Author Topic: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China  (Read 82939 times)

Offline mountainmoma

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #150 on: February 03, 2020, 08:37:29 PM »
Never panic, but prepare.

The problem with this virus, so far as we can ascertain from China data, is that there is a long time without symptoms so it spreads easily, it goes quickly to pneumonia, and has a reasonably high death rate. 

I am not going to try and find the references.  I believe the numbers I saw were R0 rate of 10 for SARS, 2-4 estimated for COV, and .1 for our normal seasonal flu. So, if what is being reported stays as its normal, in other countries than China, then it is many  times as deadly as our normal seasonal flu, but not as near as deadly as SARS or the spanish flu of 1918.   

But, second point, is that it makes alot of people very sick, if we can hospitalize and treat in this country, then we can save alot of these, but all indications are that percentagewise it causes more adverse respiratory reactions than our usual seasonal flu.  Right now out of very few ( that we know of) infections on the west coast, at least 3 had to be hospitalized, not just because of Observation.  The couple from San Benito county were just transferred today to San Francisco to a large hospital, and the male in Washington state, while initially having mild symtoms became quite seriously ill. 

I read about the Patient in washington state, and  I read about this in the New England Journal of Medicine  - so not some tabloid....

 https://www.nejm.org/doi/full/10.1056/NEJMoa2001191

So, a healthy 35 year old male, week one, looks like typical cold/flu, second week pneumonia and needs hospital care — my summary.  If many cases are like this, all at once, we will overwhelm the hospitals. This is one of our major risks.  Having too many sick at once.  At this point,  this virus or a mutation of it, will be a virus that we have to contend with, you cant keep it from spreading everywhere as it is not deadly enough nor quick enough.  But, if it is going to make a large amount of people as sick as this guy, we need to have not everyone get it at once.  So, yes, taking steps to slow down the pandemic are good.

Patient was a healthy 35 year old, non-smoker, male.  After the blood level oxygen monitoring showed that being low is when he was started on more intensive treatment ( recommend buying a fingertip monitor for home use, as then you would have a real physical indication of being bad enough to want to risk a hospital ).  They confirmed with x-rays.  They treated for pneumonia with antibiotics and extra oxygen thru a nose tube. Sounds like an IV drop of fluids which also administered the antibiotics.  They soon discontinued the antibiotics and changed to an ” investigative” antiviral. This was Illness day 9 ( hospital day 5), when he had a change of respiratory status, ie., the low O2 levels and likely breathing trouble.  So, sounds like his first week was totally unremarkable, second week was realy very sick.  Taken off O2 and medicines on illness day 12.

   
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On day 6, the patient was started on supplemental oxygen, delivered by nasal cannula at 2 liters per minute. Given the changing clinical presentation and concern about hospital-acquired pneumonia, treatment with vancomycin (a 1750-mg loading dose followed by 1 g administered intravenously every 8 hours) and cefepime (administered intravenously every 8 hours) was initiated.

    clinicians pursued compassionate use of an investigational antiviral therapy. Treatment with intravenous remdesivir (a novel nucleotide analogue prodrug in development10,11) was initiated on the evening of day 7, and no adverse events were observed in association with the infusion. Vancomycin was discontinued on the evening of day 7, and cefepime was discontinued on the following day, after serial negative procalcitonin levels and negative nasal PCR testing for methicillin-resistant Staphylococcus aureus.

    On hospital day 8 (illness day 12), the patient’s clinical condition improved. Supplemental oxygen was discontinued, and his oxygen saturation values improved to 94 to 96% while he was breathing ambient air. The previous bilateral lower-lobe rales were no longer present. His appetite improved, and he was asymptomatic aside from intermittent dry cough and rhinorrhea. As of January 30, 2020, the patient remains hospitalized. He is afebrile, and all symptoms have resolved with the exception of his cough, which is decreasing in severity.

They show his symptoms and temperature on a bar chart by day.  That second week was real bad, real high temps, throwing up, diarea, in addition to the cough and impared lungs...

Offline mountainmoma

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #151 on: February 03, 2020, 08:50:35 PM »
It is a stretch to try and make an illogical connection to the flu shot and concern over catching this new virus.  For starters, this years flu shot is not even that effective for this years flu ! Secondly, the shot also, for some, makes them feel bad. Third, the new virus looks like it is much more dangerous.  We all get to choose where our limit is to what dangers we expose ourselves to.  Some people jump out of airplanes, others find it too risky but may be comfortable with other activities

It is not helpful in having a discussion to bring in non-connected points.  But, our media just loves to do that, a good way to deflect.  Why do they feel a need to deflect ?  Why not address this virus and peoples concern about it. 

In the sense they are trying to avert panic, I guess, but insulting peoples intelligence is not the way to go about it

Offline FreeLancer

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #152 on: February 03, 2020, 09:15:51 PM »
WSJ:  Coronavirus Outbreak a Major Test of China’s System, Says Xi Jinping

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“Anyone who fails to perform their duties will be punished according to discipline and law,” Mr. Xi said, according to the official Xinhua News Agency.

Mr. Xi also said he was closely monitoring the effects of the epidemic on China’s economy, according to Xinhua.

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Russia, which has already tightened its borders and restricted air travel, might start deporting foreigners who are infected, Prime Minister Mikhail Mishustin said during a televised meeting Monday. President Vladimir Putin ordered the use of military aircraft to evacuate Russian nationals stuck in parts of China worst affected by the coronavirus.

Several governments, including the U.S. and the U.K., have chartered planes to repatriate people from Hubei.

The Israeli health ministry on Sunday began requiring all citizens returning from China to quarantine themselves at home for 14 days, and the country’s borders are closed to noncitizens who have been in China in the past two weeks. Several other countries in the Middle East—Iran, Saudi Arabia, Oman, Iraq and Egypt—took measures to distance themselves from contact with China, including suspending flights to and from the mainland.

Ms. Hua, the Chinese Foreign Ministry spokeswoman, singled out U.S. restrictions in criticizing some governments as overreacting, saying the WHO doesn’t endorse a travel ban. “We hope countries will make reasonable, calm and science-based judgments and responses,” she said.

Offline iam4liberty

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #153 on: February 03, 2020, 10:34:26 PM »
It doesnt matter whether governments implement travel bans because the airlines and other companies are doing it on their own. Even when they didnt, their employees simply refused to enter there.

Offline mountainmoma

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #154 on: February 03, 2020, 11:22:57 PM »
I said this wrong, I am not medical and forgot what R0 is.  what I typed above wasnt R0, but a comparision of fatality rates
Quote
I am not going to try and find the references.  I believe the numbers I saw were R0 rate of 10 for SARS, 2-4 estimated for COV, and .1 for our normal seasonal flu. So, if what is being reported stays as its normal, in other countries than China, then it is many  times as deadly as our normal seasonal flu, but not as near as deadly as SARS or the spanish flu of 1918.

So, those are estimates of fatality rates.  .1 regular seasonal flu; 2-4 estimate for nCOV, 10% for SARS

R0 is infection rate, how many people are infected per one carrier.  Seasonal Flu - 1.28
estimate for nCov - 2.5 to 3, with a recent study estimating it as high as 4.8

Serious Complication Rate (requires an ICU bed or extensive medical intervention) Seasonal Flu - 1%
nCov - estimated at 20%

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According to the CDC they estimates that influenza (the flu) for 2019 has resulted in between 19 million – 26 million illnesses, between 180,000 – 310,000 hospitalizations and between 10,000 – 25,000 deaths.

f you do the comparison, with 19 - 25 million illnesses, nCov could kill 570 - 750 thousand individuals, with an estimated 3.8 - 5 million people needing serious medical intervention or a ICU bed.


Offline FreeLancer

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #155 on: February 03, 2020, 11:58:58 PM »
It is a stretch to try and make an illogical connection to the flu shot and concern over catching this new virus.

Epidemiologically it appears to be closer to flu than other recent novel epidemics.  It's not an unreasonable comparison in terms of risk assessment/management.


For starters, this years flu shot is not even that effective for this years flu !

Flu vaccine rarely ever is "that effective" at preventing flu but it does reduce ICU admissions by >80%, which means you probably won't die from it.


Secondly, the shot also, for some, makes them feel bad.

It makes a lot of people feel bad.  I get mine on Friday afternoon and lay around all weekend.


Third, the new virus looks like it is much more dangerous. 

And if it actually turns out to be much more dangerous the healthcare system will sorely need beds for coronavirus patients that would otherwise be occupied by those with influenza.

Offline iam4liberty

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #156 on: February 04, 2020, 09:58:59 AM »
https://www.sfchronicle.com/bayarea/amp/U-S-officials-take-aggressive-measures-to-15027383.php
Bay Area officials scramble to contain coronavirus as UCSF accepts two patients

Offline surfivor

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #157 on: February 04, 2020, 10:26:05 AM »

Quote
(Flu shot) It makes a lot of people feel bad.  I get mine on Friday afternoon and lay around all weekend.

 Really ? It must be doing wonders for your body / health

Offline FreeLancer

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #158 on: February 04, 2020, 11:29:26 AM »
It’s a simulated viral attack that stimulates an appropriate response that gets stored with the immune system’s other battle plans.  The cytokines generated as part of the immune response in that war game make many people feel like crap.

Offline mountainmoma

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #159 on: February 04, 2020, 12:02:30 PM »
Epidemiologically it appears to be closer to flu than other recent novel epidemics.  It's not an unreasonable comparison in terms of risk assessment/management.


Flu vaccine rarely ever is "that effective" at preventing flu but it does reduce ICU admissions by >80%, which means you probably won't die from it.


It makes a lot of people feel bad.  I get mine on Friday afternoon and lay around all weekend.


And if it actually turns out to be much more dangerous the healthcare system will sorely need beds for coronavirus patients that would otherwise be occupied by those with influenza.

You know that is not what the jounalists are saying. The papers are mentioning flu shots to divert attention and to minimize concern over the nCOV.  And, this is working for many people,  so they read this and interpret it to mean that you shouldnt be concerned over the nCOV if you are not concerned about the flu ( lack of concern to them evidenced by not getting the shot)

If the papers where saying, hey, please, if medically it wont make you feel too bad, please go get the flu shot if able so that we can save hospital beds for this new, much worse virus.  But, that is not what they are saying.  Their whole intent on bringing up not vaccinating is to minimize concern over the nCOV. ( ANd, secondarily to minimize all people who are vaccine choice)

Offline FreeLancer

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #160 on: February 04, 2020, 02:04:40 PM »
I wouldn't place the blame on the media or journalists.  These are recommendations from public health and infectious disease professionals across the globe. 

While they haven't reached a clear consensus on how this novel coronavirus plays out (because we're forced to learn about how the disease behaves while we're fighting it), there is very strong agreement that the flu will likely kill many more people over the next 12 months.

It's human nature to fear the mundane less than the dramatic, despite the fact that it's the mundane that usually kills us.

Offline Mr. Bill

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #161 on: February 04, 2020, 02:28:01 PM »
Slightly-good news, maybe:

ArsTechnica, 2/4/20: Symptomless spread of new coronavirus questioned as outbreak mushrooms

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The Chinese businesswoman who spread the 2019 novel coronavirus (2019-nCoV) to four colleagues in Germany while reportedly experiencing no symptoms of the infection actually did have symptoms, according to a news report in Science.

The woman’s case, published January 30 in The New England Journal of Medicine, was considered the most clearly documented evidence that the novel viral infection could spread silently from asymptomatic people. ...

But that conclusion now appears to be based on false information. ...

According to the new report in Science, the businesswoman’s 2019-nCoV infection symptoms went unrecognized because they were mild, masked by over-the-counter medications, and—most notably—the authors of the NEJM article didn’t speak with her before the article was published. ...

Without direct communication with her prior to the publication, the NEJM article’s authors relied on the accounts of her four sickened colleagues in Germany, who said she didn’t seem sick during her visit.

But government health officials in Germany were later able to reach the Shanghai woman by telephone. People privy to details of the call told Science that she said she felt tired, had muscle pains, and took a fever-reducer during her visit. ...

[Co-author] virologist Christian Drosten of the Charité University Hospital in Berlin, said, “I feel bad about how this went, but I don’t think anybody is at fault here. Apparently, the woman could not be reached at first and people felt this had to be communicated quickly.”

Drosten went on to say that—despite the correction—the five cases highlight a potentially dangerous feature of this outbreak—that is, that the infection may not be very dangerous.

“There is increasingly the sense that patients may just experience mild cold symptoms, while already shedding the virus,” he said. “Those are not symptoms that lead people to stay at home.”

Indeed, as the outbreak has continued to escalate, experts have noted that the virus appears more contagious than initially thought and that the early outbreak responses focused heavily on identifying the most severe cases, such as those involving pneumonia and respiratory distress. That focus may have potentially missed the spread of mild disease, which may be far more extensive than what is known even now. ...

Offline FreeLancer

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #162 on: February 04, 2020, 08:41:06 PM »
Cruise ship passenger tests positive for virus

Japan Times:  At least 10 on quarantined Japanese cruise ship infected with coronavirus

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Results for 31 of them came back, and 10 people in their 50s to 80s were found to be infected and are being sent to a hospital, he said, adding that none are showing severe symptoms.

Offline iam4liberty

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #163 on: February 04, 2020, 08:58:03 PM »
Japan Times:  At least 10 on quarantined Japanese cruise ship infected with coronavirus

Ugh.  That is horrible.  Poor vacationers.

Thought about shorting cruise lines but others beat me to it.  For example, carnival cruise lines already down from $53 to $43.

Offline FreeLancer

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #164 on: February 04, 2020, 09:24:38 PM »
CDC:  Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential 2019 Novel Coronavirus (2019-nCoV) Exposure in Travel-associated or Community Settings

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Most often, spread from person-to-person happens during close exposure to a person infected with 2019-nCoV. Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs, similar to how influenza viruses and other respiratory pathogens spread. These droplets can land in the mouths, noses, or eyes of people who are nearby or possibly be inhaled into the lungs. It is currently unclear if a person can get 2019-nCoV by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes.



Guidance for stratifying aircraft contact risk based on distance from infected.

Offline iam4liberty

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #165 on: February 04, 2020, 10:33:37 PM »
Guidance for stratifying aircraft contact risk based on distance from infected.

I mentioned premium airline credit cards as a prep in another thread.  One thing they allow me to do is upgrade to First Class every flight.  There is a huge difference in spacing between that and coach.  Good thing as I have to head to NYC in three weeks and I am sure this will be lurking around there.



Offline FreeLancer

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #166 on: February 05, 2020, 12:21:37 AM »
Restricting the movement of 20 million people is difficult to achieve and often counterproductive in pandemics. But China is high tech surveillance state and might have more success.


WSJ:  China Marshals Its Surveillance Powers Against Coronavirus

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In January, a person infected with the dangerous new Wuhan coronavirus used public transportation to crisscross the eastern Chinese city of Nanjing, potentially exposing those along the way to the highly contagious pathogen.

Using the country’s pervasive digital-surveillance apparatus, authorities were able to track—down to the minute—the sick person’s exact journey through the city’s subway system.

Officials then published those and other details of the person’s movements on social media and warned residents to get themselves checked if they had been in the vicinity at the time.


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China has built a formidable digital-surveillance system in recent years, linking facial recognition, security cameras and social-media monitoring with regular human surveillance. The aim is to keep tabs on its 1.4 billion citizens, chiefly to identify and prevent threats to social order and Communist Party control.

The country’s state-run media has celebrated the application of the authorities’ big-data tracking abilities in the campaign to control the disease outbreak, touting it as an example of the social benefits of technology.

Offline iam4liberty

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #167 on: February 05, 2020, 06:50:41 AM »
Interesting thoughts on minimizing spread.

https://www.wsj.com/articles/stop-a-u-s-coronavirus-outbreak-before-it-starts-11580859525
Stop a U.S. Coronavirus Outbreak Before It Starts
It’s time to start testing patients with unexplained pneumonia, even if they haven’t traveled to China.


First, doctors must be on high alert. The Centers for Disease Control and Prevention should expand its guidance to doctors: Be suspicious of anyone with unexplained pneumonia who tests negative for common viruses, even if the patient has no connection to China.

An expanded sentinel surveillance system—detailed data collected from a network of high-risk locations—could help spot unusual clusters of illness that might be the beginning of an outbreak. If only 10% to 20% of people develop serious symptoms, then for every person diagnosed there may be eight or nine who elude detection.

Second, these expanded criteria should translate into broader screening. It’s crucial to identify cases of secondary spread, in which someone catches the virus from another person who hasn’t recently been to China.

Offline FreeLancer

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #168 on: February 05, 2020, 08:27:33 AM »
Like the authors mention, expanding surveillance to non-China-travel suspects requires vastly increased laboratory capacity.  The process of ramping up testing isn't as quick and easy as it sounds but needs to be prioritized so we can back away from quarantine, which causes more problems than it solves the longer it is in place.  Quarantine is the martial law of medicine and at best is just a stop-gap measure to buy time for more civilized approaches to dealing with an epidemic.

Offline nano.

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #169 on: February 05, 2020, 11:06:38 AM »
Not to jump into the tinfoil hat party, but anybody have thoughts on that screenshot from Tencent talking about 150K infected w/ 24K dead?

I'm wondering if it was an actual error, or if the Chinese govt. really is trying to keep a lid on just how bad it is there...

Offline Mr. Bill

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #170 on: February 05, 2020, 12:19:42 PM »
I think it would be hard to cover up 24,000 dead, even for China.  Too many Chinese citizens (and visitors) have access to telecommunications/Internet, and the word would get out.

Offline Mr. Bill

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #171 on: February 05, 2020, 01:17:32 PM »
Reuters, 2/5/20: Data suggests virus infections under-reported, exaggerating fatality rate

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...In Wuhan, the epicenter of the disease, one person has died for every 23 infections reported. That number drops to one on 50 nationally, and outside mainland China, one death has been recorded per 114 confirmed cases.

Experts say the discrepancy is mainly due to under-reporting of milder virus cases in Wuhan and other parts of Hubei province that are grappling with shortages in testing equipment and beds. ...

“It’s good to remember that when H1N1 influenza came out in 2009, estimates of case fatality were 10 percent,” said David Fisman, an epidemiologist at the University of Toronto, who was working in public health at the time. “That turned out to be incredibly wrong.”

“As the denominator is growing in terms of case numbers, and case fatality goes down and down... you start to realize it’s everywhere,” he said. ...

Offline iam4liberty

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #172 on: February 05, 2020, 02:19:31 PM »

Offline iam4liberty

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #173 on: February 05, 2020, 10:27:18 PM »
Ugh.

https://www.latimes.com/travel/story/2020-02-05/coronavirus-cruise-passengers-diamond-princess
20 aboard cruise ship now stricken with coronavirus; the rest quarantined off Japan

Offline mountainmoma

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #174 on: February 06, 2020, 12:33:12 AM »
5 employees from Good Samaritan Hospital in San Jose who took care of the Santa Clara county patients with the nCOV are now sent home for quarantine....

this is a local ( San Jose based) news station broadcast, healthcare workers segment at .38minutes

https://www.youtube.com/watch?v=YAH9TbeADMI&feature=youtu.be

No wonder they sent the san benito county couple up to SF .   

On this side of the hill, there is no change and no masks ( both ways, no masks seen on people and also no masks available at any stores) although, that was yesterday, who knows now

Offline FreeLancer

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #175 on: February 06, 2020, 09:08:16 AM »
NYT:  Wuhan is told to round up infected residents for mass quarantine camps.

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Sun Chunlan, a vice premier tasked with leading the central government’s response to the outbreak, said city investigators should go to each home to check the temperatures of every resident and interview infected patients’ close contacts.

“Set up a 24-hour duty system. During these wartime conditions, there must be no deserters, or they will be nailed to the pillar of historical shame forever,” Ms. Sun said.

The city’s authorities have raced to meet these instructions by setting up makeshift mass quarantine shelters this week. But concerns are growing about whether the centers, which will house thousands of people in large spaces, will be able to provide even basic care to patients and protect against the risk of further infection.

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Mr. Xi also said his government would crack down on people who assault medical workers and who manufacture and sell fake products, according to Xinhua, the state-run news agency. He also said that officials would take aim at those who resist epidemic prevention and control efforts, including by spreading false rumors.

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“‘Taiwan independence’ separatists have seized on the opportunity to clamor for participation in the World Health Organization’s discussions, in an attempt to use the epidemic to expand the so-called ‘international space’ of Taiwan,” read a statement from China’s Taiwan Affairs Office on Thursday.

In an apparent attempt to avoid taking sides in the dispute, the W.H.O. referred to the island as “Taipei and environs” in a list of Chinese cities and provinces with confirmed cases of the coronavirus. The United Nations body has previously referred to the entire island as Taipei — Taiwan’s capital city. It has also referred to it as Taipei, China, drawing a backlash from residents.


Things are getting nuts over there, and the repercussions will extend far beyond the epidemic itself.

Offline FreeLancer

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #176 on: February 06, 2020, 09:16:14 AM »
WaPo:  Chinese doctor who tried to sound alarm about coronavirus — but was silenced by police — has died, friends and colleagues say

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BREAKING: Li Wenliang died Thursday night after contracting the coronavirus at his workplace, Wuhan Central Hospital. He became a national hero and a symbol of the Chinese government's failings after friends reported that he sought to sound warnings about the new coronavirus on Dec. 30.

This is a developing story. It will be updated.

Offline David in MN

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #177 on: February 06, 2020, 09:54:21 AM »
Things are getting nuts over there, and the repercussions will extend far beyond the epidemic itself.

That's what is scaring me. This is the test case for how a modern society handles a relatively wimpy disease. And lo and behold the Chinese solution is to put people in camps. This is a mild flu variant that could be handled easily without stigmatizing the infected and creating a scare campaign where people clam up and play dumb. The Chinese have created the perfect storm where a person exposed now rationally does all he can to get out. Precisely the wrong policy to contain.

I can't but help thinking of Taleb's iatrogenics discussion where the doctor is worse than the disease. Something here is rotten and I don't believe the Chinese party line.

Offline surfivor

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #178 on: February 06, 2020, 12:13:57 PM »
I can't but help thinking of Taleb's iatrogenics discussion where the doctor is worse than the disease. Something here is rotten and I don't believe the Chinese party line.

 I often tend to believe or am very suspicious that that's really what it's all about anyway at some level.

That's why it has to be analyzed and investigated from many angles and you should not trust official sources where you have to rely on them to give the information that can't be verified.

That's the problem though is how can you verify information that it is trustworthy ? You can't but ocams razir says go with whatever simple explanation you can come up with and I don't like that either

Offline FreeLancer

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Re: Coronavirus 2019-nCoV outbreak in China
« Reply #179 on: February 06, 2020, 01:05:38 PM »
The Chinese have created the perfect storm where a person exposed now rationally does all he can to get out. Precisely the wrong policy to contain.

Precisely why quarantine is counterproductive, more often than not, and should be used rarely.