Time to shut the stable doors.

Be prepared: COVID-19 coming to a neighbourhood near you

[iamlost]

Given the increasing spread outside of China it may be helpful to work from a solid information foundation:
* CDC (Centre for Disease Control) index page on Coronavirus Disease 2019 (COVID-19) [cdc.gov] information.

* COVID-19 Pandemic Preparedness Resources [cdc.gov]

While the content at the links provided below was developed to prepare for, or respond to, an influenza (“flu”) pandemic, the newly emerged coronavirus disease 2019 (COVID-19) is a respiratory disease that seems to be spreading much like flu. Guidance and tools developed for pandemic influenza planning and preparedness can serve as appropriate resources for health departments in the event the current COVID-19 outbreak triggers a pandemic.

Be safe
Be well

[NickMNS]

I would like to draw attention to one particular point, regarding face masks. There has been some references made in other threads about "grabbing your face mask". So avoid misinformation here is the quote from faq section of the CDC link above:
here is the link to the specific section [cdc.gov...]

A: CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19.

The reason for this is that a face mask (cloth type) does not prevent particles from being inhaled, what these types of mask do is limit the range that particulate and viruses from infected persons can be propagated by breathing, sneezing or coughing. Masks worn by health care professionals are of a much higher standard and need to be fit-tested to ensure that air drawn in during breathing must go through the filters and not through other openings.

[lammert]

The guidelines in the Pandemic Influenza Plan (2017) on the page you link to is partly written based on experiences with the 2009 H1N1 pandemic. That flu pandemic had an estimated mortality rate of 0.02%. The mortality rate for the current virus is estimated to be a factor of 100 higher. That gives totally different dynamics and a much higher disruption of normal life.

I am not trying to scare anyone, but I hope sincerely that national and global health organization measures to contain the local outbreaks are successful.

[NickMNS]

@lammert

I am not trying to scare anyone,

This may not be your intention, but the way you frame your post the numbers certainly seem alarming.

estimated to be a factor of 100 higher

But more worrisome, is that they come unsupported.

From all accounts the mortality rate for COVID19 virus is still not fully known, but it is estimated in the order of 1 to 2%, by comparison WHO estimates the mortality rate for SARS which was another Corona virus to be in the order of 10 to 15%, with it reaching levels as high as 50% in specific age groups (eg: elderly). In Canada it reached 9.3%. So while the virus is serious, we have seen and survived worse.
source: [who.int...]

[tangor]

Do keep things in perspective ... we don't yet have enough data to KNOW anything, other than guessing.

[issues.org...]

100 x of .02 is 2 ... very significant, of course, but not the Armageddon.

[Mark_A]

The 2% fatality rate is for the whole population.
If you are in one of the susceptible sub groups, e.g. elderly and or with a preexisting condition etc, the fatality % in those sub groups is much greater.

[NickMNS]

100 x of .02 is 2 ... very significant, of course, but not the Armageddon.

No it isn't significant. H1N1 is not related to COVID19 so comparing them does not make sense. The flu kills 12000 to 61000 thousand people annually in the US alone compared to COVID19 where there have been less than 3000 deaths reported globally and none in the US so 0 to 61000 is infinity fewer deaths in the US.

Other Coronavirus diseases include MERS and SARS.
[cdc.gov...]
COVID19 has thus far proven to be less deadly than those (see post above). The death rate and severity of the disease subject to change as it propagates.

Am I suggesting that this disease is not serious, no. Not at all. But I believe that the intent of the thread was to say be vigilant, be aware and most of all be weary of the information that is circulating. The CDC and WHO have provided excellent up to date data and information on the disease and its spread, information that doesn't included sensationalist headlines and statistics.

On a more positive note, albeit maybe a bit premature, there are reports yesterday that a vaccine has been developed and is being readied for testing. Here is an article from Time:
[time.com...]

Other source information for this post:
[cdc.gov...]
[who.int...]

[graeme_p]

Conversely, if you are not in one of those groups, the risk is lower.

Rates may also vary with the health of different populations, the quality of medical care (which has quite an impact on things like murder rates as well), etc.

The important thing IMO is to keep an eye on outbreaks in your local area so you can avoid unnecessary risk. The authorities here are being quite cautious - a local school has been closed an people asked to self-isolate after some people came back from a trip to italy with flu-like symptoms.

[graeme_p]

I just read an excellent book advocating not reading/watching the news (Stop Reading the News by Rolf Dobelli) and one of the things it discussed were important issues not in the news - like possible future pandemics.

[Mark_A]

@NickMNS good news in that Time article certainly.

[Mark_A]

@graeme_P "Conversely, if you are not in one of those groups, the risk is lower."

Do you not have parents / grandparents / know smokers / have friends whose parents fit these groups etc etc ..

[engine]

As was mentioned, the face masks don't really help, and only help for a limited time, but, I guess, it makes some people feel happier.

My parents taught me good hygiene habits, and if the basics were undertaken it would reduce the risk of spreading. I see so many people fail the basics of hand washing, let alone a rigorous cleanliness regime.

I find it strange that people can't control themselves, especially when going to and coming from known areas. People should take more responsibility, imho.

What is sensible to me, although not 100% practical, is stopping all travel in affected areas, which is what is being undertaken. That is one of the best ways to help limit the spread.

What's interesting is the knock-on effects to businesses, and how far that impact will go. For example, travel-related, some factories shut down or on short weeks, etc.

[Mark_A]

@engine

..What is sensible to me, although not 100% practical, is stopping all travel in affected areas, which is what is being undertaken. That is one of the best ways to help limit the spread. ..

I agree, and fingers crossed it seems to be working in Hubei / China at the moment, yesterday China apparently had fewer new infections ~400 than were reported outside of China. (if you can believe the figures reported)

[engine]

(if you can believe the figures reported)

True, and any country would be foolish to be honest because they will become isolated very quickly.

Interesting piece about accurate info and scare stories.
[bbc.co.uk...]

[graeme_p]

@Mark_A that does not make it any less true.

In my case I do not have a lot of contact with anyone I know to be in a high risk group and can easily avoid what I do have if necessary (say I have flu like symptoms and there have been cases in the area) which greatly reduces my fear of getting it.

@engine knock on effects could be pretty drastic. Global supply chains are so fragile.

[lucy24]

any country would be foolish to be honest because they will become isolated very quickly

Hard to see how that would apply to China, though.

[iamlost]

The problem source is no longer China, which is, however late, getting on top of the outbreak but Iran, which appears in total denial and disarray.

I also note that the apparent odds of dying, if severely afflicted looks to be ~20%; the ~2% fatal figure commonly used is of all, including mild, known cases. What difference proper diagnosis followed by competent medical care makes is uncertain but likely critical.

Also: expect US confirmed instances to take a jump shortly as very few (less than 500) have actually been tested to date. This jump will not so much be new as confirmed. The back story on this lag is quite fascinating and very American.

On a dark humour note: in this oil and gas industry part of Canada N95 face masks have been so common that a year ago a box of 20 (with or without valve) could be had for $8.00CDN ($0.40CDN each). Now, if available at all, they are at least 10 times (w/o valve) to 20 times (with valve) that.

[Dimitri]

It's knocking at my door ( a few miles from my town ). I'll need to hibernate to let it pass.

[NickMNS]

As this advances we get more information. Over the weekend China released new statistics on death rates.Reported here by the BBC:
[bbc.com...]

Death rates for those above age 80 is a little less than 15%, and 8% for those 70 to 79. This seems high, and it is. To be clear I'm not trying to downplay the risks. But to put this in perspective, death rates for SARS in the elderly population was approaching 50% (see my post above).

The most worrying aspect of this whole thing is US Government response.

In conclusion, there is no need for panic, even if it is knocking at your door. The consensus appears still to be:
Wash hands
keep you distance
stay away from large crowds as much as possible.

As to N95 type masks, I have one that was fit tested (years ago now, so likely not valid), I doubt that the filters I have are the correct ones. It dates back to a previous career in heavy industry, But my point is that I really can't see myself wearing this mask to outside. Things would have to be real bad before that happens, I'm talking zombie apocalypse bad.

[ronin]

The single most useful aggregated news page I have found to stay up to date on COVID-19 infection trends around the world is this one:

[worldometers.info...] (no affiliation)

I've been returning it several times a day for the last month.

I find it cuts through the noise, usually providing a clearer summary of what is happening globally than is generally being conveyed by individual articles / bulletins from assorted news organisations.

[lammert]

My country jumped from 0 to 18 cases this week. I heard a health official on television with a very pragmatic response. The quarantine, isolation and other measures taken were not so much because of the severity of the illness or to prevent that eventually, the whole population would be exposed, but because of the lack of immunity in the population. The main goal was to slow down the spread long enough that the health system would not be overwhelmed by an inrush of patients and to allow time to develop effective treatments and vaccines. There was no expectation that the spread could eventually be contained.

[Mark_A]

I am surprised Britain does not seem yet to have any travel restrictions in place for people wanting to arrive from infected areas. I would have thought by now we would have some restrictions in place.

[lucy24]

I clocked myself singing “Happy Birthday” and came out to 7-9 seconds. Guess I’d better pick a different song. (I know one that takes seven minutes at the correct tempo, but that may be overdoing it.)

[iamlost]

Note: The Global Times is the People’s Daily (Chinese Communist Party newspaper) international affairs daily tabloid.

Info from COVID-19 Chinese patient autopsies [globaltimes.cn], 29-February-2020:

The influence of COVID-19 on the human body is like a combination of SARS and AIDS as it damages both the lungs and immune systems.
...
I think the most important thing now is to take measures at an early stage of the disease to protect patients' lungs from irreversible fibrosis
...
If irreversible damage is done, other measures, like those to prevent patients from oxygen deficit, will not be of much use

This is the closest to public technical information I’ve read.

Slight divergent:
The best ‘here’s what’s happening folks’, which tends to imply official competence (unlike the vague or contradictory platitudes elsewhere) I’ve seen is Singapores:
Coronavirus disease 2019: a timeline of the confirmed cases [gov.sg]:
Note: the shared detail is extraordinary.

As of 5 Mar 2020, MOH has confirmed 5 more cases of COVID-19 infection in Singapore. Of these, one is an imported case, the others are part of a cluster.

5 Mar 2020, 12pm
* Case 113 is a 42 year-old male French national who is a Singapore Work Pass holder, who has no recent travel history to affected countries and regions, but had been in France, Portugal and the UK. 

* Case 114 is a 62 year-old male Singapore Citizen who has no recent travel history to affected countries and regions. He is a family member of Case 115, and is linked to the cluster involving a private dinner function at SAFRA Jurong.

* Case 115 is a 62 year-old female Singapore Citizen who has no recent travel history to affected countries and regions. She is a family member of Case 114, and is linked to the cluster involving a private dinner function at SAFRA Jurong.

* Case 116 is a 50 year-old female Singapore Citizen who has no recent travel history to affected countries and regions. She is linked to the cluster involving a private dinner function at SAFRA Jurong.

* Case 117 is a 52 year-old female Singapore Citizen who has no recent travel history to affected countries and regions, but had been in Malaysia. She is linked to the cluster involving a private dinner function at SAFRA Jurong.

[Dimitri]

If you want to follow the evolution there is this :

edit I am not succeeding to post the link, the forum software is altering it :/

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

(this is not a session ID)

other links:

[cidrap.umn.edu...]

[graeme_p]

@Mark_A, I agree. It would be expensive but it could make all the difference.

@NIckMNS, yes, its good to keep it in perspective. It is less dangerous than SARS if you get it, but its more infectious so more people will get it so it could still end up a lot nastier.

People here (NW England) seem to be reacting quite sensibly - not panicking but being sensible about things like washing hands. I am inclined to avoid unnecessary travel to places that are risky (London, for example - impossible to avoid contacts with lots of people, lots of confined spaces if you travel around it, and there have been quite a lot of people infected...).

[Mark_A]

Interesting Italy has now done a complete lockdown. Some have said that the UK is 11 days behind Italy in the infections rates etc. I am not sure I agree, but if they are right we have trouble ahead.

[graeme_p]

The last few days we have seen a flattening in the number of new confirmed cases in the UK. 64 new cases on Sunday morning, but fewer than that Monday and today: [gov.uk...]

It may be just a few quite days, but its encouraging. Hopefully it is a genuine slowdown as people adjust their behaviour - people are going out less, shaking hands less etc.

[Dimitri]

The UK is no longer in the EU , so there is no risk, isn't it ?

By the way, it's start to be too close, and I am among the person at risk. Good luck everybody. Survivors will be super humans, until the next virus.

[lucy24]

not panicking but being sensible about things like washing hands

Yup, we’ve got the “Keep Calm and Wash Your Hands” posters over here too :) (Alongside the long-established ones that ask “How many germs live on your cell phone?” which gives a whole new meaning to the term “telephone sanitizer”.)

I think the most interesting and useful statistics are the ones that compare number of deaths to number of recoveries [coronavirus.jhu.edu], because then you’re looking at cases that have already finished running their course. From one country to the next, proportions of Outcome A to Outcome B vary by orders of magnitude. This is unnerving.