The Financial Times reports Coronavirus Cases in China Exceed Sars as Public Anger Rises.
Officially Admitted Stats as Noted by FT
- Admitted Infections: 9,692
- Admitted Death Toll: 213
- Admitted Suspected Cases: 15,238
- Admitted Monitoring: 102,427
The FT reported that broadcaster Tang Zhihong, head of the local centre for disease control, posted a 4-minute clip on the coronavirus that was viewed 35 million times. Tang could not (or would not) answer basic questions.
“Our taxpayers’ money goes to support this group of good-for-nothings,” said a top comment on the video, garnering 100,000 likes.
Ms. Tang was relieved of her duties within hours.
WHO Finally Declares Emergency
Earlier today, the totally incompetent World Health Organization (WHO) finally saw fit to declare this an emergency now that Coronavirus Infection and Death Rates Surpass SARS.
Click on that link for another set of excellent chart from Jim Bianco.
Q&A With Michael Pettis on the Coronavirus Impact
In case you missed it, please consider Q&A With Michael Pettis on the Coronavirus Impact
Coronavirus Facts
Unfortunately, The Fact is, We Don’t Know What the Facts Are
No one in their right mind believes the official stats from China, even as bad as they are.
How Big is the Lie?
China admits a death total of 213.
How big is the lie?https://t.co/BPwjRY73dK— Mike “Mish” Shedlock (@MishGEA) January 31, 2020
Mike “Mish” Shedlock
When it comes to China, there exists some kind of switch in many people that just goes off…. rationality out the drain.
What is the real death rate? Chris Martinson argued that since it takes awhile to die, you should compare the present number of reported deaths with the number of cases about 5 days earlier, since virtually all of the deaths as of today would be among the cases already on record 5 days ago. As of today there are 259 deaths. Five days ago there were about 2700 reported cases, implying a death rate of about 9.5%, which is about the same as SARS. If this pattern continues, worldwide deaths tomorrow should be about 420, and 560 by Sunday night.
…Zhan Qingyuan, head of infectious diseases at the China-Japan Friendship Hospital, said in a press briefing on Friday that people who had already had the virus would have developed antibodies but should remain on alert so they did not get ill again.
“The antibodies may not remain for a long time, so there is still a risk that these recovered patients will be infected again,” Zhan said. “They should continue to keep themselves protected.”…
That is not normal. It means the virus attacks the immune system to the point of affecting immune response. This would similar to some type of autoimmune disease where a virus turns the body on itself.
I admit it is a weird announcement. Might have something to do with 2019-nCoV changing like a cold virus does. Doubt it has anything to do with people being immune compromised. I imagine China is aiming to burn it out completely rather than having multiple versions of it linger for years and years.
It’s expected wrt novel viruses.
Infection of those early patients, occurred while the virus were still almost entirely genetically homogeneous. Hence developed antibodies can reasonably be expected to be more specific than after an infection by a more mature, genetically heterogeneous virus population. IOW, the second time around, the virus genome may have mutated sufficiently to render existing, very narrowly focused, antibodies, less effective than usual.
Due to the virus’ novelty, distinctiveness and rarity, the immune system also don’t get the constant barrage of “booster shots,” by way of sub-clinical contact with similar genomes, that it gets wrt more widespread, common viruses. Which, although I’m not aware of anyone (yet….) having even attempted to quantify how important this is for immune defense function against viruses, presents additional reason for caution.
In general, a novel virus simply indicates heightened carefulness, compared to a better understood, more widespread one. Doesn’t mean this one is some singularly bad monster virus from a bat filled hell. Just that it is still young enough to present more unknowns.
Oh, I forgot.
Air pollution in China is horrible.
Go look at airnow.gov
Then
aqicn.org/map/china
On most day, all of industrialized China (eg Wuhan) is worse than the worst spot in the Continental US that day.
It has been known for decades that particulate air pollution correlates with deaths from respiratory infections. There is extensive research worldwide.
Another reason we can’t assume case fatality rate in China will be similar elsewhere.
In other news, I note we are enforcing a 14 day quarantine of all the Americans who returned from Wuhan, which is the right move and indicates that at least somebody is taking this seriously.
How’s that Yuan reserve currency working?
How’s this silver lining for the US going to work if we have let in countless flights from China and haven’t quarantined a single person and this stuff starts popping up all over the US. And it’s probably in Mexico coming across the border freely as well.
What I don’t get so far is why so much is made of this virus when 1000s of people die of the flu every year? What makes this particular flu so different?
Answer to my own question from data on influenza provided by mrkutaus above: Normal influenza has a mortality rate of approx 0.05%, vs ~2-3% for this one. So this is orders of magnitude more deadly.
Actually, it is not the mortality rate by itself that is a problem. (Yes, it might have a higher mortality rate than flu, but that is unclear now due to limited information available outside of Wuhan.) It is a “novel” virus, which means there is not any herd immunity to this bug, and given its R0 of approximately 2.5 it will spread quickly and exponentially, making many people sick at the same time. In a flu epidemic, much of the population does have some immunity, limiting the spread. Chris Martenson does an excellent job of explaining this in a recent Youtube video where he mentions his frustration with news sources such as CNN misinforming the public about this. Skip to about 6:15 if you want to view just that part of the video:
Because with flu, the incubation period could be hours not days, and this virus has an incubation period of almost two weeks. On top of everything else.
A huge factor is bats and another huge factor is the meat markets in China. MERS is from Saudia Arabia, not Asia. If you look at Figure 3 in the link below, it shows a sort of “genealogy chart” (phylogenetic tree) of a bunch of different coronaviruses (CoV’s)and how they are related. Look at how closely related SARS is to all those bat CoV’s below it. Same thing with the Wuhan CoV. The common denominator is bats. We know from camel antibodies that bats transferred MERS to camels and camels to humans, we just don’t know how exactly. Since bats are hibernating right now, it’s unlikely one was at the market in December to pass the Wuhan CoV on to a human so again, some other mammal was most likely the host.
So what is different about the China bats and China markets? I’ve traveled all over southeast Asia and two southern provinces of China and their meat markets are all just as unsanitary as the next. It doesn’t necessarily seem like a sanitation issue: if the meat is infected, it’s going to pass the virus on in sanitary conditions just as well as it will in unsanitary conditions. Remember mad cow disease? Not a virus but the same idea. That was happening in sanitary European markets.
Since we’re only talking about two rogue CoV’s here, SARS and nCoV, it could just be that there are a lot more variations of CoV in Chinese bat populations to begin with, therefore, a lot higher probability that something affecting humans will arise in China.
That was supposed to post under Casual Observer’s post… “No one has asked the obvious. Why are the 3 main viral outbreaks of the last 2 decades originate from China ? MERS, SARS, and now nCoV all have their roots in China. Is it too much of the poultry not being checked for viruses ? Is it eating things that shouldn’t be eaten or lack of sanitary conditions in wildlife markets ?” …better get another cup of coffee…
Excellent comment. I remember seeing something recently about bats having an immune system that allows them to be carriers of many diseases without becoming sick.
That is also why bats are the main source for Rabies infections. I believer they are the only mammal that can live for more than a month once infected with Rabies.
A couple of points of interest. (Written from USA perspective, as will soon be obvious)
Some years ago, CMMS passed a rule that if a patient got “ventilator associated pneumonia,” the hospital would not be reimbursed for the admission. The rate of this diagnosis immediately dropped to almost zero. Hospitals made committees to review every suspected case and, surprise, the reviews almost always found another “more appropriate” diagnosis. (Epilogue: CMMS was very proud of nearly eradicating the illness.)
That’s in the USA. A host of people acting in their own short-term best interest destroyed a reporting system. Now think about China. It’s not like some powerful Chinese politician knows how many people are dying of coronavirus there. They have no idea, and neither do we. They are reporting the confirmed cases that could not be ignored or hidden.
On the flip side, I think people dramatically underestimate the superior ability of a developed nation with relative information transparency to respond to such things. We all know that this single-party communist system can’t get things right, yet for some reason we believe that, because they are authoritarian, they will be “better at quarantines” than us.
Nothing could be further from the truth. Despite our own leaders often having their heads… in a place the sun doesn’t shine, we have a variety of massive advantages.
A) A powerful fourth estate and (relative, but very strong) media transparency. The number of confirmed cases goes from five to six in this country and literally everyone paying attention knows, in two hours. In China (I blame the government, not the people), news agencies only report what they are told, and people like Mish etc. are imprisoned and/or executed.
B) A free and informed populace is empowered to behave much more sensibly than one in a repressed dictatorship where the facts are hidden as long as they can be. Believe it or not, people mostly comply with quarantines around here. The public widely supports rational emergency measures to contain illnesses. If a doctor thinks you might have active tuberculosis, you try to get out of your containment room. Good luck with that. You will be stopped by democratically empowered security backed by massive public support. If your case made the news, the vast majority of commenters would talk about nothing but how dumb you were. A free security force backed by a free, informed public is far more effective than any authoritarian one.
Unlike the story I told above, if someone finds a case of novel coronavirus in the USA, their self interest is clearly in favor of telling everyone, immediately.
C) An abundance and flexibility of resources. We are much worse at stifling wealth than China, so we have it, and we have robust systems. It would be comparatively very hard to overwhelm this system. Every hospital will make a plan to be prepared in advance. I saw it with Ebola. We prepared incredibly hard for what was ultimately zero cases.
None of this means that nothing bad will happen here. We could still experience exponential growth here. But RO and case fatality are both strongly affected by systems — and our systems are very different.
I don’t know whether or not the doctors giving out this information are behind the eight ball or not. It seems to contradict most information from other sources.
The doctors in this report infer this corona virus is not airborne
Viruses are a fraction of a micron in size, droplets are larger and eventually dry or sink. Not airborne he is talking of is “dry” virus, but droplets transfer much further and longer than he says, e.g.:
Also time on packaging he mentions, I would want to see a study on how long the virus remains viable in say a bit of grease from hand or sneeze in various environments etc. before even guessing.
So rule is to discard any broad statements and rely on pre-existing study until more relevant ones (i.e. scientific detail) are provided.
Another article of interest tentatively concludes that in practical terms surgical masks are as effective as n95 in a hospital setting. You have to read the caveats for that conclusion ( e.g. possibilities of infection outside of setting) . The point is maybe that most infections occur by particle size caught in surgical mask or from other hygiene . N95 and better fit definitely reduce contamination compared to surgical mask, and surgical mask also works to a great degree, but just donning a good mask is not the be all of it, i.e. false sense of security.
From a People’s Pharmacy newsletter yesterday, speaking of ‘normal’ US flu cases, not the new coronavirus:
“I pointed out that as of last week the CDC was estimating that 15 million people in the U.S. had come down with influenza, 140,000 had been hospitalized and 8,200 people had died from the flu.”
Scary, isn’t it, what you could get if you start multiplying those numbers by 10 or 30. While early numbers aren’t reliable, they seem to suggest that coronavirus is 10x more contagious and has 30x more hospitalizations and deaths. Let’s hope that when all is said and done it doesn’t turn out that way.
POSSIBLY BEING ON THE DEATH ROW
I dont fear death but I fear suffering-decaying before dying. As I am more than 60 years old and besides that I suffer from a severe hearth failure (with the typical chronic water retention in the lungs) I am fulfilling the specifications of a majority of people dying from that disease.
My best hope is to try to remain uninfected till hopefully a vaccine (provided the virus dont mutate) will be available. When I observe the speed of transmission in China despites strong measures taken (I dont think over here in Europe they are able to take such strong measures) it is difficult as of now to assess if that will be possible or not . The vaccine will be distributed at best around June-July this year.
No one has asked the obvious. Why are the 3 main viral outbreaks of the last 2 decades originate from China ? MERS, SARS, and now nCoV all have their roots in China. Is it too much of the poultry not being checked for viruses ? Is it eating things that shouldn’t be eaten or lack of sanitary conditions in wildlife markets ? Serious questions need to be asked and changes need to be made by the communist/socialist government of China. Maybe they wanted this to happen at some level to reduce their population. It is literally turning into a grave global risk.
I was thinking the same thing earlier today. India has just as bad of conditions and just as many people yet no significant history of viruses originating there to my knowledge. China on the other hand…
I’m no scientist but I would guess it is the husbandry/consumption of animals.
No sane person would want a pandemic. That is ridiculous. Historically, these things happen in nature all by themselves.
As to why some nasty bugs seem to originate in China, you might as well ask why Ebola starts in parts of Africa or why the world’s most poisonous spiders live in Australia. They are part of the world and that is where they live. True, there are possibly things people could do to limit these outbreaks, but first we need a very good understanding of the life cycles of all the organisms involved.
I am certain China is doing its best in a bad situation. Any thought of blaming them for this is likely misplaced.
Thats an interesting observation. I guess two thoughts come to mind.
I should clarify “their” husbandry and consumption of animals not usually consumed by humans ( not being xenophobic ). And yes Indians are vegetarian and hindu, they treat and view animals completely differently.
I think that if you watch the videos of the meat market, the answer will come to you. If China were to institute some basic sanitation, and mandate proper handling of food, I think it would prevent a lot of problems, and not just reduce pandemic risks.
Another couple of quick speculations.
Maybe India was a source of animal-human transmissible diseases in the past but we’ve become adapted to them.
The other is that south western China borders on the Himalaya’s so potentially they’re still encountering new micro ecosystems whereas most of India has been heavily populated for a long time.
…watched Wuan meatmarket video : bats, rats, snakes, dogs cats, frogs …..DISGUSTING (people) …no wonder viruses develop and thrive under those circumstances…
They are still on the Wuhan market as the vector, and two venomous snakes as having 70% similar DNA. If someone cut themselves and the snake and their bloods mixed, that could introduce coronavirus to human. If you’ve seen photos of people prepping their wild animals at that market, it’s clear safety is nowhere near job one.
China has always been the origination point for most virus infections. People live in close proximity to a variety of animals kept in unsanitary conditions, there is minimal sanitation, handwashing is virtually unpracticed ever, and eating random wild and domestic animals is widespread.
…..All flu viruses probably originate in birds, and the best environment for making the jump to humans is one where densely packed people live closely with birds and animals. Most flu strains start in China. The population of China alone is bigger than that of the whole of Africa, and 80 percent of the new human flu strains the last few decades appeared in China first…..
Viruses mutate like mad everywhere. Inter species jumps are likely primarily constrained by lack of immediate contact between species, rather than lack of possible sustainable virus mutations. Where human intervention drags wild bats, snakes, cats, pigs, ducks etc. into close enough contact to facilitate jumps, the frequency of jumps go up.
It’s for related reasons common reservoirs are in bats and birds: They fly. Hence cover more ground, and get into contact with more different other species. So they end up as conduits for viruses moving between host species. Insanely dense packed, massively heterogeneous meat markets, short circuits and supercharges this exchange like nothing else. Especially when many of the animals are still alive. Which is more common in China than in most places. Chances are humans, who have now also learned to fly far away, have by now also become a reservoir of species jumping viruses. It’s just that bats don’t tend to go on Batbook and freak out about it, whenever some mutated human common cold virus, happens to prove deadly to them. So, like a tree falling in a forest…….
Medcram.com has some good explanations.
Chinese doctors, and other health practitioners, are unusually well primed for picking up this sort of thing, from the background noise of more common flues and other respiratory ailments. They’re the land of SARS, and other outbreaks, after all. A novel virus outbreak, is just closer to the top of the mind of a physician with a seemingly healthy patient suddenly succumbing to a respiratory ailment they cannot treat, in China, than it would be in most other places.
If you look at the Lancet article linked in one of Mish’ previous posts, gene sequences done on 9 patients indicate this outbreak was picked up very early. Almost no genome difference between the sample from each patient, despite corona viruses, (and viruses in general) mutating rapidly. Indicating these 9 are likely to be among the very first hosts for a distinct new virus.
“Distinct” and “New” are pretty scary as far as virus’ go, as it indicates very little immunity. Then combine that with “Deadly.” And, by now, also “Human to Human transmissible…..”
Hence, even though raw numbers may not yet warrant this sort of a reaction, the sheer uncertainty of such an outbreak is what is driving it.
Stuki, just to confirm, you believe its probable all these wheels have been put into motion ( 25+ cities, 56 million people under martial law/quarantine, air travel restrictions, neighboring countries sealing their borders and global health emergency declaration from the WHO ) because of 200 people dying of a “new” flu virus? during flu season? Over a 2 week time frame? In a nation of 1 billion people!
Why would 56 million people in 25+ cities stay holed up in their apartments during a national holiday? something has scared the s@#t out of them.
The death rate has to be extraordinary to get this kind of reaction.
That’s a lot more believable than the same cities and countries covering up stockpiles of dead bodies, in some sort of weird conspiracy to make the death toll appear smaller than it is.
Once you have identified a virus that is new, sufficiently distinct to presumably face little existing immunity, deadly, human to human transmissible and not with overwhelming certainty contained (in say, a “secure” lab), you don’t need neither more infections, nor more deaths, for this to be a very big concern.
The fact that they got to that point so early in the outbreak, and were able to/willing to take such “extreme” measures so quickly, is a testament more to the Chinese medical community being unusually sensitive to, concerned about, and on the lookout for, novel virus outbreaks. And the Chinese state apparatus being able to respond like that, on a comparative whim. Pretty much anywhere else it, as you infer, would have taken a lot more concentrated, otherwise unexplainable carnage, before a novel virus outbreak was seriously considered as the source.
2 things are clear.
You have a tremendous amount of confidence in China and their medical system.
This virus is going to run like wildfire throughout the world and soon we will know the mortality rate and if it’s natural or engineered.
Au Contraire. I have somewhere between precious little and none at all confidence in any system. Any possible system. For very good reasons, too (being literate and not flat out stupid, for one….).
I have, though, been around enough doctors to recognize that the first thing which come to most’s mind, almost anywhere, when a patient comes in with a respiratory ailment that gets worse rather than better no matter what, is not a novel virus outbreak. If it happened in Australia about now, I can pretty much guarantee it would take plenty longer to look past every possible conceivable reactions to wildfire smoke exposure. In Colorado, they’d suspect vaping. Then unsanitary vaping. Then……
Almost everywhere outside China, there would be a phase when the first few primary care physicians who were presented with such patients, would chase down darned near any other possible hypothesis, before starting to wonder if they could perhaps be at the front lines of a novel virus outbreak. As novel virus outbreaks simply don’t happen. And only “kooks” believe Ebola suddenly showed up, out of the blue, at their particular doorstep.
Of course, as reports get written, filed and communicated, word gets around, and enough cases and circumstantial evidence piles up, eventually a virus outbreak would be tested for. But it’s not on the average GP’s immediate list things to test for, pretty much anywhere else.
On account of SARS and the scare that caused, plus perhaps a history of being the world’s preeminent virus incubator in general, it looks like China does differ in that respect. Which happens to increase the likelihood of early detection, on those once-in-a-blue-moon occasions when an actual, honest-to-goodness novel virus outbreak really is the cause of patients’ hard to pin down symptoms.
“Systems,” nor confidence in them, has exactly nothing to do with it at all.
Personal foul: Inappropriate, overuse, of, commas.
No evidence that Chinese physicians are either well trained, well paid, or well supplied with data on outbreaks. The CCP will deny and disguise any human or natural disaster until the news breaks outside of the mainland. Then they will overreact with repression, surveillance, and stigmatization. This totalitarian quarantine will not last. People must leave their dwelling for both sustenance and their sanities after a few days. Much better to ask people to cooperate and follow common sense guidelines in regards to infecting others. Also Chinese residents with the virus are being stigmatized (also a CCP specialty) which creates more incentive for hiding sickness. Democracies work better.
I agree 100% this “official” death rate must be BS. 200 people dying of the flu over 2 weeks during flu season in a nation of 1 billion wouldn’t even register on anyones radar. 200 people an hour probably die of heart attack every day of the year there. I heard in a movie once it takes 12 days for 1 million seconds to tick by and 32 years for 1 billion, so 200 people dying over a 2 week period of almost anything wouldn’t even be noticed. There has to be much more going on than the “flu” or the death rate must be far greater than their admitting.
The last four days the number infected have gone up 62%, 36%, 28%, and 25%. Does that indicate that the rate of increase in infections is slowing due to quarantines and other precautions? Or that reporting can’t keep up? Or something else? Let’s hope it is the former, and that it continues to slow.
The declining percentage increase is more likely due to a physical constraint on how quickly China’s doctors and nurses can process new cases as more people are infected. Reports have indicated the hospitals are working at full capacity (and by implication cannot work much more quickly). Looking at the recent historical chart of cases, new cases are still increasing more rapidly than a linear rate despite this physical limitation.
It is no doubt true that many people don’t even try to get treated, if they aren’t so severely hit by the coronavirus that they require hospitalization. We can be confident that the number of cases is much higher than reported, but also that the death rate is lower (since all deaths would be reported, but divided by a too-low number of infections).
I would add that there are no deaths yet outside of China, and there are 8 recorded recoveries outside of China. Thus, the recovery to death ratio is much, much better outside of China.
I do not disagree. Regarding deaths, I imagine treating this bug successfully becomes much more difficult once the number of cases completely swamps your medical system.
I think that is where most of the fear comes from. Even if this thing turns out to have high survivability in a hospital setting, not being able to be even seen by a doctor poses real problems.
Most of the deaths from this will be preventable but access to care may be non existent.
Maybe, but to be closer to that statement you need a larger sample. Even 4% mortality means roughly one fatality in twenty five patients. I think mortality is lower, maybe 1 or 2 %, which is still high enough to be concerned about. I think number of fatalities is completely under reported. I think the nature of this virus, how it behaves and the possibility of it becoming more lethal, are something to be very wary of.
Apparently immunity to flu type viruses is not long lasting, in that changes in a virus render previous immunity innefective. We have tens of thousands of people infected with the possibility of new virus emerging from that pool, and because this virus has a trait that causes high mortality it is not certain if the strength of that trait might increase also (i.e. it might become more effective somehow) .
So I am very cautious on downplaying the outbreak in any way, just hoping that it ends up being milder and eventually wiped out. This virus will be around for years or more now probably.
I totally agree that more data will be required before we really know how serious this is going to be, and that the data from outside of China will be helpful. Within 2 weeks, we will have a much better idea of how fast it will spread worldwide, and also of the percentages that require hospitalization, as well as the fatality rate.
As a minor note, some countries like Australia are in the Southern Hemisphere, and it is mid summer there, not the normal flu season. Other countries such as Thailand and Malaysia are close to the equator, and I have no idea what the normal flu season would be there, but I would the that UV would peak there is March and September.
Be interesting to see if it affects certain populations more than others, you know, race being a social construct and all
There may be a limit on manufacturing test kits. The existence of such a limit was reported by a Wuhan resident on twitter.