International COVID-19 Megathread

[PSOL]

Since this story is international, we might as well have a megathread for this crisis

https://www.reuters.com/article/us-china-health/millions-on-virus-lockdown-in-china-as-who-weighs-response-idUSKBN1ZM087

China put millions of people on lock down on Thursday in two cities at the epicenter of a coronavirus outbreak that has killed 17 people and infected more than 630, as authorities around the world worked to prevent a global pandemic.

...

Most transport in Wuhan, a city of 11 million people, was suspended on Thursday and people were told not to leave. Hours later, neighboring Huanggang, a city of about 7 million people, announced a similar lockdown.

“The lockdown of 11 million people is unprecedented in public health history,” Gauden Galea, the World Health Organization’s (WHO) representative in Beijing, said.

Other cities were also taking steps to restrict movement and contact.

There’s also been spread to Saudi Arabia

[PSOL]

Feel like this should be consolidated with the USGD thread on the same topic, though I agree it makes much more sense in the international board.

If anything, that thread should be consolidated onto this board. Very few of the new cases are expected to be from America and it is more pressing for the areas around China. I think half of the thread up on USGD is about the Chinese response to this crisis as well.

[urutzizu]

A Chinese woman from Wuhan took medication to hide certain undetermined virus symptoms from French Border Police, and has since been touring Paris and Lyon, eating in restaurants and boasting about it on social media. The Chinese embassy in Paris wants to talk to her.
https://www.scmp.com/news/china/society/article/3047334/chinese-told-comply-airport-coronavirus-checks-after-woman

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

China mobilizing to build a hospital in under a week (they did that during SARS):

Chinese city 'orders workers to build a dedicated coronavirus hospital in SIX DAYS' in a desperate bid to tackle the deadly outbreak

A Chinese city ravaged by a new deadly virus is planning to build a dedicated hospital in six days in a desperate bid to stop an outbreak of the life-threatening infection, it has been revealed.

The government of Wuhan, a major city by the Yangtze River with a population of 11million, has ordered a state-run construction company to design and build the emergency facility in Caidian District, according to Chinese media.

The institution will reportedly be modelled on a six-acre temporary treatment centre, which was built in Beijing in seven days to tackle SARS in 2003 and had 1,000 beds.

https://twitter.com/sotiridi/status/1220469185542807552

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

This doesn't sound good - one of the hopes was apparently that while it might spread once (or maybe twice) from a patient who was directly infected via animals, that it wouldn't spread beyond that. But 4 generations of spread now are apparently confirmed:

https://twitter.com/HelenBranswell/status/1220481782866489351

As for how contagious it is (this is the estimated # of people infected by each person who contracts the virus):

https://twitter.com/maiamajumder/status/1220501403057229824

Earlier today in the WHO statement the WHO said they thought it was between 1.4 and 2.5

[PSOL]

I might as well post The Guardian live update

Basically the death toll has risen to 26 with 630 infected, and people are calling for a ban on wild animal markets.

[urutzizu]

A Chinese woman from Wuhan took medication to hide certain undetermined virus symptoms from French Border Police, and has since been touring Paris and Lyon, eating in restaurants and boasting about it on social media. The Chinese embassy in Paris wants to talk to her.
https://www.scmp.com/news/china/society/article/3047334/chinese-told-comply-airport-coronavirus-checks-after-woman

At least two cases of the virus now confirmed in France and more are expected. If connected, she is in a ton of trouble.
https://www.lemonde.fr/planete/article/2020/01/24/coronavirus-deux-premiers-cas-confirmes-en-france-a-bordeaux-et-paris_6027158_3244.html

[President Johnson]

I wonder how much potential this has for really big trouble? Could we see thousands of deaths around the world as a result of this, including a mass-hysteria?

[super6646]

https://twitter.com/Laurie_Garrett/status/1220736112450326528

[rosin]

A Chinese woman from Wuhan took medication to hide certain undetermined virus symptoms from French Border Police, and has since been touring Paris and Lyon, eating in restaurants and boasting about it on social media. The Chinese embassy in Paris wants to talk to her.
https://www.scmp.com/news/china/society/article/3047334/chinese-told-comply-airport-coronavirus-checks-after-woman

At least two cases of the virus now confirmed in France and more are expected. If connected, she is in a ton of trouble.
https://www.lemonde.fr/planete/article/2020/01/24/coronavirus-deux-premiers-cas-confirmes-en-france-a-bordeaux-et-paris_6027158_3244.html

I doubt there is any connection: both newly confirmed infected people have recently been in China, (at least) one of them in Wuhan.

https://news.sky.com/story/coronavirus-outbreak-hospital-to-be-built-in-five-days-as-death-toll-rises-in-china-11916211

(yes, it is the right link, even though its title is misleading)

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

https://twitter.com/trvrb/status/1220820373261832193

Thanks to open sharing by @CDCgov, we now have the genome of the #nCoV2019 virus from the case in Washington State. https://nextstrain.org/ncov  has been updated with this data (shown here in red). 1/2



We see that the WA state case shares two mutations with cases isolated in Shenzhen, indicating shared transmission history. However, travel history for these cases suggests this is shared within Wuhan. 2/3



The accumulation of shared mutations in disparate cases with no known epi link is further strong evidence of sustained human-to-human transmission. 3/3

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

New coronavirus can cause infections with no symptoms and sicken otherwise healthy people, studies show

One child with the virus did not show any symptoms. Health authorities have said that people with the virus have shown a range of symptoms, from very mild to very severe. But an asymptomatic infection raises the question of whether people have to be showing signs of the disease to pass it to people, a question that experts are rushing to answer.

“Because asymptomatic infection appears possible, controlling the epidemic will also rely on isolating patients, tracing and quarantining contacts as early as possible, educating the public on both food and personal hygiene, and ensuring health care workers comply with infection control,” Dr. Kwok-Yung Yuen from the University of Hong Kong-Shenzhen Hospital, who led the research, said in a statement.

In this case, one has to wonder how effective (not very?) quarantine measures and travel restrictions are likely to be if they let through people that are not showing symptoms. Particularly given that there is also a fairly long incubation period... for any travel restrictions to be effective, it is probably not a safe bet to let people through just because they are not showing symptoms. However, that seems to be what has been happening in airports etc - they screen people, but only checking for fever/symptoms. Which may not be enough.

[super6646]

New coronavirus can cause infections with no symptoms and sicken otherwise healthy people, studies show

One child with the virus did not show any symptoms. Health authorities have said that people with the virus have shown a range of symptoms, from very mild to very severe. But an asymptomatic infection raises the question of whether people have to be showing signs of the disease to pass it to people, a question that experts are rushing to answer.

“Because asymptomatic infection appears possible, controlling the epidemic will also rely on isolating patients, tracing and quarantining contacts as early as possible, educating the public on both food and personal hygiene, and ensuring health care workers comply with infection control,” Dr. Kwok-Yung Yuen from the University of Hong Kong-Shenzhen Hospital, who led the research, said in a statement.

In this case, one has to wonder how effective (not very?) quarantine measures and travel restrictions are likely to be if they let through people that are not showing symptoms. Particularly given that there is also a fairly long incubation period... for any travel restrictions to be effective, it is probably not a safe bet to let people through just because they are not showing symptoms. However, that seems to be what has been happening in airports etc - they screen people, but only checking for fever/symptoms. Which may not be enough.

Already too late then.

[super6646]

https://www.ctvnews.ca/health/canada-s-first-presumptive-positive-case-of-coronavirus-found-in-ontario-1.4783477

BLAME CANADA

[Tender Branson]

It is here ! We are all going to die !

https://mobile.twitter.com/ORFBreakingNews/status/1221216410338254849

„Chinese flight attendant with suspected Coronavirus in Vienna Hospital.“

[super6646]

It is here ! We are all going to die !

https://mobile.twitter.com/ORFBreakingNews/status/1221216410338254849

„Chinese flight attendant with suspected Coronavirus in Vienna Hospital.“

Love the hyberpole.

Seriously, why has the WHO done nothing?

[Tender Branson]

The Vienna Chinawoman is doing extremely fine today and is almost symptom-free, according to a press statement from the KFJ hospital in Vienna.

A test result can be expected late at night or tomorrow. The hotel where the Chinawoman has stayed has been notified, as well as the flight crew and passengers on her flight from China to Vienna.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

5 million residents left Wuhan before lockdown, mayor reveals, as 1,000 new confirmed cases expected in city

About 5 million residents left Wuhan before the lockdown because of the deadly coronavirus epidemic and the Spring Festival holiday, mayor Zhou Xianwang revealed on Sunday, as health officials ­warned the virus’ ­ability to spread was ­getting ­stronger.

There were about 9 million people remaining in the city after the lockdown, Zhou told a press conference.

...

Ma Xiaowei, the minister in charge of China’s National Health Commission (NHC), told a press conference that battling the outbreak was complicated, particularly as it had been discovered that the new virus could be transmitted even during incubation period, which did not happen with Sars (severe acute respiratory syndrome).

“From observations, the virus is capable of transmission even during incubation period,” Ma said, adding that the incubation period lasted from one to 14 days.

“Some patients have normal temperatures and there are many milder cases. There are hidden carriers,” he said.

If 5 million people left Wuhan, then it is pretty hard to see how the cat isn't out of the bag, especially given that it apparently is transmissible even during the incubation period, and given that the incubation period is pretty long, and given that at least some people who carry the virus have had no symptoms.

So how does this not spread basically everywhere, eventually, in that case?

[Tender Branson]

5 million residents left Wuhan before lockdown, mayor reveals, as 1,000 new confirmed cases expected in city

About 5 million residents left Wuhan before the lockdown because of the deadly coronavirus epidemic and the Spring Festival holiday, mayor Zhou Xianwang revealed on Sunday, as health officials ­warned the virus’ ­ability to spread was ­getting ­stronger.

There were about 9 million people remaining in the city after the lockdown, Zhou told a press conference.

...

Ma Xiaowei, the minister in charge of China’s National Health Commission (NHC), told a press conference that battling the outbreak was complicated, particularly as it had been discovered that the new virus could be transmitted even during incubation period, which did not happen with Sars (severe acute respiratory syndrome).

“From observations, the virus is capable of transmission even during incubation period,” Ma said, adding that the incubation period lasted from one to 14 days.

“Some patients have normal temperatures and there are many milder cases. There are hidden carriers,” he said.

If 5 million people left Wuhan, then it is pretty hard to see how the cat isn't out of the bag, especially given that it apparently is transmissible even during the incubation period, and given that the incubation period is pretty long, and given that at least some people who carry the virus have had no symptoms.

So how does this not spread basically everywhere, eventually, in that case?

LOL @ the mayor of Wuhan.

He doesn't even know how many people are in his city.

Wuhan has 11 million people, not 14 million.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

LOL @ the mayor of Wuhan.

He doesn't even know how many people are in his city.

Wuhan has 11 million people, not 14 million.

This presumably depends on what outlying areas/suburbs one counts or doesn't count. According to wikipedia, the broader metro area has up to 19 million people:

https://en.wikipedia.org/wiki/Wuhan

[Tender Branson]

LOL @ the mayor of Wuhan.

He doesn't even know how many people are in his city.

Wuhan has 11 million people, not 14 million.

This presumably depends on what outlying areas/suburbs one counts or doesn't count. According to wikipedia, the broader metro area has up to 19 million people:

https://en.wikipedia.org/wiki/Wuhan

He's not the mayor of the metro area though.

Besides, the city has an area of 9.000km², which is larger than most states in Austria and larger than Delaware.

[Senator-elect Spark]

This is horrible. This can turn into a pandemic the WHO should be proactive with this.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

This is horrible. This can turn into a pandemic the WHO should be proactive with this.

Instead, WHO has been delaying declaring an international health emergency for several days now (possibly out of concern for the economy and because of pressure from China, rather than concern for health). If it is indeed correct (as was reported) that the Coronavirus strain can be transmitted by asymptomatic patients, that seems to me to be grossly irresponsible, because in that case it is basically a certainty that it will spread significantly more internationally, because it makes it basically impossible to screen people for the virus effectively/reliably. In any case, the economic cost of a weak/delayed response will end up being greater than the cost of a quick and on-the-ball response.

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

It seems like this is pretty transmissible and either very difficult and perhaps impossible to contain, so it seems to me that the next point of concern is what is the actual case fatality rate (CFR)?

Reported deaths have been consistently at around 3% of reported cases (but up to 14% or so of the first 41 cases, which have had more time to develop). However, a lot of cases are presumably unreported/unconfirmed, so that would make the true number lower (but there is no reliable telling of just how much lower).

On the flip side though, reported deaths are growing faster than reported cases where someone recovered and released from hospital, so it is unknown how many of the people who are not currently dead might still die from it prior to any recovery/release from hospital.

While 80 people have died, only 59 have actually recovered and been released from hospital according to the statistics. Even if the statistics are not necessarily entirely accurate, it is pretty disturbing to me that the # recovered is not higher, and that it is not even higher than the deaths. This seems to me like the biggest/most worrisome additional unknown at this point - how much will the recoveries of hospitalized cases start growing, and will they start exceeding deaths, or will more of the patients that haven't been released gradually succumb also?

[Former Dean Phillips Supporters for Haley (I guess???!?) 👁️]

While 80 people have died, only 59 have actually recovered and been released from hospital according to the statistics.

Here is a take on this from the flutrackers forum:

Now 2500+ confirmed cases in China with 80 deaths....and 51 discharges. 51. Really? That doesn't even seem possible. How could they have had so few discharges? It becomes even worse when you consider that 28 of the first 41 cases have been discharged, so only 23 other people have recovered from this virus in all of China? I can think of a few possibilities:

1. This virus is much more severe than reported. This seems unlikely, given that Nepal has discharged its case, Japan has discharged at least one, and Thailand has discharged 5 of 8. This wouldn't be happening if this virus really had anywhere near the 60% CFR that is computed using only cases that have resolved.
2. China is keeping most recovered patients in the hospital as a precaution because they're not really sure that they're not carrying the virus.
3. The case definition or the testing regime in China are so fouled up that in order to be confirmed, you have to be so sick that you really have a 60% chance of dying. If this is true, it means that 1500 people are going to die from this virus in the next week. I think this is probably unlikely as well, but possible.
4. China is massaging the numbers to under report the total case count by replacing each discharge with a new case, keeping the total number hospitalized correct, but not having to report the new case. The problem with this explanation is that if there are only 23 of these other recoveries in China, at some point someone would find 24+ survivors of the virus (on Weibo?) and severely damage China's credibility.
5. A slightly more severe version of #4: So many people are ill that authorities cannot keep track of which patients are confirmed and which are not, so they can't accurately report the discharge of confirmed cases.
6. You can't discharge a case if you never hospitalize it. Late in the 2003 SARS outbreak, when the number of actual confirmed ill cases worldwide had dropped to a few dozen, the USA count of ill suspected cases began to exceed the actual number of confirmed cases worldwide. The CDC was reporting about 75 suspected cases with only about 30 discharges. It took a few weeks to determine that the US was only reporting a case as discharged if it had actually been hospitalized. Cases that were so mild that they didn't need to be hospitalized (in this case, because they weren't SARS) had been excluded from the discharge count. The CDC in 2003 made a sudden adjustment once this was detected, and the US discharge count jumped up from 30 to about 70, bringing its numbers in line with the world. Perhaps China's nCoV discharge count will make a similar jump in coming days.

Personally, I'm guessing #2, followed closely behind by #4 or #5. Right now, this anomaly is worsening by the day and prevents any attempt to calculate a CFR for this virus.