It is now becoming a theme on the left that Trump was not quick enough to recognize the coming epidemic.
For that reason, I think it valuable to keep a record of the time line.
Here is the January 12, 2020 WHO report on the virus epidemic in China.
The evidence is highly suggestive that the outbreak is associated with exposures in one seafood market in Wuhan. The market was closed on 1 January 2020. At this stage, there is no infection among healthcare workers, and no clear evidence of human to human transmission. The Chinese authorities continue their work of intensive surveillance and follow up measures, as well as further epidemiological investigations.
Here is the January 30, 2020 report by WHO on the epidemic in China.
The Committee believes that it is still possible to interrupt virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk. It is important to note that as the situation continues to evolve, so will the strategic goals and measures to prevent and reduce spread of the infection. The Committee agreed that the outbreak now meets the criteria for a Public Health Emergency of International Concern and proposed the following advice to be issued as Temporary Recommendations.
The Committee emphasized that the declaration of a PHEIC should be seen in the spirit of support and appreciation for China, its people, and the actions China has taken on the frontlines of this outbreak, with transparency, and, it is to be hoped, with success.
Trump stopped incoming flights from China on January 31, 2020.
At this point, sharply curtailing air travel to and from China is more of an emotional or political reaction, said Dr. Michael T. Osterholm, an epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
“The cow’s already out of the barn,” he said, ”and we’re now talking about shutting the barn door.”
A Minnesota epidemiologist’s opinion.
Nancy Pelosi tours Chinatown on February 24, 2020.
House Speaker Nancy Pelosi made a point of taking a walk through San Francisco’s Chinatown on Monday to show that it is safe, after some merchants have seen a 50% drop in business as some fear they could be exposed to the coronavirus.
As her visit began, a large portion of Chinatown had lost power. That didn’t deter the Speaker from walking along Ross Alley and Grant Avenue.
“I’m here,” she said. “We feel safe and sound with so many of us coming here. It’s not only to say it’s safe but to say thank you for being Chinatown.”
On March 16, 2020, Mayor de Blasio was still enouraging people to attend crowded events.
For most of last week, as Mayor Bill de Blasio continued to urge New Yorkers to mostly go about their daily lives — sending their children to school, frequenting the city’s businesses — some of his top aides were furiously trying to change the mayor’s approach to the coronavirus outbreak.
There had been arguments and shouting matches between the mayor and some of his advisers; some top health officials had even threatened to resign if he refused to accept the need to close schools and businesses, according to several people familiar with the internal discussions.
So much for the urgency in dealing with the epidemic.
To be continued. Here is an interesting timeline provided by someone else. These are being posted because we are alrerady seeing the left/Democrats lying about the sequence of events at the beginning.
January 11: Chinese state media report the first known death from an illness originating in the Wuhan market.
January 15: Speaker of the House Nancy Pelosi (D-CA) holds a vote to send articles of impeachment to the Senate. Pelosi and House Democrats celebrate the “solemn” occasion with a signing ceremony, using commemorative pens.
January 21: The first person with coronavirus arrives in the United States from China, where he had been in Wuhan.
January 23: The House impeachment managers make their opening arguments for removing President Trump.
January 23: China closes off the city of Wuhan completely to slow the spread of coronavirus to the rest of China.
January 30: Senators begin asking two days of questions of both sides in the president’s impeachment trial.
January 30: The World Health Organization declares a global health emergency as coronavirus continues to spread.
January 31: The Senate holds a vote on whether to allow further witnesses and documents in the impeachment trial.
January 31: President Trump declares a national health emergency and imposes a ban on travel to and from China. Former Vice President Joe Biden calls Trump’s decision “hysterical xenophobia … and fear-mongering.”
February 2: The first death from coronavirus outside China is reported in the Philippines.
February 3: House impeachment managers begin closing arguments, calling Trump a threat to national security.
February 4: President Trump talks about coronavirus in his State of the Union address; Pelosi rips up every page.
February 5: The Senate votes to acquit President Trump on both articles of impeachment, 52-48 and 53-47.
February 5: House Democrats finally take up coronavirus in the House Foreign Affairs Subcommittee on Asia.
More coming.
“Mainstream Merdia”
New spelling.
Good work!
Hi Mike,
The contributed timeline is incorrect:
January 15th The first person with coronavirus arrives in the United States from China, where he had been in Wuhan.
January 19th Person above presents at local urgent care clinic with symptoms. WA state public health immediately notified by urgent care clinician (editorial comment: Attaboy to this clinician) and reports immediately to CDC who approves testing.
January 20th rRT-PCR test confirmed positive by CDC, person above admitted to airborne-isolation unit at local hospital.
Reference: https://www.nejm.org/doi/full/10.1056/NEJMoa2001191
Also, IIRC local reporting at the time had mentioned that the patient had taken public transit from SeaTac the approximately 40 miles home. Never saw any report of any contract tracing being done for THAT (should have been possible as all the 3-county transit systems use a shared payment card). Of course (from what we know now) given his high viral load at presentation (1/19), I bet he asymptomatically infected the whole damn plane on the 15th as well. So it probably wouldn’t have mattered.
Thanks for the corrections. I copied from someone else. Close enough for government work.
I’m stashing it here because it has already become apparent that the DNC plan is to accuse Trump of not being “prepared.”
I’m seeing it and the memo must be circulating among lefties.
I saw the thing about US patient zero on the 15th, on Redstate. Which pointed out the timing wrt to the impeachment.
I’m not so persuaded by that case that I would want to argue it.
I do not for a moment believe that we have yet figured out everything that has been going on with the spread of the infection. It seems plausible that the initial border crossing person of contagion was much earlier. If that proves true, it would feel to me like I had jumped on an convenient coincidence if I had made the argument.
The first mention on this site appears to be in the comments on Jan 24.
I mostly stopped reading “politics twitter” to just read “coronavirus twitter” for a while, and it was actually a refreshing change, which is a sad state of how horrific twitter is.
Until things started to spread here it was pretty much 99% politics free. Now it’s been subsumed into our poisoned political discourse, tragically.
The most amazing thing to me is liberals who like to portray themselves as “reasonable” are even at this point openly saying things like, hmm, can you show me any evidence that China lied and covered up the situation in Wuhan?, which is great, because it means you don’t have to pretend to take those people seriously about anything ever again.
I posted earlier at Althouse a good part of what Michael posted here, and I had gotten it elsewhere. So apologies all around. A little crowd sourcing his factual stake in the ground is no doubt welcome.
We’ll never know when the epidemic started unless they go back and test samples taken for other reasons. When we do, I’ll bet we find the first patients back in December or even November. If we do that is.
All the evidence is that it was wide spread at the first of December in China so it’s nearly certain that infectious individuals traveled here and started spreading it masked by the normal flu. Further evidence is that the first hot spots seem to be cities that have large numbers of Chinese immigrants where the epidemic could have gained momentum under the radar.
It will be interesting to see how fast or if world travel recovers. I’m sure a lot of people will remember all the people left stranded by the closing of borders. This will be multiplied many fold for the cruise industry.
Another question is how relations with China will progress. People were apparently willing to wear Nikes that were produced by various forms of forced labor as long as Nike could provide plausible deniability. I wonder if all the other things that have come to light combined with the deliberate obfuscation of the epidemic will take hold and provoke a permanent change.
The Patriots football team sent their plane to bring back a load of masks from China. I wonder if it will turn out that they got swindled. See:
https://www.chinalawblog.com/2020/03/buying-face-masks-and-other-ppe-from-china-not-for-the-faint-of-heart.html
In January and February, a Chinese real estate company in Australia sent all their employees on a scavenger hunt through the stores for masks and hand sanitizer and shipped them back home.
https://www.news.com.au/finance/business/chinese-company-shipped-out-millions-of-australias-masks-hand-sanitiser-glove-supplies/news-story/d5324e3676d38af509d5ac25c56e7cec
This is beginning to look like war by other means. It should make China radioactive, we’ll have to see what happens.
Here is an interesting article attacking Fauci and Gilead, maker of remdesivir, and asserting that remdesivir is less effective than hydroxychloroquine. I don’t know that I agree. My impression, from the very limited information available, is that remdesivir is more effective late an d hydroxychloroquine is better early.
Then author uses a non de plume, “Semmelweiss.”
I have no idea of the author’s qualifications or bias
I don’t know if I would label this “Impeachment II or III or IV.”
NBC News reports that preliminary discussions have begun on Capitol Hill regarding the establishment of a 9/11 Commission-type inquiry about the coronavirus outbreak in the United States. The discussions are said predominantly to involve Democrats and to be focused on the Trump administration’s performance. As outlined, the exercise would smack of the worst aspects of the 9/11 Commission: the partisan blame-game, which eventually petered into the look-like-we’re-doing-something creation of bloated and ludicrously expensive new bureaucracy.
Schiff has been off TV for too long now. Time to get back on.
As an informed layman, I’d agree with your impression.
From the press (I know) it seems that all the attention is on ventilators, etc. But my impression is that once you get on a ventilator for this thing, the outcome is iffy. Seems like more attention should be paid to treatments that might keep people from getting that far (and I expect is behind the scenes). Dr. Seheult on the Medcram YouTube updates has been focusing recently on ways to stimulate the innate immune system that might minimize the progression to severe disease.
https://www.youtube.com/watch?v=H1LHgyfPPQ8
JH Kellogg was just ahead of his time ;-)
It’s interesting how COVID-19 is (temporarily?) altering the pecking order of the various medical specialties.
Daughter and SiL are both doctors just out of residency on staff at a (smaller) community hospital here in the Soviet. She was the recruited specialty, and he came along in the package. Tough always finding babysitting around two doctor schedules, and G&G Soviet were typically filling in a couple times-a-month (particularly on weekends). Of course, that’s not possible for now, so they have a problem. Was discussed with hospital admin staff, and interestingly he’s the priority Doc now. Appears that as part of the current internal med residency training (SiL) they’re trained on managing ventilator cases, whereas a lot of daughter’s non-essential caseload has been cancelled out. So in case of schedule conflict, she gets covered so he’s available.
Sounds like now would be a good time for your DIL to get ventilator training. The load from managing a lot of cases is large. Hospitals are divided into too many petty fiefs. Doesn’t sound like their management is spending as much time thinking how to get things done as making sure nobody’s chain of command gets violated.
I’m not going to bother to look at your link, it sounds like the same stuff health food stores and “alternative” practitioners have been pushing since they first heard the term immune system. If you could really turn on the immune system by taking whatever they are selling, it would be too dangerous to take. The challenge is boosting the immune system without having it destroy whole organ systems.
I imagine that Schiff wants to delay information coming out until after the election. If there’s an investigation, he hopes everyone will clam up and lawyer up. Not that there isn’t plenty of blame to go around.
My recollection is that a month or 2 ago when Remdesivir was first in the news, it was mentioned that Gilead had sold its inventory to the USGov for $200 million. Said inventory consisted of 4500 doses in finished form, and 90,000 doses still at an intermediate step (presuming that Gilead would complete the chemistry and formulation into its end use form, guessing by IV drip. Doing the math, that works out to ”$2,116.40 per dose.
From Wikipedia ( https://en.wikipedia.org/wiki/Remdesivir ) comes the following copy/paste:
Synthesis
Synthesis of remdesivir in structural formulae.
Remdesivir can be synthesized in multiple steps from ribose derivatives. The figure below is one of the synthesis routes of remdesivir invented by Chun and coauthors from Gilead Sciences.[32] In this method, intermediate a is firstly prepared from L-alanine and phenyl phosphorodichloridate in presence of triethylamine and dichloromethane; triple benzyl-protected ribose is oxidized by dimethyl sulfoxide with acetic anhydride and give the lactone intermediate b; pyrrolo[2,1-f][1,2,4]triazin-4-amine is brominated, and the amine group is protected by excess trimethylsilyl chloride. n-Butyllithium undergoes a halogen-lithium exchange reaction with the bromide at −78 °C (−108 °F) to yield the intermediate c. The intermediate b is then added to a solution containing intermediate c dropwise. After quenching the reaction in a weakly acidic aqueous solution, a mixture of 1: 1 anomers was obtained. It was then reacted with an excess of trimethylsilyl cyanide in dichloromethane at −78 °C (−108 °F) for 10 minutes. Trimethylsilyl triflate was added and reacts for an additional 1-hour, and the mixture was quenched in an aqueous sodium hydrogen carbonate. A nitrile intermediate was obtained. The protective group, benzyl, was then removed with boron trichloride in dichloromethane at −20 °C (−4 °F). The excess of boron trichloride was quenched in a mixture of potassium carbonate and methanol. A benzyl-free intermediate was obtained. The isomers were then separated via reversed-phase HPLC. The optically pure compound and intermediate a are reacted with trimethyl phosphate and methylimidazole to obtain a diastereomer mixture of remdesivir. In the end, optically pure remdesivir can be obtained through chiral resolution methods.
While it has been 40 years since I worked in both research and new product development as a synthetic organic chemist, and the tools available to drug makers (reagents, reactions, separation techniques & etc.) have improved dramatically, making this in substantial quantity would be quite a challenge. It wouldn’t surprise me to learn that Gilead sold their inventory for something like their cost, excluding overhead.
If remdesivir is effective, it would be a stroke of almost unbelievable luck. As I understand, it’s either in phase II or very early phase III testing. The odds against it hitting the market might be 10:1 or worse. Not that we couldn’t use a little luck.
As for the article, when someone starts accusing people of selling out with no evidence, I close the window and don’t look back. At this time, nobody knows how remdesivir will work in the real world. Anyone that says they do is lying.
We do have that one NEJM case report with dramatic effect in an advanced case. If they had 4500 doses in hand, we should be able to get some preliminary results soon .
The one thing I do agree with in that questionable article is that FDA is no ball of fire. That is another reason why we are so lucky with Trump. Does anybody see Obama acting quickly ? I think Obama came into office with the idea of aligning with Iran. I don’t know why. Maybe ValJar or maybe just to stick a finger in the eye of America, but that was his only real interest that I can see. He let Pelosi run the Obamacare group and I see nothing else that interested him.
“We do have that one NEJM case report with dramatic effect in an advanced case.”
Yeah, my recollection is there is *one* case. I don’t understand why you’re so excited about that.
I don’t understand why you’re so excited about that.
Yeah, “Beware of the man with one case.”
Still, the case was well studied and the response was dramatic. The absence of news is puzzling. Maybe hydroxychloroquine is doing so well that the importance has receded. A vaccine will only be useful if the virus turns out to be seasonal like flu.
SARS did not and it’s the same virus. Both SARS and MERS seemed to remain animal to human with only close contact. No human to human.
Influenza comes from chickens and pigs. This is a bat virus but other vectors were involved in SARS although bats were one.
Cytokine Storm is also a complication of some SARS cases.
More info on therapy.
Todaro noticed bits of news about chloroquine being used as a treatment. He knew about the drug because a side effect can be vision problems. “There was already a national shortage of chloroquine. This is what tipped me to its potential. The UK banned exports. China made some announcement that they were banning exports of ingredients for it.” Todaro told me in a phone interview. “And then I saw that no one in the U.S. and even Europe had come out with any sort of report that chloroquine was being used, or that there were studies it had been used against SARS virus. People were paying attention to remdisivir.”
When Todaro tweeted the next day about these signs that doctors outside the U.S. were recognizing the drug’s potential, Rigano tweet-replied with a video showing “s korea and china doctors are using chloroquine, very significant effect.”
More.
When David Bryan, 58, the keyboardist for Bon Jovi, came down with flu-like symptoms on March 15 after spending weeks in New York City working on previews of Diana, a musical he cowrote, he tried resting at home in New Jersey. By Wednesday he had shortness of breath and his wife insisted he see his doctor in Brick, New Jersey, Dr. Michael Rothberg. A positive COVID-19 virus test followed.
Dr. Rothberg had heard about the HCQ/Zithromax treatment and put Bryan on a five-day course, the musician told me in a phone call while still recovering at home. He knew about chloroquine before as a malaria preventative. “I’ve taken it,” he said. “I’ve been to 150 countries with my band.”
And:
Many news media reports have smartly highlighted the initial, flawed, results of the Raoult study, including a Los Angeles Times column and a New Yorker piece focused on the dangerous potential side effects of HCQ. A lot of reporters who, understandably, hate Trump and distrust everything he says, have clearly decided the HCQ stuff is dangerous bunk and moved on to other stories. But just because Trump likes it doesn’t make it all bad.
The French doctor has continued to update his results, and they are now based on a thousand patients. Other studies are also underway, and scientists including Fauci have cautioned that the Raoult study is not being done according to the most rigorous standards. But if you want hope along with your clickbait stories of people dying from fish tank cleaner, you could report it: as of Sunday March 29, the French study reported that of 1,003 patients treated with HCQ/AZ, only one had died.
There is more about Gilead and remdesivir, including a possible source for the negative article.
A worthwhile podcast on COVID.
1. The numbers of asymptomatic infections is way underestimated. Herd immunity may come faster than anyone realizes.
2. Death count might not be accurate in models. No cultures or PCR to confirmdiagnosis.
3. Based upon limited in-vitro and anecdotal clinical data in case series, chloroquine phosphate and
hydroxychloroquine sulfate are currently recommended for treatment of hospitalized COVID-19
patients in several countries, and a number of national guidelines report incorporating
recommendations regarding use of chloroquine phosphate or hydroxychloroquine sulfate in the
setting of COVID-19. FDA encourages the conduct and participation in randomized controlled
clinical trials that may produce evidence concerning the effectiveness of these products in
treating COVID-19. FDA is issuing this EUA to facilitate the availability of chloroquine
phosphate and hydroxychloroquine sulfate during the COVID-19 pandemic to treat patients for
whom a clinical trial is not available, or participation is not feasible.
4. First NEJM series of COVID 19 with some getting remdesivir but not results provided.
A large proportion of patients in this series presented with shock that required vasopressor support. In patients who had an echocardiogram, myocardial dysfunction was uncommon. The lack of bacterial or viral coinfection suggests that the observed shock was directly related to Covid-19. In these preliminary data, Covid-19 infection appears to differ from seasonal influenza, which is commonly associated with bacterial coinfection due to pathogens that colonize the nasopharynx, such as staphylococcus and streptococcus.16 Regarding antiviral interventions, 7 patients received compassionate-use remdesivir, but we have insufficient information to report associated outcomes. Bronchoscopy was performed in a minority of patients and did not appear to change clinical management.
5. Trial of HC in 62 patients with 31 in HC therapy and 31 controls. Good response in “time to recovery.” This is a controlled trial.
“FDA is no ball of fire”
It seems institutional actors who’ve wedded themselves solely to phase III trials have difficulty reacting in a crisis.
Fauci recently suggested a zero case point as the point at which social distancing can be relaxed.
Does anyone think that’s achievable with this sort of thing?
At what cost?
“A vaccine will only be useful if the virus turns out to be seasonal like flu.”
I assume you mean, if it comes back every year like the flu? Because it seems optimistic to think this thing is going to go away at all–flu season is over, and this is still growing. Singapore and Japan which had looked promising seem to be on the brink of losing containment, certainly the latter is sounding serious alarm bells. I don’t think we’re ever going to get to “normal” until there is a vaccine (I was saying back by early February or so that we need a moonshot vaccine development program).
Singapore and Japan which had looked promising seem to be on the brink of losing containment, certainly the latter is sounding serious alarm bells.
It would be unusual for the virus to reinfect someone who had had it, unless they had been treated with HC before immunity was established. I don’t know of another virus that was able to overcome immunity although vaccines do seem to fade more than natural immunity caused by the disease.
This should be added to the timeline. CNN’s Acosta attacking Trump as “xenophobic” for stopping flights from China on January 31,2020.
Mike: I don’t understand your 11:12 post–it seems like you’re implicitly referring to achieving herd immunity and ending the problem that way, but no one is seriously talking about that approach anymore, and it seems entirely based on the completely unproven claim that huge numbers of people have already been infected and never known it. I guess once tests are reliable and mass-produced, neither of which is the case right now, we can start to find out if that’s true or not.
Absent an effective vaccine, there isn’t a question of containing this. Huge numbers of people have been infected, or at least many more than can be quarantined. It’s there and it’s going to do whatever it is going to do. At some point, the prevalence of infections should level off and start to decline to some sort of background level. The flu actually happens year round, the numbers spike during the winter. Now it’s a question of how long this takes and whether the number of active infectious people circulating is low enough for the risk to susceptible and vulnerable people to be tolerable.
It looks probable that a vaccine will be developed eventually but it will take longer than we can afford for most of us to sit at home trying to hide from it. It looks to me as if we’ve bought enough time to find at least somewhat effective treatments. This should lower the risk enough to let us restart the world with those that are especially vulnerable taking added precautions.
MCS:
“those that are especially vulnerable taking added precautions.”
I wish this talking point would die in a fire. Ever since day one, in China (whose numbers we don’t in general believe at all), through Italy, and now in the US, we’ve seen an extremely high fraction of the ICU-level-severity cases are young, despite the BS talking point that only the old and sick are at risk. Far more as a proportion than is the case for flu (and of course, it puts waaaay more people in ICU than the flu). In China the argument could perhaps be made that it was due to triage–they were leaving the old patients to die–but now we know that’s not the case. So there is no way to know who is “especially vulnerable”–no matter who you are, there is perhaps a 10-20% chance you will end up in the ICU for weeks, with probable permanent severe lung damage. I don’t know about you, but I’m not taking that risk. If through testing we can show that that number is actually less than 1% (and there are zero actually substantiated claims of that that I’m aware of), then maybe you could do that, but even that would be way higher than most people are willing to bear.
I guess once tests are reliable and mass-produced, neither of which is the case right now, we can start to find out if that’s true or not.
There is no way, yet, to know how many were infected but had no or m ild symptoms which they did not attribute to the pandemic.
no one is seriously talking about that approach anymore,
Really ? I don’t see that.
Ever since day one, in China (whose numbers we don’t in general believe at all), through Italy, and now in the US, we’ve seen an extremely high fraction of the ICU-level-severity cases are young, despite the BS talking point that only the old and sick are at risk.
There is the phenomenon of “Cytokine Storm” but otherwise the young are far less at risk.
See this chart, for example,
Many of those deaths in age below 44 are in seriously impaired individuals.
Where does 10-20% in the ICU come from? Not remotely any numbers I’ve seen. We can probably protect most of the people that we know are at elevated risk, and as time goes on, make better judgements as to which others are. Treatments will lower the risk and load of those. I said lower risk, not eliminate it. Some number of the people that die of flu complications every year are not in high risk groups.
There really isn’t an alternative. I have no faith that our present planned economy of essential services will be any better than any other planned economy. Eventually the light will go off and the water will stop flowing from taps. Especially, sooner than you imagine, we’ll run out of money to keep things going.
I’ve said that I was working in one of these essential enterprises. We are processing this work but so many of our customers are stopped that we are operating at a fraction of our normal revenue. At some point, the pay checks start bouncing and we have to shut down regardless of how essential we are. At the very least, we’ll lose much expertise and knowledge from something we’ve been building for the last ten years.
And your shutdown, MCS, could have a negative impact on response to the crisis. See David Foster’s recent post on problems GE is having sourcing materials to manufacture face shields because pointy headed bureaucrats have unilaterally shut down some of their suppliers.
Hydroxychloroquine may spoil the party for the Media and the Democrats.
Apparently, according to Hannity today, the only state where HCQ is not available is New York.
Nevada has also banned it but I don’t know if that governor has backed down like the one in Michigan.
MCS: You’re totally right, I misspoke, that’s the percent hospitalized, not the percent in ICU. Still way way too high for my comfort.
On February 13, Gov Cuomo urges people to join him in marching in the Chinese New Years parade in New York City https://www.governor.ny.gov/news/governor-cuomo-delivers-remarks-marching-flushing-lunar-new-year-parade
Here is another contribution to the time line by Cleta Mitchell.
Here is a key fact: In the beginning, China lied. People died. Although the first case of the coronavirus was reported in Wuhan, China in early December 2019, the Chinese authorities continued through January 2020 to downplay the potential for the disease to spread.
The World Health Organization (WHO) reinforced China’s falsehoods, saying on Jan. 14 that “Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel coronavirus (2019-nCoV) identified in Wuhan, China.” This was five to six weeks after the opposite was confirmed to be the case in Wuhan.
Good summary and the Democrats continue to allege without facts about this.