# Is anyone else concerned with this new virus in China that is becoming a bigger problem every day? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [January 23, 2020, 12:42pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841 "2020-01-23T12:42:40Z")\ **Posts on this page:** 20\ **Page:** 22
**Author:** ![steatopygia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/steatopygia/32/3132_2.png) [@steatopygia](https://boards.straightdope.com/u/steatopygia)\ **Post date:** [February 13, 2020, 10:40am UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/423 "2020-02-13T10:40:33Z")
> [@polar\_bear](#): > > As has been posted before, the decision to quarentine the shop was not done to protect the people on board… > > Verstuurd vanaf mijn moto g(6) met Tapatalk Except for the fact that as soon as any patient tested positive,they were brought onshore. ---
**Author:** ![steatopygia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/steatopygia/32/3132_2.png) [@steatopygia](https://boards.straightdope.com/u/steatopygia)\ **Post date:** [February 13, 2020, 10:49am UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/424 "2020-02-13T10:49:58Z")
In other words, by keeping everyone concentrated on that ship, they now have 218 infectious patients in the local hospitals. If they had brought them ashore, and placed them in a less constricted environment, they would almost certainly would be taking care of less patients. ---
**Author:** ![bordelond](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bordelond/32/150_2.png) [@bordelond](https://boards.straightdope.com/u/bordelond)\ **Post date:** [February 13, 2020, 11:15am UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/425 "2020-02-13T11:15:21Z")
> [@Isamu](#): > > By keeping them on the boat Japan can claim a lower number of infections “in Japan”. They are not “in Japan” so they don’t get counted. They’re still getting counted as Japanese cases, though typically there is a comment made about the cruise ship when Japan’s numbers are reported. Plus, the infected are removed from the ship and brought to land, as **steatopygia** points out. So they are on Japanese soil. ---
**Author:** ![Machine\_Elf](https://avatars.discourse-cdn.com/v4/letter/m/82dd89/32.png) [@Machine\_Elf](https://boards.straightdope.com/u/Machine_Elf)\ **Post date:** [February 13, 2020, 11:51am UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/426 "2020-02-13T11:51:04Z")
> [@steatopygia](#): > > In other words, by keeping everyone concentrated on that ship, they now have 218 infectious patients in the local hospitals. If they had brought them ashore, and placed them in a less constricted environment, they would almost certainly would be taking care of less patients. When you say “them”, you’re not just talking about the 218 infected patients; you’re talking about all 3700 people on that ship. 218 infected patients can be managed in land-based facilities, but there is no place on land to secure 3700 people in quarantine. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [February 13, 2020, 12:13pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/427 "2020-02-13T12:13:09Z")
Not to mention that critically ill people are not likely to try to escape quarantine - and at least one person, in Russia, did defeat a locked door and leave quarantine early. Sure, she’d tested as not sick _so far_ but if she’s incubating an infection and is now wandering around the general public… Yes, quarantine is very like being prison. Nobody wants to be locked up. No, it’s not fair to the people in quarantine who committed no crime. Yet… that is how quarantine is, and sometimes it is the most effective way to confine a disease to prevent an epidemic. People on board a ship can’t leave, or certainly can’t leave without great difficulty. As noted, confining 3000+ people in quarantine _anywhere_ is going to be problematic. ---
**Author:** ![TokyoBayer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tokyobayer/32/13989_2.png) [@TokyoBayer](https://boards.straightdope.com/u/TokyoBayer)\ **Post date:** [February 13, 2020, 12:39pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/428 "2020-02-13T12:39:50Z")
> [@DSeid](#): > > Meanwhile they must have run a big backlog batch of samples - confirmed case number JUMPED today after a small flattish patch. That’s one reason to not read too much into the daily fluctuations in cases. We just don’t know enough about the testing and how that is happening. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [February 13, 2020, 2:29pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/429 "2020-02-13T14:29:09Z")
> [@TokyoBayer](#): > > That’s one reason to not read too much into the daily fluctuations in cases. We just don’t know enough about the testing and how that is happening. Except that this isn’t just the usual daily fluctuation noise issue related to testing - as referenced already this is a dump of switching over from lab confirmed to “clinically confirmed” inclusive. The result, using numbers [in the CNN](https://edition.cnn.com/asia/live-news/coronavirus-outbreak-02-12-20-intl-hnk/index.html) article about it, increased the number of cases “confirmed” in Hubei by over 40% overnight. > [@](#): > > Hubei authorities confirmed an additional 14,840 cases of the virus in Hubei on Wednesday, which brings the total number of cases in the epicenter of the outbreak to 48,206. The 14,840 figure includes both test confirmed cases and clinically diagnosed cases. > > The government explained they are now adding “clinically diagnosed cases” in the tally of cases to make it easier for these patients to receive treatment early. ---
**Author:** ![bordelond](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bordelond/32/150_2.png) [@bordelond](https://boards.straightdope.com/u/bordelond)\ **Post date:** [February 13, 2020, 2:36pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/430 "2020-02-13T14:36:29Z")
In the “clinically diagnosed” cases (AIUI, diagnosis by lung X-ray) … how can they tell the difference between COVID-19 and symptoms of the various common-cold viruses, other viruses that can cause preumonia, other respiratory distress, etc? Or is it being considered safe to assume that anyone in/around Wuhan with significant lung blockage is infected with COVID-19? ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [February 13, 2020, 2:43pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/431 "2020-02-13T14:43:53Z")
The “lab confirmed” testing was known to be backlogged because demand for testing kits is outstripping manufacture and supply. So the “lab confirmed” totals were known to be undercounts. “Clinically confirmed” is known to be an overcount because it is certainly picking up false positives - people who have respiratory infection of a different sort, or pneumonia of a different sort - but will more rapidly identify actual cases. Which is preferable? Is undercounting due to a test undersupply _useful_ from the standpoint of dealing with a public health emergency? Is overcounting the lesser evil in this case? If you’re a nation dealing with a dozen infections being precise and using a lab to identify the precise problem while your testee is either sitting in a hotel room/equivalent or in an isolated hospital room receiving treatment isn’t a problem. If you’re in a city of 60 million in lockdown and you have _tens of thousands_ of sick people, your health system is overstressed, you’re running out of basic medical supplies… I’m not sure insisting on a lab certification of each and every potential infection is the best route to take. Yes, this is going to bugger up the preciseness of statistics. I’m sorry about that, but dealing with this emergency is no doubt going to take priority over pristine statistics for those in the trenches. It’s not like announcing a larger number is going to make China look better, or somehow benefit them. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [February 13, 2020, 2:54pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/432 "2020-02-13T14:54:22Z")
> [@bordelond](#): > > In the “clinically diagnosed” cases (AIUI, diagnosis by lung X-ray) … how can they tell the difference between COVID-19 and symptoms of the various common-cold viruses, other viruses that can cause preumonia, other respiratory distress, etc? > > Or is it being considered safe to assume that anyone in/around Wuhan with significant lung blockage is infected with COVID-19? As I implied in my prior post - there are going to be “false positives”. Some people who have non-Covid infections are going to be lumped in with the Covid infections. From the standpoint of quarantine, that is, separating the infected from the non-infected, and isolating people with an infection, the actions that prevent the spread of Covid also will prevent the spread of colds and flus and that’s not a bad thing, either. I’m not sure, exactly, how clinically a doctor could distinguish Covid from flu. I do know that colds and flus can be distinguished by symptoms and intensity of those symptoms. In some cases this will be either “best guess” or “err on the side of caution”. It’s not as precise as RNA identification in a lab, but that sort of testing takes more time and uses resources that are in limited supply. You can do that in London or California or other places with few ill people at a time to care for. You can not do that in a city of millions with tens of thousands of sick people. Some things don’t scale and size/quantity does matter. As to whether or not “sick in Wuhan = Covid” I can’t say - it would involve looking at what would be a typical number of sick patients with a suite of symptoms (fever, respiratory, etc.) vs. the number currently displaying those symptoms. I don’t have access to those stats, but if someone does it might be an interesting comparison. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [February 13, 2020, 3:33pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/433 "2020-02-13T15:33:40Z")
> [@Broomstick](#): > > The “lab confirmed” testing was known to be backlogged because demand for testing kits is outstripping manufacture and supply. So the “lab confirmed” totals were known to be undercounts. > > “Clinically confirmed” is known to be an overcount because it is certainly picking up false positives - people who have respiratory infection of a different sort, or pneumonia of a different sort - but will more rapidly identify actual cases. > > Which is preferable? > > Is undercounting due to a test undersupply _useful_ from the standpoint of dealing with a public health emergency? Is overcounting the lesser evil in this case? > > If you’re a nation dealing with a dozen infections being precise and using a lab to identify the precise problem while your testee is either sitting in a hotel room/equivalent or in an isolated hospital room receiving treatment isn’t a problem. > > If you’re in a city of 60 million in lockdown and you have _tens of thousands_ of sick people, your health system is overstressed, you’re running out of basic medical supplies… I’m not sure insisting on a lab certification of each and every potential infection is the best route to take. > > Yes, this is going to bugger up the preciseness of statistics. I’m sorry about that, but dealing with this emergency is no doubt going to take priority over pristine statistics for those in the trenches. > > It’s not like announcing a larger number is going to make China look better, or somehow benefit them. How does doing this help the process of “dealing with this emergency”? From the _medical_ POV it really doesn’t matter what you call it, unless you do something different based on the name. If it is influenza and they are significantly ill or high risk you give Tamiflu as something different. If no risk factor some give Tamiflu anyway but it does little. And providers can make that choice without testing using clinical judgment of an Influenza-like illness (ILI). For Covid-19? As of now no specific antiviral. Same supportive care and quarantine, yes? The “confirmed case” number is meaningful to have a sense of how it is spreading and what its morbidity and mortality rates are. Creating a database that defines “sick in Hubei” = Covid-19 is not helping the database accomplish that, its most useful function. Resources can be decided based on how any are sick of anything that demands the resources. ---
**Author:** ![bordelond](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bordelond/32/150_2.png) [@bordelond](https://boards.straightdope.com/u/bordelond)\ **Post date:** [February 13, 2020, 4:24pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/434 "2020-02-13T16:24:35Z")
> [@Broomstick](#): > > Yes, quarantine is very like being prison. Nobody wants to be locked up. No, it’s not fair to the people in quarantine who committed no crime. Yet… that is how quarantine is, and sometimes it is the most effective way to confine a disease to prevent an epidemic. [Something has changed](https://www.usatoday.com/story/travel/cruises/2020/02/11/coronavirus-thailand-bars-holland-america-cruise-ship-disembarking/4714464002/): > [@](#): > > While all Diamond Princess guests are still allowed to remain on board through the end of the Feb. 19 quarantine period, Japanese health officials plan to start a voluntary process to let passengers off the ship. > > It will happen in phases. Older adults with pre-existing health conditions and more of the “most medically vulnerable guests” will be let off first, according to an update from the cruise line, provided by Negin Kamali, director of public relations. > > Guests will be tested for coronavirus prior to disembarking: Those who test positive will be transported to a local hospital, while those who test negative will be allowed to leave and head to a quarantine housing facility. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [February 13, 2020, 4:36pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/435 "2020-02-13T16:36:29Z")
> [@DSeid](#): > > How does doing this help the process of “dealing with this emergency”? > > From the _medical_ POV it really doesn’t matter what you call it, unless you do something different based on the name. If it is influenza and they are significantly ill or high risk you give Tamiflu as something different. If no risk factor some give Tamiflu anyway but it does little. And providers can make that choice without testing using clinical judgment of an Influenza-like illness (ILI). For Covid-19? As of now no specific antiviral. Same supportive care and quarantine, yes? 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. > [@DSeid](#): > > The “confirmed case” number is meaningful to have a sense of how it is spreading and what its morbidity and mortality rates are. Creating a database that defines “sick in Hubei” = Covid-19 is not helping the database accomplish that, its most useful function. 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. > [@bordelond](#): > > [Something has changed](https://www.usatoday.com/story/travel/cruises/2020/02/11/coronavirus-thailand-bars-holland-america-cruise-ship-disembarking/4714464002/): Looks like Japan is going to off-load the boat in a controlled manner, then. Well, good for them if they’ve found a better solution. ---
**Author:** ![bordelond](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bordelond/32/150_2.png) [@bordelond](https://boards.straightdope.com/u/bordelond)\ **Post date:** [February 13, 2020, 4:50pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/436 "2020-02-13T16:50:01Z")
For some reason … I was thinking COVID-19 diagnoses was chiefly being confirmed through microscopic observation of the virus itself. I had thought my son was diagnosed with H1N1 this way in 2009 – they took a nasal swab, smeared it on a slide, and looked at it under a microscope. No RNA sampling or anything. I thought they actually did a visual ID on the virus, and furthermore that they could distinguish strains of flu through the microscope. Anyway, the coronaviruses all seem to look a lot alike when magnified. So it looks like positive ID of COVID-19 does require an RNA test. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [February 13, 2020, 5:23pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/437 "2020-02-13T17:23:37Z")
The test, for influenza and for Covid-19, is a [PCR](https://en.wikipedia.org/wiki/Polymerase_chain_reaction) based one. ---
**Author:** ![bordelond](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bordelond/32/150_2.png) [@bordelond](https://boards.straightdope.com/u/bordelond)\ **Post date:** [February 13, 2020, 5:32pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/438 "2020-02-13T17:32:22Z")
> [@DSeid](#): > > The test, for influenza and for Covid-19, is a [PCR](https://en.wikipedia.org/wiki/Polymerase_chain_reaction) based one. Dang … I’m 99% sure the pediatrician didn’t do all that, unless the equipment is much smaller and the PCR testing much quicker than I am thinking. ---
**Author:** ![pullin](https://avatars.discourse-cdn.com/v4/letter/p/c57346/32.png) [@pullin](https://boards.straightdope.com/u/pullin)\ **Post date:** [February 13, 2020, 5:33pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/439 "2020-02-13T17:33:28Z")
My eldest has been in Singapore for over a week. Shortly after arrival, he got sick with what appeared (to him) to be a cold. He decided to self-quarantine in the hotel room for the next 5 days until he got the results from the Docs there. No idea what kind of test, but they told him yesterday it wasn’t Covid, only a sinus infection and he could travel. He finally arrived home this morning. He had to pass through several temperature scanning setups to get home, and said things are a little tense in international airports right now. Thankfully he had no fever and passed through without getting stopped. I’m just glad he’s OK and home. I’ll report tomorrow morning on my hangover… ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [February 13, 2020, 5:45pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/440 "2020-02-13T17:45:35Z")
> [@bordelond](#): > > Dang … I’m 99% sure the pediatrician didn’t do all that, unless the equipment is much smaller and the PCR testing much quicker than I am thinking. There are office based rapid flu test kits that use antigen detection methods. Their false positive and negative rates are widely considered unacceptable and far poorer than clinical judgement diagnosis at accuracy … they are used by many even still but have become less used over the last several years. PCR turnaround is 30 to 45 minutes if there is a real (not back office) lab on site. ---
**Author:** ![steatopygia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/steatopygia/32/3132_2.png) [@steatopygia](https://boards.straightdope.com/u/steatopygia)\ **Post date:** [February 13, 2020, 10:14pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/441 "2020-02-13T22:14:47Z")
> [@steatopygia](#): > > I think if they have any more positives, they are going to have to move everyone to land. On land they can have at least some isolation from each other. I’m not sure why that wasn’t done right away. Either over confidence that it wasn’t going to spread, or a lack of space. > [@Broomstick](#): > > … > Looks like Japan is going to off-load the boat in a controlled manner, then. Well, good for them if they’ve found a better solution. 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. ---
**Author:** ![China\_Guy](https://avatars.discourse-cdn.com/v4/letter/c/779978/32.png) [@China\_Guy](https://boards.straightdope.com/u/China_Guy)\ **Post date:** [February 13, 2020, 11:24pm UTC](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841/442 "2020-02-13T23:24:25Z")
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… [Previous page](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841.md?page=21) [Next page](https://boards.straightdope.com/t/is-anyone-else-concerned-with-this-new-virus-in-china-that-is-becoming-a-bigger-problem-every-day/846841.md?page=23)