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  • SARS-CoV2/COVID-19 Update 29 Feb 2020

    Posted by Trent Telenko on February 29th, 2020 (All posts by )

    The themes of this update will be on issues of

    – COVID-19 spread,
    – World Headlines,
    – US Good News,
    – US Mixed News,
    – A sample of US Relevant Coronavirus Stories,
    – Medical Information of the Day,
    – The SARS-CoV2 Virus and it’s COVID-19 infection ARE NOT THE FLU
    – The On-Going Just-in-time, Sole Source in China Supply -Chain Crisis, and
    – The social media and videos COVID-19 tracking source section.

    Top line, There are currently 85,996 confirmed COVID-19 cases worldwide, including 2,942 fatalities as of the 29 February 2020 at 2:46 p.m. ET time hack on the BNO News corona virus tracking site (https://bnonews.com/index.p…/…/the-latest-coronavirus-cases/) There are 59 and growing nations including China plus three “Chinese special administrative regions” (Macao, Hong Kong and Taiwan) that have reported COVID-19 infections. China, Taiwan, Hong Kong, Japan, Thailand, Singapore, Italy, Iran, Germany and R.O.K. all appear to have local, or endemic, spread of the disease.

    The US may currently have endemic spread as the CDC has confirmed 62 cases of coronavirus in the US (and there late breaking news of a COVID-19 death in Washington State and the slimming of a senior care facility in Kirkland). These include 44 people who were aboard the Diamond Princess cruise ship, three people repatriated from China and 15 US cases.

    Spread inside the US cases include:
    California: 9
    Massachusetts: 1
    Washington state: 1
    Arizona : 1
    Illinois: 2
    Wisconsin: 1

    World Headline Summary:

    o Health authorities in Texas and Oregon report 12 new coronavirus cases in US
    o US coronavirus case total hits 63, 2nd case ‘of unknown origin’ confirmed
    o US issues travel advisory for Italy
    o Italy says first case discovered in Lazio
    o China, SK release nightly figures
    o Google says employee who visited Zurich office has coronavirus
    o France confirms 57 cases
    o Italy reports 3 deaths in Lombardy; nat’l toll now 21; total cases 821
    o Google employee tests positive for coronavirus after visiting Zurich office
    o British man becomes 6th ‘Diamond Princess’ passenger to die
    o Two Japanese dogs tested positive for coronavirus
    o Mulvaney says school closures, transit disruptions may happen in US
    o Dr. Tedros said Friday that there’s no evidence of ‘community outbreak’
    o Mexico confirms 1st virus case [More below]
    o Fauci warns virus could take ‘two years’ to develop
    o Kudlow says “no higher priority” than the “health of the American people
    o Toronto confirms another case
    o WHO says 20 vaccines in development
    o St. Louis Fed’s Bullard pours cold water on market hopes
    o Netherlands confirms 2 more
    o United cuts flights to Japan
    o Advisor to CDC says shortage of tests in US creating a “bottleneck”
    o Nigeria confirms first case in sub-saharan africa
    o South Korea reports more than 1,000 new cases in under 48 hours
    o Italy cases surpass 700
    o WHO says virus will ‘soon be in all countries’

    Good News — The Trump Administration is beginning to accept COVID-19 Reality. See:

    Exclusive: U.S. postpones summit with ASEAN leaders amid coronavirus fears – sources

    U.S. President Donald Trump had invited leaders of the 10-member Association of Southeast Asian Nations (ASEAN) to meet in Las Vegas after he did not attend a summit with the group in Bangkok in November.

    “As the international community works together to defeat the novel coronavirus, the United States, in consultation with ASEAN partners, has made the difficult decision to postpone the ASEAN leaders meeting,” one of the sources, a senior administration official, told Reuters.

    The official added that the United States values its relationships with ASEAN member nations and looks forward to future meetings.

    https://www.reuters.com/…/exclusive-u-s-postpones-summit-wi…

    Mixed News — Despite the Trump Administration taking huge steps in preparedness, they are both inadequate in scale and being mis-represented as to criticality.

    Exhibit A of “inadequate” from Former FDA director Scott Gottlieb

    Scott Gottlieb, MD@ScottGottliebMD
    Tonight administration announced they are allowing high complexity U.S. labs to advance their own tests for #Coronavirus. Coupled with public health labs, which will be at full tilt by Friday using revised CDC test, capacity could reach 10,000+++ tests a day in next two weeks.
    2,147 9:44 PM – Feb 28, 2020

    And courtesy of the NYT’s virus live feed:

    “The U.S. Food and Drug Administration announced Saturday that it was authorizing American laboratories to develop their own coronavirus tests, which should significantly increase the country’s testing capacity.

    The effect could be rapid. About 80 labs and private companies have applied for emergency approval for tests they have already created. If they have submitted evidence that the tests work, the labs and companies will be able to use them immediately, rather than wait for the F.D.A. to complete reviews and issue approvals.

    “This action today reflects our public health commitment to addressing critical public health needs and rapidly responding and adapting to this dynamic and evolving situation,” the F.D.A.’s commissioner, Stephen M. Hahn, said in a statement.

    Experts have been frustrated with the limited availability of coronavirus tests in the U.S., which until now could only be provided by the Centers for Disease Control and Prevention. Broader testing will enable more rapid detection and isolation of people who have the coronavirus to help contain the spread of disease.”

    Trent Observation & Comment: We needed this level of testing (10K a day), which we will get in 2-weeks, about six weeks ago (Mid-January 2020). We will need 100,000 tests a day in about 2-weeks based upon exponential growth. Still, a 2.8 orders of magnitude improvement** is important as we are improving from a base of less than 500 COVID-19 tests in a six weeks.  [ ** Assuming about 35 COVID-19 tests a day multiplied by ~285 to get roughly 10K a day.]

    Exhibit B From the CDC:

    CDC has a new category of COVID-19 tracking:

    A presumptive positive case has tested positive by a public health laboratory and is pending confirmatory testing at CDC.”

    The above is due to CDC’s self-inflicted test kit shortages.

    See:
    https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

    Trent’s Dead Serious Comment — Based on it’s 2014 performance with the Ebola outbreak at Dallas’ Texas Health Presbyterian, the CDC’s silence on the on-going collapse of the current non-vaccination based American public health standards on Tuberculosis and the on-going COVID-19 testing debacle. I’d have to say the CDC is a on-going, multi-decade long, Federal government conspiracy against the public interest.

    Put this thought in the back of your head for later and if you have time, see my 2014 “Collapse of American TB Public Health” column on Chicagoboyz here: https://chicagoboyz.net/archives/44047.html

    Exhibit C of “Inadequate” from the FDA:

    >sigh<

    This is a classic Fed bad news press release that passes information with a anodyne summary to placate the “Normies,” while the heart attack for the experts is buried behind a page or two long wall of text.

    See:
    Coronavirus (COVID-19) Supply Chain Update
    For Immediate Release:
    February 27, 2020
    Statement From:
    Commissioner of Food and Drugs – Food and Drug Administration
    Stephen M. Hahn M.D.
    https://www.fda.gov/…/coronavirus-covid-19-supply-chain-upd…

    Anodyne statement: The FDA has recognized there is a China supply chain problem for drugs, “nothing critical” impacted.

    See text passage:

    “Also, as part of our efforts, the FDA has identified about 20 other drugs, which solely source their active pharmaceutical ingredients or finished drug products from China. We have been in contact with those firms to assess whether they face any drug shortage risks due to the outbreak. None of these firms have reported any shortage to date. Also, these drugs are considered non-critical drugs.”

    Heart attack: But we are officially telling you to ignore drug expiration dates until further notice.

    See this text passage:

    “Additional Resources
    The FDA is using all our existing authorities to address COVID-19, and we welcome the opportunity to work with Congress to further strengthen our response capabilities and emergency preparedness. There are four specific proposals included in the President’s budget that would better equip the FDA to prevent or mitigate medical product shortages.

    1 Lengthen Expiration Dates to Mitigate Critical Human Drug Shortages: Shortages of certain critical drugs can be exacerbated when drugs must be discarded because they exceed a labeled shelf-life due to unnecessarily short expiration dates. By expanding the FDA’s authority to require, when likely to help prevent or mitigate a shortage, that an applicant evaluate, submit studies to the FDA, and label a product with the longest possible expiration date that the FDA agrees is scientifically justified, there could be more supply available to alleviate the drug shortage or the severity of a shortage.”
    >snip<

    This is a sample of US Relevant Coronavirus Stories

    1. Wife of US soldier who has coronavirus in South Korea also infected, military says

    By KIM GAMEL | STARS AND STRIPES Published: February 28, 2020

    SEOUL, South Korea — The wife of an American soldier who tested positive for the new coronavirus also has been infected, the military said

    Saturday as the total number of confirmed cases in South Korea neared 3,000.

    The soldier was the first U.S. service member to contract the pneumonia-like illness, which has spread rapidly since first appearing in China late last year.

    His wife has been in self-quarantine since Wednesday, when her husband tested positive, according to U.S. Forces Korea.

    “She is currently being transported to a U.S. military hospital where she’ll be in isolation under direct medical care and supervision from U.S. military medical providers,” USFK said in a press release.”

    https://www.stripes.com/…/wife-of-us-soldier-who-has-corona…

    2. Mexico confirms first 2 coronavirus cases, health official says
    2/29/2020
    https://www.foxnews.com/…/mexico-confirms-first-coronavirus…

    “Mexican health officials announced the country’s first two confirmed cases of the novel coronavirus on Friday, saying the patients are from Mexico City and the northern state of Sinaloa.

    Mexico’s assistant health secretary, Hugo Lopez-Gatell, said a second test is still pending for the Sinaloa case, adding that doctors are “treating this as confirmed,” according to The Associated Press.”

    3. Exclusive: U.S. weighs restrictions at border with Mexico over coronavirus threat
    FEBRUARY 29, 2020 / 12:24 PM / UPDATED 11 MINUTES AGO
    https://www.reuters.com/…/exclusive-u-s-weighs-restrictions…

    4. TEXAS – evacuee cases

    SAN ANTONIO – The number of evacuees infected with the novel coronavirus climbed to 11 on Friday, per the U.S. Centers for Disease Control and Prevention.

    The CDC reports those infected with the coronavirus include nine from the Diamond Princess cruise ship, one from the Wuhan group of quarantined passengers and one that was transferred from the Marine Corps Air Station Miramar in San Diego, Calif.

    San Antonio city officials maintain that the risk of the virus spreading to the general public is still low.

    A total of 145 people remain under quarantine orders in San Antonio after two planes — one from Wuhan and one from Tokyo — arrived at Joint Base San Antonio Lackland.

    https://www.click2houston.com/…/11-cases-of-coronavirus-c…/…

    5. Run, Hide and Hoard is breaking out in Hawaii:

    Hoarding in the USA? Coronavirus sparks consumer concerns
    FEBRUARY 28, 2020 / 3:38 PM / UPDATED 16 HOURS AGO
    Brad Brooks, Andrew Hay
    https://www.reuters.com/…/us-china-health-usa-hoarding-idUS…

    6. Coronavirus now in Oregon
    Updated 6:43 PM; Today 5:26 PM
    By Fedor Zarkhin | The Oregonian/OregonLive

    Selected abridged statements from the article:

    A Washington County teacher is sick with the first presumptive case of the new coronavirus in the state, Oregon health officials said Friday.

    The person tested positive for coronavirus. The case needs to be confirmed by federal health officials. The patient is isolated at Kaiser Permanent Westside Medical Center. It is a case of community-spread disease. The person is a teacher at a Clackamas County school and may have exposed people there, health officials said, and had contact with people in Forest Hills Elementary School at Lake Oswego.

    The state would not disclose their age, sex or specific condition.

    Now, the school district is shutting down the school where the teacher works so that health officials can do their investigation and talk to employees and let families known their children could have been exposed.

    https://www.oregonlive.com/…/coronavirus-appears-in-oregon.…

     

    Medical Information of the Day:

    First, in the study referenced below, there was a 35% infection rate for those exposed to someone who had the COVID-19 infection. Put in real terms, 9 people caused 48 infections. So in these cases (see photo) the R0 was 5.3. That is one person infected five(+) people or three people will infect 16 more.

    Secondary attack rate and superspreading events for SARS-CoV-2
    Yang Liu
    Rosalind M Eggo
    Adam J Kucharski
    Published:February 27, 2020
    https://www.thelancet.com/…/PIIS0140-6736(20)30462…/fulltext
    https://www.thelancet.com/action/showPdf…

    “If transmission is stratified by contacts within and outside of the household, the relationship between R0 and household risk is: R0=SARHNH+ SARCNC, where SARH and SARC are the secondary attack rates within household and wider community (ie, outside household), respectively, and NH and NC are the numbers of at-risk contacts made, respectively.3 An infection with a high household SAR but a modest R0 would therefore suggest transmission is driven by a relatively small number of high-risk contacts. A large household SAR further suggests that between-household transmission risk is lower; otherwise the observed R0 would be larger.

    More data are needed to reliably estimate the true within-household and between-household transmission for SARS-CoV-2; recent reports might be biased towards larger transmission events. However, if it transpires that most at-risk contacts have a close relationship with cases, and superspreading events tend to occur at large gatherings of these close contacts, measures to reduce infection risk during such gatherings and subsequent tracing of close contacts of cases might have a disproportionate effect on reducing overall transmission.

    We declare no competing interests.”

    Trent’s comment: Practical implication — This might mean families have to eat individually and apart?

    Second, more on the COVID-19 reinfection phenomenon. Maybe it’s real?

    CIDRAP – Some COVID-19 patients test positive days after recovery
    Today, 05:48 PM
    http://www.cidrap.umn.edu/…/some-covid-19-patients-test-pos…

    Or maybe there is good news regards “re-infection” of the recently cleared. It is increasingly look like the “re-infected” are actually people whose tests were false negatives that lead to their release.

    See:

    Breadth of concomitant immune responses underpinning viral clearance and patient recovery in a non-severe case of COVID-19
    Irani Thevarajan, Thi HO Nguyen, Marios Koutsakos, Julian Druce, Leon Caly, Carolien E van de Sandt, Xiaoxiao Jia, Suellen Nicholson, Mike Catton,

    Benjamin Cowie, View ORCID ProfileSteven Tong, Sharon Lewin, View ORCID ProfileKatherine Kedzierska
    doi: https://doi.org/10.1101/2020.02.20.20025841
    https://www.medrxiv.org/conte…/10.1101/2020.02.20.20025841v1

    Abstract
    We report the kinetics of the immune response in relation to clinical and virological features of a patient with mild-to-moderate coronavirus disease-19 (COVID-19) requiring hospitalisation. Increased antibody-secreting cells, follicular T-helper cells, activated CD4+ and CD8+ T-cells and IgM/IgG SARS-CoV-2-binding antibodies were detected in blood, prior to symptomatic recovery. These immunological changes persisted for at least 7 days following full resolution of symptoms, indicating substantial anti-viral immunity in this non-severe COVID-19.

    This Twitter thread below is an analysis of the above medical paper:

    Florian Krammer@florian_krammer
    https://threadreaderapp.com/thread/1233338746789036032.html

    “THREAD/1: We saw now several reports of reinfection and I wanted to talk a little about that. While immunity induced by SARS-CoV-1, MERS-CoV and human CoVs is not very long lived, an immune response is typically induced and antibodies persist for 1-3 years.

    2) Now, there is evidence that people with COVID19 mount an immune response (e.g. medrxiv.org/content/10.110…). That makes re-infection, especially short-term extremely unlikely. What is more likely is, that the patient is still shedding virus but some of the tests were negative.

    3) Follow up tests can turn positive after a few negative tests, e.g. because sampling was better. Also, and this is a very important point, just because somebody still tests positive in a nucleic acid based test, does not mean they are still shedding infectious virus.

    4) E.g. Measles RNA can be detected for months in patients, long after infectious virus shedding has stopped. This is also the case for other viruses. And I think this is the most likely scenario here. “

    Trent’s comment: I sure hope it’s just isolated incorrect diagnosis as regards someone being over an infection, as opposed to we have no immunity after the infection is defeated.  Mark this for your “Watch This Development Closely” files.

    And finally for this section, this is a “Medical Information Story” that is noteworthy more for -where- this message is coming from that it’s content —

    Preparing for Coronavirus to Strike the U.S.
    Getting ready for the possibility of major disruptions is not only smart; it’s also our civic duty
    By Zeynep Tufekci on February 27, 2020

    https://blogs.scientificamerican.com/…/preparing-for-coron…/

    Trent Comment: “Preping” for “The End of the World as You Know It” is now “Kool” for the medical establishment media. If you have not bought at a minimum a couple of weeks worth of food, and anti-viral cleaning supplies, yesterday was a good time to do so.

     

    The SARS-CoV2 Virus and it’s COVID-19 infection ARE NOT THE FLU

    The following are extracts of information from the report from the WHO visit to China. This was good to know for perspective on what SARS-CoV2 Virus/COVID-19 infection do to large numbers of people.

    Based on all 72,314 cases of COVID-19 confirmed, suspected, and asymptomatic cases in China as of February 11, a paper by the Chinese CCDC released on February 17 and published in the Chinese Journal of Epidemiology has found that:

    – 80.9% of infections are mild (with flu-like symptoms) and can recover at home.
    – 13.8% are severe, developing severe diseases including pneumonia and shortness of breath.
    – 4 .7% as critical and can include: respiratory failure, septic shock, and multi-organ failure.
    – In about 2% of reported cases the virus is fatal.

    Risk of death increases the older you are.

    Relatively few cases are seen among children.

    Age of Coronavirus Deaths
    Based on all 72,314 cases of COVID-19 confirmed, suspected, and asymptomatic cases in China as of February 11, a paper by the Chinese CCDC released on February 17 and published in the Chinese Journal of Epidemiology [1] has found that the risk of death increases the older you are, as follows:

    COVID-19 Fatality Rate by AGE:

    *Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). This probability differs depending on the age group. The percentage shown below does NOT represent in any way the share of deaths by age group. Rather, it represents, for a person in a given age group, the risk of dying if infected with COVID-19.

    AGE
    DEATH RATE*
    80+ years old –
    14.8%

    70-79 years old
    8.0%

    60-69 years old
    3.6%

    50-59 years old
    1.3%

    40-49 years old
    0.4%

    30-39 years old
    0.2%

    20-29 years old
    0.2%

    10-19 years old
    0.2%

    0-9 years old
    no fatalities

    *Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%).
    In general, relatively few cases are seen among children.

    Outcome of Pre-existing Medical Conditions (comorbidities)

    Patients who reported no pre-existing (”comorbid”) medical conditions had a case fatality rate of 0.9%. Pre-existing illnesses that put patients at higher risk of dying from a COVID-19 infection are:

    COVID-19 Fatality Rate by COMORBIDITY:

    *Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). This probability differs depending on pre-existing condition. The percentage shown below does NOT represent in any way the share of deaths by pre-existing condition. Rather, it represents, for a patient with a given pre-existing condition, the risk of dying if infected by COVID-19.

    PRE-EXISTING CONDITION DEATH RATE*
    Cardiovascular disease
    10.5%

    Diabetes
    7.3%

    Chronic respiratory disease
    6.3%

    Hypertension
    6.0%

    Cancer
    5.6%

    no pre-existing conditions
    0.9%

    *Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%).

    The following video addresses the WHO report presenting the data above:

    MedCram lecture, Feb 28
    Dr. Roger Sehault

    Coronavirus Epidemic Update 28: Practical Prevention Strategies, Patient Age vs. Case Fatality Rate
    https://www.youtube.com/watch?v=quDYb_x54DM

     

    The On-Going Just-in-time, Sole Source in China Supply Chain Crisis

    Made-in-China Fertilizer Becomes Scarce for Top Buyer
    By Pratik Parija and Debjit Chakraborty
    February 24, 2020, 12:11 AM EST
    https://www.bloomberg.com/…/made-in-china-fertilizer-become…

    Current, updated daily info on China info about their activity. Traffic, coal consumption, containers, etc.
    Very useful.
    https://www.capitaleconomics.com/the-economic-effects-of-t…/

    Very Useful Twitter thread on China’s finances:

    Dos Equis Virus Balding 大老板@BaldingsWorld
    Real question is how long China can hold out with basically skeleton level activity. We are now at 5 weeks since any real activity and there is no sign of return to normal on the horizon. The question then becomes when will things return to normal and what is the fall out? 1/n

    https://threadreaderapp.com/thread/1233581343054843904.html

    ============
    Recommended COVID-19 Daily Search Links

    Worldometers’ COVID-19 CORONAVIRUS OUTBREAK Page
    https://www.worldometers.info/coronavirus/

    Coronavirus COVID-19 Global Cases Map by Johns Hopkins CSSE
    http://coronavirus-realtime.com/

    BNO News
    Tracking coronavirus: Map, data and timeline
    https://bnonews.com/index.p…/…/the-latest-coronavirus-cases/

    Nucleus Wealth Corona Virus Update Page
    https://nucleuswealth.com/…/updated-coronavirus-statistics…/

    Twitter:

    Scott Gottlieb MD
    https://twitter.com/ScottGottliebMD

    Dr Eric Ding
    https://twitter.com/DrEricDing

    Steve Lookner
    News Anchor & Founder of @AgendaFreeTV
    Specialize in breaking news. Daily COVID-19 live streams
    https://twitter.com/lookner

    Live updates from the team behind BNO News. Currently covering coronavirus.
    https://twitter.com/BNODesk

    You Tube Video channels with COVID-19 Updates

    Dr. John Campbell
    UK Doctor w/personal connections to Iran
    https://www.youtube.com/user/Campbellteaching/videos

    Agenda-Free TV
    https://www.youtube.com/cha…/UCshCsg1YVKli8yBai-wa78w/videos

    Dr. Seheult’s COVID-19 Update videos at MedCram.com
    https://www.youtube.com/user/MEDCRAMvideos

    Dr. Chris Martenson COVID-19 updates
    [For Peak Prosperity Prepper site]
    https://www.youtube.com/user/ChrisMartensondotcom/videos

    -End-

     

    44 Responses to “SARS-CoV2/COVID-19 Update 29 Feb 2020”

    1. Trent Telenko Says:

      So it begins — The long-term care facility in Kirkland Washington linked to COVID-19 has 108 residents and 180 staff members. So far, 27 residents have symptoms as do 25 staff members, according to Washington officials.

    2. Gavin Longmuir Says:

      In other news, about 530 US citizens died today from ordinary flu/pneumonia.

    3. Dan from Madison Says:

      While I am keeping an interested side eye on the situation, I am beginning to come over to Gavin’s side on this ongoing debate on these pages. I am also convinced that supply chain will be by far a bigger issue with covid-19 than direct deaths from the virus itself. The media fanning the flames of panic won’t help.

    4. Brian Says:

      Since we now have proof that the virus has spread to the general population in many areas globally for at least a few weeks (in order to see deaths start), we’ll know who is “right” by April 1 (though there are multiple points of issue–to me the “how deadly is the disease” question is actually far, far less important than the “how do you react in highly uncertain circumstances” one). We have to hope that the ~15% number of “severe cases” is not correct, because the medical system cannot possibly cope with those sorts of numbers.

    5. Dan from Madison Says:

      I would say that is fair, Brian and like the flu I think the thing has basically spread out already. When everyone can get outside and open windows in a month or two (at least in the northern climes) I also believe symptoms and deaths will slow, exactly like the flu – from what I am reading, the virus act flu-like. Also, the US is not China or Iran. We typically don’t live in filth and have a pretty advanced medical system for all of its warts, so I don’t expect the death rate to exceed the flu. The bigger problem will be reporting of the deaths, and the media intentionally stirring up panic to sell ads and clicks which is inevitable.

    6. Christopher B Says:

      – 80.9% of infections are mild (with flu-like symptoms) and can recover at home.

      I get that it’s *not the flu* but it sure doesn’t look like Black Death, either, especially since we’re talking about data from a country with obvious problems providing health care. Maybe there’s a middle ground here, somewhere?

      I also lean towards Gavin’s assessment with the stipulation that the biggest problem will be virtually everyone coming in contact with the disease will exhibit symptoms at least due to lack of immunity.

    7. Tom Holsinger Says:

      Here’s a link to the Washington state breakout story, with confirmation of Trent’s figures on many of the patients and staff are suspected to have CoVid-19:

      https://www.seattletimes.com/seattle-news/health/coronavirus-death-seattle-washington-state/

    8. Brian Says:

      “80.9% of infections are mild (with flu-like symptoms) and can recover at home.”

      That number is good (sort of) for the average individual, but really really bad for society. Estimates have said that 70-80% of people could be infected, and that seems to match what is seen at the Korean church. One fifth of that is that roughly 15% number. 15% of the US population is like 45 million people. Care to guess how many hospital beds there are in the US? Like 500k. How many ICU beds? Like 95k. (Go ahead and try to get the number of extreme sick down by claiming whatever special attributes about us you like, but you have to get it down not by a factor of 2 or even 10, but by 200 in order to not crush the medical system.)

      That’s why quarantine/lockdown responses are necessary, because even these “don’t worry, it’s just the flu” numbers mean total catastrophe for the medical system. What we have to do is prevent the virus from getting to that high level of penetration of the population.

    9. Brian Says:

      Please read this thread if you’re in the “just the flu” camp:
      https://twitter.com/ChristoPhraser/status/1233738443756384259
      Discussions emphasising ‘COVID19 is more serious than flu’ will probably become moot in the coming days and weeks, and for many people already have, but in case you are engaged in them, I would consider trying to get accurate numbers for flu, and to make some general points. 1/n

      First off, flu mortality is sufficiently low that it is hard to measure, and requires a degree of modelling just to get at. That in itself tells you something. 2/n

      Second, the vast majority of flu cases are not reported or diagnosed, so data are pieced together from various surveillance systems and studies. 3/n

      etc.

    10. MCS Says:

      At this point, the number of test that can be made is irrelevant since there isn’t any sort of specific treatment. It may even be counterproductive. From here on out, it will be vitally important to keep as many people out of and away from hospitals as possible. The last thing we need is for anyone that sneezes to go to the ER to get tested.

      I thought that there might be a small chance that this could be contained. An accurate and widely deployed test would have helped then. Now, all a test will be good for is to collect statistics. If the WHO test had a false negative as high as has been said, it probably contributed to the spread rather than helping to contain it.

      If I was a high up in the CDC, I would probably be getting my C.V. in order. I’m sure they think they have Trump dazzled with double talk. I expect changes.

      Should masks become advisable, they surely can be made from any suitable fabric, like bed sheets or even the better grade paper towels.

    11. Tom Holsinger Says:

      Brian, only 1/3 of the US population in 1918 contracted the Spanish Flu, and that was a virgin field epidemic too. The reason for only 1/3 was that the thing mutated so fast. Right now we have no idea on how susceptible CoVid-19 is to mutation. Plus there will probably be an effective vaccine in two years +/- 6 months, though that does not include manufacturing and deployment time where my wild-a***d guess is another 6 months.

      IMO predictions in the 50-70% range infection are straight-line ones which rarely happen in the real world.

      Basically we simply can’t know right now what the high end of the infection rate might be. IMO the 1/3 rate of the 1918 Flu is reasonable, but it could easily vary from 1/6 (16.7%) to 40%.

      But even if the total infected American percentage is 16.7% of 336 million Americans, that still comes out to 39.2 million for the US, of whom about 7% will have critical care needs (2.7 million), and we have only 95,000 ICU beds. The 2% lethality rate of the 1918 Flu produced 675,000 fatalities among the 33.75 milllion Americans infected then. Comparable lethality (2%) among a hypothetical 39.2 million American infected by CoVid-19 would produce 784,000 dead Americans.

    12. Paul Says:

      Re 1917. We are not 1917. There were no, none, zero antibiotics then. No steroids. Even no asprin. There were no ventilators. So that same influenza today would be a lot less fatal.

      The population back then was a lot less healthy. No blood pressure pills, no treatment for heart disease. No to poor central heating. People didn’t have hot water heaters. One survey at the beginning of WW2, 1940, half of troops came from homes with out door toilets. Diets were poorer. Many adults had grown up with poor nutrition.

      So the population was frailer.
      No drugs.
      No equipment
      No to little central heating nor hot water.
      Sanitation was worse.

    13. Paul Says:

      On the other end, our time. We have a larger percentage of old people that are seeming fine due
      to modern medicine and wealth, but lets get real. They are hanging on by a steady thread, kept in reasonably fair health by the best we have. Many if not most would of long been dead in 1917 before the Spanish Influenza came along.

      I suspect we have a old population of smokers. We wouldn’t of had that in 1917. I think the 1917 population, plus add smoking, might be what the Chinese population today is like. Many of the old Chinese came up, grew up, survived the Mao hardships, starvation, poor nutrition, no to low health care( except the Bernie Sanders barefoot doctors handing out an asprin for your stomach cancer ). Plus now todays Chinese smoke, a lot. Plus it seems that the health care today in China is way worse than anyplace in the US( Socialist elite heros excepted ).

      So the MSM scare death rates taken from China, err…junk.

    14. Stanley Says:

      Thread on Washington state outbreak by Trevor Bedford. Genome analysis suggests hundreds of infected.

      https://twitter.com/trvrb/status/1233970271318503426

    15. Brian Says:

      thread:
      https://twitter.com/DellAnnaLuca/status/1233938781616521216
      Probably the single most important headline this week:
      – After just one week from the outbreak, Northern Italy is already considering expanding its hospital beds capacity because 1 in 11 patients goes in ICU

      The Lombardy equiv. of the minister of Health, 5 days ago:
      “in Lombardy no problem with the number of hospital beds”.
      Today: “the hospital beds [in this hospital] are not enough anymore […] even the ICU beds are saturated […] we’re working on expanding our capacity to react.”

      In Lombardy they’re delaying non-urgent surgeries and are re-hiring retired nurses and doctors.
      Bergamo Lodi & Cremona are out of beds.

      Etc., etc.

      And it’s still relatively early days there. That ~10% number (which will certainly rise as time goes on) is just not sustainable. Again, any sort of quarantine measures that can slow (stopping is impossible now, unfortunately) the spread are absolutely imperative, ASAP, to keep the “number of infected” value as low as possible. And the most common “lots of people in close quarters” facilities are what? Schools. Expect mass closings well before the end of the school year. I wonder what will happen for Easter this year, one of two days when churches are absolutely packed shoulder to shoulder–will people be told to stay home? (The Pope is still sick, btw.)

    16. Gavin Longmuir Says:

      Tom H: “Comparable lethality (2%) among a hypothetical 39.2 million American infected by CoVid-19 would produce 784,000 dead Americans.”

      That would be tragic, of course. On the other hand, something more than 2,800,000 Americans are expected to die this year anyway, even without this particular virus. And it is a reasonable guess that the sets of those Americans who would have died anyway in 2020 and those who would hypothetically die from the virus would have a significant overlap.

      Amidst all the hype and Doomer Porn, something which seems fairly clear is that those susceptible to dying from the new virus are mainly the very old and those whose health is already seriously compromised by a pre-existing condition. We all have to die eventually. The real question is how many “excess” deaths will occur because of the virus?

      If we took a wild guess that about 10% of Tom’s 784,000 estimate would represent those who otherwise would have survived 2020, that would put the “excess” deaths at about 78,000 — or about half the number of Americans who will die violent deaths in traffic accidents in 2020.

    17. MCS Says:

      Hospitals, especially ICU’s are sized for normal times. I’ll bet that in most ICU’s right now there are at most 2-3 empty beds. Especially during flu season. The challenge will soon be to keep the not too sick as far from the hospitals as possible.

    18. Mike K Says:

      Hospitals, especially ICU’s are sized for normal times. I’ll bet that in most ICU’s right now there are at most 2-3 empty beds

      In our hospital, the ICU was divided between coronary care, respiratory care and step down. Respiratory care tended to be noisy and subject to more contamination. If I were doing it, I would have an isolation ward for those not on respirators. I would hope that Remdesivir would be used on those close to needing a respirator, as I hope it is as effective as it was in the first Washington state patient.

      We will see if it works out. The Chinese are doing a study but I don’t trust their results.

    19. Brian Says:

      thread:
      https://twitter.com/ScottGottliebMD/status/1233940433081896960
      1/n #COVID19 hits older, vulnerable adults hardest. But there’s also data suggesting some disproportionate impact on younger adults when viewed relative to #flu. We compare hospitalizations by age from this China COVID19 data set to rates in U.S. for flu
      6/n But hospitalization rates by age of COVID19 compared to flu, with all the caveats of confounding factors which are substantial, could suggest middle aged and younger adults get serious illness at disproportionate rate relative to the experience with influenza. This isn’t flu.

      Chinese numbers are complete garbage, of course, so it’s hard to know what conclusions can actually be drawn. It’s possible that their numbers are skewed because they’re mostly just letting older people who show symptoms die, and not letting them be hospitalized (i.e., welding them in their apartments, etc.).

    20. Brian Says:

      “The challenge will soon be to keep the not too sick as far from the hospitals as possible.”
      I think this should be telemedicine’s moment. People, especially in areas with outbreaks, should be required to consult with a doctor remotely before they are able to go to a local facility. That would spread out the burden (i.e., if there is an outbreak in Seattle, doctors there need to be all-hands-on-deck to deal with it, while doctors in, say, Florida, can help out with basic screening remotely), and help to slow the spread by keeping sick and potentially sick people from gathering in the waiting rooms of hospitals, urgent care centers, etc.
      Mostly, of course, the government should have been preparing people a month ago for what to do if (when, if we’re being honest) there are cases in their area. Even now they’re hardly doing anything.

    21. Anonymous Says:

      Re: Paul’s comment above, “So the population was frailer.
      No drugs.
      No equipment
      No to little central heating nor hot water.
      Sanitation was worse.”

      The population was less frail, stronger, in 1917 because of the latter four points you made. Natural selection was a bigger factor in the earlier 20th century and we’re overall a lot weaker population nowadays.

      tyouth20

    22. Tom Holsinger Says:

      Stanley & Brian – your posts of Twitter thread links were very helpful.

    23. MCS Says:

      Thankfully, I haven’t had any experience with ICU’s in 25 years. If the layouts are still similar, they simply aren’t compatible with maintaining isolation between patients.

      It would have been nice to have the tools and forewarning to keep it out of nursing homes but that horse left the barn a long time ago.

      My memory from the Ebola outbreak is that the patients ended up where they did because those were the only hospitals with as many as 4 isolation suites.

      I don’t think there is going to be any way to avoid being exposed and dealing with it as well as possible if I get sick. I’ll do what I think makes sense to put it off as long as possible. I made my last Sam’s run for the duration. I won’t be able to avoid grocery stores but I intend to keep it to every other week or less.

      I doubt that the health care system can function if every doctor, nurse and tech that gets it is sidelined for some indefinite time. All the things that keep them busy now aren’t going to stop happening. We’ll all just have to take our chances like it was the 1800’s.

    24. Trent Telenko Says:

      The medical establishment is recommending greater than droplet level personal protective equipment in dealing with SARS-CoV2/COVID-19 and airborne treatment room protocols. (See American Academy for Anesthesiologists recommendations below)

      Personal observation — This -appears- to be in reaction to a fomite contamination concern.

      Short form: When someone coughs enough in a room. They can so pollute the atmosphere and surfaces of the room that even a blowing air conditioning vent could stir up virus carrying particulates. The over pressure exhaust through a hepa filter would remove viral particulates from the air and allow the use of PPE-3 verus PPE-4. This is important as PPE-4 is very rare and requires training to use and get out of without contaminating yourself.

      —————-
      American Academy for Anesthesiologists recommends:

      Coronavirus (2019-nCoV)
      Information for Health Care Professionals

      Place patients in an Airborne Infection Isolation Room2
      Health care professionals entering the room should use airborne and contact precautions, including eye protection.
      Personal protective equipment-3 (PPE) to be worn includes:

      o Either an N95 mask, for which one has been fit-tested, or a powered air-purifying respirator (PAPR)4.;
      o A face shield or goggles;
      o A gown;
      o Gloves.

      An Airborne Infection Isolation Room (AIIR) has a negative-pressure relative to the surrounding area. A minimum of 6 air changes per hour (12 air changes per hour are recommended for new construction or renovation). Air from these rooms should be exhausted directly to the outside or be filtered through a high-efficiency particulate air (HEPA) filter before recirculation. Room doors should be kept closed except when entering or leaving the room, and entry and exit should be minimized. Facilities should monitor and document the proper negative-pressure function of these rooms. If an AIIR is not available, patients who require hospitalization should be transferred as soon as is feasible to a facility where an AIIR is available.“

      https://www.asahq.org/about-asa/governance-and-committees/asa-committees/committee-on-occupational-health/coronavirus

    25. Trent Telenko Says:

      This is one of those nightmare COVID-19 datum’s that can’t wait for an update.

      If this SARS-CoV2 virus isn’t a bio-weapon, it is a by G-d 85% stand in for one.

      See below:

      FluTrackers.com
      @FluTrackers
      ·
      7h
      “The significance of this study is that asymptomatic carriers are found to be highly infectious, & the period of infection may be as long as 3-4 weeks…the higher the viral load in the body, the more infectious it is

      https://flutrackers.com/forum/forum/-2019-ncov-new-coronavirus/china-2019-ncov/831003-china-covid-19-cases-outbreak-news-and-information-week-9-february-23-february-29-2020?p=832670&#post832670

    26. Trent Telenko Says:

      Joy.

      See:
      ————
      Rice University asks “small group” to self-quarantine due to employee’s possible exposure to coronavirus

      The Houston university said it’s making the move out of an abundance of caution.

      BY MATTHEW WATKINS MARCH 1, 202011:39 AM

      Saying the move was out of an abundance of caution, Rice University on Saturday asked a “small group of students and faculty” to self-quarantine because a university employee might have been exposed to the new coronavirus while traveling overseas.

      The university didn’t disclose who the employee is, where in the university the person works or where the employee traveled — other than to say it was not to a country on the Centers for Disease Control and Prevention’s restricted travel list. The university community was notified of the quarantine in a campus-wide alert late Saturday night.

      https://www.texastribune.org/2020/03/01/rice-university-says-employee-might-have-been-exposed-coronavirus/

    27. Trent Telenko Says:

      This is a Chinese government media source, i.e. as trust worthy as the American CDC. COVID-19 causing fibrosis damage to the lungs is very bad news. Do an internet search on the term “Pulmonary fibrosis” to see why.

      https://www.globaltimes.cn/content/1181121.shtml

      Autopsies show severe damage to COVID-19 patients’ lungs and immune system, according to a doctor in Wuhan reached by the Global Times, who called for measures to prevent fibrosis of the lungs at an early stage of the disease.

      “The influence of COVID-19 on the human body is like a combination of SARS and AIDS as it damages both the lungs and immune systems,” Peng Zhiyong, director of the intensive care unit of the Zhongnan Hospital of Wuhan University in Wuhan, told the Global Times on Friday.

      Peng said he had just talked to Liu Liang, a forensic specialist from the Tongji Medical College at Huazhong University of Science and Technology. Liu’s team has reportedly conducted nine autopsies on deceased COVID-19 patients as of February 24.

      “The autopsy results Liu shared inspired me a lot. Based on the results, I think the most important thing now is to take measures at an early stage of the disease to protect patients’ lungs from irreversible fibrosis,” Peng noted.

      If irreversible damage is done, other measures, like those to prevent patients from oxygen deficit, will not be of much use, he said.

      Liu’s team published a paper on an autopsy they conducted in the Journal of Forensic Medicine on Tuesday.

    28. Trent Telenko Says:

      There are multiple reports of “Normie Florida Man” making appearances at the Walmarts, SAM’s, Costco’s and Fry’s around the country buying up the entire stock of stores hand sanitizer, bleach, cleaning alcohol, and dry goods like pasta, beans and rice.

      My advice here is drive by stores and look at the parking lots before going in. In fact, you may want to wait a couple of days before hitting stores until the initial wave of panic buying blows over.

      Being in the middle of a mob of panicked shoppers is a lot more immediately dangerous than COVID-19.

    29. Gavin Longmuir Says:

      Trent T: “If this SARS-CoV2 virus isn’t a bio-weapon…”

      Not sure I follow your logic. A virus with a long incubation period that leaves most of those who catch it asymptomatic & unaware they even have a disease would certainly be good at maximizing spread. But that means it is going to spread among your own army, your own population as well as among the enemy. And then even those who get sick are mostly not incapacitated. As a bio-weapon, it really sucks!

      Now, one could imagine that a government which has promised to provide its people with social security & health care it cannot afford might be interested in a virus which targeted the old & sick, as this one appears to do. But wouldn’t it just be easier to adopt something like the English NHS and put all those sick old people on long, long waiting lists for treatment? [For Brian’s benefit, that is called sarcasm].

      A question worth pondering is — How long has this virus existed in the world? Since its symptoms are so similar to influenza (which millions of people catch in any year), it may have been with us for a lot longer than we realize.

    30. Trent Telenko Says:

      This is the medical report on the ‘super spreader’ demographic mentioned by Flu trackers —

      Clinical Characteristics of 24 Asymptomatic Infections with COVID-19 Screened among Close Contacts in Nanjing, China https://www.medrxiv.org/content/10.1101/2020.02.20.20025619v2.full.pdf

    31. MCS Says:

      What Gavin said. There are already enough diseases. What you need to make a weapon is a way to direct it. Then you have to be able to protect your own personnel without tipping your hand to potential adversaries. Knowing all the time that it will only last until someone else discovers a cure or vaccine. There isn’t any evidence that I’ve seen that they are any closer to a treatment or prevention than we are.

      After SARS, China had plenty of legitimate reason to research corona viruses. As did we. No need to invoke some dark plot. If it actually came from a lab, incompetence is more than a sufficient cause.

    32. DaleCozort Says:

      First, the number of traffic deaths/year in the US is a little under 40,000, about half the number of COVID-19 deaths projected above, not half that number as indicated in one of the comments above.

      Second, In terms of the seriousness of COVID-19 versus a typical flu: The key thing to look at is not necessarily death rates. I would be more concerned by rate of hospitalization. If hospitalization rates hit 10% or even 5% of infections and you hit 40% of the population getting it, then at the peak of the epidemic the bulk of the population will be effectively without health care, because COVID-19 will have more than used up the capacity of the health care system.

      So the key question to ask is what percentage of cases are serious enough to require hospitalization? The best sources of data for that would probably be South Korea and Singapore because they are testing extensively and proactively which probably metheyns they are

    33. DaleCozort Says:

      First, deaths from motor vehicle accidents are a little under 40,000/year, so the projected number of COVID-19 deaths would be roughly twice the traffic death toll, not half of it as stated above.

      Second, while COVID-19 death rates are worrisome, I’m more concerned with rates of hospitalization. If 5 or 10 percent of the people who get the disease go to the hospital and 40 percent of the population gets it, that means that at the peak of the epidemic, we may be effectively without modern health care because the epidemic will use up all of the medical resources.

      We should have enough data outside China to start estimating hospitalization rates by now. South Korea and Singapore should give us a pretty good indicator. Look at total cases and serious cases for those countries and we can probably get a decent ballpark idea, because both countries are being very proactive in testing, which means they are likely to be catching a high percentage of non-serious cases, Yeah, they’ll miss some non-serious cases, but some of the initially non-serious cases will progress to serious cases. So we can have a pretty good order of magnitude idea of what is coming by looking at South Korean figures and figuring what percentage requires hospitalization.

    34. DaleCozort Says:

      Sorry about the sort of duplicate comments. Computer froze with the message incomplete and apparently unsent, so I went to my iPad and redid it.

    35. Trent Telenko Says:

      Chinese medical officials in Wuhan admitted that the reinfection rate of the Coronavirus is at least 14%.

      They Recovered From the Coronavirus. Were They Infected Again?
      https://www.nytimes.com/2020/02/29/health/coronavirus-reinfection.html?fbclid=IwAR1qYp5ZlAgJcf6c6iwrvopCajV2iJKbwkUHp_EKPW17qNejsjcg_VjuDVY

      And see:
      https://www.reuters.com/article/us-china-health-chengdu/coronavirus-patient-re-hospitalized-in-chinas-chengdu-after-testing-positive-again-idUSKBN20F13C

    36. Trent Telenko Says:

      This is a very, Very, VERY worth while video to watch on COVID-19 today (3/1/2020).

      The Last Day To Prepare (Mostly)
      2/29/2020
      https://www.youtube.com/watch?v=QVQC1hAYZBs

      Apparently the SARS-CoV2/COVID-19’s R(0) (arh nought) is between 4.7 and 7. That is, one person gets it, they give it to 5 to seven others.

      Please down load the CDC file mentioned in the video at this link:

      https://stacks.cdc.gov/view/cdc/11425

      Text below from the You tube link posted above:

      Here on leap day 2020 (February 29th) the US records its first coronavirus death on the continent, a 50+ year-old man in Washington State. Cases continue to grow exponentially in South Korea and Italy. Meanwhile, most hospital systems in western countries are woefully unequipped for any large influx of serious respiratory patients.

      After dragging its feet for seeming forever, the CDC “allows” states to begin testing on their own. Finally, and inexplicably.

      Through all of this we’ve been consistently telling you that you need to prepare. Now it’s more or less too late. Already many communities are experiencing runs on basic items of food and water. Any preparing you do from here on out needs to be done ultra-responsibly and without any hoarding.

      From here on out the words are going to be “mitigation” (not containment) and “non-pharmaceutical interventions” or NPIs. That’s a fancy way of saying no large gatherings, no school, and no unnecessary travel or contact.

    37. Gavin Longmuir Says:

      DaleCozort: “First, the number of traffic deaths/year in the US is a little under 40,000, about half the number of COVID-19 deaths projected above, not half that number as indicated in one of the comments above.”

      Dale, thank you for that correction. I was thinking about the total number of accidental deaths annually in the US (167,127 in 2018 according to the CDC), and misremembering that as traffic accident deaths.

      On the hospitalization issue, maybe we should be more open-minded. If this virus is similar to the flu (although Hong Kong data says this virus is less serious with a lower mortality rate), then the hospitals which manage to handle the yearly flu outbreaks resulting in about 60,000 annual deaths may be able to deal with the load.

      If the hospitals get overloaded — and maybe even before the hospitals get overloaded — we might want to think about treatment alternatives. If this virus is as bad as some people think, does it make sense to bring those highly infectious cases into hospitals where there are many other susceptible patients whose health is already compromised because of many different conditions? Might it make more sense to deliver oxygen and any relevant medications to the patient in his own home? If this really is a crisis, then we need to be creative and flexible!

    38. Brian Says:

      If we see mass deaths at that extended-care facility in Washington, the public fallout is going to be really bad. Saying “it’s just the flu / they were all sick old people” ain’t going to cut it.

      The government in Seoul is now asking for people to work from home. AND they are asking for a murder investigation into leaders of the church at the epicenter of the outbreak. This is desperation and flailing about looking for a scapegoat.

      We’ve also started to see the first videos of dead bodies in the streets in Iran, as if they just keeled over dead. So bizarre. The sort of thing that was so freaky in the early days (all the way back in late January, which seems like years ago right now), when only Wuhan was in lockdown. I have absolutely no idea what to make of it, any more than I knew what to make of it then, except that it ain’t “just the flu” we’re dealing with.

    39. Tom Holsinger Says:

      The most disturbing news today lies in Brian’s post linking the Italian report twitter thread stating that 1/11 of the Tuscany, Italy, victims of CoVid-19 required critical care. That is 9% and tends to confirm the Chinese report of 7% requiring critical care. I say “tends to confirm” because we don’t know how reliable that report may be.

      IMO we can put a low end on the CoVid-19 infection rate of at least equal to that of ordinary influenza, which varies from 5% to 20% among Americans depending on the year. CoVid-19 is clearly more infectious and lethal than ordinary flu, so the low end infectious rate is probably more like 10-20%.

      The US population is currently 331 million so a 10-20% infection rate means 31-62 million Americans will contract it.

      If the proportion of victims needing critical care is 7-9% (8% average) as known statistics indicate, I don’t see how the currently estimated fatality rate can go under 2%. This is ordinary math given that the US has only @ 95,000 intensive care beds. The minimum number of Americans requiring critical care for CoVid-19 would be 2.5 – 5.0 million.

      Even if the proportion of people requiring critical care is halved, that would still be a demand for 1.25 – 2.5 million critical care beds with only 95,000 available.

      This thing will be a disaster even at a low end infectious rate. A 1918 Spanish Flu infectious rate of 33% and critical care rate of 8% of infected would create a demand for 8.8 million intensive care hospital beds, i.e., 93 times the number available.

      Right now the only available data is really grim. More should be forthcoming with in a month, but IMO we won’t know how bad is bad until June.

    40. DaleCozort Says:

      Unfortunately, it now seems inevitable that we will be finding out how serious the virus is, probably within about two weeks out west and in Chicago, based on how fast it progressed from initial community spread to thousands of cases in S Korea and Italy.

      The trick to avoid overloaded hospitals is to (a) Slow spread within a community. A big spread AFTER flu season is more manageable than one in addition to the normal seasonal flu. It also avoids big peaks. (b) Slow geographic spread so medical personnel can shift to overloaded areas. (c) Be ready to mobilize retired medical personnel and people with medical backgrounds who have recently moved into other fields, (d) Mobilize industry to identify and fill bottlenecks in treatment capability. Are there enough oxygen tanks? Hoses? Antibiotics for secondary bacterial infections? Enough people to work with other members of the household of a victim staying at home to train them so they can help without getting infected ? Enough easy to use telepresence setups so medical workers can check on at home patients and transfer them to a hospital if they need intubation?

    41. Tom Holsinger Says:

      Brian – re your last above about “videos of dead bodies in the streets in Iran.

      I saw a video in an earlier CoVid-19 article by Trent with a security camera clip showing a masked Chinese guy working with a laptop who fell over in convulsions at his desk. He then went into spasms and quivering on the floor identical to those of a Chinese hospital patient on a gurney in an earlier news video. The masked guy’s spasms ceased after about 30-60 seconds and he became very still on the floor. It was pretty clear that he died on camera. Plus he went from working normally to dead in a minute or two.

      Trent saw the same thing, and told me privately that it looked like a “cytokine storm”, and his opinion was that this explained the videos and photos of people in Wuhan dying on the streets.

    42. Trent Telenko Says:

      These are two on-the-ground comments [below] from Washington State from my face book feed that I put a whole hell of a lot of credence in.

      BLUFF — We are likely in the low tens of thousands of COVID-19 infected in Washington state alone, simply based on the air traffic numbers in the month of January 2020.

      And — also based on airline travel numbers for January — likely every major urban area with a Chinatown and every major American university with a Chinese student population has cases of COVID-19 developing right now.

      This should be showing up in the next two weeks as local COVID-19 testing in the USA ramps up to 10,000 tests a day up to reveal the above facts.

      ============
      Living here I can tell you it’s way more than 1000 people just from the differing sickness patterns I’ve seen the very very few times I’ve gone out in public the last month as compared to the last 20 years here. It’s in every western Washington city of any size and note, and the dry cough of doom is prevalent everywhere you go. And that is totally not normal here – we are a drippy sinus region when we get sick due to the year round humidity, pollen and spores.

      I ran the math on SeaTac back when Hubei was locked down and it’s bad…. check their statistics … 9% international travelers at 50m a year… during a high volume time for international travel had us having about ~400k potential vectors fly through each month. Then you weight that for region, and narrow that down a bit… to just Asia and the official January numbers are ~100k Asian travelers in January 2020 …. and yeah… we were mathematically slimed hard by first or second week of January. Which is all I needed to spring into action myself.>/em>

      See this link
      https://www.portseattle.org/page/airport-statistics

    43. Mike K Says:

      It sounds like Cytokine Storm is a local phenomenon in China.

      One of the most perplexing questions regarding the current COVID-19 coronavirus epidemic is the discrepancy between the severity of cases observed in the Hubei province of China and those occurring elsewhere in the world. One possible answer is antibody dependent enhancement (ADE) of SARS-CoV-2 due to prior exposure to other coronaviruses. ADE modulates the immune response and can elicit sustained inflammation, lymphopenia, and/or cytokine storm, one or all of which have been documented in severe cases and deaths. ADE also requires prior exposure to similar antigenic epitopes, presumably circulating in local viruses, making it a possible explanation for the observed geographic limitation of severe cases and deaths.

    44. Tom Holsinger Says:

      Mike, then why are victims dropping dead on the streets in Iran?