SF Mayor London Breed Declares Local Emergency Amid Coronavirus Outbreak
The city of San Francisco declared on Tuesday a state of emergency even if at the moment there are no confirmed cases of Covid-19 in the area.
“Although there are still zero confirmed cases in San Francisco residents, the global picture is changing rapidly, and we need to step-up preparedness,” Breed said in a statement. “We see the virus spreading in new parts of the world every day, and we are taking the necessary steps to protect San Franciscans from harm.”
President Trump will hold a news conference on Covid-19 today at 6:00 PM ET.
The global pandemic is spreading: Europe Prepares for Pandemic as Illness Spreads From Italy
New cases of the coronavirus popping up across Europe. Dozens of infections in Iran stoking fears about an uncontrolled spread in the Middle East. Global market jitters continuing after a steep slide. American health authorities warning that it was a matter of when, not if, the epidemic would reach the United States. A toxic political climate in Washington complicating the public health challenge.
For the first time, more new cases were reported outside China than inside, according to the World Health Organization. Chinese officials on Tuesday reported 411 new infections; in the rest of the world, the number was 427. The total number of cases globally has now reached 80,980 and nearly 3,000 have died.
In the European Union, which prides itself on open borders, new cases were recorded in Austria, Croatia, France, Germany, Greece and Spain. Most were tied to Italy, where the authorities have been struggling to contain an outbreak that has infected at least 325 people, most of them in the north near Milan.
Hotels in Austria, France and the Canary Islands of Spain were locked down this week after guests tested positive for the virus or were suspected of having it. The steps to limit contagion differed from place to place, but large group gatherings were often the first things to be canceled where the virus had been detected.
Coronavirus Cases by Country
News Updates
The U.S. CDC yesterday suggested that the risk of a coronavirus pandemic is likely and is alerting the public to begin preparing for community spread in the United States.
Dr. Anne Schuchat, the CDC’s principal deputy director declared: “It’s not a question of if. It’s a question of when and how many people will be infected.”
Chart and updates from Worldometers.
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Mike “Mish” Shedlock
With the US soaring poverty an homeless rate,just need one person to catch the virus, could literally infirm an entire city ,maybe the whole state!
The die is cast, now. Trump and the Republicans made a massive bet that then can contain this, and prevent it from spreading in the US. If it does spread, expect a Democrat in the White House, with a 2/3 majority in both houses for at least a dozen years. I just don’t know why they wouldn’t act like they care, even if they don’t. It makes no sense to make such a huge stake on such a risky bet.
trump can’t even differentiate it from ebola, and has put Whitey Pence in charge of the operation. If this is truly dangerous, we’re boned.
The single case in Romania reported today was in Italy THREE WEEKS ago! Which suggests the virus was present and being shared in Italy the early part of February. Food for thought…
Reuters is saying
“The man had been in direct contact with an Italian citizen who traveled to Romania earlier this month,” Costache told reporters.
So maybe not as originally reported?
Vagaries of the press. Thanks for the update. Adds a further twist!
Welcome. They still didn’t make it clear though, they didn’t say last point of contact with his Italian friend, so it still could have been before the current outbreak. So purposefully vague maybe.
If you want a clear example of that though, translate
This person had no known contact with Chinese or people from Italy. Two weeks ago he developed a fever and went off work, was moved to hospital, ended up with pneumonia, and today tested as infected with sarscov2. Apart from the last two days he had full contact with family, friends, unprotected staff in hospital, his doctor etc. He is recovering, all who were in contact with him were told to continue as normal but to report if they start any symptoms.
You just gave an excellent summary of how an epidemic comes about. Ignorance kills (especially when abetted by a cavalier attitude).
In Spain there are different regional authorities, they have different attitudes (and not as obvious as seems because you can have right wing in charge of a staunch left wing bureaucracy, or viceversa, or various other combinations). That is how in Canary Islands one guest tests positive and the whole hotel with 1000 guests is quarantined for two weeks, whereas in Andalucia as above, family and close contacts were told to carry on their normal day to day.
Media sensationalism at it’s finest. Why don’t they add in the 25% of the population of adults in the USA have non-alcoholic fatty liver disease going up to 33% soon.
Corona Virus is mostly a fecal virus.
White man sanitation good, as stated by Mr. Karl Denninger. Might be racist, but good! 57 cases less 19 from the cruise ship incubator total real cases 38! Nobody has died yet! Percentage of deaths higher than regular flu! Not good! Deaths will drop as we acclimate and develop resistance to it! It is pretty virulent not over the top like the media wants you to believe! However overall death rate much lower than SARS, Zika and Ebola! So far so good in the USA, keep your fingers crossed! Homeless escapements could be another problem, SF, New York, LA, Etc. and other large cities. EDUCATE THESE PEOPLE AND GIVE THEM PORTABLE TOILETS, HAND WASHING STATIONS, GARBAGE BINS, ETC. The might use them since it has become a life and death situation.
Where sanitation is not good the virus is flourishing, that is most of the world unfortunately!
Wash you hands and practice good sanitation!
It is good Trump started moving the supply chain home! we will adapt quickly, you mark my word.
Mish has done an excellent job on covering this viral attack!
Imaginative take when most studies show that it travels via multiple route–spray from sneeze and cough, snot and spit on surfaces, fecal/oral and, in some cases, seems to hang in the air after the infected person has left the area. In fact, the fecal/oral transmission has only recently been seen as a major component.
What do you have tho say about the thousands of medical personnel ill in China? They don’t know about washing their hands?
White man sanitation good? So Italians are not white? They have a few deaths already. As I said before, it’s just easier to reclassify white as “everyone except Italians”
Denninger is a crazy moron.
In a study just published in lancet, the stools and urine contain no viral loads, and Septum samples showed higher viral loads than throat swabs. The viral load peaked at 5-6 days after symptom onset.
Can you provide any study that shows viral loads in stool samples? I would like to compare it to the lancet study.
Edit – NVM, I found it. It was from Feb. 2, and involved a patient with diarrhea. It would seem that occasionally, if a person has diarrhea, it can pass that way, but for others, that is not necessarily true.
No cases in San Francisco, but the first case in the US was discovered just south in Santa Clara, better known as the Silicon Valley.
Plus with the large Asian population in the city, the chances of someone having it already is pretty high.
You’re right. And Mexico…no cases in Mexico? Are they just lucky?
Over the long run, if the virus becomes endemic, quarantines are not viable. Not in China, nor anywhere else.
As has been said a thousand time by now, the idea is to slow the rate of infections to keep the medical demand as low as possible.
If the medical system gets overwhelmed, then less serious cases that can’t be cared for as needed will turn into fatalities.
I wrote in the long run, if the virus becomes endemic. Pay attention for once.
There is no way this could be done every winter, for example.
Very important will be the level of immunity after infection, whether reinfections were severe. I imagine an open kind of quarantine is possible. If tests became cheap, easy and accurate, we might test ourselves for example say every few days, limiting outbreak by not having much transmission. Changes in day to day sanitation at work, reducing contact/presence to minimum, disinfection of goods etc. all added together might limit the spread to acceptable, but still allow all nescessary activity to continue.
Even if it is endemic or recurrent, still is a good idea to limit the chance of infection as much as possible.
There might be a point where the real economic costs became too great – not just markets or inconvenience but where the loss of essential activity of a country leads to greater problems. We should not end up there.
Ive stated this before, China is between a rock and a hard place. Not getting the economy going will itself turn into a disaster and getting the economy going from my 2 cents will result in the whole country’s hospitals being overwhelmed.
Pick your poison. I have seen some statements of its a balancing act to somehow have a controlled pandemic. Using that analogy, its like having 500 lb weights at the very ends and one small misstep results in one weight falling off.
Don’t really know what the CFR Case Fatality Ratio is but it will definitely be higher with an overrun medical system.
Im wondering how other governments react? quarantines, let it runs its course?
And again will summer have any impact on the rate of infection?
If China is under-reporting its numbers and things are far worse than we can imagine, I wonder if China in its present political configuration will survive. You’re right Roadrunner, they are in an unwinnable situation. Hmmm, but every current government is a convenient target. If this thing gets out of control, we might see a lot of changes in a lot of places.
China is absolutely lying about its numbers. I did a screen shot of numbers for Chinese provinces outside of Hubei on 2/20 5:43 am – so in 6 days these are the changes in total cases:
Gunagdong 1332 –> 1347 +15
Henan 1265–>1272 +7
Zheziang 1175–>1205 +30
Hunan 1010–>1017 +7
Anhui 987–>989 +2
Jiangxi 934–>934 +0
Shandong 546–>756 +210 (maybe this is true?)
Jiangsu 631–>631 +0
Chongqing 560–>576 +16
So either China is much better at catching ALL the cases, the contact tracing etc, or people are too afraid to go in to get tested or most likely they are just lying because they know people need to get back to work. If people aren’t working, the society will revolt, government will collapse the CCP will lose their power. It’s a conscious decision.
Based on doubling times they would need to catch more than 99% of the cases. Doubtful to say the least.
I’m a retired high school and community college history teacher and I can’t help but be reminded of the Spanish Flu pandemic. Except this is faster, in that we’re now dealing with intercontinental jet travel rather than steam ship.
History unfolding before us.
As a history teacher, you may know that the Spanish flu happened on top of the devastation of WW1 and various revolutions, economic crises and famines in a time when it wasn’t even known that the flu is a virus.
We don’t have much famine recently globally, certainly there are wars underway, economic crisis is never far off, nor revolutions, but a pandemic might help these happen more. We have a better understanding, but no vaccine and limited ability at care in a pandemic situation, we have transport that spreads the virus fast, the biggest cities ever… so I would not be so sure.
In 1918 they understood germs, even if not viruses, so in general they did act more or less as we would today
FIFY…Despite no KNOWN cases, the Mayor of SF declares an emergency…
Via ZH and why testing isn’t being done maybe.
“Wang explained that although nucleic acid testing is currently the only official test method that Chinese medical staff use to diagnose coronavirus, the result is not accurate.
“Only 30 to 50 percent of the patients present positive,” according to Wang.
He explained that all patients who test positive are infected with the coronavirus, but another 50 to 70 percent of patients are actually infected but cannot be detected by nucleic acid testing.”
Though South Korea announced plans to test thousands.
Another figure from China, forget where, 14% at least are still infected /reinfect after being declared virus free.
Any indication of how many of those who are infected, but who cannot be detected by nucleic acid testing, go on to become critically ill or die?
Complete detection of absolutely all infected may be some ultimate goal. But is pretty unrealistic during a widespread outbreak. Second best is detection of those at risk of getting critically ill, early enough to possibly intervene.
Not in the article, but I expect same as anyone else who has the virus – it is the test, or point of test, that is variable, not the patients, I think.
I thought that also, but then if you are more or less telling people they don’t have the virus, and they do, they may spread it more. It creates a lot of confusion, so not sure – I suppose if the endeavour/meaning was properly understood by people then not such a problem. Actually the insecurity it creates is that we know we cannot track the spread properly, on the other hand not testing is also a false sense that no-one has the virus yet.
Case in point. In Spain about eight new cases in the last day, all via Italy… except for one in Seville, who has been hospitalised with pneumonia for six days already, hasn’t travelled… so now they suspect there might be an undetected outbreak from an unknown source in the city. So far everyone had assumed not because they weren’t doing tests except for those with travel or contact, so no other cases detected.
>so now they suspect there might be an undetected outbreak from an unknown source in the city.
Pretty much what I have been telling you yesterday. The virus is a lot more spread out than the numbers suggest. I suspect it means that the total mortality rate is much lower than the numbers suggest too.
I was just waiting for you to say that…
It is the only way the patterns of spreading make sense. Unless you want to go deep into conspiracy territory.
So far in Europe, except for one case in Spain and one in Italy, all infections I know of are traceable, and there is no heavy hidden background infection found either in any wider tests !!! So I think if there is conspiracy going on you are closer to it than myself !!!!!!!!!!!!! X 100653457
No idea what that number at the end of your post means…
There is a strong selection bias among the traceable cases.
I don’t deny the selection bias. You have one severe case confirmed, as in Italy, and they then trace a hundred other cases from that, in this case across Europe. That will include eighty mild cases from that original infection that would not have been tested. That is understood. However, you also have other outbreaks going on NOW, unregistered. People who flew in from elsewhere with mild cases starting them, or contacts via Italy that were missed. Out of every ten of those, two will be severe enough to be tested, and from that they will then test and find a hundred more cases of mild infection. The bias is towards severe, but the registry of wider mild cases is not far behind, a week or two, shorter if they decide to do mass testing. In short, the main part of the bias is eliminated quite quickly. So I might say now there are five hundred people unregistered with nCov walking around, fifty times those registered, but case statistics will not appear for another couple weeks or a month maybe , and by that time the background infection rate will have been sampled as best as possible and its number will be close to accurate. So I just don’t buy the idea that many are infected and only the severe are picked out, not now because most related mild are traced, and not in the greater sum eventually presented, though at specific cherry picked times it might look like that . This is why the lack of proper data from China is frustrating or wrong also.
Adding in from Worldometer
” UK: 7,132 concluded tests, of which 13 positive (0.2% positivity rate). [source]
Italy: 9,462 tests, of which 470 positive (5.0% positivity rate), awaiting results: unknown. [source]
France: 762 tests, of which 17 positive (2.2% positivity rate), 179 awaiting results. [source]
Austria: 321 tests, of which 2 positive (0.6% positivity rate), awaiting results: unknown. [source] “
Even with just that many tests aimed at related cases, they would likely have picked up if there was also a widespread mild infection going around, so far none, as the symptoms of those in Italy tally with being infected by the original route.
What is a disconcerting possibility however is of a very long incubation, or where the virus never clears after infection, where the level of virus is too low to detect, with seemingly random outbreaks as it activates for whatever reason – this is completely speculative also if that is the way we will discuss. Better is to demand figures and details and then work out what the reality is, because for now we are left with too much guesswork for lack of them.
Btw, the number at the end is the secret code we discussed not long ago, regarding accessing the security registry of a certain country 😉 😉 😉
“….it is the test, or point of test, that is variable, not the patients, I think.”
Nucleic acid testing for a mutating, hence genetically variant, virus is not entirely straight forward. How sensitive the test is, is dependent on how closely the pathogen dna (rna in this case) matches the probe molecule used to bind to it and detect it. For a novel virus, those probe molecules, hence tests based on them, is not unlikely to have been “rushed out” to the clinic based on a less complete picture of the virus in all its variants, than is the case for something like HIV, which has been around “forever.”
IOW, it could be, that differences in detection is not just due to differences between patients, nor how a specific test was administered, nor random; but also due to patients being infected by slightly different viral genomes. And neither is it impossible that different viral genomes, result in different distributions of symptoms and outcomes.
Best answer I found to that is
“Meanwhile, a group at Hong Kong University have developed two one-step quantitative RT reverse transcription PCR tests targeting both the open reading frame 1b (ORF1b) and the N regions of the viral genome based on the first sequence deposited at GenBank; these two test have been validated using two clinical specimens obtained from patients infected with SARS-CoV-2. The tests are explicitly designed to identify multiple viruses in the sarbecovirus subgenus to which SARS-CoV-2 belongs, given a lack of data on the genetic diversity of SARS-CoV-2 in humans and animals. As no other sarbecoviruses are known to be circulating in humans, a positive test can be considered as confirmation that a subject is infected with SARS-CoV-2 or a related animal virus. The N gene assay is recommended as a screening test and the ORF1b test is recommended as a confirmatory test. “
So if this is still procedure then it depends if the N essay possibly misses certain strains for any reason, because ORF1b seems to be more certain.
Rereading the article and
” The lab of Christian Drosten, of the Institute of Virology, Charité University Hospital, Berlin, along with academic collaborators in Europe and Hong Kong, published details of a real-time PCR (RT-PCR) diagnostic test and workflow on 23 January, which detects SARS-CoV-2 and distinguishes it from SARS-CoV. The group verified the test in the absence of SARS-CoV-2 isolates or patient samples but confirmed its specificity against 297 clinical samples from patients with various other respiratory infections. This formed the basis of shipments of 250,000 kits, which the World Health Organization (WHO) dispatched to 159 laboratories across the globe in recent weeks.”
Is more pertinent in fact, and I don’t know how accurate those would be. You would think they would cross check results with the more comprehensive ORF1b tests to see if they were missing certain strains for example, but who knows….and I don’t know what test each country is using either.
Chevron sent its oil and gas traders home from the Canary Wharf, London, office today, as one of its staff had flu-like symptoms after visiting an unspecified country with an outbreak.
Uk Dept of Health advice to employers is not to send employees home while test results are awaited….and not to send employees home if another employee tests positive.
I am wondering what to make of that. It’s almost as if they don’t see the need to control it.
Canary Wharf is a pretty people-dense place. Lots of nice air conditioned buildings for viruses to spread around, lots of sandwich shops, coffee bars and pubs for patient zero to visit. I guess 10 days from now….
In Spain they are saying expressly not to wear masks (based on WHO saying they were useless without further measures?) , no follow up of inbound passengers, no temperature checks at airports. I cannot believe they would dissuade people from wearing masks, herd mentality says that people need the excuse of a recommendation by authority before they start to, otherwise many won’t. Hard to figure out the approach they are taking – shortage of masks for health workers is one reason cited, the rest seems like incompetence and no preparation, probably the idea of putting off tourists affects their presentation also.
Venturing far into supposition, but thinking about this a little more, something is off with all this advice.
In short, it seems like the UK govt has decided not to take a strong stance on this.
The only reasons i can think of for this is that (1) control and quarantine measures have been shown not to work or (2) that there is something important about the virus that we do not know or that (3) governments are incompetent.
1 is clearly nonsense since they have worked in China, 3 is what we like to think, but is unlikely to be true.
In the discussion about pros and cons of quarantine this week, Carl pointed out that he expected that “letting it rip” would result in high death rates because hospital resources would be overrun. I’m just wondering if there is any statistic about progression from mild to severe to critical. If most patients with severe disease do not progress, then maybe the narrative from the NHS talking about patients being treated at home by GPs makes sense, and there will be no overwhelming NHS impact from patients who were never going to die. I know this sounds like nonsense but the Chinese authors of the paper, and commenters on here, have observed that no severe cases have died. On the one hand this is what you’d expect, because if they got worse, they’d be classed as critical, but this is so obvious that i wonder why it was even mentioned. Could it be that there is something that is specific to initial presentation that clearly leads to a worse outcome. For example, it was mentioned that some patients experience GI problems prior to flu symptoms coming on. Is it possible that those patients have worse outcomes? Or something else due to initial presentation.
If i knew i only had to hospitalise 5% of the sick, then that is a very different proposition to 20%. 15000 acute and 300 critical care NHS beds might be enough to deal with that 5%.
From how new information on the working of the virus is being released, I think various authorities are in the dark. They will have good stats that will give them a numbers game to plan with, but they are taking the median approach of business as usual and stepping in if visibly nescessary, they are waiting behind the curve and trying to keep public perception channeled. In short they are not prepared to make moves that will disorder. My view, and I note it in different ways in different countries according to their manner. Noticed UK “leak” of reasonable worse outcome of 80% infected half a million fatalities.
Today Buxton had first school closure in UK, I know Buxton and around well. Here in south western Europe I’m very aware that the virus will be establishing itself now. It is not ground zero obviously, but might end up looking like that. People are more subdued now, there is uncertainty around, one that people don’t know how to place because usually they have an opponent to challenge or blame, but a virus doesn’t react much to what they think. Authorities are getting criticised here as well.
I was out and about in SF yesterday afternoon and I saw plenty of girl scouts out and about selling their cookies. Declaring a State of Emergency without “real” numbers is stupid. Next time, when s*** hits the fan, no one would listen.