Wuhan, nCV, germs....

Scrubber3 said:
Short of someone being there and being virologist with expertise dealing with this exact type of virus, im taking anything anyone says with a grain of salt.

Is it highly contagious? Yes (FACT)
Is it contained? No (FACT)
Potentially lethal? Yes (FACT)
Is the information coming from China viable? No (FACT)

Is there reason to be worried based upon the above information? You be the judge. I have some schooling and experience in the medical playground. Im worried, but not saying the sky is falling.


Stick you head in the sand or become prepared (whatever "prepared" means to you).
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I think I can smell what you are stepping in. Your saying we should all buy another gun, right?
 
gc70 said:
Why?

The incidence of transmission on the cruise ship seems fairly radically different from the transmission patterns outside Wuhan.

I have begun to wonder whether the virus was originally more contagious and has mutated to be less contagious over time.
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Indeed, it is quite striking. At 218 confirmed cases, the plague ship is home to far more infections than even the second highest country - Singapore at 67 confirmed cases. I suspect there are at least a few factors at play:

1. Cruise ships are floating petri dishes - note how norovirus spreads like gangbusters on a cruise. Lots of people in very close proximity, often lots of interactions with greater numbers of people (i.e., on a cruise, you meet lots of new people, whereas at a shopping mall there are lots of people, but very little interaction), lots of recirculated air (like a flight, but instead of hours, a cruise can last for weeks), lots of meals being prepared by staff who are also subject to the same infection but even worse, because they spend much longer on that floating petri dish than the passengers - and compare the food handling by staff on a 2 week cruise vs 4hr flight, both in number of meals as well as opportunities to contaminate the food (mostly getting pre-prepared, wrapped/cover food/drink on flights).

2. They are testing everyone on the plague ship (or I believe more accurately, everyone who has had contact with someone who has been infected, which probably means most on board will get tested); on land, we are only testing those who show up at hospitals (in China), or those who present symptoms AND had recent contact with someone from Hubei (most of rest of world). So it could be that, on land, many infections go undetected (seems likely) because people don't show up at hospital or their doctor, because their symptoms are very mild/fleeting or it amounts to a flu that they ride out at home. This may actually be a good thing - i.e., maybe for most, this is essentially another flu-like virus and once it sweeps the world, we will have herd immunity the way we do influenza.

3. Cruise is in East Asia, so it's likely that the demographics of the passengers reflects this. Thus far, East Asians seem far more susceptible to severe illness from Kung Flu than others. Seems most others are able to shake it off like a cold or flu. Not clear why, but some suggestion that it's not ethnicity that is playing a role, but cigarette smoking - and Chinese love their cigarettes, especially men, which might explain why in China, there are significantly more male cases than female cases.

What is really crazy is that apparently a Japanese doctor boarded that ship to take a look around and he is now infected. WTFBBQ! I would assume that by the time he boarded, he knew how transmissible this virus is, and would have taken all precautions, and he wouldn't have been there for very long (hours at most), and yet he still got infected. Of course it's possible he was infected at the hospital (1700+ infected medical personnel in China - that CCP has admitted to) and only developed symptoms (and thus got tested) after visiting the plague ship.
 
drypowder said:
Indeed, it is quite striking. At 218 confirmed cases, the plague ship is home to far more infections than even the second highest country - Singapore at 67 confirmed cases. I suspect there are at least a few factors at play:

1. Cruise ships are floating petri dishes - note how norovirus spreads like gangbusters on a cruise. Lots of people in very close proximity, often lots of interactions with greater numbers of people (i.e., on a cruise, you meet lots of new people, whereas at a shopping mall there are lots of people, but very little interaction), lots of recirculated air (like a flight, but instead of hours, a cruise can last for weeks), lots of meals being prepared by staff who are also subject to the same infection but even worse, because they spend much longer on that floating petri dish than the passengers - and compare the food handling by staff on a 2 week cruise vs 4hr flight, both in number of meals as well as opportunities to contaminate the food (mostly getting pre-prepared, wrapped/cover food/drink on flights).

2. They are testing everyone on the plague ship (or I believe more accurately, everyone who has had contact with someone who has been infected, which probably means most on board will get tested); on land, we are only testing those who show up at hospitals (in China), or those who present symptoms AND had recent contact with someone from Hubei (most of rest of world). So it could be that, on land, many infections go undetected (seems likely) because people don't show up at hospital or their doctor, because their symptoms are very mild/fleeting or it amounts to a flu that they ride out at home. This may actually be a good thing - i.e., maybe for most, this is essentially another flu-like virus and once it sweeps the world, we will have herd immunity the way we do influenza.

3. Cruise is in East Asia, so it's likely that the demographics of the passengers reflects this. Thus far, East Asians seem far more susceptible to severe illness from Kung Flu than others. Seems most others are able to shake it off like a cold or flu. Not clear why, but some suggestion that it's not ethnicity that is playing a role, but cigarette smoking - and Chinese love their cigarettes, especially men, which might explain why in China, there are significantly more male cases than female cases.

What is really crazy is that apparently a Japanese doctor boarded that ship to take a look around and he is now infected. WTFBBQ! I would assume that by the time he boarded, he knew how transmissible this virus is, and would have taken all precautions, and he wouldn't have been there for very long (hours at most), and yet he still got infected. Of course it's possible he was infected at the hospital (1700+ infected medical personnel in China - that CCP has admitted to) and only developed symptoms (and thus got tested) after visiting the plague ship.
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Some if my same thoughts as well. The high number of medical staff infected concerns me because they all practice higher basic isolation skills than most "civilians". I say that, but during the almost epidemic community (hospital) infection of MRSA a few years back, our hospital received recognition for significant reduction in contamination buy enforcing a radical new concept, hand washing.
 
georgel said:
Some if my same thoughts as well. The high number of medical staff infected concerns me because they all practice higher basic isolation skills than most "civilians". I say that, but during the almost epidemic community (hospital) infection of MRSA a few years back, our hospital received recognition for significant reduction in contamination buy enforcing a radical new concept, hand washing.
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WHO seems to think that most of those 1700+ medical personnel were infected in the second and third week of January, before they really understood they were dealing with a new zoonotic virus.

I'm betting hospital transmission in Wuhan was widespread, as infected staff proceeded to infect many patients. Awareness was raised nationwide very early in the virus' spread to other parts of China, whereas it was spreading undetected in Wuhan for weeks. That might explain why > 80% of all China cases are in Hubei.
 
georgel said:
... our hospital received recognition for significant reduction in contamination buy enforcing a radical new concept, hand washing.
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Sadly, I have no problem believing this.
I can't even tell you how often I see people handling OPIM and then touching their face with their gloves on, pulling cell phones out of pockets, not removing gloves or washing hands when going into "clean" offices/rooms areas.
 
Plague ship infections have risen again, up 70 to 355, or ~10% of passengers and crew, or a whopping 29% of the 1219 tested. Clearly as they test more, they will find more infections, though I expect the final infection rate will be significantly lower than 29%, but also greater than 10%. Kinda surprised cruise ship stocks have held up so well given the circumstances.

Some countries have seen enough - among them, America and Italy are going to evacuate their citizens. The 40 Americans who are currently infected will receive treatment in Japan.
 
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2/16/20 Mainland China seems to be flattening out at ~2k new confirmed cases a day (with all the caveats about the testing limitations there as well as the caveat that commies always lie). Hubei lockdown is growing more intense as CCP is focusing on strangling the virus here. Growth in other parts of China remains slow - almost suspiciously slow, and I'm guessing some cities/provinces didn't have their numbers in by the deadline for the daily countrywide report. CCP is talking up bringing factories fully back online, but the quarantines in much of the country (far more than the entire US population is under some form of quarantine in China - the scale boggles the mind) make that nearly impossible.

Rest of world continues to grow, but much of the growth in the past week or so has come from the plague ship which, with 355 cases, is nearly as much as all of the world ex-China. S'pore, Japan and HK are all starting to get a little worrisome as it seems they are having community transmission.

Updated charts: Confirmed cases in thousands. Right side axis is # under medical observation - these are people who are contacts of confirmed cases who aren't yet suspected of having the virus; they're just being observed (either state run or self-imposed quarantine) to see if they develop symptoms. Fortunately that # is falling, but caveat with respect to China's ability to effectively contact trace when the scale of infection is so large.

The suspected case count is also falling - these are people presenting with symptoms, but not yet tested positive for virus (or positive CT scan in Hubei) - this is good news as this is the most likely pool of new confirmed cases. If the suspected case count continues to fall, I would interpret that as the Chinese medical system (particularly in Hubei) catching up to the spread of infection. Presumably a large chunk of the decrease in suspected cases is a result of the change in reporting of confirmed cases in Hubei where positive CT scan is sufficient to confirm COVID-19 infection (which is why there was such a large increase in Hubei a couple of days ago) .
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Same chart using log scale. For those not familiar with log scaling, here's the gist of it - with regular (arithmetic) scaling, a 100 unit difference represents the same vertical distance on a chart no matter what the absolute numbers are - e.g., if the confirmed case count goes from 100 to 200, that vertical distance on the chart will be the same as when case count goes from 1000 to 1100. The 'problem' with this is it 'hides' the rate of change. Going from 100 to 200 is a 100% increase. Going from 1000 to 1100 is only a 10% increase. On a log scale chart, the vertical distances represent the % change, not the absolute difference. So a 10% change will show the same whether the absolute numbers are going from 10 to 11, 100 to 110 or 1000 to 1100.
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drypowder said:
CCP is talking up bringing factories fully back online, but the quarantines in much of the country (far more than the entire US population is under some form of quarantine in China - the scale boggles the mind) make that nearly impossible.
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I am not at liberty to say what my source is, but it is 99% verified. Factories in Mainland are at 30% staffing levels vs, 2019 CNY Return. Office Staff are working from home for unprecedented levels of broadband requirements, and taxing the system.
 
Plague ship update: 454 have tested positive so far. Hard to believe all were infected prior to ~12 days ago when the quarantine began. Which suggests viral transmission despite a fairly strict quarantine.
 
I was fairly optimistic this virus would be contained, but seeing enough over the weekend that I'm starting to get a little nervous.
1. While the official data out of China is looking fairly good, esp declining number of suspected cases paired with declining number of new confirmed cases, the steps the CCP is taking don't jive. We know about the massive quarantines, but it seems every day I am hearing about some other city (outside Hubei) imposing quarantines. Setting aside the issue of how are people going to travel to get back to work (~1/3 of China's workforce is migratory), the ever expanding quarantine doesn't jive with the fact that < 20% of confirmed cases are outside of Hubei. Also, we've seen videos of them fumigating streets. Now we're hearing that the banks are going to disinfect and 'quarantine' cash; and if the cash came from places like hospitals or transportation systems, it will be destroyed and replaced with new bills. WTFBBQ! During even the worst flu seasons, I've never heard CDC say we shouldn't handle cash, much less US banks taking the steps the Chinese are taking. They know more than they're telling the world.

2. Community level transmissions in Singapore and Japan, not all of which have an identifiable transmission chain. This means that there are surely more transmissions and undetected infected in these countries. If these countries get hit hard, that would amplify the trade disruptions we are going to see from China.

3. Plague ship - at 454 infections (and growing), it seems very likely that some of the transmissions occurred during the quarantine. This highlights how easily transmissible this is - certainly more than influenza. And if many of these transmissions came during the quarantine (which we don't know), then we know for sure that China is dramatically understating the infection rate (or more likely, they have no idea how large it is, but they're scared, hence the drastic actions that seem disproportional to the reported scale of infection outside of Hubei). We kinda knew it already, given that commies always lie, but the plague ship post-quarantine really convinced me.

4. Westerdam cruise ship - who knows how many of these people are carrying the virus and now they're disbursed all over.

Long-term, I'm confident this will pass without anything like the armageddon predictions, but near-term I was thinking the worst was over, but not so much now.
 
The more time passes, the more contradictory some of the information seems.

There are been 897 cases in 28 countries outside China, with a whopping 50% or 454 cases from the cruise ship in Japan.

Net of recoveries, there are 767 cases in 20 countries outside China with 59% or 454 cases from the cruise ship in Japan.

And there have been a grand total of 5 deaths outside China.
 
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gc70 said:
There are been 897 cases in 28 countries outside China, with a whopping 50% or 454 cases from the cruise ship in Japan.
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I'm interpreting the plague ship situation to mean that many countries are having undetected transmissions. As noted earlier, this could be good - assuming we are past incubation and these people are just shaking off what appears to them to be a cold or mild flu. But if many of those transmissions are in recent days, we could see uptick in viral pneumonia cases (or other symptoms that would drive someone to seek medical attention).

What should give us useful info on this is the new program in 5 US cities where they will screen patients presenting with fever for the virus. All cities with significant Chinese presence.
 
I'm not too concerned about the number of HC workers. I imagine most of those happened in the early days. No HC worker gowns up and puts on a N95 for suspected flu or 99% of other vial infections.

As for CT, it shows the same as most other parenchymal lung disease; that is, CT doesn't definitively diagnose it, but rather show that it is one of 'n' number of similar diseases.
 
I’m a little concerned about the Chinese response, it is out of proportion with reporting.

Mobile World Congress in Barcelona was just cancelled, and that’s a damn big deal.
 
Apparently the diamond princess has 10 more confirmed cases than all countries (other than china) combined.
They've been confined to their rooms, right? so how is it spreading? do they pipe swamp air back to the rooms? is it very airborne? what's up?
 
JimB said:
I’m a little concerned about the Chinese response, it is out of proportion with reporting.

Mobile World Congress in Barcelona was just cancelled, and that’s a damn big deal.
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a lot of international conferences seem to be cancelled this season. As somebody who remembers what fancy govt funded trips are like, that sucks all around. lots of lost deposits, lots of lost vacations.
 
Chuckman said:
I'm not too concerned about the number of HC workers. I imagine most of those happened in the early days. No HC worker gowns up and puts on a N95 for suspected flu or 99% of other vial infections.

As for CT, it shows the same as most other parenchymal lung disease; that is, CT doesn't definitively diagnose it, but rather show that it is one of 'n' number of similar diseases.
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Agreed, and that's what WHO's initial assessment was - 2nd and 3rd week of Jan transmissions.

What is worrisome to me is the Japanese doc who boarded the plague ship to check things out. You'd expect he was wearing PPE. It's possible he was infected earlier and only developed symptoms after visiting the ship.
 
plague ship update: another 88 infected, bringing total to 542. Incredible.

Getting harder to accept that all these infections occurred prior to the quarantine. Which also makes it harder to believe that there is no undetected transmission in other countries.
 
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drypowder said:
plague ship update: another 88 infected, bringing total to 542. Incredible.

Getting harder to accept that all these infections occurred prior to the quarantine. Which also makes it harder to believe that there is no undetected transmission in other countries.
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And now another 79 positives, bringing total to 621.
 
I have been worried that with the reports that it was dying down and being contained, that it was really a smoldering fire, waiting to erupt.

You don't build new hospitals for something passing.
 
More reports of doctors and nurses among the dead from the virus. Blows up the whole "only the elderly and compromised are dying."

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fishgutzy said:
More reports of doctors and nurses among the dead from the virus. Blows up the whole "only the elderly and compromised are dying."

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30 and up are vulnerable, but the older, the more vulnerable. Other risk factors also matter. With medical personnel, I wonder if some are getting infected by more than one strain, making it impossible for the body to fend off two or more strains simultaneously, even in the absence of other risk factors.
 
Plague ship added only 13 infections today, so now up to 634. But from yesterday to tomorrow, people who tested negative, don't display symptoms and haven't been in contact with someone who was infected, are being set free to leave and travel on their on recognizance. Seems very risky given that the PCR test is known to have false negatives and people can be asymptomatic for longer than 14 days.

But perhaps the more pressing news is how Japan, Singapore and South Korea are all at risk of their own epidemics. SK now at 104, Japan at 94 and S'pore at 84. Apparently SK still allowing flights to/from China. If true, that's a dereliction of duty by the government.
 
drypowder said:
But perhaps the more pressing news is how Japan, Singapore and South Korea are all at risk of their own epidemics. SK now at 104, Japan at 94 and S'pore at 84. Apparently SK still allowing flights to/from China. If true, that's a dereliction of duty by the government.
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27 minutes after your post, new data shows South Korea at 156.
 
I have had people scoff at my Tin-Foil beliefs until they have an epiphany of their own.

So today, I am working on some data modeling and I hear the door chime and a "Hello! FedEx". I holler to come on back. I meet him half way and sign for the small vinyl package of rushed samples we had coming in from our overseas team.

We talk a bit about the snow and I wished him a good day and weekend. I was walking back looking at who is the contact and realize this was shipped Over Night. From Shanghai. Hmmmmmm........

I put it on my buddies desk and immediately go wash my hands, soaked with Purell and thoughg about lighting the alcohol on fire. LoL.

Buddy gets in, saw the package and said, check these out... before he grabbed it.
I said, "wait... I just saw the overnight from our boys... isn't that amazing that we don't know everything about COVID19, yet here is an Overnight package wrapped in Vinyl?"

He laughed and then it clicked. He said, "You dont think that would survive on a package do you?"

I said if the cruise ship vectors were consent forms, why couldn't it be 18 hour overnight on Vinyl?

He opened, grabbed the samples and slathered them all in Purell...
 
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