CDC Begins Passenger "Funneling" re 2019-nCov
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Now the U.S. diplomatic evac charter isn't going to Ontario either.
https://www.foxnews.com/health/plane...rt-hagman-says
Coronavirus
Published 14 mins ago
The plane was initially headed to Ontario International Airport in 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."
Published 14 mins ago
Plane carrying US evacuees from China amid coronavirus outbreak diverted to California air base
By David Aaro | Fox NewsA 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. 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."
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The Australians are going to quarantine their Wuhan evacuees on Christmas Island.
https://www.sbs.com.au/news/australi...ristmas-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.
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.
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The Australians are going to quarantine their Wuhan evacuees on Christmas Island.
https://www.sbs.com.au/news/australi...ristmas-island
https://www.sbs.com.au/news/australi...ristmas-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.
Corona virus likely already established in the Philippines
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.
The Mainland China travel associated with the booming off-shore gambling centres here (POGOs) would suggest the virus arrived some time ago.
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.
The Mainland China travel associated with the booming off-shore gambling centres here (POGOs) would suggest the virus arrived some time ago.
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.
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DAL, UA, AA halt all flights between US and China
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.
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.
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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.)
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.)
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)
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
STATUS of 2019-nCoV
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).
[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} [b]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] 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
(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.
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} [b]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] 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
Last edited by fdr; 31st Jan 2020 at 23:18.
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Coronavirus: US declares emergency and issues new entry rules
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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.
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.
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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.
O'nG,
K, FWIW.....
. 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:
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:
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.
with apologies to E.B.Browning...
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.
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)
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.
)
- 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.
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.
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.
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?
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?
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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.
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…
Fatalities
jMV:
[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
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).
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
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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.
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
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
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
Morrison; remarkable to imagine that he is the best of the best of the best...
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
Last edited by fdr; 1st Feb 2020 at 12:48.
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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.
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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…
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…
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.
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Ooh. Wrong answer. R0 = 4.1! Which isn’t good.
https://www.peakprosperity.com/new-c...ontagion-risk/
Nought what the doctor ordered. Any crew discounts on Tamiflu going?
Edit: Does Tamiflu even work for this thing?
https://www.peakprosperity.com/new-c...ontagion-risk/
Nought what the doctor ordered. Any crew discounts on Tamiflu going?
Edit: Does Tamiflu even work for this thing?
Last edited by bunk exceeder; 1st Feb 2020 at 20:39.
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China reports an outbreak of H5N1 bird flu in Hunan province
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
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
Last edited by Response Ability; 1st Feb 2020 at 20:47. Reason: add title
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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.