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BA cancel all flights to and from China due to Coronavirus

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Old 6th Feb 2020, 00:38
  #101 (permalink)  
 
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Originally Posted by flynerd
And just this now there is a new report of 594 deaths just in Hubei province..

China's health officials have confirmed the death toll from the coronavirus outbreak in Hubei province has reached 594, with 19,665 cases of infection
source: abc.net.au/news
Yes, that appears to be the latest from the Chinese Health Ministry. The one-day increase in Hubei was just under 3,000 new cases and 70 additional deaths. Nothing in those numbers to suggest that the 2% CFR estimate is unreasonable, although we still have no idea how many cases are uncounted.

The WHO 5 February situation report shows a total of 32 new cases outside of China. 13 of those are in Japan, where they have 3,700 people quarantined on a cruise ship and ten of those 13 new cases are passengers from the ship. Latest news from Japan is that 10 more passengers have tested positive for 2o19-nCoV, which is hardly surprising. Only one new ROW death in that WHO report, and that's the case in the Philippines that had previously been reported elsewhere.
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Old 6th Feb 2020, 01:26
  #102 (permalink)  
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Perhaps. We really don't have enough data to know that with much confidence.

No. Two days is at the low end of the estimated latency (incubation) period, which is thought to range between 2 and 14 days. The earliest estimates of a mean were around 6.4 days. In a 30 January study published in the New England Journal of Medicine -- https://www.nejm.org/doi/full/10.1056/NEJMoa2001316 -- 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. And the time between presumed exposure and onset of symptoms was widely varied.
O'nG

I drank a lot of coffee to put in a 2 day value, and here is the reason why is had some angst.

It takes time for the cases to be identified (the point in question) which is then added to a recorded period from detection to outcome. If the mean is applied, then for fatalities recorded on 30 Jan, (213) these would have come out of a pool of patients identified by the 21st, (326 cases, [JHU]). That results in an excessively high mortality rate, given that there are recovered patients (171 recoveries recorded by 30th January) The time to determination of recovery is not identified, so that may be a valid number, or may be higher or lower than actual cases related to cases as of the 21st January. Using that number however, we get 171+213=384 case outcomes, good and bad, from... 326 cases on 21st January. That all looks fine, except the recovery cases are a subset of total cases as far as I understand, following the general premise that 20% of identified cases need ICU care, and 1/2 of those cases end badly. The truth of that is unknown to the public, it is known to the PRC govt, and presumably WHO, CDC etc.

What is evident is that the CFR being quoted by WHO and the CDC etc is flawed, and significantly under reports the rate. Post an outbreak, such as SARS or EBOLA, then the data compares all known cases against all known outcomes. WHO & CDC methodology of using todays fatalities against todays identified cases neglects every fatality that exists for the cases known today that have not run their course of illness to conclusion, good or bad. Going back only the period from today to the average time for an adverse outcome to develop remains within known data and has a rational meaning at that time. Time from diagnosis to conclusion is a metric that is able to be measured. Guessing future deaths is, a guess.

The data does suggest that there is considerable missing data. (IMHO that is more likely to be good than bad paradoxically, more cases that are undiagnosed would reduce the CFR ratio, and this thing is spreading rather well within China. We still have a cycle or two to go in the rest of the world to see how bad it is going to be, but right now, if the figures are correct, this looks generally like a critical problem for the PRC, and a manageable problem to the rest of the world). From 23 DEC 2019 to 21 JAN 2020, there is a certain progression which is geometric but the rate changes from the 21st January to 28th January the rate accelerates. That may be the effect of the Lunar New Year travel causing a widespread expansion of the base, or it is backfilling of the data that was missing, increased accuracy of the reports as the outbreak is taken seriously. From the 30th to date the case rate has a relatively constant exponent, charts as approximately a straight line on a log scale. The last couple of day there is a possible reduction in that exponent, just a hint. Non PRC cases have remained relatively constant in total numbers, trending away from the PRC progression rate. Recorded fatalities are still increasing with an exponent, but it is considerably lower than the PRC case development rate, the fatality exponent has reduced in the last week, but is still an exponent value.

Within China, case development is still a geometric progression, suggesting that the total cases will continue to spread there significantly. Very roughly, the exponent of case development and fatalities are similar at this time,

Outside of China, the spread is either at a lower rate or is being underreported. fatalities outside China remain very low, and associated to PRC cases or nationals. At the total cases level of the non PRC area today, the Mainland China experience had a number of fatalities recorded. This signal is still not present in the non PRC cases, and that may just be due to environmental differences, (weather: temperature, humidity etc) or other causes. It also may be that the mortalities are being missed as nCoV, and are being classified as Influenza fatalities. All things are possible, but the longer the period before fatalities occur in the non PRC region, the greater the likelihood that there is a difference in the outcomes due to unknown factors.

Right now, there are around 4 fatalities that have not occurred in the non PRC area that are going to be the canary in the cage to how this outbreak is going to develop... If they develop in the next 3 days, the whole globe is going to take a correction. If they don't materialise, then there is a clue towards a cure from ascertaining why this is the case; there is an opportunity to support the PRC with medical support and a better allocation of resources to the combating of the outbreak. In total impact terms, this is a tragedy but it isn't the end of the world as we know it, but it will potentially alter demographics in some places.








Last edited by fdr; 6th Feb 2020 at 03:54. Reason: add charts (incl 7 day extrapolation)
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Old 6th Feb 2020, 02:33
  #103 (permalink)  
 
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After reading an article today regarding the relative immunity of the young to coronaviruses I realise that whatever CFR is calculated will reflect the total case load, but fatalities will be skewed to the older, more male end of the pool. Older males thus will suffer a CFR quite a bit higher than the raw numbers suggest.
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Old 6th Feb 2020, 04:46
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Originally Posted by Australopithecus
After reading an article today regarding the relative immunity of the young to coronaviruses I realise that whatever CFR is calculated will reflect the total case load, but fatalities will be skewed to the older, more male end of the pool. Older males thus will suffer a CFR quite a bit higher than the raw numbers suggest.
It's not really a matter of immunity. It's unlikely that any group of humans has significant immunity to a novel virus, unless it is very similar to one that has previously infected a population and resulted in a persistent capacity to develop an effective antibody response. And viruses mutate incredibly rapidly, so that isn't something that would be expected in this case. It is certainly true, though, that some cohorts typically suffer more from diseases like this than others. Older people often make up one of the more-susceptible cohorts (and often have preexisting conditions that make any systemic illness more dangerous). That seems to be the case here, and, for whatever as-yet unclear reason, most deaths to date are in males. If these trends continue, Australopithecus' expectation may well turn out to be correct.
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Old 6th Feb 2020, 07:58
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Yeah, bad choice of words on my part. I meant the apparent relatively mild symptoms in the young, and very small numbers of complications.

As O'n'G mentions, pre-existing conditions feature in the fatalities. I wonder what fraction of the population is free of those by 65 years of age. That cohort would have lots of ex-smokers too.

“Pre-existing” reminds me that there are tens of millions of uninsured low-income people in the US. I can imagine all too well how that could play out.
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Old 6th Feb 2020, 10:25
  #106 (permalink)  
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https://www.cnn.com/2020/02/06/us/co...day/index.html

Planeloads of Americans flee growing coronavirus outbreak in Wuhan as 12th case is reported in the US

CNN)Planeloads of Americans fleeing the fast-moving coronavirus outbreak in China are arriving at military bases across the United States this week on what could be the final chartered flights.......

Evacuations of Americans from Wuhan started last month after one flight landed at a base in California with nearly 200 Americans aboard.
On Wednesday, two more flights out of Wuhan arrived in California carrying a total of 350 passengers.

Both planes landed at Travis Air Force Base -- between San Francisco and Sacramento. Of those, 178 passengers from one plane stayed at Travis while the other plane refueled before taking the others to Marine Corps Air Station Miramar in San Diego.

And two more evacuation flights are scheduled to arrive from Wuhan later this week -- one headed to Lackland Air Force Base in San Antonio, Texas, while the other one is going to Eppley Airfield in Omaha.

This week's flights will likely be the last ones. The State Department does not anticipate chartering any planes after this week, an official said.

About 1,000 Americans live in Wuhan, and priority on chartered flights was given to US citizens at a higher risk of contracting coronavirus if they stay in the city, the State Department has said.......
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Old 6th Feb 2020, 14:28
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Originally Posted by ORAC
About 1,000 Americans live in Wuhan, and priority on chartered flights was given to US citizens at a higher risk of contracting coronavirus if they stay in the city, the State Department has said.......
Judging relative risk of exposure in Wuhan? That has to be an exercise in futility. Maybe they mean those with a greater risk of developing severe cases. It might be possible to take a stab at that -- sort of.
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Old 6th Feb 2020, 16:48
  #108 (permalink)  
 
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Captive Patients

Must be pretty grim being kept on a ship with an epedemic around.

For those of a statistical bent it might provide some hard data I suppose - 10 became 20 today...
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Old 6th Feb 2020, 17:06
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Previously healthy young doctor who whistle blows in China he had warned them of a new virus, and then dies - Hmmmmmn OK...........
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Old 6th Feb 2020, 18:05
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Originally Posted by rog747
Previously healthy young doctor who whistle blows in China he had warned them of a new virus, and then dies - Hmmmmmn OK...........
Now they are changing the story and saying he is seriously ill. Hope he makes it.
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Old 6th Feb 2020, 18:27
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Originally Posted by Twitter
Now they are changing the story and saying he is seriously ill. Hope he makes it.
South China Morning Post (Hong Kong) reports, as of a few minutes ago, that Li is alive, but in critical condition, per the Wuhan hospital. SCMP is pretty reliable on coronavirus news from the PRC, having better contacts there than most Western news organizations.

https://www.scmp.com/news/china/soci...ities-outbreak
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Old 6th Feb 2020, 18:55
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Originally Posted by Australopithecus
“Pre-existing” reminds me that there are tens of millions of uninsured low-income people in the US. I can imagine all too well how that could play out.
Indeed. I saw an extraordinary complex piece of US protective medical equipment shown as for a victim who had arrived there. I did feel that if they did not have sufficient medical insurance one would not have seen the supplier for dust ..
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Old 6th Feb 2020, 19:11
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For what is worth, was mucking about with the Chinese numbers and came up with this:



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Old 6th Feb 2020, 19:22
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Originally Posted by WHBM
Indeed. I saw an extraordinary complex piece of US protective medical equipment shown as for a victim who had arrived there. I did feel that if they did not have sufficient medical insurance one would not have seen the supplier for dust ..
The expensive equipment you saw was likely the ISOPOD they used to transport the first 2019-nCoV case in Washington State:




Not only did they use the ISOPOD, they put the patient into one of the two beds in their isolation ward and sent in their one and only robot to treat him. As you can probably guess, ISOPODS and high-tech isolation wards are few and far between, no less so in the US than anywhere else in the Western world. Treatment robots are in even shorter supply.

If and when an outbreak even remotely of the scale of what's happening in Wuhan develops here in the US, facilities and personnel will be utterly overwhelmed. There's not enough of anything, anywhere. There may be a very few individuals whose wealth is adequate to avoid the queues and command scarce resources, but merely having good health insurance won't be enough. No one will get what doesn't exist.

As far as access to care, the the law requires hospitals to treat patients who arrive at an emergency room, at least to the extent required to stabilize them, without regard to ability to pay. So, in that setting, it's pretty much a matter of first-come and most critical, first served. Of course, patients who are admitted but don't have good coverage or lots of money (hardly anyone has that much money) will be financially ruined, for years or decades, when the bills arrive.

And many won't be admitted, regardless of coverage, because there won't be adequate space, beds, other facilities, medical staff, lab techs . . .
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Old 6th Feb 2020, 19:28
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Originally Posted by OldnGrounded
South China Morning Post (Hong Kong) reports, as of a few minutes ago, that Li is alive, but in critical condition, per the Wuhan hospital. SCMP is pretty reliable on coronavirus news from the PRC, having better contacts there than most Western news organizations.

https://www.scmp.com/news/china/soci...ities-outbreak

Current headline on SCMP, quoting Wuhan Central Hospital on their Weibo account:

"Coronavirus: Li Wenliang, doctor who alerted public to the outbreak, dies of the disease

Wuhan Central Hospital confirms Li’s death, as commenters on Chinese social media mourn his loss and express anger at his treatment
Li, 34, was one of eight doctors who tried to share information about the coronavirus only to be reprimanded by Wuhan police"

https://www.scmp.com/news/china/soci...ities-outbreak

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Old 6th Feb 2020, 19:34
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In respect of wealth / poverty / insurance coverage - whether a patient can afford treatment or not, it is of course in the interests of the whole community to isolate him. Death is a great leveller.
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Old 6th Feb 2020, 19:50
  #117 (permalink)  
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Two Brazilian air force jets are on their way to China to rescue a group of about 34 Brazilian citizens from the city at the centre of the coronavirus outbreak. Brazil’s state-run news agency, Agencia Brasil, says the planes are currently in Poland waiting for clearance from Chinese authorities to continue their flight to Wuhan. The delay is reportedly the result of the high number of international repatriation missions trying to fly into the Chinese city.

Once back in Brazil those being evacuated from Wuhan will be placed in quarantine for 18 days at a military base in the city of Anápolis, in Brazil’s midwest. According to the Estado de São Paulo newspaper, Argentina has asked Brazil for help in evacuating 15 of its citizens.
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Old 6th Feb 2020, 20:09
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Originally Posted by OldnGrounded
Very sad. There's a real strain of authoritarian sociopathy built into the Chinese system. Not only their system, of course, but it's very persistent there and has been for a long time.
Not only China hides facts - Iran, Russia... there are more closer to home too.
Who knows how this would have affected the spread if the nipping could have been closer to the bud? Complete scandal.
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Old 6th Feb 2020, 20:22
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Originally Posted by Twitter
Not only China hides facts - Iran, Russia... there are more closer to home too.
Who knows how this would have affected the spread if the nipping could have been closer to the bud? Complete scandal.
Yes, there's a lot more of that than most of us would care to recognize or admit. And not all of it -- not nearly all of it -- is in nations that we think of as "bad guys."
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Old 6th Feb 2020, 20:33
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China grows isolated as airlines cancel more than 50,000 flights amid coronavirus epidemic

Published Thu, Feb 6 2020 1:46 PM EST Updated an hour ago

[. . .]
These steps have left China, the world’s second-largest air travel market after the U.S., more isolated. Airlines in dozens of countries — from New Zealand to Finland to the United Arab Emirates — have scaled back service or in the case of U.S. airlines canceled flights altogether to the Chinese mainland and Hong Kong as the coronavirus spreads. This will drive down airlines’ 2020 revenue and deprive other segments of the travel industry, including hotels and retailers, of high-spending tourists.

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Last edited by OldnGrounded; 6th Feb 2020 at 20:33. Reason: Fix formatting.
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