I don’t think you’re getting the message here. It’s not the phosphorylated “crown” or type of virus that’s scary. It’s the spread, IN a given time segment. No flu that you or I have encountered has grown geometrically. With only 95,000 ICU beds in the US where do you propose all the ‘crtically’ sick are going to go?
... the initial emergence of the virus was not the Huanan seafood market. Spread of the virus was already occurring person-to-person in October-November (or earlier) and gradually increasing into December. Thus, some of the 14 of the 41 patients who had no exposure to the Huanan seafood market (see page 3 Figure 1B) would be explained. Thus, the presumed rapid spread of the virus apparently for the first time from the Huanan seafood market in December did not occur. Instead the virus was already silently spreading in Wuhan hidden amidst many other patients with pneumonia at this time of year. Thus, some of the 14 cases with no exposure to the Huanan market out of the total 41 cases (see article page 3, figure 1B) could be explained by the pre-existing chains of transmission causing ongoing person-to-person transmission and/or transmission from infected animals (1 or more species) in other markets inside and/or outside Wuhan, or anywhere along the supply chain of infected animals. [...] If in fact the virus was silently spreading unrecognized amidst other types of pneumonia in Wuhan, in the absence of a specific diagnostic test, for several months before its discovery in early January 2020, then the virus was already present across parts of Wuhan and other places in Hubei province, other parts of China, and even in limited numbers to some other countries. Thus, China could not have instituted earlier control measures against an undiscovered virus.
Hey Chris, unless you seen it already, you (your YouTube channel) is linked on a Bloomberg article:
“On YouTube, a series of videos accusing media organizations of suppressing information had hundreds of thousands of views.”
https://www.bloomberg.com/news/articles/2020-01-29/coronavirus-misinformation-is-incubating-all-over-social-media?utm_campaign=news&utm_medium=bd&utm_source=applenews
What a perfect way to delegitimize someone without a single shred of evidence. Absolutely no attempt to counter any claims…just throw Chris in with the drink bleach for a cure crowd. Shit like this almost makes me want to see this go exponential to show these twits how little they comprehend. Think about Peter Schiff telling the CNBC people that the housing bubble was a disaster back in 2007 as they openly laughed at him. This is seriously a wonderful example of the loss of trust we suffer from. We being free thinking people interested in the possibilities and not the crowd control propaganda. It’s all a big joke
.
Beijing, Shanghai, Guangzhou and Shenzhen
these cities are reporting 100 plus cases
God only knows the real numbers
here’s a scary thought: how long until these cities fall and turn into Wuhan? Can the Chinese really lock down these cities for weeks on end before cratering it’s econony? How long can people last on lockdown in those cities without food or water?
Scary to think about. Can they prevent the spread to these major cities or is inevitable they will turn Into Wuhan
Uki78, agreed. I was surprised as I mostly like what I’ve seen of Bloomberg. Chris/Adam/PeakProsperity’s take on this virus has been measured, fact based, restrained and every time Chris has made predictions he has said, these are just predictions. Unfortunately, he’s been pretty accurate so far. He has counseled caution, which is a very reasonable course given what we’re seeing. Anyway, if he’s proven right I’m sure Bloomberg will apologize. Right? Oh, did I lapse into sarcasm there? Oops.
Being prepared makes me sleep better at night and I’m ready to help my neighbors if they need it. There is no vaccine for Ncov-19 yet (although I’m betting they’ll come out with one in record time). But to my way of thinking, reasonable preparation ahead of time and a measure of self-reliance is the best inoculation against panic. Luckily, in this latter respect, I think the PeakProsperity community has already developed herd immunity!
The info from PP has been really on point and much more in depth than the general media. The possible benefits of elderberry syrup has been an actionable piece of info. I bought enough for my family and a few neighbors…and left the rest on the shelf so someone else could buy it later. Ditto with N95 masks.
Adam and Chris, keep up the good work!
Response to outbreak is often linked to organisational capacity and logistics.
Case fatality rate from cholera (infection I’m most familiar with, though it was 15-20 years ago I worked with it directly) without proper treatment was around 50% of severe cases, with timely and proper treatment this could be brought back to 1-2%). The low number can be achieved when you have the infrastructure, competent and motivated staff (med and non-med), proper and well-running organisation, and sufficient and adequate equipment and materials.
From a medical point of view cholera is mostly about keeping people hydrated. Severe cases of cholera can need up to 20 l of IV fluid per day. Keeping a thing like that going needs a good supply chain running. In one case in Mozambique (1998) where we had just started, the hospital was overflowing (almost literally), and one evening they chartered trucks and (unannounced) dumped their 300 patients into our cholera treatment centre that we were still setting up. It took a while to get things under control. The main challenge here was organisation and logistics.
As long as you’re in the capacity of the organisation to manage the outbreak you’re pretty much in linear territory and have some level of control. Once you pass the capacity though, control is lost and things start getting their own life; it goes into exponential mode (more chaotic).
If you have a well-oiled system probably the impact of the outbreak can be managed adequately in developed countries, and fatalities can be minimised. The response system is complicated though and dependent on many things working well (our focus on efficiency undermines our capacity to deal with shocks), and that’s not a given if the genie is out of the bottle (and it seems to be well past this point).
As has also been said here on PP, there will be other systems that are affected by this that may play out in unexpected ways. So I think it is still early days to say that impact of this outbreak will be limited.
From all evidence, I think BorderPatrol (above) is right. Though this virus is very infectious, the actual fatality rate in First-World nations appears low. China is bad and will remain bad - because they are overwhelmed. Fear and panic make it worse.
I went to work in a Sydney hospital yesterday ( with a high number of Chinese overseas visitors amongst them) and wore full PPE all day and that made me the “weird one”
It’s summer and the beaches and bars are humming with barely dressed people.
The cognitive dissonance I’m experiencing is strong! The waters lovely this time of year and going to the beach is the antithesis of strong PPE.
Questions: 1) Is the P95 mask effective or do we really need a P100. We know the genome, it’s a question of particle size isn’t it? 2) Why do so few people get exponential functions? 3) Please remember to teach people how to remove their PPE safely too… this got some healthcare workers in previous contagions. Keep up to good work!
“Do you feel lucky?”. “Well, do you punk?”
I totally get it. Most people will not die of Coronavirus if infected. And, it’s probably the case that it only hits the hardest when people are older, already have poor general health (obesity included), or are smokers. However, some younger healthy people will also become very sick & possibly die because of an exaggerated response of their immune system.
The thing about almost every young healthy person is that they have older moms, dads, grandparents, aunts, uncles, friends, etc who might not be in the best of health, are smokers, are very obese, etc.
I’m a physician & take care of hospitalized patients. I’ve seen enough patients die or become extremely ill from the flu. I will never forget a 26yo previously very healthy patient I had that eventually left the hospital with a tracheotomy & feeding tube in place after a 4 week admission for the flu. The irony is she was diagnosed with the flu within a day of symptoms & promptly received a prescription for Tamiflu. Tamiflu is pretty effective in decreasing severity & duration of symptoms when taken promptly after symptoms appear but has to be within 2-3 days for any effect. She elected not to fill that prescription because she didn’t want to spend the $75. The kicker is she had perfectly manicured nails. Those manicures cost at least $75+ from what the nurses told me.
So, do you feel lucky? Well, do you punk?
Just wondering why the recovery rate quoted is lower than the death rate.
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
Does it take longer to recover than to die?
Sorry if this is basic stuff for you learned folks but I can’t understand this atm
“On YouTube, a series of videos accusing media organizations of suppressing information had hundreds of thousands of views.”I never accused them of any such thing. I did expose how "media organizations" were using horribly misleading statistics that always served to downplay the risks here. And it's true that I did scroll through their online offerings noting that their coverage of the virus was woefully inadequate given those risks. What I said was that if one got their coronavirus info from "media organizations" you were either going to be misinformed or uninformed. That assessment stands. MSM has proven itself to have become utterly incapable of being useful here, and I'm sorry the Bloomberg "journalists" took it personally, but that's on them and their chosen profession. Is that harsh? With any luck, yes, and correctively so.
The fast spread of the virus is alarming - and I see many who are inducing fear by playing up that side of things. You have a chance to balance that by letting people know that fatalities are low. If you are the one guy consistently doing this - I feel you will gain a lot of traction. Fear and panic make this thing worse. Be the truly “balanced” guy - like your friend John Barry.
11% mortality rate in hospital patients worsened in a short period of time
and died of multiple organ failure.
17% patients developed acute respiratory distress syndrome which is a indication of mortality rate outside hospital.
https://marlin-prod.literatumonline.com/pb-assets/Lancet/pdfs/S0140673620302117.pdf
Confirmed superspreaders, like with SARS, carrying nCoV 2019 but no symptom but spreading the disease.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30154-9/fulltext
Just wondering why the recovery rate quoted is lower than the death rate.This has come up a lot so let me take a shot at answering it. It begins by making sure we have our terms agreeably defined. "Infected" - this means someone with or without symptoms who tests positive for nCoV. "Death" - means someone who has tested positive for nCoV dies within a defined window of time relative to the symptoms of an active nCoV infection. "Recovered" -what does this mean exactly? I don't know, and cannot find it defined anywhere. In theory it should be "anyone and everyone who was infected with nCoV but isn't sick and has circulating antibodies produced by their own body." With a huge number of people recovering naturally and at home, this cannot be the definition as it's being used in the official statistics. I suspect what they mean is "anyone who was hospitalized in serious condition but got better and is not ambulatory and discharged." But that's just a guess. Assuming that's a correct guess, then "recovered" is a small subset of the total population of infected persons. There are lots of ways for all of these numbers to be wildly off. Many infected people may never be detected because the test kits just weren't available (this is quite possibly a very large number). Deaths could be wrongly recorded, either by not being recorded at all, or because the death cert was filled out wrong (e.g. "pneumonia" rather than "nCoV viral pneumonia"). Recovered is going to fluctuate depending on where the clinical line is drawn on that definition (which should include everyone infected) and upon cases being accurately detected and so forth. I truly believe this virus can be effectively treated in a properly equipped and functioning medical center. The ex-China data tells us that. As AfriDev explained, that depends on the medical system not being overwhelmed. Which is my main concern. The China data is very concerning. China did not just shut down it's largest and most economically important cities for no good reason...they had the data...which they are not sharing with us unfortunately. So we have to squint through the fog and try to assess the severity by their actions, which are quite extraordinary. Nothing ordinary about this at all.
The fast spread of the virus is alarming – and I see many who are inducing fear by playing up that side of things. You have a chance to balance that by letting people know that fatalities are low. If you are the one guy consistently doing this – I feel you will gain a lot of traction. Fear and panic make this thing worse. Be the truly “balanced” guy – like your friend John Barry.I have and continue to. Check out this video release from 1/28/20 from the 1:13 mark onwards: https://www.youtube.com/watch?v=CMXcMtqH8ak&t=326s But let me ask you something because I really need an answer. How does "fear and panic make this thing worse"? It's a legit question. I hear that view of yours a lot. It's usually presented as if it's a universally accepted truth. Something that all rational people just know and accept. But now I'm asking for a concrete answer to this question; "How do fear and panic harm more than help addressing a contagion?" Specifically, what is it that happens that makes things worse if people are motivated by fear or panic? Riots? Muggings? Suicides? What happens? Specifically. Give me examples, please, nice concrete ones because those work for me. If we de-tune your emotionally laden words ("fear" and "panic") a touch I believe there's another set of words that might apply; "concerned" and "alarmed." If there's smoke pouring into my bedroom I want to become concerned and alarmed as fast as possible if that leads me to take actions that will motivate me towards safety. So what would happen if people became aware of the risks of this virus? What bad things would result if people got knocked out of their complacent slumber and were suddenly motivated to take actions? Well they might:
- Read more and become educated
- Discuss this openly with friends and family and co-workers
- Be motivated to actually employ the better hygiene practices recommended by the CDC
- Begin to use appropriate social distancing to prevent the spread of disease.
As you know, after studying this situation quite intensively, my take is that this virus is very infectious - but also low fatality (especially outside China).
How do fear and panic make it worse? Right now China is the best example of this.
Firstly - everyone with a “sniffle” overloads the hospital system and much time is wasted checking every possible case. Second - the entire economy shuts down over something that actually has a low chance of killing people. Thirdly - authorities overreact in just about every possible way - spooking the masses even more.
We all know that an overloaded hospital system is much less effective. Fear and panic make this “overloading” and inefficiency much more likely. They clog up the system and make everything “reactionary” instead of orderly.
If the Chinese economy slumps over this thing - it will be more because of FEAR - than the actual virus itself. Fear can kill.
-Andy
As you know, after studying this situation quite intensively, my take is that this virus is very infectious – but also low fatality (especially outside China).You are missing critical data here. The "serious complication rate" (SCR) is 20%. It's not "fear and panic" that are overloading the hospital system it's critically ill patients. The 'fear and panic' is actually causing the usually crammed streets of Shanghai and Beijing to be entirely abandoned - exactly what you'd want to see if combating a contagion. But I think you are missing just how terrible this virus really is. The 20% SCR is really awful. And I take your point about not wanting to see hospitals overloaded with people with sniffles and such. That's a fair point. Which is where an effective program of education is required. People need to know what they are learning here. Namely, don't ever go to a hospital during a pandemic unless you really, really have to! And to avoid the pandemic coming, people need to know this is a beast of a virus. It is not "a low fatality" illness. You have that very wrong. It is a highly contagious disease with a ridiculously high SCR that is an order of magnitude-times-three more fatal than the flu. Don't be fooled by the low deaths outside China yet. If the CFR is 3% all we'd expect so far would be 2-3 deaths. Fewer if the age cohorts were skewed younger. Which means we really, really don't want it to gain a foothold and rampage across any territory it hasn't already conquered. Which mean we need people to have an appropriate level of alarm so they will be receptive to learning some new behaviors. It is your view that I think paves the way for the virus to come here and get going.
From what I know of any emergency, fear and panic ALWAYS make things worse. Sometimes the panic actually kills more than the emergency itself. This thing has all the hallmarks of that kind of situation.
And by the way, I regard that “serious complication rate” as far from proven or reliable. I bet that SCR figure proves to be much lower outside China. We will only know after several more weeks.
Meantime - I remain opposed to anything that heightens fear in people - because ultimately I believe it does more harm than good.
-Andy
Has anyone seen any news of the case in Arizona at all? I’m supposed to be flying out to Phoenix next Thursday for a conference. I’ve considered not going so that I stay away from the airports. Part of my thought to not go is that my wife is supposed to go and she is 16 weeks pregnant. Would it be wise to not go, or is that overthinking this too much?