright lining, the severe complications appear to be a limited subset of older, or immune compromised, diabetic, cardiac or pulmonary compromised subjects. If that is correct, or remains the case, then medical care outside of China appears to have a fair chance of minimising the adverse outcomes.

[Twitter]

More than one country doing these flights - the word aircraft was actually plural and the comment was serious.
Lots to consider, no tuppeny last minute charters this time.

[the_stranger]

Hopefully the evacuation aircraft will operate with recirc fan off, amongst the other precautions.
Not of it is an airbus, keep those fans running if you want the cleanest air.

[Twitter]

Not of it is an airbus, keep those fans running if you want the cleanest air.

That’s interesting Stranger. Doesn’t the recirc fan reduce the rate of cabin complete air renewal?
I know our cabin crews (not a Bus) were complaining of stale air when they were first incorporated.

PS
And, thinking about it, it may not be long before precautions as fdr describes may be needed on other (scheduled) flights

[Rated De]

Chris Martenson has a very good piece on this.
He is not an alarmist, he has a PhD in toxicology.

We are now told the asymptomatic people are travelling being "screened" is theatre.
We now have people to people transmission.
The WHO behaving like a trade organisation.
Why the hell haven't flights been banned?


https://www.youtube.com/watch?feature=youtu.be&v=Nk5P_iRYwTY

[Airbubba]

Looks like San Francisco is no longer a sanctuary city for the virus and the evac flight will route through ANC to ONT.

The U.S. evacuation flight from Wuhan is airborne with a Connie B-744.

https://cimg7.ibsrv.net/gimg/pprune.org-vbulletin/966x652/cks371_7003e195b36dad6e6c6047ac76e20b87bcdef7ce.jpg

[fdr]

The U.S. evacuation flight from Wuhan is airborne with a Connie B-744.

Connies planes may be more than a match for 2019nCoV....

The German and Japanese human to human transmission outside of PRC should trigger a major change in the WHO position on the outbreak.
About time.

On the related closed thread, comment was made on the fact that the virus had killed at least one health worker. It suggested that health workers would be healthy subjects. Docs and nurses seem to run the gamut of condition that most of the rest of us unwashed do, wouldn't necessarily conclude that without supporting evidence. Medical teams should be more aware of the procedures for infection control, but the early video indicated the wrong types of masks being used, without eye or face protection, and in some cases incorrect mask types being worn incorrectly. To become a statistic when working in close proximity to infectious substances and more importantly all the untrained and unwitting potential carriers of the virus makes it a full time demand to be correct in procedure, which is a tall ask anywhere. Spread of virus within medical staff is historically common and is practically darn hard to avoid.

To date, the fatalities have been almost exclusively in PRC, if not totally. The stats on the external rate will become apparent once enough time has passed, but the rate of case confirmation in PRC is running at an average of 148% per day, roughly doubling every 2 days. The daily statistics show a fair amount of variation, from 117% to 218%, but a regression or average looks about the same, 1.5x daily. The external cases are running, 148% average per day since a report of 4 cases overseas. Out of all of those, there are 2 external transmissions where the person contracting the virus has not been in Wuhan.

Mortality rates are around 1.8% as of this morning, of all confirmed cases, and as above, all of those have been in Wuhan so far. In 10-14 days we will have enough info to determine whether care within PRC is a factor in the outcome. If a differential mortality rate remains, then that should give clues as to how best to adjust care in PRC to lower mortality rate. If the mortality rates result in similar trends, then that will at least provide information on who is most at risk so intervention effort can be best employed. In the meantime, the stats appear to be very quiet in Russia and in the Philippines. Suspect that all is not as quiet as indicated in the stats there.

Surgical masks have limited time effectiveness, and what effectiveness there is is in limiting transmission from the wearer to others. N95 masks with good seals have modest effectiveness to stop particulates getting to the nose and mouth. Eye protection is needed to stop a vector via that path. Once the wearer is outside of the area where airborne contamination is expected, then contamination deposits on surfaces that are then touched and transferred by contact of the hand to the face is a major problem; entering a lift or opening a door is inviting a transfer if gloves and sterile procedures to avoid transfer to the face is not employed. That comes down to not touching your own face with your own hands, which the mask of any sort will assist with. Fidgeting with the mask is inviting transfer... This is not rocket science, but in our own operations, we have had to review and adjust protocols to avoid the risks that we have interfacing with those involved in the care of such patients.

Good news is that the rate of transmission (er, case confirmation) will not remain at 148% per day... the bad news is that it may increase or decrease. Fortunately, It is most likely to decrease, as at the current rate, by the end of February, the total cases would have grown to over a Billion, (with a B), and that would be a fairly noticeable effect on activity rates, so isolation is likely to occur naturally, which will reduce that rate. Due to the latency problem arising from the possibility that this virus is contagious while in a asymptomatic state, there is already a much larger number of people with the virus than would have been the case with SARS and MERS. Assuming that all infections lead to confirmation in due course, then there is around 1 Million vectors happily floating around in PRC and in the planes already that are asymptomatic. The unknown is how many people can be asymptomatic and still spread the virus while never becoming a confirmed case, and how many other cases are just not reported as they have been discounted as being normal illness and deaths (Phillipines, Russia etc). Suspect that the real case is around 4 times higher than that, so about 4 Million little vectors running around today. That suggests Elvis has left the building, and all up this is a tail chase of mitigation more than prevention.

This virus is going to run its course, and hopefully medical care will cope with the patient load which will certainly increase, and will be able to come up with appropriate therapies within existing resources to moderate fatalities. The clue may well be the difference in outcome between PRC and external today. If not, then by the end of February, we need about 30 Million new plots for burials.

The rates are going to change, and hopefully all will moderate, that is transmission control reducing new confirmed cases, and mortality rate from confirmed cases. They can move in either direction, but the efforts are being made to lower them all. The planet has a lot of people on it, and the annual mortality rate, without tiffs between nations is in the 3% range with new births making up for that. An increase in mortality rates for various parts of the population of 1.8% is pretty rough on that part of the population, but wont ultimately end up being apocalyptic. It may ruin the individuals day, but it will bw a blip in the overall growth rate, we delay messing up the planet by about 6 months. For the elderly, infirm, and young there is an incentive to take precautions, it's their lives that are most likely at stake at present. The elderly can mainly take responsibility for their own cases, the young increase the burden on the parents, and that is a powerful incentive to get it right.

[Airbubba]

Connies planes may be more than a match for 2019nCoV....

Looks like they are taking precautions on the flight deck in China.

https://cimg3.ibsrv.net/gimg/pprune.org-vbulletin/2000x1258/qncw3cbugdi9cfdy3arluisooom_00ab4429437f5f49f3cb05585647b7ab 644803bf.jpg

[fdr]

Looks like they are taking precautions on the flight deck in China.

https://cimg3.ibsrv.net/gimg/pprune.org-vbulletin/2000x1258/qncw3cbugdi9cfdy3arluisooom_00ab4429437f5f49f3cb05585647b7ab 644803bf.jpg

Curious looking B744. (Chinese characters for Emergency Opening are a clue)

A fashion statement. If done well, a crew would have a low but not zero risk of infection. Someone would have gone to the toilet, eaten, scratched their nose, etc in the flight from A to B. Assume that is zero, they are happy campers. The plane, it needs cleaning, and checking before going out on more activity. Monitoring the crew and pax for the incubation period and doing testing for the virus would clear the crew and be anecdotal to the airplane. Was there catering, ground staff onboard, CIQH etc in Wuhan..? Plane will shure look purty after it's scrub though.

[Airbubba]

BA is halting flights to PEK and PVG:

British Airways to halt Beijing, Shanghai flights28 January 2020 By Seth Miller (https://paxex.aero/author/paxex-guru/)

As health concerns mount and waiver options grow some airlines are going a step further in their response to the virus outbreak in China. British Airways (http://ba.com/) is taking the significant step of halting its flights to Shanghai and Beijing effective immediately. A formal announcement is expected early Wednesday in London.

Based on documents reviewed by PaxEx.Aero (https://paxex.aero/) the carrier’s flights BA39 and BA169 on 28 January 2020 will be the last flights in for a month. The crew working those flights will return as passengers and all downline crew will also return on the BA38 and BA168 flights leaving China on 29 January.


https://paxex.aero/2020/01/british-airways-to-halt-beijing-shanghai-flights/

[Beamr]

Jan 28 (Reuters) - Finnish airline Finnair said it would suspend its routes to Nanjing and Beijing's Daxing airport until the end of March, the first European airline to cancel flights to mainland China amid growing fears about the spread of a new flu-like virus.

https://www.cnbc.com/2020/01/28/reuters-america-update-1-finnair-cancels-some-china-flights-as-virus-fears-spread.html

[Airbubba]

Now the U.S. diplomatic evac charter isn't going to Ontario either.

Coronavirus (https://www.foxnews.com/category/health/infectious-disease/coronavirus)
Published 14 mins agoPlane carrying US evacuees from China amid coronavirus outbreak diverted to California air baseBy David Aaro (https://www.foxnews.com/person/a/david-aaro) | Fox News (http://www.foxnews.com/)A plane carrying about 210 U.S. citizens evacuated from Wuhan, China—the epicenter of the deadly coronavirus—was diverted Tuesday to California’s March Air Reserve Base "for the logistics that they have," an official said.

The plane was initially headed to Ontario International Airport in California (https://www.foxnews.com/category/us/us-regions/west/california). Curt Hagman, the chairman of the San Bernandino County Board of Supervisors and a commissioner at the airport, said on social media that the CDC had informed him of its decision to divert the flight.

"Ontario International is one of the repatriation airports for the west coast and we are always prepared to receive our citizens abroad in times of emergencies," Hagman said in a video posted to his YouTube channel. "We were prepared but the state department decided to switch the flight to March Air Force Base for logistics that they have."


https://www.foxnews.com/health/plane-with-u-s-evacuees-from-china-diverted-from-california-to-air-force-base-curt-hagman-says

[Airbubba]

The Australians are going to quarantine their Wuhan evacuees on Christmas Island.

Australians stranded in Wuhan to be evacuated to Christmas Island

Scott Morrison has announced some of the 600 Australians stuck in the epicentre of the coronavirus outbreak will be evacuated.

Updated Updated 1 hour ago
By SBS News

The government is planning to evacuate some Australians stuck in Wuhan and surrounds, using Christmas Island as a quarantine area.

"We're preparing a plan for an operation to provide some assisted departures for isolated and vulnerable Australians in Wuhan and the Hubei province," Prime Minister Scott Morrison said on Wednesday.

"This will be done subject obviously to working closely and with the authority and approval of the Chinese government ... I stress that this will be done on a last in, first out basis," he said.

"We're particularly focused on the more vulnerable components of that population. That's young people, particularly infants, and those who are elderly."

Mr Morrison said Christmas Island would be used "as a quarantine area" where the evacuees would stay for 14 days.

He said it was too early to tell how many of the 600 Australians in and around Wuhan will be evacuated.

Locally, the prime minister said an additional one million masks will be distributed around the country.

"This is a serious and evolving situation," he said.



https://www.sbs.com.au/news/australians-stranded-in-wuhan-to-be-evacuated-to-christmas-island

[Rated De]

The Australians are going to quarantine their Wuhan evacuees on Christmas Island.



https://www.sbs.com.au/news/australians-stranded-in-wuhan-to-be-evacuated-to-christmas-island


errr eventually.
The runway is a little short, so unlike the poor souls arriving by boat, these exposed individuals will be sent to Darwin or Learmonth, wander around a while then board aircraft to Christmas Island...
Sort of defeats the purpose.

Meanwhile QF continue to operate all services to mainline China so it is theatre anyway.

[martynj3]

other cases are just not reported .... (Phillipines, Russia etc)

A probable explanation for the lack of identified cases in the Philippines is that until today, there was no lab capable of performing the test (samples were sent to Australia). Thanks to Japanese generosity, the correct reagent has just arrived in Manila.

The Mainland China travel associated with the booming off-shore gambling centres here (POGOs) would suggest the virus arrived some time ago.

[fdr]

A probable explanation for the lack of identified cases in the Philippines is that until today, there was no lab capable of performing the test (samples were sent to Australia). Thanks to Japanese generosity, the correct reagent has just arrived in Manila.

The Mainland China travel associated with the booming off-shore gambling centres here (POGOs) would suggest the virus arrived some time ago.

Thanks, that would make sense. The stats are only as good as the data sampling is. The potential for this to be dependent on a factor such as ACE2 will be helpful in resource allocation. It is certain that the PRC has a major public health matter on their hands already, and while they are taking measures, they may very well need global support if the predisposition of certain populations becomes clear. Building a hospital in 10 days is an amazing response and effort, but staffing that is going to be equally as difficult or moreso. In the next 2 weeks, this beast is going to show it's true colours, which currently suggests there is a predisposition. Recognising a factor like that early would save lives.

For our little part, we have implemented IC protocols to permit the continuation of specialist cross border operations. We are not alone in doing so.

[Response Ability]

As of 1:00 PM PST January 31, 2019:

DAL, UA, AA halt all flights between US and China. scmp.com/news/world/united-states-canada/article/3048497/american-airlines-pilots-sue-halt-us-china-flights

Trump declares public health emergency and will quarantine U.S. citizens returning from China's Hubei Province.
marketwatch.com/story/trump-declares-public-health-emergency-and-will-quarantine-us-citizens-returning-from-chinas-hubei-province-2020-01-31

The repatriated 195 at MARB under federal quarantine order (1st quarantine in US in 50 years) (Distinguish between "isolation" means when patient is ill and "quarantine" for people exposed and not yet sick.)

CDC "...preparing as if this were the next pandemic..." "...strong measures now may be able to blunt the impact of the virus on the United States..." (my interpretation of that last statement is that CDC considers that the virus will "impact" the US in contrast to the previous characterization of risk is low.)

The CDC test shows 2019-nCoV negative or positive when the patient is ill. Test reliability unknown at this time for asymptomatic people.

CDC team to China to access "best data" at the epicenter especially concerning asymptomatic transmission. (important because the virus is new and its characteristics are being studied and learned even as we speak)

This week Jan 25 - 31: Huge increase in cases in China. Over 10K cases. 26% increase in # of cases in last 24 hours. WHO declares "public health emergency of international concern (PHEIC)" Person to person transmission is confirmed. Asymptomatic transmission id confirmed.

[OldnGrounded]

Trump declares public health emergency and will quarantine U.S. citizens returning from China's Hubei Province. . . .
The repatriated 195 at MARB under federal quarantine order (1st quarantine in US in 50 years) (Distinguish between "isolation" means when patient is ill and "quarantine" for people exposed and not yet sick.)

Quarantines don't really work for diseases that are easily transmitted and have long-ish latency periods. There's never an effective way to identify the people who would need to be quarantined.

The CDC test shows 2019-nCoV negative or positive when the patient is ill. Test reliability unknown at this time for asymptomatic people.

If it is reliably accurate, that's good for informing treatment decisions and for determining when patients should be isolated (ignoring the problem of having sufficient facilities and staff for isolation of large numbers of sick people). It won't help with transmission control, because it's effectively impossible to test large populations of asymptomatic people.

CDC team to China to access "best data" at the epicenter especially concerning asymptomatic transmission. (important because the virus is new and its characteristics are being studied and learned even as we speak)

As indicated in one of RA's citations, it appears that transmission from an asymptomatic carrier has been confirmed.* If asymptomatic transmission is common, and the rapid early spread of the virus suggests that is fairly likely, it will be very difficult to prevent a pandemic.

The good news is that, so far, it appears that only a minority (perhaps 20% per earliest estimates) of infections result in serious illness and the mortality rate seems, so far, to be <2%. We don't yet know what portion of that 2% received prompt and effective supportive care.

It's a good bet that 2019-ncov is going to be a significant factor in world affairs and travel, probably for some time. Serious impacts to aviation are nearly certain.

*https://www.nejm.org/doi/full/10.1056/NEJMc2001468

[fdr]

The current corona virus is causing enough of an irritant with the WHO still suggesting a soft approach is adequate. So how does that stack up?
(As this is a train wreck in progress, the reports are pending peer review so are not necessarily the last word on the subject, but the studies of interest are using methodology that is similar or the same as that conducted many years ago in the SARS outbreak).


We estimate the effective reproduction number for 2019-nCoV based on the daily reported cases from China CDC. The results indicate that 2019-nCoV has a higher effective reproduction number than SARS with a comparable fatality rate. [5]

That is not going to look good. SARS R0 was around 2.76 (Beijing) to 3.01 (Guangzhou), it changed from location to location. Current latest R0 estimate is 4.08, and the associated study undertook a sensitivity analysis to determine a confidence interval of their answer which came out with an R0 95%CI between 3.37 and 4.77, SD=0./36. This study has higher R0 values than the WHO's estimate which was running around 1.4 to 2..

The earlier study [4] also gave early estimates that were higher than the WHO estimated an R0 of 3.11, with a 95%CI of 2.39-4.13.

Mortality rates in the study are indicating higher levels of mortality in the Chinese region, well above the WHO levels, however that has it's own interesting sidebars. SARS mortality was variable across the region, with Beijing having a rate of 7.66%, and Guangzhou having a rate of 3.61%. An initial value for 2019-nCoV is suggested at 6.5%. The methodology of estimating mortality rate in the middle of an outbreak where there is an unquantified lag for incubation to detection, and therefore incubation to fatality means the figure is pretty vague. Most if not all media and health reports have used todays confirmed cases with todays attributed fatalities, which does not reflect the lag in the numbers being used. On the other hand, for this outbreak, there is a high probability of underreporting of confirmed cases to actual cases, as a significant percentage of those infected do not appear to have symptoms that result in a confirmation. A paradoxical hope is that the underlying rate of cases is indeed underreported, and as the fatalities are all identified to the virus, then the true rate is considerably lower. Some suggestion of an underlying rate that is around 10x greater would be curiously comforting.

The effectiveness of screening alone [1][2] hints that there was little liklihood of success by using the conventional screening, no wonder the PRC went into lockdown, a day late and a dollar short, but at least they tried. Sods law was this happened over Chinese New Year; sucks to be us.

A possible glimmer of light comes from the observation that if the average infectious period is reduced to <2.3 days, then the outbreak would stop. There are ways of doing that, China has commenced such action that would alter that in essence, a mass clampdown on activity, which in a round about manner achieves the same outcome. The rest of the world is still looking for a fiddle to play. Once the genie is in your neighbourhood, (and with the ineffective screening that was originally applied, that means anywhere on the planet today that had no contact with other people for the last 30 odd days) contact control is all that is left to play with to adjust the outcome, other than therapy for those with acute symptoms. The international spread of the virus still appears to be a lower rate than the mainland PRC condition, and as yet the lack of fatalities appears to be a variance from the mainland PRC experience. The lag between known contraction of the virus and a fatality is not yet reported, and it may well be that there is a considerable lag which underlies the current variance.

The reported variation in the ACE2 receptor [6] has a small study population, but it is still consistent with most external observations to date, however, non Chinese nationals have now become confirmed in Japan and other locations. The PRC Govt is taking substantial action as indicated below, yet they are unlikely to get on top of this any time soon, the lag in the cycles has to run its course. Elsewhere, the WHO and basically every other govt has responded with less than stellar timeliness and effectiveness.

Looking at R0=4, today we are around the 8th to 10 cycle of infection, (20K- 327K cases, reported is a subset of actual cases). Without check, the global population has saturation at around 17 to 18th cycle. (5.3B- 21.5B cases, current population is ~ 8B). A fatality rate of 6.5% is pretty nasty at that point...

The figures suck enough that action to break the process is probably worth the inconvenience. Strategic opportunists will always look for an advantage, but we are all in the same lifeboat, and it is taking on water.

Limit contacts, take personal Infection Control seriously, and treat symptoms.

In the west, that is going to be seen by some as an infringement on individual freedoms, so don't expect that to be effective without some change of mindset.

We are dealing with an evolving virus, one that is changing over time, any characteristic of it may change for better or worse than it is now, only time will tell.

So glad that at least we are surrounded by great leaders as this time in history has seen fit to bless us with: .... fill in the blanks.....


Update on pneumonia of new coronavirus infections as of 24:00 on January 30

At 04:00 on January 30, 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps reported 1982 new confirmed cases, 157 severe cases, and 43 new deaths (42 cases in Hubei Province, Heilongjiang Province). 1 case in the province), 47 new cases were cured and discharged, and 4812 new cases were suspected.

　　As of 2400 on January 30, the National Health and Health Commission has received a total of 9,692 confirmed cases (31 cases in Sichuan Province were subtracted from the cumulative confirmed cases) in 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps. A total of 213 deaths and 171 cases were cured and discharged, with a total of 15,238 suspected cases.

　　At present, a total of 113,579 close contacts have been tracked (21 cases of reductions in Beijing). On the day, 4,201 people were released from medical observation, and a total of 102,427 people were receiving medical observation.

　　A total of 28 confirmed cases were reported from Hong Kong, Macao, and Taiwan: 12 from the Hong Kong Special Administrative Region, 7 from the Macao Special Administrative Region, and 9 from Taiwan.

　　(Information comes from the official website of the National Health Commission)






References:

[1] Estimated effectiveness of traveller screening to prevent international spread of 2019 novel coronavirus (2019-nCoV)
Katelyn Gostic, Ana C. R. Gomez, Riley O. Mummah, Adam J. Kucharski, James O. Lloyd-Smith
medRxiv 2020.01.28.20019224; doi: https://doi.org/10.1101/2020.01.28.20019224

[2] Risk of 2019 novel coronavirus importations throughout China prior to the Wuhan quarantine
Zhanwei Du, Ling Wang, Simon Cauchemez, Xiaoke Xu, Xianwen Wang, Benjamin J Cowling, Lauren Ancel Meyers
medRxiv 2020.01.28.20019299; doi: https://doi.org/10.1101/2020.01.28.20019299

[3} The incubation period of 2019-nCoV infections among travellers from Wuhan, China
Jantien A. Backer, Don Klinkenberg, Jacco Wallinga
medRxiv 2020.01.27.20018986; doi: https://doi.org/10.1101/2020.01.27.20018986

[4] [b]Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic predictions
Jonathan M Read, Jessica RE Bridgen, Derek AT Cummings, Antonia Ho, Chris P Jewell
medRxiv 2020.01.23.20018549; doi: https://doi.org/10.1101/2020.01.23.20018549

[5] Estimating the effective reproduction number of the 2019-nCoV in China
Zhidong Cao, Qingpeng Zhang, Xin Lu, Dirk Pfeiffer, Zhongwei Jia, Hongbing Song, Daniel Dajun Zeng
medRxiv 2020.01.27.20018952; doi: https://doi.org/10.1101/2020.01.27.20018952

[6] Single-cell RNA expression profiling of ACE2, the putative receptor of Wuhan 2019-nCov
Yu Zhao, Zixian Zhao, Yujia Wang, Yueqing Zhou, Yu Ma, Wei Zuo
bioRxiv 2020.01.26.919985; doi: https://doi.org/10.1101/2020.01.26.919985

[Longtimer]

Coronavirus: US declares emergency and issues new entry rules
1 hour ago
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Related TopicsCoronavirus outbreak

Media captionThe BBC's online health editor on what we know about the virus
The US has declared a public health emergency over the spread of the coronavirus and said it would deny entry to any foreign nationals who have visited China in the past two weeks.

US citizens returning from Hubei province, where the outbreak started, will be quarantined for 14 days.

Nearly 10,000 cases of the new virus have been confirmed, most of them in China, since it emerged in December.

More than 100 cases have been reported outside China, in 22 countries.

On Friday, Beijing said the death toll had risen by 45 to 258 - all of them in China and 249 in Hubei.

Earlier, it emerged that the number of new coronavirus cases worldwide had overtaken that of the Sars epidemic, which spread to more than two dozen countries in 2003.

There were around 8,100 cases of Sars - severe acute respiratory syndrome - during the eight-month outbreak. In total, 774 people were killed by Sars.

On Thursday, the World Health Organization (WHO) declared a global health emergency over the new outbreak.

What has the US said?
In a public statement on Friday, US Health Secretary Alex Azar said US citizens returning from Hubei province would face 14 days of quarantine while those returning from other parts of China would be allowed to monitor their own condition for a similar period.

"Following the World Health Organization decision, I have today declared that the coronavirus represents a public health emergency in the United States," he told reporters.

Image copyrightREUTERS
Image caption
Health Secretary Alex Azar said the new restrictions would come into force on Sunday
Citing the need to relieve pressure on authorities, he said that foreign nationals who had travelled in China in the past 14 days would be denied entry to the US.

"The risk of infection for Americans remains low and with these, and our previous, actions we are working to keep the risk low," he added.

Can people recover from coronavirus? And other questions
How quarantine has fought disease through the ages
The lessons learned from the Sars outbreak
Another confirmed case in the US on Friday - in California - brought the number there to seven. Robert Redfield, director of the Centers for Disease Control and Prevention, said 191 people were under observation for the disease.

What's happening elsewhere?
The US announcement came as other countries around the world scrambled to contain the spread of the new virus, 2019-nCov.

On Friday, the UK confirmed its first two cases.

Estimates by the University of Hong Kong suggest the true total number of cases could be far higher than official figures suggest. Based on mathematical models of the outbreak, experts there say more than 75,000 people may have been infected in the city of Wuhan alone, where the virus first emerged.

Most cases outside China involve people who have been to Wuhan. But Germany, Japan, Vietnam, the US, Thailand and South Korea have reported person-to-person cases - patients being infected by people who had travelled to China.

WHO spokesman Chris Lindmeier warned that closing borders could in fact accelerate its spread, with travellers entering countries unofficially.

"As we know from other scenarios, be it Ebola or other cases, whenever people want to travel, they will. And if the official paths are not opened, they will find unofficial paths," he said.

He said the best way to track the virus was at official border crossings.

Image copyrightGETTY IMAGES
Image caption
Every region in mainland China has confirmed cases of the new coronavirus
Meanwhile in Wuhan, voluntary evacuations of hundreds of foreign nationals are under way.

The UK, Australia, South Korea, Singapore and New Zealand are expected to quarantine all evacuees for two weeks to monitor them for symptoms and avoid contagion.


Media captionInside the US laboratory developing a coronavirus vaccine
Australia plans to quarantine its evacuees on Christmas Island, 2,000km (1,200 miles) from the mainland in a detention centre that has been used to house asylum seekers.

In other developments:

Sweden confirmed its first case - a woman in her 20s who arrived in the country on 24 January after visiting the Wuhan area
Russia said two Chinese citizens had been placed in isolation after they tested positive for the virus
Singapore closed its borders to all travellers from China
Germany confirmed its seventh case - a man from a company in Bavaria where five other workers have tested positive
Italy declared a six-month state of emergency after two Chinese tourists in Rome were diagnosed with the coronavirus
Thailand confirmed its first case of human-to-human transmission
Mongolia suspended all arrivals from China until 2 March. It also banned its citizens from travelling to the country
Russia decided to close its 4,300km (2,670-mile) far-eastern border with China
Japan raised its infectious disease advisory level for China
Some 250 French nationals were evacuated from Wuhan
India confirmed its first case of the virus - a student in the southern state of Kerala who was studying in Wuhan
Israel barred all flight connections with China
North Korea suspended all flights and trains to and from China, said the British ambassador to North Korea
Guatemala announced new travel restrictions, saying anyone who had been to China in the past 15 days would be prevented from reaching the country
What about China?
How is China handling this?
A confirmed case in Tibet means the virus has now reached every region in mainland China.

The central province of Hubei, with a population of nearly 60 million people and where nearly all deaths have occurred, is in a state of lockdown.

Diary of a life in locked-down Wuhan
Coronavirus: What it does to the body
Wuhan: The London-sized city where the virus began
Wuhan has effectively been sealed off and China has put numerous transport restrictions in place to curb the spread of the virus. People who have been in Hubei are also being told to work from home.

China has said it will send charter planes to bring back Hubei residents who are overseas "as soon as possible". A foreign ministry spokesman said this was because of the "practical difficulties" Chinese citizens had faced abroad.

The virus is affecting China's economy, the world's second-largest, with a growing number of countries advising their citizens to avoid all non-essential travel to the country.

[OldnGrounded]

A possible glimmer of light comes from the observation that if the average infectious period is reduced to <2.3 days, then the outbreak would stop. There are ways of doing that, China has commenced such action that would alter that in essence, a mass clampdown on activity, which in a round about manner achieves the same outcome.

Could you elucidate, please? What are those ways?

[fdr]

Could you elucidate, please? What are those ways?

O'nG,
K, FWIW.....


Our study also suggests that by reducing the average infectious period to <2.3 days, the resulting will decease to a value less than 1, meaning the epidemic can be effectively controlled.
. Prior reference [5]

Estimate of incubation time gives a start point to the problem (prior reference [3])

An individual has a point in time when they are exposed, they then go through the process of incubation, and at some point in the incubation period two things may occur, the immune response to the virus will result in symptoms of an infection, and at some point, the virus will be able to be transmitted to other hosts. The concern with 2019-nCoV is that there is possible early transmission at a point where there are no symptoms, and if so, screening is not overly effective. Whether that really is the case is still open to investigation, that being one of the german cases. In the end, the problem is that the symptoms may be undetected and that complicates the issue. The surface contaminant transfer vector is often a significant cause of infection, and there is no information as yet on the survival time for this virus outside of a host. There will be a time that it can survive, at least as long as the medium it is in, saliva etc, is viable. It may be much longer, virus can survive in pretty hostile conditions as a viable structure.

Below, the time series of the patients history shows some cases which give a basis for a minimum period to go from:

high likelihood of no exposure (GREY)
to being exposed (WHITE)
infected but asymptomatic (PINK)
to being symptomatic (PURPLE)
to being confirmed (BLUE)

In the asymptomatic (pink) to either symptomatic (purple) or confirmed (blue), we have the potential to spread. The current stats suggest that there is a large background number of cases that exist that are asymptomatic and not counted or known, and a number of cases being symptomatic but not reported, for various reasons, from privacy concerns, lack of recognition etc.




https://cimg1.ibsrv.net/gimg/pprune.org-vbulletin/1090x1488/screen_shot_2020_02_01_at_10_01_53_am_53e79ed56bdc24230629d0 62417d1e6dd3d648a8.png
from reference [3]


The same reference document as above gives the following CDF curve. That can also be described with a distribution spread, which follows in the box plot comparing this virus with prior virus outbreaks. Whether the virus can be transmitted in the asymptomatic case or not is functionally immaterial. As the local environment and population you are within has a level of risk of exposure that is dependent on where we are on the vectors to date, unless you have spent that last few weeks in Antarctica, a boomer or an ICBM silo, the extended contacts that have already occurred since late December 2019 have a risk of exposure around you already. If's high in Wuhan, it's not zero in Reno, El Paso or Rome (the other one, in Italy). Due to that, infection control by the individual is necessary to reduce the possibility of contracting the virus, and possibly being a vector for spread.

back to the premise of stopping the spread by reducing the average infectious period to less than 2.3 days, that suggests the pink to blue part of the time series above needs to be altered. To do that, when the pink period alone exceeds the required 2.3 day period, then that indicates already that the solution is infection control. To achieve infection control, the tools available are:

Droplet Control: (you outbound: any surgical mask, inbound to you: n95 or higher filtering), and separation from droplet sources. (avoid concerts, pubs, tax audits, the dock at the old bailey, hospitals, and... your work space with other people, and... schools. Kids are a factory for spread of anything, from jam and peanut butter to knits, and viruses.
Surface Control; every surface you touch has a history of prior contacts, and should be considered to be contaminated. Being contaminated itself isn't the problem, can't easily stop that, but you can stop the consequences. Intervene with gloves, surface sanitizers, surface cleaners, er, UV... etc... read the stuff on your chlorox wipes and your other anti viral cleaning agents. Stopping the real problem which is the transfer from your hands to your face and membranes takes diligence or obstruction by masks... Even if the droplet is not the problem, at least having a surgical mask will act to prevent some hand to face contact. (put on a helmet and see how long you go before you want to remove it to scratch, pick, rub etc your face and bits attached so elegantly. ( Space Balls/Morons from outer space. https://www.youtube.com/watch?v=QMWDPJymksI )
Isolation. The lower contacts you have the fewer occasions you have to be good at what you do. There is a balance between being effective and being reasonable. Going to a concert or pub is an exposure risk. going to the supermarket once a week is a manageable exposure. There is no need for the TEOTWAWKI survivor scenario; with reasonable and simple practices, services can continue, but they need to be deliberate in their protocol application, and anyone involved needs to assume that only one person cares about your welfare.
Time to normalisation is dependent on getting the exposure down far enough so the outbreak dies out, or the virus is attenuated by mutation (good luck with that one, it was the outcome in The Andromeda Strain, not sure of any real world case that has occurred), or that herd immunity is established naturally, (takes time) or by developing an immunity from finding a vaccine magic BB. All things shall pass... Add the infection time to the end of last infections, + the maximum time to develop to confirmation, and hey, thats over, get on with the search for Trumps foibles.

Just add water.

The question of transmission while asymptomatic arises from one of the German cases. The traveller from WooHoo gets Schweinhock and kartoffel in Germany, and then returns to WooHoo, and gets symptoms after their return. Ein Arbeiter, den ich Zeit damit verbringe, gute Arbeit für das Wohl meiner Meister zu leisten, back in Germany gets sick; dies ist in der Tat bedauerlich und sollte in einem perfekten System nicht passieren. So, unless the symptoms were so mild they were missed..., in fact, who cares, the carrier in this case wasn't aware they were sick, no one was, until they got back to WooHoo, back on the other side of the rock. The minor issue is that the carrier could have been contagious on the flight out, certainly was on the flight back, and everyone involved was doing their own thang, gittin' on with stuff as we do, scratching noses and shaking hands in at least 3 airports, buses, customs control points etc. etc. etc.

(there is also a silver lining in this case... as an experiment, the peeps all involved in this event would have an illness uptake over time that would eventually give a good idea on the real level of transmission that exists. It just takes time for that to occur, and it also takes the "volunteering" of the guinea pigs in this epidemiological study. It also gives more information on the age/health/sex/ethnicity sort of variables by circumstance)

By reports for the last month, it is a sub set of all that have the virus that get symptoms to the extent they seek medical assistance. The time to seek medical assistance also has changed which is good, the time series shows that. A problem is that as the number of cases increases the time to diagnosis will stop reducing and start increasing again, and as a natural response to frustration, peeps that are sick will just not bother to go to the doc/vet etc. As medical staff get sick, they are at the epi-center of the problem, then delays would tend to increase without active measures. China builds hospitals, excellent, but they need docs, nurses, cleaners, blood sucking lawyers etc....

Most protocols include administration and other warm fuzzy stuff, which is definitely needed from the societal response, but for the individual, the need is to remain informed, so "cunning plans" can be made and messed up appropriately.
https://cimg1.ibsrv.net/gimg/pprune.org-vbulletin/1152x834/screen_shot_2020_02_01_at_9_59_44_am_9683cb8a3300b49f9184189 b0dfe2c617972055a.png


https://cimg3.ibsrv.net/gimg/pprune.org-vbulletin/1292x988/screen_shot_2020_02_01_at_9_59_17_am_1c88d680e5cce6eb4111080 f01958a5d87929954.png




with apologies to E.B.Browning...


How do I love thee? Let me count the ways.
I love thee to the depth and breadth and height
My soul can reach, when feeling out of sight
For the ends of Being and ideal Grace.
I love thee to the level of everyday’s
Most quiet need, by sun and candlelight.
I love thee freely, as men strive for Right;
I love thee purely, as they turn from Praise.
I love thee with the passion put to use
In my old griefs, and with my childhood’s faith.
I love thee with a love I seemed to lose
With my lost saints,—I love thee with the breath,
Smiles, tears, of all my life!—and, if God choose,
I shall but love thee better after death.




Baldrick: Well, I have a cunning plan, sir.

Edmund: All right, Baldrick — for old time’s sake.

Baldrick: I have a plan, sir.

Edmund: Really, Baldrick? A cunning and subtle one?

Baldrick: Yes, sir.

Edmund: As cunning as a fox who’s just been appointed Professor of Cunning at Oxford University?

Baldrick: Yes, sir.

Voice: On the signal, company will advance!

Edmund: Well, I’m afraid it’ll have to wait. Whatever it was, I’m sure it was better than my plan to get out of this by pretending to be mad. I mean, who would have noticed another madman round here?

[crankyanker]

The good news is that, so far, it appears that only a minority (perhaps 20% per earliest estimates) of infections result in serious illness and the mortality rate seems, so far, to be <2%. We don't yet know what portion of that 2% received prompt and effective supportive care.

I don't think that's a particularly meaningful representation of the risk associated with this virus.

First, not all provinces are reporting outcomes (death or recovery) but all are reporting infections. Likewise only China has recorded deaths, and only Japan and Thailand have reported outcomes (all recoveries) outside China. If you concentrate on Hubei (which has been releasing information for a longer period of time) you'll see 249 deaths and 7,153 reported cases (or 3.5% rate of death). Another (perhaps better) estimate of the case fatality rate (CFR) would be to use only cases with known outcomes. In that case, the results are much more dramatic with the provinces reporting deaths showing from 10-100% CFR. Provinces that showing no deaths aren't showing many recoveries either. Hubei stands at about 60% CFR if you only look at known outcomes.

SARS, when all was said and done, had a CFR of around 15%. China reported a dramatically lower (around 9%) number of dubious origin. The Spanish Flu was somewhere around 3%. This is worse and I highly doubt China would've quarantined folks so quickly if this were as minor as a flu pandemic. It's nice to think that things are just that much worse in China, however I think it's just a matter of time. Japan didn't even bother quarantining the passengers on the repatriation flight.

There's not a ton of contrast, but the grey provinces are not reporting outcomes, the nearly white ones are reporting recoveries with no deaths. Well apparently not being able to post URLs includes not being able to attach images. I digress…

[fdr]

jMV:


Up to 24 pm 25 Jan 2020, a total 1,975 cases were confirmed infection of 2019-nCoV in China mainland with a total of 56 deaths occurred. The latest mortality was approximately 2.84% with a total 2,684 cases still suspected.The China National Health Commission reported the details of the first 17 deaths up to 24 pm 22 Jan 2020.The deaths included 13 males and 4 females. The median age of the deaths was 75 (range 48-89) years.Fever (64.7%) and cough (52.9%) were the most common first symptoms in deaths.The median days from first symptom to death were 14.0 (range 6-41) days, and tended to be shorter among people of 70-year old or above (11.5[range 6-19] days) than those with ages below 70-year old (20[range 10-41]days, P=0.033).
[1]

This is an ongoing train wreck; the latest fatalities are lagging by this reference by around something less than 14 days from first symptom to death, it appears that from first symptom to confirmation started out at about 10-14 days, and has reduced to around 5-6 days. Using the shorter period, then the number of fatalities today can be assessed against the confirmed cases that existed when the fatal case contracted the virus. Either method can be used, but the basis needs to be known. CNN etc are using current cases, vs current deaths, that is correct in a post event review, but will give a lower figure than looking at how big a problem really exists. Due to the relatively rapid spread of the current cases, surpassing SARS totals in the first month of the known outbreak, then prudence would seem to be worthwhile. This is every bit as nasty as SARS was, and is spreading at a fair rate.

Any other factors that affect transmission or outcome at the present are going to be important to establish promptly, but in the absence of a treatment other than of the symptoms, then basic infection control seems logical to apply. If factors such as age, preexisting conditions etc develop further, then effort may be able to be targeted more effectively, but that remains hints only today.



[1] Wang, W., Tang, J. and Wei, F. (2020), Updated understanding of the outbreak of 2019 novel coronavirus (2019‐nCoV) in Wuhan, China. J Med Virol. Accepted Author Manuscript. doi:10.1002/jmv.25689 (https://doi.org/10.1002/jmv.25689)

[Rated De]

Using the shorter period, then the number of fatalities today can be assessed against the confirmed cases that existed when the fatal case contracted the virus. Either method can be used, but the basis needs to be known. CNN etc are using current cases, vs current deaths, that is correct in a post event review, but will give a lower figure than looking at how big a problem really exists. Due to the relatively rapid spread of the current cases, surpassing SARS totals in the first month of the known outbreak, then prudence would seem to be worthwhile. This is every bit as nasty as SARS was, and is spreading at a fair rate.


Chris Martenson's work on this virus is first rate.

The NEJOM case study into Germany proved asymptomatic transmission and generational transmission rates were increasing.
The concern being R0 could well exceed SARS.
The interesting thing about it, is that Patient 1 had two day direct contact with index patient, patient 2 only a day: They were at a business meeting. Patients 3 and 4 only contact with Patient 1.

All patients contracted nCov, BUT (and it was only a hypothesis), that perhaps, just maybe outside China, many transmissions can be managed without hospital admission.

Like or dislike the Trump administration, but what the US did was actually provide a way to stop transmission by stopping travel. Weasel words from the WHO weren't "recommending" travel restrictions.
Ever the dullard, Morrison had to move. The USA have pincered Australia, who now have reluctantly applied a ban. "Self Quarantine" for Chinese Permanent residents of Australia sure to be effective /sarc

[fdr]

Like or dislike the Trump administration, but what the US did was actually provide a way to stop transmission by stopping travel. Weasel words from the WHO weren't "recommending" travel restrictions.
Ever the dullard, Morrison had to move. The USA have pincered Australia, who now have reluctantly applied a ban. "Self Quarantine" for Chinese Permanent residents of Australia sure to be effective /sarc

Isolation may not feel like a very effective measure, but with the current status, it is the one tool that exists. The great thing is, it is within the power of every individual to be the master of their own destiny. Now I definitely hope that the factors affecting transmission and morbidity become clearer promptly, in the meantime, we have choices.The Chinese recognise that, and they have tried to stop the spread. While the cases appear to be out of control there, even now, limiting contact for a period will still have a meaningful interruption to the spread, even there. It is incongruous that the rest of the world has any hesitation in taking the same action as the Chinese have seen fit to. There is precious little benefit to anyone in letting the situation deteriorate more, even if hesitant from concerns of global economic impact. Much like flight safety, if you think that the cost of prevention is expensive, try the cost of an accident.

Morrison; remarkable to imagine that he is the best of the best of the best...

https://www.youtube.com/watch?v=_huL5ynaI8Y

Chris Martenson has a background in epidemiology, and with lab work supporting studies. He is very concerned with the current state of response to this outbreak and is not happy with the presentation of statistics on CFR in this case. With a suspected high R0 value, that matters to determine the need for timely response.

IC response doesn't mean shutting down the planet, it is taking action to control infection, and reduce unnecessary exposure for a period. That is not apocalyptic; we wear a rain coat and use an umbrella in rain, why wouldn't we take basic, simple precautions to mitigate a virus?

This is the last comment I will be making on the subject. I will respond to PM's only on subject. The authorities are finally taking appropriate action on the matter.

regards

[OldnGrounded]

O'nG,
K, FWIW.....

. Prior reference [5]

Estimate of incubation time gives a start point to the problem (prior reference [3]) . . .


Yes, I think I understand. I've reviewed the cited references. However, I have missed the relationship to the assertion in your post to which I responded:

A possible glimmer of light comes from the observation that if the average infectious period is reduced to <2.3 days, then the outbreak would stop. There are ways of doing that, China has commenced such action that would alter that in essence, a mass clampdown on activity, which in a round about manner achieves the same outcome.

I don't see how any public health measure could change either the average latency period (the period between exposure and appearance of symptoms) or the average time during which an infected individual is shedding virus particles into the environment. Perhaps you meant something else by "infectious period."

[OldnGrounded]

I don't think that's a particularly meaningful representation of the risk associated with this virus.

First, not all provinces are reporting outcomes (death or recovery) but all are reporting infections. Likewise only China has recorded deaths, and only Japan and Thailand have reported outcomes (all recoveries) outside China. If you concentrate on Hubei (which has been releasing information for a longer period of time) you'll see 249 deaths and 7,153 reported cases (or 3.5% rate of death). Another (perhaps better) estimate of the case fatality rate (CFR) would be to use only cases with known outcomes. In that case, the results are much more dramatic with the provinces reporting deaths showing from 10-100% CFR. Provinces that showing no deaths aren't showing many recoveries either. Hubei stands at about 60% CFR if you only look at known outcomes.

SARS, when all was said and done, had a CFR of around 15%. China reported a dramatically lower (around 9%) number of dubious origin. The Spanish Flu was somewhere around 3%. This is worse and I highly doubt China would've quarantined folks so quickly if this were as minor as a flu pandemic. It's nice to think that things are just that much worse in China, however I think it's just a matter of time. Japan didn't even bother quarantining the passengers on the repatriation flight.

There's not a ton of contrast, but the grey provinces are not reporting outcomes, the nearly white ones are reporting recoveries with no deaths. Well apparently not being able to post URLs includes not being able to attach images. I digress…

The point I wanted to make, using examples of very early estimates (mostly by WHO and US CDC) is twofold. First, the evidence to date suggests that transmission control of this disease is going to be very difficult and widespread epidemics, even a pandemic, are likely and possible, respectively. Second, early indicators suggest that the health consequences for populations, generally, don't so far appear catastrophic. That would be true whether case mortality is <2% or ~4%. Obviously, even those numbers would be of serious concern.

Just an aside on the apparently-higher percentage of fatalities in Hubei: The statistics reflect only those cases that are known to health officials. With a disease that, in most cases, doesn't cause alarming symptoms, a very large percentage of infections typically escapes diagnosis. Assuming that 2019-NCov fits that pattern, the case mortality, overall, is likely lower than official statistics indicate.

[bunk exceeder]

Ooh. Wrong answer. R0 = 4.1! Which isn’t good.

https://www.peakprosperity.com/new-coronavirus-ro-of-4-1-massive-contagion-risk/

Nought what the doctor ordered. Any crew discounts on Tamiflu going?

Edit: Does Tamiflu even work for this thing?

[Response Ability]

As if China does not have enough to do right now:

China has reported an outbreak of the deadly H5N1 bird flu in Hunan province, which lies on the southern border of Hubei province, the epicentre of the rapidly spreading coronavirus.

“The outbreak occurred in a farm in the Shuangqing district of Shaoyang city. The farm has 7,850 chickens, and 4,500 of the chickens have died from the contagion. Local authorities have culled 17,828 poultry after the outbreak,” according to a statement by China’s Ministry of Agriculture and Rural Affairs on Saturday.

No human cases of the Hunan H5N1 virus has been reported.

The Hunan H5N1 outbreak comes even as the Chinese authorities continue to scramble to contain the spread of the novel coronavirus, further stretching the nation’s already heavily strained resources needed to combat the health threats.

scmp.com/news/china/society/article/3048566/china-reports-outbreak-deadly-bird-flu-among-chickens-hunan

[crankyanker]

Just an aside on the apparently-higher percentage of fatalities in Hubei: The statistics reflect only those cases that are known to health officials. With a disease that, in most cases, doesn't cause alarming symptoms, a very large percentage of infections typically escapes diagnosis. Assuming that 2019-NCov fits that pattern, the case mortality, overall, is likely lower than official statistics indicate.

That the statistics are only showing what's known is exactly why I focused on Hubei. The rest of the provinces are only recording a handful of outcomes. Chongqing is showing about a 25% CFR (which is still awful) with 3 recoveries and 1 death. They simply haven't been dealing with this long enough to have meaningful data. Hubei still shows a 60% CFR with 249 deaths and 168 recoveries. While there's almost certainly underreporting, I don't think that it's limited to those with limited illness. I doubt the mortality rate for 2019-nCoV will eventually become similar to a typical flu. You simply don't quarantine 60 million people for the seasonal flu.

[CurtainTwitcher]

Ooh. Wrong answer. R0 = 4.1! Which isn’t good.

https://www.peakprosperity.com/new-coronavirus-ro-of-4-1-massive-contagion-risk/

Nought what the doctor ordered. Any crew discounts on Tamiflu going?

Edit: Does Tamiflu even work for this thing?
Probably not, the mechanism of action is specific to influenza. IIRC it wasn't very effective, only reducing the symptoms by about a day (from ~6.5 to 5.5 days).

[bunk exceeder]

Probably not, the mechanism of action is specific to influenza. IIRC it wasn't very effective, only reducing the symptoms by about a day (from ~6.5 to 5.5 days).

Well, it’s a good thing I still have my Hello Kitty SARS mask then. An ounce of prevention....

[OldnGrounded]

That the statistics are only showing what's known is exactly why I focused on Hubei. The rest of the provinces are only recording a handful of outcomes. Chongqing is showing about a 25% CFR (which is still awful) with 3 recoveries and 1 death. They simply haven't been dealing with this long enough to have meaningful data. Hubei still shows a 60% CFR with 249 deaths and 168 recoveries. While there's almost certainly underreporting, I don't think that it's limited to those with limited illness. I doubt the mortality rate for 2019-nCoV will eventually become similar to a typical flu. You simply don't quarantine 60 million people for the seasonal flu.

No, no and no. There is exactly no credible evidence or analysis to support fatality rates anywhere near those percentages. And the gross numbers of cases you cite are ridiculously low. As of two hours ago, the South China Morning Post reported a total of just over 9,000 confirmed cases in Hubei, with about 1,100 becoming seriously ill and around 450 currently critically ill. The China-wide case total is reported as 14,380 and total deaths as 304. All of those numbers will keep changing, rapidly, of course.

Here's the link to the transcript of the WHO press conference on the 29th, with the estimates of 20% serious and about 2% fatal: https://www.who.int/docs/default-source/coronaviruse/transcripts/who-audio-script-ncov-rresser-unog-29jan2020.pdf

[crankyanker]

No, no and no. There is exactly no credible evidence or analysis to support fatality rates anywhere near those percentages. And the gross numbers of cases you cite are ridiculously low. As of two hours ago, the South China Morning Post reported a total of just over 9,000 confirmed cases in Hubei, with about 1,100 becoming seriously ill and around 450 currently critically ill. The China-wide case total is reported as 14,380 and total deaths as 304. All of those numbers will keep changing, rapidly, of course.

Hubei is currently reporting 9,074 confirmed cases, 294 deaths, and 215 recovered patients. At the high end that puts the CFR around 58% if you only look at known outcomes, at the low end at 3.2% if you don't with much of that depending on how accurate you think that the reporting on case outcomes is accurate. If you believe that there are a significant amount of infected persons who simply never see serious symptoms and either don't seek medical advice or are turned away then sure 3.2% seems reasonable. I don't believe that the CCP would quarantine so many people so quickly if they were looking at something near the severity of the H1N1 flu. Nor do I believe that there's a mass of people whose symptoms are so minor that they're not being counted.

I don't think that a 50-60% CFR will prove to be accurate, even with deaths lagging by a few weeks, but I suspect it will be in the double digits (and likely higher than SARS which was around 15%).

[etudiant]

The reliability of any of these numbers is low. There is a desperate shortage of beds and the hospitals are hugely overtaxed, with even basics such as testing kits in short supply.
Plus there is an ongoing flu seasonal peak, so there are pressures to post the deaths as flu or organ failure rather than nCoV.
The floor estimate for the case fatality ratio will be from the foreign patients outside of China, who are getting really first rate care. That could change very quickly if the efforts to prevent the spread of the disease fail
So if there are 100 cases in the US in another couple of weeks, which would indicate the virus has escaped confinement, we may find out that the 'natural' CFR is really ugly.

[OldnGrounded]

Hubei is currently reporting 9,074 confirmed cases, 294 deaths, and 215 recovered patients. At the high end that puts the CFR around 58% if you only look at known outcomes, at the low end at 3.2% if you don't with much of that depending on how accurate you think that the reporting on case outcomes is accurate. If you believe that there are a significant amount of infected persons who simply never see serious symptoms and either don't seek medical advice or are turned away then sure 3.2% seems reasonable. I don't believe that the CCP would quarantine so many people so quickly if they were looking at something near the severity of the H1N1 flu. Nor do I believe that there's a mass of people whose symptoms are so minor that they're not being counted.

I don't think that a 50-60% CFR will prove to be accurate, even with deaths lagging by a few weeks, but I suspect it will be in the double digits (and likely higher than SARS which was around 15%).

With respect, you should stop telling people what you believe and suspect. Your assessment is utterly illogical and your suspicions can only increase the confusion and fear that are already widespread and dangerous. Please just stop it and use the time you would otherwise spend opining to stay up to date on information from reliable sources.

Note: The WHO report from yesterday indicates that transmission by asymptomatic carriers appears to be "rare." If that turns out to be correct, it's very good news.

US CDC 2019-nCoV Situation Summary (https://www.cdc.gov/coronavirus/2019-ncov/summary.html)

WHO 2019-nCoV Information (https://www.who.int/emergencies/diseases/novel-coronavirus-2019)

[OldnGrounded]

The reliability of any of these numbers is low. There is a desperate shortage of beds and the hospitals are hugely overtaxed, with even basics such as testing kits in short supply.
Plus there is an ongoing flu seasonal peak, so there are pressures to post the deaths as flu or organ failure rather than nCoV.
The floor estimate for the case fatality ratio will be from the foreign patients outside of China, who are getting really first rate care. That could change very quickly if the efforts to prevent the spread of the disease fail
So if there are 100 cases in the US in another couple of weeks, which would indicate the virus has escaped confinement, we may find out that the 'natural' CFR is really ugly.

Please stop the unfounded and uninformed speculation and go read the ongoing situation reports from the people who actually know what's going on and are expert at interpreting it.

[OldnGrounded]

Update: A study from Germany that's just making the rounds appears to contradict the WHO observation, from yesterday, that transmission from asymptomatic carriers may be rare.

Letter to the New England Journal:Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany (https://www.nejm.org/doi/full/10.1056/NEJMc2001468?query=featured_home)CNN story with comments by Anthony Fauci (who is definitely the real deal in epidemiology):'There's no doubt': Top US infectious disease doctor says Wuhan coronavirus can spread even when people have no symptoms (https://www.cnn.com/2020/01/31/health/coronavirus-asymptomatic-spread-study/index.html)

[CurtainTwitcher]

Lancet Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30260-9/fulltext) pdf direct (https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930260-9)
FindingsIn our baseline scenario, we estimated that the basic reproductive number for 2019-nCoV was 2·68 (95% CrI 2·47–2·86) and that 75 815 individuals (95% CrI 37 304–130 330) have been infected in Wuhan as of Jan 25, 2020. The epidemic doubling time was 6·4 days (95% CrI 5·8–7·1). We estimated that in the baseline scenario, Chongqing, Beijing, Shanghai, Guangzhou, and Shenzhen had imported 461 (95% CrI 227–805), 113 (57–193), 98 (49–168), 111 (56–191), and 80 (40–139) infections from Wuhan, respectively. If the transmissibility of 2019-nCoV were similar everywhere domestically and over time, we inferred that epidemics are already growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about 1–2 weeks.InterpretationGiven that 2019-nCoV is no longer contained within Wuhan, other major Chinese cities are probably sustaining localised outbreaks. Large cities overseas with close transport links to China could also become outbreak epicentres, unless substantial public health interventions at both the population and personal levels are implemented immediately. Independent self-sustaining outbreaks in major cities globally could become inevitable because of substantial exportation of presymptomatic cases and in the absence of large-scale public health interventions. Preparedness plans and mitigation interventions should be readied for quick deployment globally.

[JanetFlight]

Corona Virus has just made another *victim*...Hummmmm.. Dr. Eric Feigl-Ding who's posts about the HIV/ nCoV almost reached fearmongering-doomporn interpretation status, it seems has changed his stance on the matter.

*Dear friends, after learning that the original authors have formally retracted yesterday’s “uncanny” titled pre-print article, I believe it is prudent to delete the earlier posts 16-24 pertaining to it.*

Twitter.com /DrEricDing/status/1223834719651094528

Some science community saying now»»»
"You dont need to be a scientist to feel those reports were junk science upon the first read..."

[OldnGrounded]

Corona Virus has just made another *victim*...Hummmmm.. Dr. Eric Feigl-Ding who's posts about the HIV/ nCoV almost reached fearmongering-doomporn interpretation status, it seems has changed his stance on the matter.

*Dear friends, after learning that the original authors have formally retracted yesterday’s “uncanny” titled pre-print article, I believe it is prudent to delete the earlier posts 16-24 pertaining to it.*

Twitter.com /DrEricDing/status/1223834719651094528 (https://twitter.com/DrEricDing/status/1223834719651094528)

Some science community saying now»»»
"You dont need to be a scientist to feel those reports were junk science upon the first read..."

I just took a look at his Twitter feed. He's working very hard to scare the hell out of everyone while tossing in enough caveats to defend himself against accusations of alarmism. I accuse: He's an alarmist.

[OldnGrounded]

We have now entered into the phase of whether to believe or not believe. Contradictory disinformation is now flying all over the place. Whether that info or disinfo is benevolent or malevolent matters not. Whether that info or disinfo is intentional or unintentional matters not. Welcome to dither. The only thing that helps is to think / post only facts that are proveble by multiple independent sources. Opinions are not of much help in a scenario such as the present wherein causing dithering can turn out to be fatal. This is why I have such respect for pilots. They can't afford to dither. Opinions don't help when there are problems in flight. And in this 2019-nCoV we are all together on this flight of our one ship in space.

Absolutely right. Scaremongering, conspiracy craziness, and just plain wrongheaded nonsense is flooding the media. Pilots and engineers wouldn't buy into that sort of silliness if we were talking about aviation, and it would be very wise not to do it with regard to this viral disease.

For readers of English, there are a handful of informative and authoritative sites that should be the go-to places for reliable information:

UK Department of Health and Social Care Coronavirus Information (https://www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public)

US CDC Novel Coronavirus Information (https://www.cdc.gov/coronavirus/2019-ncov/index.html)

WHO 2019-nCoV Information (https://www.who.int/emergencies/diseases/novel-coronavirus-2019)

Australian Department of Health Novel Coronavirus Information (https://www.health.gov.au/resources/publications/novel-coronavirus-2019-ncov-what-you-need-to-know-qing-kuang-xu-zhi)

For up-to-date raw data and statistics, and the latest serious estimates of things like R0, latency period, etc. the Worldometers site is generally reliable: https://www.worldometers.info/coronavirus/

If it's in The Lancet, or JAMA, or New England Journal of Medicine or similar prestigious publications, you can be pretty sure it's not nonsense, but it may not be unquestionable fact, either. There's going to be a lot of uncertainty, even among real experts, for some time to come.

[fdr]

As yet, 2 fatalities outside of PRC. first in PHI on Sunday, and this morning in HKG. Both cases appear to have been patients with compromised immune systems.

Question on veracity of the PRC data output, for various non nefarious reasons. Their total cases are likely to be under reported due to logistical demands in dealing with a high rate of transmission. That alone should suggest that the spread rate should be a concern. Fatality rates should be better reported, but that also appears now to be under some stress, and could also be under reported in PRC at present. Hope otherwise.

On linear axis, the data gets untidy fast with a geometric progression, but it shows the overall growth. The PRC case appears to have an inflexion point around the 24th, where the rate changed substantially, but then falls back towards a fairly uniform geometric progression. Possibly the data prior to that point is under reported, and that was corrected around that point. PRC spread remains at same overall rate without much change, which is not what we need. Thats PRC.

Non PRC, the early progression is similar to the PRC case in the early stages. As the virus would have travelled in one of our shiny incubators, with lots of other opportunities to spread, that is still odd, the early rate would have been potentially like letting cats out of a bag, and an earlier development of cases outside of the PRC would have been likely, and did not occur as such. The spread did however go to many different countries in parallel, but not with a large step locally. That is before, now, the current non PRC cases while growing, do not show the same progression that they have done in the PRC. That could be doe to under reporting but the rest of the world is paying attention, even if the WHO had to be dragged into the light. The curve on the foreign cases is what would be seen if a control was effective, or the conditions for maintaining a high R0 was removed.

The non PRC fatality rate is below that which would be expected at this point if CFR's were similar in both populations. It is effectively zero at this time, for cases that were transferred external to the PRC. That doesn't mean that it isn't about to change in the near future, it may well do so, but it is below the progression that is seen on the PRC cases, noting that the PRC cases are probably understated for total cases, and may be close to correct for fatalities. That is also open to error, with cases possibly being attributed to the virus on one hand, and others not having been recorded due to remote communities and the privacy preferences of family.


https://cimg6.ibsrv.net/gimg/pprune.org-vbulletin/1236x798/screen_shot_2020_02_04_at_8_33_50_pm_4cdc78012f86408f8770108 a8e7a6d8f25967763.png



On a normal/log scale, the difference in the last 5-6 days in the non PRC cases shows up as below. The date series lag is removed in this example, and the curves matched to give a preliminary lag time, which comes out at about 22 days. The non PRC cases show a rate change that has slight confidence that it should be correct, reporting in the countries concerned should be reasonable (Many countries have not reported as yet what is happening, but those that are reporting can be considered to be reasonable).

On the following chart, a straight line would be a geometric progression, so a curve away, a lowering of the cases/# from any line is good. The last chart is the same data on linear axis. Both of these charts show curves for various R0 and days per Cycle with the latter converted to a date.

In the graphs showing fatalities, they curiously happened to shadow the non PRC cases, however they split from the non PRC case in the last week, the fatality rate remaining geometric at present, the non PRC cases reducing the exponent by the looks of it.

https://cimg5.ibsrv.net/gimg/pprune.org-vbulletin/1966x1180/screen_shot_2020_02_05_at_3_05_17_pm_df93bd9cbd6c30a8fa50a84 67e82a301eeb6b1c4.png


https://cimg0.ibsrv.net/gimg/pprune.org-vbulletin/1962x1182/screen_shot_2020_02_05_at_3_04_41_pm_dba9c64fcc633c3a9a76985 00f720241ef7949c4.png

[FlareArmed2]

Good data and analysis.

I've been plotting only since 20 Jan but I show the same curves. What is not readily apparent in your presentation (you can see it but it's not clear) is that there is an inflection point around 28 Jan in the China data to a much lower growth rate. By happenstance I read a Time article (https://time.com/5776500/coronavirus-outbreak-containment-time/) today which quotes: (1) Wuhan shutdown started on 23 Jan; (2) average incubation period is thought to be 5 days; (3) it is assumed that it takes five days for symptoms to become severe enough that a patient presents to a hospital and gets tested.

Just to be clear, I identified the inflection point at 28 Jan several days ago, it is only now that I find that there might be a reason for that. It's nice to have a different source provide some confirmation of a possible reason.

This means that, if it appears in the record, there will be inflection points at 28 Jan (ie five days after 23 Jan) and 2 Feb (five days after that). I'm being cautious here, but I think we are just beginning to see a glimmer of a change for the better:


https://cimg9.ibsrv.net/gimg/pprune.org-vbulletin/943x530/200203_ncov_73a7ea5f5710c3e313b0ee070a98a012240a37b8.png
"Cases" are number of cases reported in mainland China (M. China) and rest of the world (ROW), from John Hopkins University (https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6).
Y-axis is plotted as a logarithm, so straight lines on graph show the exponential rate.
Coloured lines on chart show examples of specified daily increase in number of cases reported. They are not lines of best fit.


https://cimg3.ibsrv.net/gimg/pprune.org-vbulletin/943x530/200203_ncov_rate_caa90bbfb78ef63bbc40510549de1807457cbbca.pn g

"Daily change" for mainland China (M. China) and rest of the world (ROW), from John Hopkins University (https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6).
Coloured lines on chart are linear lines of best fit.
Lines extending beyond data points are extrapolated and therefore not data-based but are speculative.