Response to kelley.otani
Kelley, if you read the Flutrackers’ post with the most detail on the teleconference, it says that in the past, asymptomatic transmission has not been shown to lead to a pandemic. This may explain why they have not been making a big deal out of it. However, my understanding is that you can also show that in a setting where people are in each others’ company on a daily basis, it makes no difference to upper respiratory infection rates if you remove sick individuals, since the transmission likely occurred before onset of symptoms. So I’ve had the same concern you have.
[Sparky1 summary]
Some (not all) of the difficulties of nCoV data collection and case/outcome reporting have come from the lack of available reliable tests and testing facilities. Mid-January the CDC reported central lab capabilities of processing tests in batches of 200 per day, and tests weren’t even sent to Wuhan (“ground zero”) in quantity until about Jan. 16, 2020. (See my other posts and links on this topic.) Thereafter per President Xi’s directive, lab capacity was to be ramped-up to process up to 2,000 tests per day (date of full capacity was not specified and current status is unknown).
Given additional observation, research and data over the past few weeks, China CDC changed/updated their definition of “suspected” nCoV cases on: Jan. 15 (“first edition” in the CDC diagnosis and treatment plan), Jan. 18 (“second edition”), Jan. 22 (“third edition)”, and Jan. 27 (“fourth addition”). The definition of “confirmed” nCoV cases changed twice via first and second editions (above dates), but the treatment plan changed for confirmed cases in the third edition. Prior to third edition (i.e., Jan. 22), confirmation was provided by the national CDC “or designated” (e.g., provincial agency). With the third edition revised treatment plan, review and confirmation can be provided by “city level disease control agencies” and remained unchanged in the fourth and current plan.
Source, China CDC “2019 New Coronavirus Epidemic Progress and Risk Assessment”, item #2 (1/28/20, translated, h/t Gert van der Hoek, FluTrackers)
[Sparky1 opinion/observation] It is highly unlikely that the Chinese CDC (or others) have retroactively adjusted their case reporting statistics to reflect the most recent definitions of “suspected” and “confirmed” cases. It is also possible that different countries are using different and/or “outdated” definitions in their case reports.
Note that China now apparently has the capability to screen, test and confirm cases at the city level, whereas the US currently relies on local providers for screening and testing, with test samples sent to one national lab (US-CDC) for analysis and confirmation, which adds at minimum 3 days to obtain test results.
Gosh Jan, I so appreciate and concur with your very thoughtful post! FWIW, I think you should trademark the phase, “Prepare according to your risk, not your fears.” I think it brilliantly, succinctly embodies a key aspect of “resilience” as a core value and aspiration here within the PP community.
However, I have this nagging concern about, when all things considered (even the “unthinkable”) those individuals (many so-called “leaders” i.e., “puppet masters”), and institutional policies and practices that give evidential credence to the concept of eugenics.
Question: So…what if the nCoV was, in fact, an intentional or unintentional consequence or byproduct of the Wuhan BSL-4 lab or other “research” and not an act of nature/natural selection? Or if trusted institutions’ and officials’ maddening dissembling, complacent, obfuscation, ridicule, censorship and persecution of accurate, actionable information and information messengers is actually intentional to achieve a desired political, economic or even demographic outcome that ultimately decreases human populations and enriches a select few? How might that awareness change our personal and societal approach to this particular–natural vs. manufactured–crisis that effectively reduces human populations?
Personally, I think my mindset and actions towards immediate, short and longer-term (i.e., 3+ years) preparedness would be the same and adjusted, based on assessed and continually updated prioritized risks and resources. But my level of intensity and time horizon might shift significantly as awareness of potential threats and impacts (e.g., multigenerational or even existential) became known.
Admittedly, I have more questions than answers. I feel like I’m living in multiple dimensions of macro- and micro- disjointed realities, with all sorts of incrementality in between.
Bottom line: I’m taking care of my loved ones, then (and) nature.
Well-grounded on the brighter side: Today I harvested several cherry tomatoes from two permaculture, rogue, overwintered, neglected volunteer tomato plants in January. My free-roaming urban hens are obviously not taking any crap from my two shelter-dogs.
Life will find a way. 
I’ve been seeing more mentions of culling misinformation by the MSM lately. As is typically done this will likely mean spinning actual facts to meet the narrative that is deemed politically and economically acceptable by the powers that be.
Maybe they will actually stop the fake news and not totally spin the facts on this one - we can hope!
https://www.cnn.com/2020/01/31/health/us-coronavirus-hoaxes-trnd/index.html
As mentioned in your videos, we can’t divide the number of current fatalities by the current number of infected to get the CFR because it takes about a week from the onset of symptoms before death. Is there a better way to estimate the true CFR? (200 Fatalities (Jan 30) – 25 Fatalities (Jan 23)) / 800 infected (Jan 23) = 21.8% CFR ? This seems a bit high.Yes, probably very high. I think. To get a true CFR you need two numbers: (1) the total number of infected and (2) the total number of deaths of infected people. I have strong reason to suspect that (1) is wildly, enormously (politically) understated. I now suspect that the actual infection numbers are 10x to 100x higher than reported. I've just come across a Chinese study that put the calculated R0 at 4(!!) And I have strong reason to suspect that (2) is wildly, enormously (politically) understated. So let's not get too hung up on the minutia of it all. Here's what we do know; this virus is a beast, it's highly infective, and very deadly for older patients. We can confidently say that its CFR is far, far above regular flu. If it's only a 1% CFR, that's still one order of magnitude (10x) higher than the seasonal flu, which is bad enough. But I strongly suspect it's higher than 1%. However we just don't know yet.
We just got back into Mongolia a couple days ago. Thankfully we were able to get our flight rerouted from a Beijing transit to a Seoul transit instead… United Airlines was (surprisingly) helpful in accommodating that at no charge. The trip through the Incheon(Seoul) airport wasn’t too unusual; they did have us walk through the temperature screening checkpoints (interestingly they separated the people flying from Bangkok to a separate lane than those of us coming from San Francisco), and about 90% of the people were wearing masks. In Customs I did notice a woman a little ahead of us with a Chinese passport who was politely escorted to some other area instead of passed through. She didn’t show any signs of being sick, but I won’t fault them for being liberal with secondary screening. I expected them to ask us if we’d been to China recently (we actually had been 6 weeks prior), but they never asked any questions of that nature.
As Chris mentioned in an earlier video, Mongolia has effectively closed its borders with China with regards to people; only goods are allowed to cross, and only via railway at the Zamyn Uud crossing. This includes those just transiting through China (SO glad we got the reroute through Korea). The one exception is that Mongolian citizens will be allowed in from China, but will be required to stay in hospital quarantine for 2 weeks if I heard right. And the Mongolian government has banned its citizens from traveling to China until early March. The general sentiment here seems to be that Mongolians have zero trust in China’s government and information coming out of it, and so are taking pretty aggressive action and assuming the worst. It’s one of those rare times I find myself in grudging approval of any given government action. 
As to life here, all the universities, kindergartens, and schools are closed until March 2nd (my son is loving that latter part!), and they’ll be broadcasting school lessons on TV in the meantime. All movie theaters, video arcades, and large-scale entertainment venues are closed in the meantime as well, but to the best of my knowledge the bars and pubs are still open (gotta draw the line somewhere I guess!). We were told that initially there had been some panic-buying at the supermarkets at the first word of government action, but since then I guess people calmed down and the supermarkets are now stocked as normal (minus some produce normally sourced from China). My grocery trips and other forays outside of the house over the past two days have been pretty uneventful, with the only noticeable difference being a little less traffic (yay!), noticeably less pedestrians (no school so not surprising), and about 3/4 of people here wearing masks. But life doesn’t feel all that different than it did before. So far supply chains are still functioning and people (other than teachers) are still going to work. I’m trying to convince my in-laws to gradually stock up on storable foods and household essentials like I’ve been doing for years; they have a lot of meat in the freezer and a fair amount of flour and rice but that’s about it. A lot of the food and products imported into Mongolia come from or through China, and there’s no telling how disruptive this pandemic might be to that supply line.
Anyway, for being as close to China as we are I think Mongolia could get through this a little better than one might think. Much of the small amount of Mongolia-China travel this time of year was at border crossings far from the initial source of the virus, and most of that being locals buying or selling across the border. No reported cases yet, and it could be the (relatively) quick action of the government might have bought Mongolia some time. It’d be a real good thing too, because the medical infrastructure and hospitals here are not well-equipped to handle this. Keeping fingers crossed…
Hi all,
I don’t post very much here but I very much value the work carried out by PP. It’s really shaped a lot of my outlook since coming across it (via Mike Maloney’s ‘Hidden Secrets of Money pt 8’ video about 15 months ago – Chris’s segment really leapt out at me!) I have a ‘love/hate’ relationship with the site, if I’m being honest – I ‘love’ what it provides but ‘hate’ that such a site actually needs to exist, if people get me? ?
My own feelings on this since starting to take this seriously last weekend (following the PP weekly newsletter) have gone from real, almost irrational fear of the type Andy_S is likely on about (“oh God, this thing will kill us all!! Gotta get out of the city!!!”) to what others here have helpfully referred to as a heightened state of concern, driven by that underlying fear. I’ve taken quantifiable, actionable steps to reduce myself and my family’s vulnerability to this thing should it arrive here (no confirmed cases as yet in Czech Republic);
- I’ve made sure the car’s petrol tank is full ‘just in case’. We do not need to use the car every day due to excellent public transport.
- Purchased several bottles of elderberry syrup. No doubt not as good as homemade stuff, but better than nothing!
- Ordered some N95 masks. I’m ‘on the list’, basically, as demand has totally cleaned out supply
- Stocked up a bit on canned goods. I already have a bit of a stash, no doubt not nearly as much as many regulars here have but we’re not too bad on this front
- Got hand sanitiser + antibac liquid soap. I’ve also increased my own handwashing and am avoiding touching my face as much as possible. This is hard as my face seems to be incredibly itchy all of a sudden since I can’t touch it, lol! This has an added side-benefit, as I’ve a lousy, lifelong habit of biting my nails and the skin around them, so this is giving those long-suffering fingers a great chance to recover!
Im in the UK and followed PP for several years.
The first two cases confirmed in the UK tourist city of York.
The government response seems predictably relaxed.
the hotel is still offering rooms at the low-low price of £75
https://www.google.co.uk/amp/s/www.telegraph.co.uk/news/2020/01/31/two-people-england-have-testedpositive-coronavirus/amp/
Greendoc, good advice on sprouting, thanks!
I looked around for good deals on seeds for sprouting, and Country Life Natural Foods , clnf.org, seems to have some very reasonably priced organic seeds compared to Amazon and other places I looked. Lots of other bulk grains, seeds, etc.
can be read online here:
https://www.medrxiv.org/content/medrxiv/early/2020/01/24/2020.01.23.20018549.full.pdfKey findings
● We estimate the basic reproduction number of the infection (??0) to be significantly greater than one. We estimate it to be between 3.6 and 4.0, indicating that 72-75% of transmissions must be prevented by control measures for infections to stop increasing.
● We estimate that only 5.1% (95%CI, 4.8–5.5) of infections in Wuhan are identified, indicating a large number of infections in the community, and also reflecting the difficulty in detecting cases of this new disease. Surveillance for this novel pathogen has been launched very quickly by public health authorities in China, allowing for rapid assessment of the speed of increase of cases in Wuhan and other areas.
● If no change in control or transmission happens, then we expect further outbreaks to occur in other Chinese cities, and that infections will continue to be exported to international destinations at an increasing rate. In 14 days’ time (4 February 2020), our model predicts the number of infected people in Wuhan to be greater than 190 thousand (prediction interval, 132,751 to 273,649). We predict the cities with the largest outbreaks elsewhere in China to be Shanghai, Beijing, Guangzhou, Chongqing and Chengdu. We also predict that by 4 Feb 2020, the countries or special administrative regions at greatest risk of importing infections through air travel are Thailand, Japan, Taiwan, Hong Kong, and South Korea.
● Our model suggests that travel restrictions from and to Wuhan city are unlikely to be effective in halting transmission across China; with a 99% effective reduction in travel, the size of the epidemic outside of Wuhan may only be reduced by 24.9% on 4 February.
● There are important caveats to the reliability of our model predictions, based on the assumptions underpinning the model as well as the data used to fit the model. These should be considered when interpreting our findings.
Early this morning I had a very routine diagnostic screen done at Providence Medical Center in Medford, OR, several hundred miles from the nearest confirmed Corona virus case. When I registered they asked me if I had returned from China in the last 14 days. I wish had asked them what they do with someone who says “yes.”
Amazing stuff. Looks like it’s time to start acting on the to do list this weekend.
However we do have 2 reports from hospitals.
Of the 99 patients with 2019-nCoV pneumonia, 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure.
Age, years
Mean (SD) 55·5 (13·1)
Range 21–82
≤39 10 (10%)
40–49 22 (22%)
50–59 30 (30%)
60–69 22 (22%)
≥70 15 (15%)
Of the 41 admitted hospital patients got acute respiratory distress syndrome (12 [29%]) and six (15%) died. Median age was 49·0 years.
So total 140 patients from which 17 died. Thats 12 %.
29 patients had respitory problems which makes 20 %.
All in all i would say the fatality rate is between 12 and 20 %.
Hi Sparky1,
Thanks for your comment. I also want to acknowledge cranky Granny’s comment.
There is no question that the hot present moment of a global health crisis is not the time to start a discussion around population culling. Definitely a surefire way to rankle… for what its worth I do not think that the term ‘eugenics’ is being applied incorrectly in this context. It applies more to controlling breeding for optimal human outcomes. I have first hand experience with this aspect. As person who is disabled, I was told by a doctor when I was about ten that it would be best if I never had kids. It was and remains a common attitudinal problem in the medical community.
I am not aware of a single ‘term’ that can capture what I am trying to say. As I read all of the comments and information being put forth there are stark realities that materialize, such as:
- there are not enough test kits or hospital beds to adequately deal with a pandemic
- there are no known vaccinations or cures at this time
- there are hard limitations of what can be done quickly on a mass scale
So with R0 greater then 3, with a fatality rate greater then 12%, with superspreaders, with cured people in short time infected again we have the greatest nightmare all times on our hand which will continue for ever and ever, with vicious rounds of infections over and over again.
Brrr…
To be honest, if we had ultimately ended up having to transit through Beijing instead of rerouting through Seoul earlier this week, I think our chances of getting nCoV would be relatively minimal (masks on, plenty of sanitizer, staying only in the International Terminal, and not eating any food locally prepared). But I knew our chances of that “recently been to China” stigma creating ongoing problems for us would be significantly higher. As it is sometimes I feel the locals here are staring at me a little more than normal. Hopefully I’m just imagining it, but in situations like this having more suspicious attitudes towards foreigners is unfortunate but understandable.
In response to Matties: it’s not the case fatality ratio that is 10% it’s the mortality of people who were sick enough to get to hospital. Some (hopefully many) are asymptomatic. This could be the problem here in the US - we are not finding new cases because it’s asymptomatic for many people. If we wanted to know how the infection is spreading, we would need to test all contacts whether symptomatic or not.
10% in hospital mortality is bad enough, but it’s not 10% overall. There is research on how to estimate mortality rates early in an epidemic, but I haven’t delved into that. Interesting to note that the article referenced above estimating the scope of the epidemic doesn’t even try to estimate a mortality rate - not even a range. However, the same article suggests that in terms of cases, we are several days ahead of Chris’s exponential projections, and being held back by incomplete testing.
https://www.medrxiv.org/content/medrxiv/early/2020/01/24/2020.01.23.20018549.full.pdf
Suzie,
I got the very same question here in Portland, Oregon, a week ago when checking in to a Providence facility to see my PT. And I did ask what would happen if I’d answered “Yes.”
Their answer was I’d be given a mask and immediately sent to the ER (across the street).
They need to get their Heinies in gear and round up some more masks…check 'em for fit, too.
Lol, Well Done! to both thc0655 for the original “Comic Interlude” post, and to Thrivalista’s “Masked Inadequacy” cheeky response.
Here’s the original photo and post in case anyone missed in this very long thread.
