outbreak! (ebola, sars, coronavirus, etc)

Crazy that that biggest outbreak anywhere outside of China is a cruise ship with 3600 as-yet-uninfected people still aboard. 136 cases confirmed on the Diamond Princess so far. Sounds like a nightmare scenario - especially given the advanced danger with the cruise-ship age demographic.

I'm going to Singapore tomorrow.

3600 as-yet-uninfected is actually quite reassuring (I mean excluding the obvious possibility of them becoming infected).

On the Diamond Princess, the passengers/crew were originally told that with every new case, their 14-day quarantine would be reset. The ventilation system between cabins is connected, and people without any close contact with known cases were infected. It was like some preface to a J.G. Ballard novel social breakdown.

The current plan is they'll keep the original quarantine end date of Feb 19 for the whole ship, except for resets “only for close contacts of newly confirmed cases.”

There's still probably a interesting low-budget screenplay in the story...

Speaking of cruise ships, some of the strictest health security I've ever experienced was on a cruise ship. Virtually non-stop invitation/instruction to wash or disinfect hands, and an explicit disclaimer that anyone seriously ill will be quarantined. But cruise ships are also a good example of how this stuff often goes down. The cruise lines get a lot of shit for making people sick, but more often than not it's someone on board that was sick to begin with that gets the germ ball rolling. And then things spread and people are stuck.

all is well

Nothing can stop them from dancing! Optimistic patients with mild symptoms caused by the #coronavirus dance at a temporary hospital in Wuhan pic.twitter.com/EKY0jyczh4

— China Xinhua News (@XHNews) February 10, 2020

https://i.guim.co.uk/img/media/b50b698a36ce50bad98d86f5b77c461705c19f9c/24_26_3193_2367/master/3193.jpg?width=1920&quality=85&auto=format&fit=max&s=4769c993f26a16f58258d4cd45481587

You (literally) make me feel like dancing ...

Interesting that life in Chinese cities far from Wuhan have been affected this much:

https://www.reddit.com/r/Cooking/comments/f0qjm9/what_the_coronavirus_forcing_me_in_lockdowns/

Sobering analysis:

GAZETTE: But what is most important for the public to know about this?

LIPSITCH: There’s likely to be a period of widespread transmission in the U.S., and I hope we will avert the kind of chaos that some other places are seeing.

https://news.harvard.edu/gazette/story/2020/02/harvard-expert-says-coronavirus-likely-just-gathering-steam/

My wife was on the train yesterday morning, and seated across from her was a woman wearing a face mask. When my wife sneezed, the woman got up and moved.

I hope that I die to a disease with a more impressive name than COVID-19.

It’s an abbreviation for “coronavirus disease 2019.” The World Health Organization’s director-general explained in a media briefing Tuesday how careful they had to be when picking a moniker: “We had to find a name that did not refer to a geographical location, an animal, an individual or group of people, and which is also pronounceable and related to the disease.”

Shouldn't have a name so close to the best birds IMO

Relatively few face masks here in Singapore, compared to Indonesia.

Jesus.

we estimated that the number of infected individuals during early epidemic double every 2.4 days, and the R0 value is likely to be between 4.7 and 6.6

This paper offers a potential reason why COVID-19 (and SARS, which also attaches to lung cells via the ACE2 receptor) is more virulent in Asians. The study clearly needs replication with more tissue donors.

We also noticed that the only Asian donor (male) has a much higher ACE2-expressing cell ratio than white and African American donors (2.50% vs. 0.47% of all cells). This might explain the observation that the new Coronavirus pandemic and previous SARS-Cov pandemic are concentrated in the Asian area.

(which was not peer-reviewed)

Rather little of the COVID-19/2019 nCoV literature has gone through the whole peer review process. We're already up to ~540 results on Scholar, mostly preprints.

More cruise ship drama:

https://www.straitstimes.com/asia/se-asia/coronavirus-cruise-ship-rejected-by-five-ports-runs-out-of-options

2300 people being scooted around in international waters as nobody is willing to let them dock, food and medicine running out.

I guess it makes a change for wealthy westerners to be the boat people being forced away from ports.

this guy sells knockoffs and also ends up describing what he's seeing https://www.fashionrepsfam.ru

^ spam

There has been a very big jump in the number of cases within China in the last 24 hours, though that has followed a change to the way in which patients are diagnosed, so it’s not obvious whether things are getting worse or whether they’re just getting better at identifying how bad it was.

Russian containment measures are going about as well as you’d expect:

https://www.themoscowtimes.com/2020/02/12/russians-escape-coronavirus-quarantine-cages-a69257

A woman who’d been told she’d tested negative but still had to stay in lockdown for two weeks short-circuited the electro-magnetic lock on her hospital cell and escaped.

My understanding is that today's case/death jump is a one-day info dump in which current and past cases and deaths that only had clinical diagnoses (incl. pneumonia in CT scans), but not PCR-test confirmation of the COVAD19 virus (which is bottlenecked), were reclassified.

Drill down to serious/critical cases and there's actually some improvement:

Yesterday - 5,724 serious /1,517 critical
Today - 5,647 serious / 1,437 critical

Not new, but food for thought: 29% of the infected at one Wuhan hospital are medical staff.

COVAD COVID

Oh good a coronavirus patient just turned up at my local A&E in an Uber.

Good advertising idea for Uber: "We'll take anyone in our cabs'.

uber: no longer just in the business of killing traditional taxi businesses

gig economy more like gag, you cough on me. In my opinion

https://www.theguardian.com/world/live/2020/feb/17/coronavirus-live-updates-us-citizens-japan-diamond-princess-cruise-ship-china-wuhan-hubei-cases-death-toll-latest-news

So basically this luxury cruise ship has been turned into a concentration camp, and everyone on board are now internees, left to fight off the fast-moving virus if they're able? A sobering preview of humanity's future, nothing to see here though don't worry.

That’s not quite the example I’d use when we have the camps on Nauru

Although our tropical camps have been very useful for interning our zombie apocalypse victims.

Ukraine protesters attack buses carrying China evacuees

https://www.bbc.co.uk/news/world-europe-51581805

It's safe to say that a lot of global tensions (and racism) are going to get a venting over the next while.

We haven't had a lot of confirmed cases in Vietnam yet (and all but one has been cleared) but the govt has shut down all schools for the past month and it looks likely they will be closed until the end of March to be safe. Myself and most of my friends here are teachers, nearly all of us out of work (I'm very lucky not to be, for the time being). Many of my expat friends out of work have thought about leaving the country, and of course, no one knows how the schools will make up for missing two months of classes. So it's a bit grim in my circles before we've really had to deal with the virus at all

To Andrew's point, there's a shit ton of anti-China racism here too

weird story about the S Korean cultist who refused to be tested then spread it to like half her congregation

South Korean universities started like a month late because of this now, now they’re going again as the virus begins to spread there. I’m going there in April.

State department dumb as a bag of spanners.

https://www.washingtonpost.com/health/coronavirus-diamond-princess-cruise-americans/2020/02/20/b6f54cae-5279-11ea-b119-4faabac6674f_story.html

Euler I’m not sure it’s actually spread much beyond that cult. Hard to know though. It helps to have the buffer of North Korea. Pretty hard border there.

Hmm ok! I thought I saw that it was getting going. It’s not going to stop me from going, unless the borders get closed, which seems very unlikely.

https://pbs.twimg.com/media/ERZlRtLXkAABN2i?format=jpg

China's draconian measures seem to be working. Or they're lying.

New cases really picking up in South Korea, Iran.

there was an infected japanese couple that were on oahu and maui and flew back home. there have been basically no updates about it after the fact and I think they haven't been testing anyone for it here.

Italy has put twelve towns in Lombardy and Veneto on lockdown.

https://www.bbc.co.uk/news/world-europe-51602007

The cases in Lombardy appear to link to a guy who had no record of travel to China and they currently have no idea how he got it.

Bought more masks, bleach, hand-sanitizer, and canned goods today. Enough of the first 3 to give to my elderly parents who aren't paying much attention.

Where are you, Sanpaku?

My wife is dealing with the effects of a fair chunk on the students enrolled for the classes she’s teaching this semester not being able to show up. Along with being made programme director for the masters programmes in her department last semester, it’s ended up being a lot of work.

Despite pleas to the contrary Chinese restaurants appear to be pretty empty, no incoming Chinese and people avoiding them. We had an awesome Hunan garlic feast on Friday in a mostly empty restaurant.

I have travel booked for japan, before and during golden week. I’m wondering if my plans will eventuate or if this will spread.

sanpaku is in new orleans iirc

how exactly will this kill me? dehydration/vomiting? this is my time to shine

Ed: NOLA, a mile from a 75 yr old father. It's not my field, despite reading Laurie Garrett for decades. I've just been following the more public epidemiologists and infectious disease Drs, some on the more alarmed side (@DrEricDing et al), some more reserved (Dr. John Campbell is rather calming), joining in on the beatdowns of conspiracy nuts at r/ChinaFlu. If your planning on redditing this pandemic, the saner sort hang at r/COVID19.

Re: hosing my parents with Purell: Had to buy a wiper blade, was surprised to find a big display of the economy size hand-sanitizer at the entrance (no shortages there), and a misplaced box of N95s in the hardware section (they've been scarce). No intention of hoarding/arbitrage, just wanted some boxes (not cases) for the parents. There's a low probability that we'll see lockdowns in the US, though nothing comparable to Wuhan.

mookiproof: Death (mostly in the elderly and those with comorbidities) mostly comes through suffocation as one's lungs fill with fluid. Like SARS, COV SARS-2 responsible for COVID-19 targets the lung's cilia cells, preventing mucus transport, and then the innate immune system (macrophages etc) damages lung tissues with oxidative bursts. Alveoli fill up with mucus, pus, blood, and at some threshold there's not enough oxygen transport for life. ICUs can handle this (oxygen and ventilators), but in Hubei, critical cases rapidly outnumbered critical beds. I suspect few parts of the world overbuild their critical care infrastructure, and the non-COVID-19 cases still need care...

Seems likely the WHO will declare a pandemic in the near future. A "super-spreader" subset of the infected appear to be contagious for weeks before any symptoms, so containment is no longer the game. China's herculean/draconian efforts bought the world around 6 additional weeks to prepare. Police shoving people into quarantine wards isn't good optics (though a sound practice), and much appears to be pointless busy-work (sterilizing the sidewalks), but the extra time potentially will save millions.

There are some 90 antiviral drug trials taking place, a couple labs have already expressed Covid-19 shell proteins (in bacteria) for potential use as vaccines, its been really impressive watching global infectious disease science drop their current projects (for the duration) and tackling this.

I am watching Chernobyl right now and it just reinforces how little faith I have in the people that ultimately make decisions of communication about these things.

I saw people wearing masks in the airport yesterday and thought they were out of their minds tbh.

I am kind of whatever about the masks but will pick up some n95s when I get home home since they are also useful for other things. It is funny to see white people wearing them in public now though.

I would pick up n95s on sight as they have become rare as hens teeth in Australia (P2s here)

NB this is bushfire related, rather than strictly about focus-19. My wife has asthma and I had to send off to China for 3M particulate masks (the irony).

oh yeah, I have asthma and I was also thinking of fire related things and even tear gas (although I don't think they are that useful for that butI have a better non-disposable gas mask).

at the start of the recent chilean protests I was surprised how poorly prepared a lot of our friends (the non-chilean ones) were. the grocery stores were all shut down or on abbreviated schedules +the curfews and people didn't have enough food in their house for a week. We always have enough for a month and that's mostly because I get anxious if I am somewhere where it takes a long time to get certain things in stock. I didn't even bother trying to find n95s here (hawaii) and probably got some of the last few disposable surgical masks in the market last month.