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  #451  
Old 02-13-2020, 06:24 PM
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The huge spike was also due to the head of Wuhan and Hubei Province being replaced. The new guys have every incentive to get the bad news out and blame it on the previous guy...
  #452  
Old 02-14-2020, 03:05 AM
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It seems they decreased the death and infection counts by a bit due to duplication.

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China's National Health Commission revises down death toll after "duplication"
According to the National Health Commission, the current number of infections in mainland China is 63,851, up 5,090 from the day before, while the death toll has risen to 1,380.
From here. From what I remember of yesterday's numbers, those are indeed reductions.

And then there's this (same source):
Quote:
A North Korean official has been executed for going to a public bath while he was meant to be in quarantine, a report in the South has claimed.
I wonder if that guy is counted in the death total...

Last edited by dtilque; 02-14-2020 at 03:07 AM.
  #453  
Old 02-14-2020, 03:10 PM
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This seems bad from a transmission standpoint: two Tokyo taxi drivers test positive for COVID-19.
  #454  
Old 02-14-2020, 09:40 PM
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I don't know - I'm not a doctor. If, based on clinical findings, a reasonable "best guess" can be made as to whether something is "cold", "flu", or "covid", and if based on the symptoms patients are routed to appropriate treatment then it helps the emergency by speeding up the evaluation/triage/routing of people to appropriate levels of care. Just restricting tamiflu to actual cases of the flu would help.

If no distinction can be made then... I dunno. Maybe not.

Since all information is filtered through at least one language translation and journalists who are not trained medical personnel (with a possible few exceptions) I'm not sure anyone reading this thread is going to be able to give a definitive answer to that.

Regardless - I fail to see how new diagnostic criteria that increases the number of cases would be instituted for any reason other than medical/triage/treatment reasons. If anyone displaying any level of ILI is quarantined then it probably will stop or at least slow transmission of not just covid but also actual flu and colds. Which might not be a bad side effect.


I'm sorry - were you under the illusion that ANY database tracking ILI's is some how complete or pristine? We know actual flu is not tracked with absolute precision. We know a lot of mild cases of ILI's never see a doctor or are recorded. Yet somehow those stats are waved around like they actually mean something, imperfect as they are. Maybe 100% absolute accuracy is not required to get meaningful information from stats.

I can understand where doctors in Hubei are more concerned with diagnosing symptoms and providing treatment than running RNA analyses with test kits that are in short supply. Their priority is going to be treating people and trying to avoid being infected themselves...
When the care is supportive care (oxygen as needed, IV fluids as needed, treating co-morbid bacterial infections as needed, so on) it does not (or rationally should not) matter if the cause is Covid-19 or an unidentified virus. Both should be treated the same. It does seem however that sick patients who needed that care were being turned away unless they had the diagnosis attached of Covid-19. A stupid way to ration care if that is what they were doing.

The data is sloppy and hard to interpret. Imperfect is a major understatement.

That said the accurate information is out there. This was a retrospective data dump of cases that had met that criteria.

After the first big number the next day's new case number dropped significantly. As of this minute today's is only 190 new cases reported, but I'd expect to see more added later on.
  #455  
Old 02-15-2020, 04:10 PM
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I think Japan gambled and lost. I haven't seen anything reported but the only charitable answer is that Japan needed this much time to prepare land based quarantine facilities.
Japan is a large rich nation and I don't think this is the case.
Alternatively, since we are still in the initial quarantine period (starting Feb 4, now Feb 16, only 12 days of quarantine so far), Japan gambled and won: there were cases of NC19 on board, and they were successfully quarantined.
  #456  
Old 02-15-2020, 05:37 PM
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Alternatively, since we are still in the initial quarantine period (starting Feb 4, now Feb 16, only 12 days of quarantine so far), Japan gambled and won: there were cases of NC19 on board, and they were successfully quarantined.
I think my poor writing skills have resulted in a misunderstanding. I believe Japan should have moved the passengers to land based quarantine as soon as possible, not just released the the passengers and crew. Cruise ships are widely known to be one of the worst possible places to try and contain a viral outbreak.

If someone wants to argue that keeping the passengers on board the ship prevented the virus from spreading on land, then why transfer infected passengers to land? They effectively created 218 (at least) new reservoirs of disease to bring to land and try and contain there.

Land based quarantine would have kept the virus from spreading so widely. That ship is the second largest outbreak of the virus in the whole world. Bigger than any country outside of China.

This isn't just my opinion.

"I think it's been a bad decision from the start," said Dr. Amesh Adalja, an infectious-disease specialist and a senior scholar at the Johns Hopkins Center for Health Security in Baltimore. The quarantine was "cruel and inhumane" and "created a horror show on the ocean." The ship quarantine, which has been going on for over a week, has already led to a major increase in the spread of the virus, even extending to a quarantine officer, he told Live Science. "The virus is being served up more and more victims by the Japanese government so long as this quarantine lasts," Adalja said.
  #457  
Old 02-15-2020, 05:59 PM
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The data is sloppy and hard to interpret. Imperfect is a major understatement.
I would say there are 2 wild cards in this.

One is the location of people who had the virus prior to initial reports. Have any of them traveled outside of china?

The other thing is the mutation rate. Are we going to get a more aggressive version of it down the line?
  #458  
Old 02-15-2020, 08:01 PM
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I am nervous the US is doing so little on this.

We still have planes arriving daily from China and people and luggage are not being checked.

Yes luggage. The luggage which gets handled by several people then sits in a hold touching other bags then gets handled by more people before it finally gets to the right person (maybe). And thing is nobody ever does any spot checking for disease.
  #459  
Old 02-15-2020, 08:39 PM
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"I think it's been a bad decision from the start," said Dr. Amesh Adalja, an infectious-disease specialist and a senior scholar at the Johns Hopkins Center for Health Security in Baltimore. The quarantine was "cruel and inhumane" and "created a horror show on the ocean." The ship quarantine, which has been going on for over a week, has already led to a major increase in the spread of the virus, even extending to a quarantine officer, he told Live Science. "The virus is being served up more and more victims by the Japanese government so long as this quarantine lasts," Adalja said.

Well, he's the expert, but how could he possibly know? Given the long symptom-free period at the start of infection, after 'more than a week', the number of cases caused by quarantine would only know be becoming visible --- and that doesn't seem to be the case --- and the cases now visible would have been contracted before quarantine measures started.

Last edited by Melbourne; 02-15-2020 at 08:41 PM.
  #460  
Old 02-15-2020, 08:50 PM
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I am nervous the US is doing so little on this.



We still have planes arriving daily from China and people and luggage are not being checked.



Yes luggage. The luggage which gets handled by several people then sits in a hold touching other bags then gets handled by more people before it finally gets to the right person (maybe). And thing is nobody ever does any spot checking for disease.
So how does one "spot check" luggage for "disease"?

Last edited by Shmendrik; 02-15-2020 at 08:51 PM.
  #461  
Old 02-15-2020, 10:04 PM
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We still have planes arriving daily from China and people and luggage are not being checked.

Yes luggage. The luggage which gets handled by several people then sits in a hold touching other bags then gets handled by more people before it finally gets to the right person (maybe). And thing is nobody ever does any spot checking for disease.
Intuitively ... this seems like an unlikely vector for the spread of COVID-19. I don't think just touching things, or items being in the proximity of the things touched, etc. spreads this illness. The chain between an infectious person, with droplets on their hands or whatever, touching something that someone else touches that someone else touches that someone else touches ... that someone finally handles luggage in a Chinese airport. Just seems too tenuous and drawn out. The viral load of the droplet gets attenuated, someone along the line washes their hands or handles something hot or something. If your luggage was being handled in Wuhan right now, right before you went to pick it up ... I could see being concerned.

I liken it to when people worry about catching things from using a public toilet. For all intents and purposes, it virtually can't happen ... but some percentage of people do worry about it.

Accordingly ... I don't think Cambodia Prime Minister Hun Sen was doing anything particularly risky when he embraced passengers disembarking from the MS Westerdam cruise ship (article). The ship was denied entry to several ports after last being docked at Hong Kong on February 1st.
  #462  
Old 02-15-2020, 10:45 PM
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I liken it to when people worry about catching things from using a public toilet. For all intents and purposes, it virtually can't happen ...
This is simply not true. Whether it's a door handle or keyboard it is possible to transfer a virus from person to surface to person. The toilet seat meme is about transfer through skin contact only when the transmission avenue is from skin contact to something like eye contact. Once infected it's spread faster through sneezing.

They don't know the lifespan of this particular virus but in it's family of viruses the upper lifespan can be up to 9 days.

for veterinary coronaviruses the lifespan can be longer than 28 days. This is why you hear of concern about such viruses mutating from animal susceptibility to human .
  #463  
Old 02-15-2020, 11:06 PM
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This is simply not true. Whether it's a door handle or keyboard it is possible to transfer a virus from person to surface to person. The toilet seat meme is about transfer through skin contact only when the transmission avenue is from skin contact to something like eye contact. Once infected it's spread faster through sneezing.
I think we agree. What I meant by "virtually can't happen" was specifically the toilet seat meme -- as distributed in the past regarding rumors of STDs caught from public restroom use.

Your point about viruses spreading from person to surface to person is granted. My doubts are about a virus spreading from infected person to surface to healthy person to healthy person to surface to healthy person to surface ... and so on. After some number of exchanges, the virus is going to be washed away, killed by sanitizer, mechanically removed, or attenuated in some other way. So a healthy person at, say, 20 degrees of remove from the infected person and the objects that person touched ... that healthy person is not at particular risk of contracting COVID-19. I admit this is my intuition about the matter -- I will not be able to cite research.

I saw an "up to 9 days" study. In laboratory conditions, at a just-so temperature ... seemed more like the virus "lucking out" environmentally than an absolutely certain number of days the virus would live on a surface.

Last edited by bordelond; 02-15-2020 at 11:09 PM.
  #464  
Old 02-16-2020, 04:36 AM
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Up to nine days in optimum conditions on a hard surface.

But in the real world conditions are seldom optimum.

Also, this family of viruses on hard surfaces can be rendered harmless by either household bleach or rubbing alcohol. Which, by the way, is one way hand sanitizers work - they use alcohol to kill various microscopic nasties.
  #465  
Old 02-16-2020, 07:45 PM
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Up to nine days in optimum conditions on a hard surface.

But in the real world conditions are seldom optimum.
I live in a climate controlled world from my house, to the car, to work, and back. So that's 17 hrs a day.

Countries like India with densely populated cities have serious water quality issues from beginning to end. In the real world that 9 days is a continuously overlapping event operating in a petri dish.

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Also, this family of viruses on hard surfaces can be rendered harmless by either household bleach or rubbing alcohol. Which, by the way, is one way hand sanitizers work - they use alcohol to kill various microscopic nasties.
for hand sanitizer to work you'd have to use it every time you touched something that is touched by someone else. We couldn't even deal with HIV and that took almost no effort at all to protect ourselves from.

Barring that the likelihood of a government official entering your office in a bio suite and a spray fogger is zero.

I'd say we're lucky it started in a country that has iron rule over it's citizens and it currently isn't a massively contagious disease. If China can contain it then it becomes another flu virus we can inoculate against going forward.
  #466  
Old 02-16-2020, 10:18 PM
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I think we agree. What I meant by "virtually can't happen" was specifically the toilet seat meme -- as distributed in the past regarding rumors of STDs caught from public restroom use.

Your point about viruses spreading from person to surface to person is granted. My doubts are about a virus spreading from infected person to surface to healthy person to healthy person to surface to healthy person to surface ... and so on. After some number of exchanges, the virus is going to be washed away, killed by sanitizer, mechanically removed, or attenuated in some other way. So a healthy person at, say, 20 degrees of remove from the infected person and the objects that person touched ... that healthy person is not at particular risk of contracting COVID-19. I admit this is my intuition about the matter -- I will not be able to cite research.

I saw an "up to 9 days" study. In laboratory conditions, at a just-so temperature ... seemed more like the virus "lucking out" environmentally than an absolutely certain number of days the virus would live on a surface.
I hope your right.

I work for the post office and we get LOADS of mail which come directly from China. These are often small, plastic, airtight packages. And we get thousands if not millions of them.

Its starting to be a worry.
  #467  
Old 02-16-2020, 10:44 PM
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I hope your right.

I work for the post office and we get LOADS of mail which come directly from China. These are often small, plastic, airtight packages. And we get thousands if not millions of them.

Its starting to be a worry.
Germane to your concerns:

https://www.npr.org/sections/health-...ail-from-china
  #468  
Old 02-17-2020, 05:08 AM
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I live in a climate controlled world from my house, to the car, to work, and back. So that's 17 hrs a day.

Countries like India with densely populated cities have serious water quality issues from beginning to end. In the real world that 9 days is a continuously overlapping event operating in a petri dish.
Optimum conditions for human beings is not optimum for survival outside a host for this virus, which prefers low humity, cool temperatures, and no sunlight (which I take to mean it doesn't like UV).

A country like India - which tends to be hot and humid - would not be optimum for this virus. Nor would it be in the water supply, presumably.

It's a virus, not a bacteria - it can't reproduce outside a living body, unlike bacteria that can reproduce in water.

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for hand sanitizer to work you'd have to use it every time you touched something that is touched by someone else.
No, you have to use the hand sanitizer between touching other things and touching yourself (face, eyes, nose, mouth). Or touching other people.

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I'd say we're lucky it started in a country that has iron rule over it's citizens and it currently isn't a massively contagious disease. If China can contain it then it becomes another flu virus we can inoculate against going forward.
It's not a flu virus.

Prior attempts to make a vaccine against the coronavirus resulted in a vaccine more deadly than the SARS virus - which is not to say it's impossible to develop a safe vaccine, just that it's not as straightforward as you seem to think.
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Old 02-17-2020, 09:05 AM
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We still don't have an effective vaccine against HIV
We know that Dengue is not well-addressed via vaccine.

We might get a vaccine for COVID-19, but I'm not betting on that. I am curious if there are effective vaccines against any other corona viruses, though.
  #470  
Old 02-20-2020, 08:57 AM
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Now China has gone back to reporting only cases that have been laboratory confirmed, instead of clinically detected. That's most likely why the number of new cases there has decreased in the last couple-three days. This changing of the criteria is going to play havoc with the computation of statistics, such as the mortality rate.

Last edited by dtilque; 02-20-2020 at 09:00 AM.
  #471  
Old 02-20-2020, 09:11 AM
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Now China has gone back to reporting only cases that have been laboratory confirmed, instead of clinically detected. That's most likely why the number of new cases there has decreased in the last couple-three days. This changing of the criteria is going to play havoc with the computation of statistics, such as the mortality rate.
I was wondering what was up with that. I was starting to get hopeful. Only 396 new cases from China today.
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Old 02-20-2020, 11:28 AM
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most aptly titled


There are at least 4 different threads about this outbreak here. I have been posting mostly to this thread but I would be happy to consolidate. Snowboarder Bo's thread in MPSIMS has a better title. I think I am going to try and post there. YMMV of course.
  #473  
Old 02-20-2020, 11:30 AM
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That apparently only explains the decrease today, not the last few days.
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China's National Health Commission also reported 394 new confirmed cases, significantly lower than the 1,749 infections announced nationwide the previous day. A total of 74,576 victims are now infected.

The drop, the largest in almost a month, came after Chinese authorities changed their methodology for counting cases in Hubei province, the epicentre of the outbreak, to only include those confirmed through genetic testing.
The drops getting to under 2K new cases per day were before that change back.

Meanwhile
WHO follows the without changing definitions. This referencing last Friday:
Quote:
The World Health Organization said it wants more clarity on how clinicians in Hubei are making diagnoses, Dr. Tedros Adhanom Ghebreyesus, WHO's director general, said Friday during a news briefing in Geneva. The fear is that without lab tests, diseases with similar symptoms could get counted as COVID-19 cases.

Since there's no known treatment for novel coronavirus, the change shouldn't hinder patients' ability to get care. But for scientists tracking the outbreak, it could muddy the waters.

It's important "to ensure other respiratory illnesses, including influenza, aren't getting mixed into the COVID-19 data," Tedros warned. The WHO continues to report cases using its own numbers, which don't include the clinically diagnosed cases coming out of Hubei.

According to WHO figures, 48,548 cases had been reported through Friday.
  #474  
Old 02-20-2020, 11:35 AM
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Sorry I didn't link to the thread, I have a little case of the 502/504's.

The thread
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Old 02-20-2020, 11:45 PM
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Now China has gone back to reporting only cases that have been laboratory confirmed, instead of clinically detected. That's most likely why the number of new cases there has decreased in the last couple-three days. This changing of the criteria is going to play havoc with the computation of statistics, such as the mortality rate.
Of note the last three days have all been around 500 new cases per day. Before the definition change there had only been a one day drop to that level having dropped from the 4K new cases per day peak.

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Originally Posted by steatopygia View Post
There are at least 4 different threads about this outbreak here. I have been posting mostly to this thread but I would be happy to consolidate. Snowboarder Bo's thread in MPSIMS has a better title. I think I am going to try and post there. YMMV of course.
The MPSIMS thread is aptly named for what a MPSIMS thread is supposed to be - breaking news. It is not however the most appropriate forum for discussion about what the news means and does not mean. IMHO of course. The two in IMHO might've been better off having been merged early on, though.
  #476  
Old 02-21-2020, 10:21 AM
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Frankly, the ship is not a nice place to keep all these folks - especially the poor folks stuck in windowless staterooms for several days at a time. However, in terms of containing a potential public health disaster that could kill thousands more in Japan, this is the best solution. The ship already has what it takes to feed and house all these people in one place and prevent them from wandering into town; just bring more provisions to the ship, pay the crew a bunch of overtime (maybe even hazardous duty pay?), and keep anyone from crossing the gangway.
It winds up that keeping people on board was not a good idea after all. The US government told the people it evacuated that conditions on the ship weren't safe, which is one reason the evacuees are being quarantined again in the States. A Japanese doctor posted a video severely critical of the measures on the ship.
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Old 02-21-2020, 10:42 AM
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It winds up that keeping people on board was not a good idea after all. The US government told the people it evacuated that conditions on the ship weren't safe, which is one reason the evacuees are being quarantined again in the States. A Japanese doctor posted a video severely critical of the measures on the ship.
There wasn't a good place to put all those people on land in Japan. Keeping them on the ship (as opposed to bringing them all ashore in Yokohama) wasn't an inherently bad idea, but in this case it was poorly executed. They didn't do a good job of isolating the passengers from each other, and they didn't do a good job of keeping the crew from spreading contagion all over the ship, including to each other. Perhaps the most sensible thing would have been for various nations to collect their citizens from the ship shortly after it came to port in Yokohama (instead of now) and then bring them to a well-managed quarantine in their homeland. An effective quarantine for a few hundred people is far easier than one for a few thousand people.
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