Modelling 2019-nCOV outbreak
February 24, 2020 1:58 PM   Subscribe

Nowcasting and forecasting the potential domestic and international spread of the 2019-nCOV virus. This Lancet article published in late January has proven prescient. "Our findings suggest that independent self-sustaining human-to-human spread is already present in multiple major Chinese cities, many of which are global transport hubs with huge numbers of both inbound and outbound passengers (eg, Beijing, Shanghai, Guangzhou, and Shenzhen). Therefore, in the absence of substantial public health interventions that are immediately applied, further international seeding and subsequent local establishment of epidemics might become inevitable. On the present trajectory, 2019-nCoV could be about to become a global epidemic in the absence of mitigation...."

"...Nevertheless, it might still be possible to secure containment of the spread of infection such that initial imported seeding cases or even early local transmission does not lead to a large epidemic in locations outside Wuhan. To possibly succeed, substantial, even draconian measures that limit population mobility should be seriously and immediately considered in affected areas, as should strategies to drastically reduce within-population contact rates through cancellation of mass gatherings, school closures, and instituting work-from-home arrangements, for example."

"Our 2019 OAG data indicated that for cities outside mainland China excluding Hong Kong, the daily average number of international outbound air passengers was LW,I=3633 and that of international inbound air passengers was LI,W=3546 in Greater Wuhan during January–February, 2019 (table 2)... Our calibrated Tencent mobility data indicated that for cities in mainland China, the daily number of domestic outbound travellers was LW,C(t)=502 013 and that of all domestic inbound travellers was LC,W(t)=487 310 in Wuhan at time t before chunyun (Jan 10). During chunyun, these estimates were LW,C(t)=717 226 and LC,W(t)=810 500."
Of note: Table 2 Cities outside of mainland China to which Wuhan had the greatest volume of outbound air travel in January–February, 2019.

Number of air passengers per month in 2019
Bangkok 16 202
Hong Kong* 7531
Seoul 5982
Singapore 5661
Tokyo 5269
Taipei 5261
Kota Kinabalu 4531
Phuket 4411
Macau 3731
Ho Chi Minh City 3256
Kaohsiung 2718
Osaka 2636
Sydney 2504
Denpasar-Bali 2432
Phnom Penh 2000
London 1924
Kuala Lumpur 1902
Melbourne 1898
Chiang Mai 1816
Dubai 1799
Data were obtained from the Official Airline Group.

--

Question: Why hasn't Bangkok reported more cases of 2019-nCOV? It's air traffic volumes from Wuhan are almost as large as those to Seoul, Tokyo and Singapore combined.
posted by storybored (958 comments total) 74 users marked this as a favorite
 
For your latest WHO Sitreps go here
posted by lalochezia at 2:00 PM on February 24 [1 favorite]


International Direct Flights from Bangkok.

"Bangkok Airport has non-stop passenger flights scheduled to 166 destinations in 54 countries."
posted by storybored at 2:04 PM on February 24




[heads up: this thread very very much needs to not be about context-free doomsaying. Engage with the content and with each other, there are real people affected by this.]
posted by jessamyn (staff) at 2:43 PM on February 24 [53 favorites]


COVID-19 Fatality Rate by AGE:

*Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). This probability differs depending on the age group. The percentage shown below does NOT represent in any way the share of deaths by age group. Rather, it represents, for a person in a given age group, the risk of dying if infected with COVID-19.

AGE DEATH RATE*
80+ years old 14.8%
70-79 years old 8.0%
60-69 years old 3.6%
50-59 years old 1.3%
40-49 years old 0.4%
30-39 years old 0.2%
20-29 years old 0.2%
10-19 years old 0.2%
0-9 years old no fatalities
posted by chavenet at 3:01 PM on February 24 [31 favorites]


I haven't been able yet to find information yet indicating how long the people who fall ill experience their symptoms for. I guess that would be - for those in the "recovered" set, what was the mean or average number of days they were ill?
posted by kitcat at 3:18 PM on February 24 [1 favorite]


While the efforts are heroic, this horse has already bolted. No need to shut the barn door. That some individuals can be infectious and walk around for 2 or 3 weeks with no symptoms is how it escaped. Best to think of it as an especially nasty flu. Every flu season with a new strain is a pandemic. This too will be a pandemic with apparently modest mortality rates. Well, unless you are unfortunately one of the statistics.

I will be working the polls on Super Tuesday. I've already had my flu shot. I will be stocked with unscented hand wipes (no need for anti-bacterial since they have no effect on viruses). I am practicing keeping my hands away from my eyes, nose and mouth. And this is just for the flu. There is no way in hell I'll be working November. This thing could have significant political consequences...
posted by jim in austin at 3:19 PM on February 24 [9 favorites]


I'm supposed to play SXSW and am having second thoughts, especially given the quarantine in San Antonio.
posted by grumpybear69 at 3:23 PM on February 24 [2 favorites]


We all know how valuable city pairs are economically - it's a lot, so maybe the question is who's going to play chicken with a recession in an election year and not close down airports?

(It's a one answer test)
posted by Reasonably Everything Happens at 3:30 PM on February 24 [1 favorite]


As someone whose parents live in the country with the second highest number of confirmed cases (South Korea) and whose extended family live in the South Korean city that is the epicenter of the breakout (Daegu), I am trying to keep in mind that the huge spike in confirmed cases is due in part to Korean lab techs burning the midnight oil.

From three days ago: Very detailed #covid19 reporting from South Korean health officials. They have tested, or are awaiting results on, almost 20,000 individuals; demonstrating a significant diagnostic capability. They appear to have a current testing capacity of more than 3,000 cases a day.

Which reassures me slightly about what's happening in Korea, but then alarms me about the rest of the world.I think it was Scott Gottlieb who was pointing out that Italy had only tested 4000?
posted by spamandkimchi at 3:32 PM on February 24 [22 favorites]


Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now”.
The most crucial (and overdue) risk communication task for the next few days is to help people visualize their communities when “keeping it out” – containment – is no longer relevant. The P word is a good way to launch this message.

But the P word alone won’t help the public understand what’s about to change: the end of most quarantines, travel restrictions, contact tracing, and other measures designed to keep “them” from infecting “us,” and the switch to measures like canceling mass events designed to keep us from infecting each other.

We are near-certain that the desperate-sounding last-ditch containment messaging of recent days is contributing to a massive global misperception about the near-term future... For weeks we have been trying to get officials to talk early about the main goal of containment: to slow the spread of the virus, not to stop it. And to explain that containment efforts would eventually end. And to help people learn about “after containment.” This risk communication has not happened yet in most places.

...One horrible effect of this continued “stop the pandemic” daydream masquerading as a policy goal: It is driving counter-productive and outrage-inducing measures by many countries against travelers from other countries, even their own citizens back from other countries. But possibly more horrible: The messaging is driving resources toward “stopping,” and away from the main potential benefit of containment – slowing the spread of the pandemic and thereby buying a little more time to prepare for what’s coming.
posted by spamandkimchi at 3:34 PM on February 24 [23 favorites]


Also from the above article
Even officials who say very alarming things about the prospects of a pandemic mostly focus on how their agencies are preparing, not on how the people they misperceive as “audience” should prepare. “Audience” is the wrong frame. We are all stakeholders, and we don’t just want to hear what officials are doing. We want to hear what we can do too.

We want – and need – to hear advice like this:
- Try to get a few extra months’ worth of prescription meds, if possible.
- Think through now how we will take care of sick family members while trying not to get infected.
- Cross-train key staff at work so one person’s absence won’t derail our organization’s ability to function.
- Practice touching our faces less. So how about a face-counter app like the step-counters so many of us use?
- Replace handshakes with elbow-bumps (the “Ebola handshake”).
- Start building harm-reduction habits like pushing elevator buttons with a knuckle instead of a fingertip.
posted by spamandkimchi at 3:37 PM on February 24 [18 favorites]


Question: Why hasn't Bangkok reported more cases of 2019-nCOV?

It could just be plain old under-reporting. But also I was there for a conference around the end of January and I had been warned to bring masks with me--not because of corona, but because of pm 2.5 air pollution. Masks were already in very widespread use by mid-January and maybe even earlier. Also, spray hand sanitizer was set up at all of the transit entrances/exits I passed through as worry about corona picked up; local planners seemed more on top of it than elsewhere. Maybe all three?
posted by Gotanda at 3:37 PM on February 24 [5 favorites]


I just finished reading You Are Likely To Get The Corona Virus, a pretty sober exploration of what the virus is, and why vaccines are likely a while off. Of course, the added fun is that I read it, and this thread, on a crowded morning train in Japan, coming out of Chiba where so far, we’ve heard about an elementary school teacher testing positive (after being symptomatic at school, but not wanting to cause trouble by missing work), and a businessman who tested positive after a week of business trips around Japan.

I mean, with the way things work here, commuter trains packed to where it’s hard to move in the morning, and a culture of ignoring being sick so as to not cause problems for others (as well as the absolute bureaucratic nightmare that has been the handling of it so far), I can’t see it not spreading around the country, and for me, it’s manifested itself as a vague dread of an inevitability.

What does worry me is people in Japan talking about why the government here can’t just do what China is doing, and Korea is starting to do, with essentially detaining the infected and restricting movement. I’d really like to believe there are ways to combat something like this without resorting to totalitarian measures, and I’d really like to keep thoughts of those measures out of the mind of the nostalgic-for-the-fascist-old-days Abe government.
posted by Ghidorah at 3:41 PM on February 24 [19 favorites]


To tack on, there are already reports of ostracism of healthcare workers and their families here, from workplace bullying of doctors and nurses who boarded the Princess Diamond to treat the sick, as well as nurses at a hospital where an infected person was treated, where children of nurses working at the hospital were not allowed to go to school or daycare. That, in turn, created a nursing shortage at the hospital because without daycare, many of the nurses needed to stay home to care for their kids.
posted by Ghidorah at 3:51 PM on February 24 [11 favorites]


grumpybear69:

I'm supposed to play SXSW and am having second thoughts, especially given the quarantine in San Antonio.

FYI, the quarantine in San Antonio is 100% pre-emptive. That is, Americans evacuated from China were flown to Lackland AFB in San Antonio and directly put into quarantine for 14 days, even though they had shown no symptoms. The quarantine was to observe them for long enough to make sure they didn’t start showing symptoms.

Some more details. One person did start showing symptoms and is being treated; the others in that first group never showed any symptoms in 14 days and are now out of quarantine, because they demonstrably don’t have the virus.

Local news has been running with fearmongering clickbait headlines like “Coronavirus patient quarantined in San Antonio” — leaving the false impression that someone was running around SA spreading the virus until they were forcibly quarantined. In fact it is quite the opposite — they were quarantined from the get-go, and developed symptoms while under quarantine, so they did not spread it at all.

As an Austin resident, I worried much more about the measles and rubella patients who were in fact running around the city and the airport spreading those viruses.
posted by snowmentality at 4:19 PM on February 24 [22 favorites]


I fully expect to contract the coronavirus. It could be anywhere from asymptomatic to catastrophic. But the thing that worries me isn't the virus or the potential mortality. It's the likelihood that I'll be mugged by the US healthcare system. A hospital stay could be devastatingly costly and I have no safe way to protect myself from out-of-network charges.

Some people are going to become fantastically rich off of this outbreak and it will be over the backs of the people who suffer.

The US healthcare system is a disgrace.

I don't mean to minimize the effects of this disease outside of the US at all. Some countries will respond responsibly and others won't. Some will have resources and others will be strapped. But in the US we have the resources but we will respond in the most disgraceful way possible.
posted by sjswitzer at 4:30 PM on February 24 [23 favorites]


This too will be a pandemic with apparently modest mortality rates.

The currently tracked mortality rates would still be very high for influenza, though fortunately not in SARS territory. Of course it does seem more likely that they will be adjusted down rather than up as the extent of minor and asymptomatic infection becomes clear.
posted by atoxyl at 4:32 PM on February 24 [3 favorites]


A friend of the family had tickets booked to a relative's wedding in Israel. She had to cancel her trip because flights from Australia to Israel go through Asia, and Israel is reportedly quarantining everyone who passes through Hong Kong, Bangkok, and presumably other Asian airports. I don't know what other countries are going to be imposing similar restrictions, but it's potentially going to be a problem for us.
posted by Joe in Australia at 4:35 PM on February 24 [2 favorites]


But in the US we have the resources but we will respond in the most disgraceful way possible.

It's already happening, as the insurer for someone who had traveled to China and was ill hit him with a $1400 bill (or more, it could still go up to $3200) when it turned out it was just a standard flu and not coronavirus. One of the biggest risk factors for this becoming a serious issue in the US is stuff like springing huge out-of-pocket bills on people who are in the highest-possible risk group and are taking the exact actions that could prevent the disease from spreading further.
posted by Copronymus at 4:53 PM on February 24 [12 favorites]


The Atlantic article is a good one. For a while now it has seemed like this would just spread everywhere and that quarantine measures had been put in place too late. Especially after listening to this Feb 11 Deep State Radio Podcast interview with Laurie Garrett and comparing what she was talking about with actions taken here in Japan.

I fully expect it to spread widely. I'm supposed to go to Vietnam Sunday to Thursday for work. And, I really am looking forward to the trip. Flying to a university in Danang vs commuting in Tokyo? Not sure which is more of a risk. Work is likely to pull the plug this week or maybe Vietnam.

It's a weird race to see who can shut down borders too late, but also nobody wants to be first to do post-containment like cancelling graduation in three weeks. A race that everyone loses because they are doing the low to no impact symbolic stuff like cancelling one person traveling, but not yet willing to do the hard stuff like cancelling a meeting for a dozen people here where it is spreading or shutting down athletic practices and meets on campus.

People have weird reactions that aren't all that rational. Friday, was hiking on the outskirts of Tokyo. (Stay in the fresh air away from people.) But at the end of a beautiful day, the public bath was crowded while the normally bustling restaurant was empty. Hmmm, sit in close proximity in hot water with a dozen strangers versus eat one to two meters away from a couple of other hikers.
posted by Gotanda at 5:05 PM on February 24 [11 favorites]


- Think through now how we will take care of sick family members while trying not to get infected.
this is a DIY guide that was being circulated on the internet some weeks ago - it's in English and Chinese. (obviously it's not ideal, but a lot of home-nursing guides that have been going around don't take the high transmissibility of the virus into consideration; this one at least tries to.)
but! hopefully most people here won't need to be in this situation though (this sort of situation is only likely to happen if health infrastructure/hospitals are overrun..) if your family member is a confirmed case then they should be isolated in a hospital*.

if you are in a situation where the family member is not confirmed, but sick, then just distance yourself, don't share cutlery/towels/etc, don't go near them unless you absolutely have to. and the family member should be wearing a surgical mask (to contain their fluids and protect others). if the family member needs to see a doctor, they should see the same doctor and not doctor-hop. also consider teleconsults (although the usefulness of a teleconsult would depend on the reliability of your country's protocols for reporting suspected cases - here teledoctors will refer you to either an in-person consult or the central health authority in charge of covid cases if they think you might actually have the virus).

- Start building harm-reduction habits like pushing elevator buttons with a knuckle instead of a fingertip.
the knuckle thing is kinda not that great since apparently there is still some risk with a knuckle (since your knuckle might also come into contact with your face eventually). here people (including myself) use pen tips/capped sticks. (some use condoms apparently but that seems wasteful.)
basically, get a chopstick/stick/pen-without-ink, and stick a pencap over it. when you need to press buttons, uncap your stick and press the button, then re-cap it.


Also... in case there's anyone reading this who doesn't know, there has been an ongoing MeTa for people in countries directly affected by COVID-19. (thank you to dorothyisunderwood for starting it.) If that's you, join & we can all vent & share resources together :p


*in some countries/cities this might not be the actual policy in future (depending on the extent and nature of spread). milder cases may be officially told to stay home even if they are confirmed to have the virus (in order to free up hospital resources for those that really need them). in that scenario i guess that guide will be more relevant.
posted by aielen at 5:26 PM on February 24 [14 favorites]


Gotanda and I were talking about this yesterday, and yeah, the graduation cancelling thing, that might happen. From a Japanese school year, this might be hitting at the second best time. The school year ends in the next week or so for a lot of primary and secondary schools. Many universities are already finished with classes, and there's usually a short break until the beginning of April. I wouldn't be surprised if primary and secondary schools begin to cancel classes and end the year earlier (not without precedent, as many schools did this after the Fukushima earthquake).

Personally, I'm all for it, as long as they remember to also cancel school clubs and tell kids to stay home. During most breaks in Japan, a lot of the students are still coming to school for club practice nearly every day, which, if clubs aren't cancelled, would make any efforts to close early meaningless. While it seems like a simple, and safe decision, having worked in Japanese schools for the better part of my time here, the pushback against cancelling clubs would probably be a lot stronger than cancelling classes. Priorities, I guess.
posted by Ghidorah at 5:32 PM on February 24 [3 favorites]


Of course, that school break time also has a lot of travel in Japan, soo....

[My wife and I still have plans to be in Japan next month during that time, planned long ago since younger relatives will be free from school. It's unclear whether Japan is or is not "safer" than the US, since both countries are essentially not testing anyone. Still in a holding pattern since cancellation is too late to get any money back, so we'll just have to see what happens.]

At least with our friends and family, they seem a lot less concerned/aware than people in the US, but that may be heavy sample bias as my US friends/family are much more news junkies.
posted by thefoxgod at 5:38 PM on February 24


spamandkimchi, that article you posted makes a lot of sense. Thanks for that. We do need to change the mindset.
posted by storybored at 5:48 PM on February 24


Yeah, it'll be deeply personally disappointing for me if they cancel graduation March 20th, but it is likely the right thing to do. It falls into that "We know we should, but we probably won't." category. I know that there was discussion about calling it off, but it is really hard to go first. Students, parents, and faculty have been working towards this for years. Lots of money has already been spent.

The complete absence of the Ministry of Education here is pretty much textbook example of the failures in the linked articles. The Ministry website is still focussed on management of the return of students from China, (Don't tolerate bullying. Kind words, but it's gonna happen.) The current Minister, Kōichi Hagiuda, spoke February 18th and is still stressing "cough etiquette" at events like graduation.

They are still half-heartedly trying to close the door and completely unwilling to take the hard measure of recommending cancelled or symbolic ceremonies--something like an address, diplomas to a few representative students, and livestream it. The complete abdication of any leadership from government on this is frustrating and depressing. It makes it very hard. Not looking forward to trying to make decisions about and manage the planned start of classes in April if the Ministry can't even give us cover to cancel opening ceremonies for a couple thousand kids and family cycling through an auditorium all day.
posted by Gotanda at 6:56 PM on February 24 [3 favorites]


As Gotanda said, the imminent events are what we're talking about now (I just found out that one of Japan's best craft beer festivals, held in a ski resort in the mountains, decided to cancel), but the opening ceremonies in April, and how things go, that's the sort of long term discussions that need to be happening. I mean, and I dearly hope, it'll blow over soon, but that honestly doesn't seem to be the case. The urge to get everything back to normal and carry on is really strong here, and elsewhere, too, obviously. Things like Macau closing casinos for two weeks, that's going to be a huge hit to their economy. What happens if, after the two weeks are up, the virus hasn't gone away? There are so many dominoes in the chain that I wonder how many people who need to be doing the planning just aren't because the size of it all is just too overwhelming? How many questions just aren't being asked because the answer is just too unbearable?
posted by Ghidorah at 7:52 PM on February 24 [2 favorites]


Yeah, I just found out that my school has cancelled this Saturday's party (separate from graduation) for the graduating students, and will be closing the school after exams are done, no clubs or activities. Of course, that's still two or three weeks away, but it's clearly not something being done lightly.
posted by Ghidorah at 9:42 PM on February 24 [1 favorite]


the 2019-nCOV virus

Isn't the official science-based name COVID-19. Varying the nomenclature like this will only encourage people to go back to racist tags like China Flu.
posted by fairmettle at 10:37 PM on February 24 [1 favorite]


I think officially the disease is called COVID-19, and the virus, which used to be 2019-nCoV, is now SARS-CoV-2? It is confusing and there are still several terminology variants floating around.
posted by atoxyl at 12:02 AM on February 25 [7 favorites]


Trump’s flailing incompetence makes coronavirus even scarier (Matthew Yglesias, Vox)
America’s pandemic response capabilities have been systematically dismantled.
It's the usual things - budget cuts, driving out experts, organizational negligence.
posted by ZeusHumms at 9:49 AM on February 25 [2 favorites]


Trump’s flailing incompetence makes coronavirus even scarier

Trump: Don't worry. We've got this. We're close to having a vaccine.

What?

White House press office: He was talking about ebola.
posted by JackFlash at 10:05 AM on February 25


Im not super worried about dying from the coronavirus in a developed country but I am worried for all the people on leas developed countries. Thr videos out of Iran are very sad. And for people with other conditions that depend on medications manufactured in affected countries that will ve in short supply soon.

Also if I'm going to get this I might prefer to do it now while ICU beds are available. Not sure its feasible to avoid eventual infection.
posted by fshgrl at 10:53 AM on February 25 [2 favorites]


More level-headed advice from Ian M. Mackay and Katherine E. Arden, posted at Virology Down Under (the site that spamandkimchi posted a link to, above):

So you think you're about to be in a pandemic . . . What can we plan for and do?
Let’s break this into two main categories.

Reducing our risk of being infected
Reducing the chance we will run out of essential foods and goods . . . Label up a “Pandemic Stash” box, and begin to slowly fill it with items that won’t go off and that you won’t touch unless needed. Buy a few of the things each weekly shop. Don’t buy things you won’t eat later, don’t hoard and don’t buy more than you’ll need for a 2 week period. We’re not talking zombie apocalypse . . .
On Twitter, Mackay is @MackayIM. Jody Lanard (as in spamandkimchi's link) is @EIDGeek.
posted by cybercoitus interruptus at 11:24 AM on February 25 [5 favorites]


"don’t buy more than you’ll need for a 2 week period"

This I don't get. At any given time, I have at least a month's worth of food in my pantry and kitchen, probably closer to 2. Unless you have space or money issues, why would you deliberately scant? One of the advantages of having good stores is that you can share with other people without worrying about depriving your own household.
posted by tavella at 11:52 AM on February 25 [5 favorites]


This I don't get. At any given time, I have at least a month's worth of food in my pantry and kitchen, probably closer to 2. Unless you have space or money issues, why would you deliberately scant? One of the advantages of having good stores is that you can share with other people without worrying about depriving your own household.

Well, if everyone who can afford it races out to get a month's food, there won't be anything left on the shelves for anyone else - and there are a lot of people who can't afford to buy a month's food at once. Also, if everyone who can afford it panic-buys a ton now, there will be a weird distortion in the supply chain where the shelves are bare for a few days until new stuff comes in.

Given that there are still very few cases in the US (and even absent good testing, we'd know if there were a big cluster in New York or something - there'd be a noticeable uptick in unusual pneumonia) it doesn't seem like this is the time for everyone - and I stress, everyone who can afford it - to strip the shelves. Much better to buy a bit at a time starting now on the assumption that even in a worst case scenario we have lag time.
posted by Frowner at 12:01 PM on February 25 [10 favorites]


Yes, but they already say "buy a few of the things each weekly shop" so that's covered, they seem to be making a general instruction that having more than two weeks' supply is bad. Even if you are talking purely about self-isolating after a contact, that's cutting it very tight, given you might not be able to restock instantly after 14 days. And if you have a multi-person household, then you may have a series of ill people and have to be in quarantine for a much longer period. It's just bad advice, IMHO.
posted by tavella at 12:12 PM on February 25 [1 favorite]


Please be safe, MeFiites.
posted by doctornemo at 12:12 PM on February 25




We don’t have anywhere close to a month of food in our flat. That’s partly due to space issues but mostly because we have a dozen grocery stores within a 15 minute walk, plus all the UK supermarkets do cheap and quick delivery. Obviously that’s not the case for a lot of people - but it is the case for many in cities.
posted by adrianhon at 12:33 PM on February 25


FPP based on the Miami Herald article MrVisible links to.
posted by XMLicious at 12:37 PM on February 25 [2 favorites]


they seem to be making a general instruction that having more than two weeks' supply is bad

My guess is, they're trying to walk a fine line of getting as many people as possible to prepare, without setting off panic-buying/hoarding.

Personally I'm figuring out how to apply this climate change article's rhetoric suggestions to COVID-19, too. My own social circles currently think of this as "over there / Them," not "what happens when it's here / Us."

Rhetoric suggestions: "Social — Making climate change an issue in your social circles, and sharing ideas about solutions with friends and neighbours.
Supportive — Support climate change talk within a positive framework.
Simple — Make climate-friendly behaviours easy and convenient. . . . "

(New-to-me word I picked up from reading about coronavirus: distantiate, to keep at a distance)
posted by cybercoitus interruptus at 12:46 PM on February 25 [3 favorites]


CDC tells Americans to brace for coronavirus (Beth Mole, Ars Technica).
In a press conference Tuesday, Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said that the American public and businesses should prepare for the possibility that the new coronavirus will spread in the US.

Given the rapid increase of COVID-19 in other countries outside of China in recent days, “we expect we will see community spread in this country,” Messonnier said. “It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness.”

Parents should talk with schools and daycares about outbreak responses and closure plans, and they should ask about tele-school options, she advised. Companies and employees should think about remote working arrangements and alternative childcare. And people should look into the availability of tele-medicine options with their healthcare providers.
US stock prices have fallen 6% in the past two days.
posted by mbrubeck at 5:06 PM on February 25 [5 favorites]


just had a text from an Irish friend living in Florence for 16 years, a parent in the school her daughter goes has been confirmed as Covid19. The authorities appear to only contain the acrive virus and she in Florence has not been able to get good masks, as 1 kid in high school, the older one is in second MedEd
posted by Wilder at 5:12 PM on February 25


It seems I misunderstood yesterday. My school will close next Friday on the last day of final exams, meaning students will essentially not be at school for a month. And Facebook has turned into a steady stream of events being canceled. One pretty standard thing here is a general lack of confidence in the government's ability to do anything remotely effective. On the other hand, Dentsu, which is a pretty giant corporation in Japan just told everyone working in their headquarters office to switch to working from home in reaction to an employee being diagnosed with the virus.

As far as the events being cancelled, there's a solid undercurrent in responses of people complaining that this is all an overreaction, and honestly, I'd rather the over-reaction than this turning into something worldwide. All of this "they said SARS would be bad, but nothing happened" is actively harmful, conditioning people to take things too lightly. SARS didn't "happen" because the equivalents of the CDC in affected countries did their level best to keep it from happening. Every time a new thing comes up and doesn't become a pandemic is a freaking victory, and should be treated as such.
posted by Ghidorah at 5:35 PM on February 25 [5 favorites]


Given that there are still very few cases in the US (and even absent good testing, we'd know if there were a big cluster in New York or something - there'd be a noticeable uptick in unusual pneumonia)

This is an interesting (and important) point of discussion. My impression is that, as of right now, the U.S. largely is absent good testing. I've seen several epidemiologists express their concerns
and frustrations about this. At the same time I'd think we would know if a cluster of severe cases presented itself... right?
posted by atoxyl at 6:38 PM on February 25 [1 favorite]


The two weeks is a cache above and beyond ones regular stores. I'd guess most people have at least a few days of food on hand if not a week or two.

Though considering the sort of panic buying that happens in the lead up to a hurricane maybe that is optimistic.

My worry is my prescription meds. My insurance (like most extended plans in Canada) will A - only cover a 90 day supply and B - only when I have less than 30 days remaining. I'm about to hit the window so I'll be good as long as any disruption isn't effecting my meds 120 days from now.
posted by Mitheral at 2:42 AM on February 26 [1 favorite]


At the same time I'd think we would know if a cluster of severe cases presented itself... right?

Let's say that New York starts seeing an uptick in unusual pneumonia. Are they going to keep quiet about that? Or San Francisco, which has declared a preemptive state of emergency to free up funds and create a coordinating structure? SF has a LOT of travel between China and the US. When there's widespread community transmission in the US, it will be visible in cities that get a lot of international travelers, unless the frequency of serious cases is very very low and in that case things won't get that bad.

Remember that the future is uneven in the US - it's true that our medical infrastructure is shit for low income people and in badly governed places, but in rich, organized places it's okay.

One thing I'm wondering about: smoking. I've seen a couple of papers that suggest that smokers are at significantly higher risk for complications than non-smokers.
posted by Frowner at 6:22 AM on February 26 [1 favorite]


as of right now, the U.S. largely is absent good testing

From The Guardian yesterday:
The CDC acknowledged that the test kits it began distributing to state authorities earlier this month have been found to be faulty. The agency said in a statement that “performance issues were identified related to a problem in the manufacturing of one of the reagents which led to laboratories not being able to verify the test performance”.

[Head of immunization at the CDC Nancy] Messonier said that 12 “states and localities” had working test kits, but according to independent health experts, that overall number includes only five states.

[...]

Jeremy Konyndyk, who led the Obama administration’s response to the Ebola outbreak in 2014, said it was unclear why the US was lagging behind the rest of the world on testing.

“It is puzzling to me that the government has been unable so far to resolve that problem, at a time when most other countries that are facing the disease have been able to do testing at a much larger scale,” Konyndyk said. “We have a lot of people in the government working very, very, very hard on this, but we do not have the kind of fully mobilized US government response that we need.”
posted by heatherlogan at 7:27 AM on February 26 [1 favorite]


From the same Guardian article:
“The coming week is going to be a very telling time in this outbreak,” Saskia Popescu, an epidemiologist at George Mason University, said. “There’s a lot of concern around the limited testing that’s getting done in the United States right now.”

Popescu said there was also a serious shortage of personal protective equipment, such as face masks .

The health and human services secretary, Alex Azar, asked for $2.5bn in emergency funding. He said the country currently has a stockpile of 30m surgical masks, but his department estimated that 10 times that number could be needed.
(The population of the United States is a little under 330 million.)
posted by heatherlogan at 7:31 AM on February 26 [1 favorite]


It's almost as if it's difficult to mount a coordinated national response to a public health emergency when the health system is cobbled together out of thousands of private companies at cross purposes to each other. Huh.
posted by sjswitzer at 7:54 AM on February 26 [7 favorites]


The thing is, doctors aren't stupid. If there's a big uptick in atypical pneumonia cases even IF they haven't been tested for the virus, someone is going to go to the media - that's what happened when this first started in China. This is doubly and trebly true since everyone is on high alert. I just don't think that there can be an illness that spreads easily spreading the in the community right now today with a 2% fatality rate without someone spotting it pretty quick on symptoms alone. Anyone worth their salt knows that the tests aren't reliable now, too.

A possibility is that the fatality rate is way lower than currently believed, of course.

Obviously there's going to be community spread in the US, but I just don't see how at this point there could be lots of cases being missed, unless the complication and fatality rates are extremely, extremely low and sort of blending into seasonal noise.
posted by Frowner at 8:23 AM on February 26 [2 favorites]


As of Monday, NYU has pulled all of their students studing abroad in Florence and told them to disperse for a week, and then they will resume classes remotely for the month of March.

Dang. I guess those kids can travel for a week, but it's still scary as hell for their families back home.

NYU says they are learning a lot, having just flipped their Shanghai campus to online-only in acouple of weeks, over the Lunar New Year holiday!

(And here I was starting to plan a trip to England and maybe Paris in July/August... Welp, that seems scuppered.)
posted by wenestvedt at 9:18 AM on February 26


2,770 deaths from 81,294 reported cases gives a fatality rate closer to 3.4%, not 2%.
posted by emelenjr at 9:19 AM on February 26


It's like Trump cutting funding to the CDC and agencies fighting international desease in the pursuit of tax breaks for people who won't even notice was a bad idea.
posted by Mitheral at 9:31 AM on February 26 [1 favorite]


Chinese medical staff request international medical assistance in fighting against COVID-19 [Yingchun Zeng, Yan Zhen; Feb. 24th, The Lancet]
posted by MrVisible at 12:10 PM on February 26


2,770 deaths from 81,294 reported cases gives a fatality rate closer to 3.4%, not 2%

Most of the stuff I've read from researchers/etc says that any fatality rate right now is certainly overstated, because the "reported cases" don't include everyone with the virus. No country is testing everyone, and people can be completely asymptomatic or have mild symptoms such that they may never present to a hospital/etc.

So the denominator is larger that 81,294. How much larger, no one can say for sure, of course. On the Diamond Princess, "322 of 621 people tested positive but showed no symptoms". If they had not been on that ship, they would not have been tested at all.
posted by thefoxgod at 2:26 PM on February 26 [2 favorites]


The most alarming thing to me so far - as a Canadian and on behalf of this continent I guess - is what I have just read - that Trump wants more personal control over how the US handles the virus:

From this CNN live update:
President Trump has privately expressed frustration with his Health and Human Services Secretary Alex Azar, who has taken the lead on coordinating the response so far, and is blaming him for not keeping him updated enough, sources say.

[...]

The President has blamed Azar for not keeping him updated and allowing him to weigh in on crucial decisions, and has weighed selecting another point person as alarm about the outbreak is on the rise, though he has not followed through on it yet.

[...]

The President and other officials have also directed their anger at Dr. Nancy Messonnier, the CDC official who has been a public face of the coronavirus response, for what officials claim is overly fatalistic messaging.
(Sorry if I shouldn't link CNN, I'm not the most fluent in US news sources.)

Trump usually gets what he wants. But this - can we please, please leave this to the experts?
posted by kitcat at 2:37 PM on February 26 [1 favorite]


[One deleted; let's not link to tabloid sources promoting conspiracy stuff.]
posted by LobsterMitten (staff) at 2:53 PM on February 26 [4 favorites]


Although the sample size is smaller, it might be worthwhile to consider the Diamond Princess statistics. 638 tested positive, 4 fatalities at the moment. This is a 0.6% fatality rate. However, there are still some people who are critically ill in hospital, and perhaps others who may still succumb. Also passengers are more affluent than the general population and probably in good health. These factors would skew the true fatality rate higher than 0.6%. On the other hand, there may be more seniors among the passengers than in the general population. This would skew the fatality rate lower.
posted by storybored at 3:08 PM on February 26 [5 favorites]


That article in The Lancet Posted by MrVisible reports that
So far 1716 Chinese staff have been infected with COVID-19 and nine of them have unfortunately passed away.
That's a fatality rate of over .5% among a cohort that probably represents most of the people infected among the population of medical personnel; also a cohort that presumably excludes children, the aged, and the already ill. If further members of that group pass away the figure will rise, but in any event I think we should treat this fatality rate of .5% as being very much a floor.
posted by Joe in Australia at 3:29 PM on February 26 [1 favorite]


CDC reports first coronavirus case of "unknown origin" in the US. [Evidence that community spread seems to be occurring].
posted by thefoxgod at 3:48 PM on February 26 [3 favorites]


Additional details from the Washington Post about the new US case: First person in U.S. tests positive for coronavirus with no link to foreign travel.
A person in Northern California has contracted the coronavirus without traveling to regions hit by the outbreak or coming in contact with anyone known to have the infection, the first sign that the disease may be spreading within a U.S. community, the Centers for Disease Control and Prevention reported Wednesday night.

The individual is a resident of Solano County, according to the California Department of Public Health. The patient is being treated at UC Davis Medical Center, according to a person familiar with the case who spoke on the condition of anonymity because the details are not public.

Solano County is home to Travis Air Force Base, where hundreds of Americans repatriated from China, and others brought home from the Diamond Princess Cruise ship have been kept in quarantine. Many of them have been released.

The health department said it has already begun tracing people who may have come in contact with the individual.
posted by mbrubeck at 6:52 PM on February 26 [3 favorites]


Mike Pence, who enabled an HIV outbreak in Indiana, will lead US coronavirus response (Nicole Wetsman, The Verge)
Pence has a track record of ignoring public health evidence
Trump downplays risk, places Pence in charge of coronavirus outbreak response (Toluse Olorunnipa, Josh Dawsey and Yasmeen Abutaleb; Washington Post)
posted by ZeusHumms at 8:30 PM on February 26 [1 favorite]


You mean the same Mike Pence who claims there is no evidence that smoking kills?

Can I get off this bus, because I think the addled driver is headed over the cliff.
posted by JackFlash at 9:37 PM on February 26 [3 favorites]


Today, the Japanese prime minister asked that all schools in the country shut down from Monday, March 3rd, until the start of the next school year in April.

That sound you hear is the sound of school administrators, parents whose children will suddenly be home all day instead of at school, and any part-time or hourly worker dependent on hours connected to school trying to figure out what the hell they're going to do. Absolutely no info that I’ve seen about any kind of assistance from the government about how this is supposed to go, or what will be done to help out.
posted by Ghidorah at 4:08 AM on February 27 [12 favorites]


The new coronavirus and racist tropes (Amanda Darrach, CJR)

An analysis of coronavirus coverage finds that the media are playing up stereotypes and tropes that lead to increased racist behavior around the world. Some related stories are being ignored.
posted by ZeusHumms at 9:02 AM on February 27 [5 favorites]


The article that I posted from the Lancet yesterday has now been retracted.
On Feb 26, 2020, we were informed by the authors of this Correspondence1
that the account described therein was not a first-hand account, as the authors had claimed, and that they wished to withdraw the piece. We have therefore taken the decision to retract this Correspondence.
posted by MrVisible at 9:29 AM on February 27 [5 favorites]


It seems obvious that Trump put Pence in charge so that when containment ultimately fails, he has someone other than himself to blame.
posted by gwint at 11:22 AM on February 27 [4 favorites]


I think this was linked via a CNN article, but this essay from a 2017 Smithsonian Magazine issue about the 1918 flu was pretty interesting. It focuses on the mistakes made then by public health officials.

From the article:

Then there are the less glamorous measures, known as nonpharmaceutical interventions: hand-washing, telecommuting, covering coughs, staying home when sick instead of going to work and, if the pandemic is severe enough, widespread school closings and possibly more extreme controls. The hope is that “layering” such actions one atop another will reduce the impact of an outbreak on public health and on resources in today’s just-in-time economy. But the effectiveness of such interventions will depend on public compliance, and the public will have to trust what it is being told.

That is why, in my view, the most important lesson from 1918 is to tell the truth. Though that idea is incorporated into every preparedness plan I know of, its actual implementation will depend on the character and leadership of the people in charge when a crisis erupts.

posted by bowtiesarecool at 2:42 PM on February 27 [7 favorites]


The thing that is incredibly confusing to me is the hyperfixation on the spread vs the consequences of actually getting it. I get the flu once every single year. Once every single year post-nasal drip turns it into bronchitis. Every year around 3 days after bronchitis onset I pay $35 to see someone at Urgent Care and $10~15 for a 5-day Z-pack. Two days later I’m better. This pattern has been 100% consistent for the last thirteen years.

After hours of digging I am struggling to find anything that suggests the coronavirus is worse than the annual rite of passage for most adults with significant exposure to the public, with nothing as yet indicating that is the case.

Why, basically, do we care? Why does this matter in the slightest? Everyone seems to be in pants-shitting terror over The Flu 2: Slightly More Stealthy Edition. Genuinely confused as to why this is international quarantine/shelter in place/stock market collapse territory. I don’t need it ELI5’d or anything, just looking for a straightforward answer on this and asking around that’s apparently true of most of my friends/co-workers as well.
posted by Ryvar at 6:04 PM on February 27 [2 favorites]


If everyone gets something in a very short period, and 20% of those people need significant medical attention and 25% of those people need ICU-level support, you have a problem, that's why. If a hundred people get it and 15 need significant care and 5 need high level support, the medical system can handle it. If 150,000 people get it and 7,500 people need ICU-level care, you're screwed.

The point is the speed and ease of transmission, not the seriousness. If you're under forty and have no pre-existing conditions AND you don't have, eg, a friend with diabetes or elderly relatives, sure you're fine. Everyone else has various reasons to worry.
posted by Frowner at 6:10 PM on February 27 [24 favorites]


Also, if you're young and healthy and waltzing around coughing on people, you're facilitating the speed of spread, which means more people in the ICU all at once.

And if the ICU is full of coronavirus cases, it can't deal with, eg, heart attacks. And people have died in China from non-flu causes because they couldn't get emergency surgery because the hospitals were full.

Now, in Guangzhou and Zhejiang, where public health measures have so far kept the spread of the disease limited and slow, the fatality rate has been lower than in Hubei...and that's probably because medical personnel, supplies and hospital beds are available.
posted by Frowner at 6:13 PM on February 27 [8 favorites]


After hours of digging I am struggling to find anything that suggests the coronavirus is worse than the annual rite of passage for most adults with significant exposure to the public, with nothing as yet indicating that is the case.

In addition to what Frowner said: we have a functional flu vaccine, every year, that significantly dulls what would otherwise be a far more severe impact. And despite that, the flu is still quite bad! Even if coronavirus was otherwise exactly the same as influenza, that would be quite bad. People tend to underestimate the flu's impact and risk because of its perceived normalcy.

The flu causes hundreds of thousands of hospitalizations every year; the main reason it's mortality isn't higher is because we've built an extensive medical infrastructure to keep people alive through it, to backstop those cases that vaccines don't catch. The CDC estimates that without vaccinations, we'd be looking at a few million more cases per year, a few million more doctor and hospital visits, tens or hundreds of thousands more hospitalizations, and certainly more deaths.

If coronavirus patients require (or seek) a lot of medical intervention, that 'annual rite of passage' is also going to get riskier for a lot of people because the healthcare industry will have a harder time helping people through it.
posted by cjelli at 6:43 PM on February 27 [6 favorites]


After hours of digging I am struggling to find anything that suggests the coronavirus is worse than the annual rite of passage for most adults with significant exposure to the public

First, most adults don't get influenza anything remotely like every year, so if you're doing that you're either not getting influenza or something else is affecting your risk factors. (Last I checked median was maybe once every five years.)

Second, I don't know how you came to the conclusion that the coronavirus isn't worse than season influenza (which, in and of itself, you are inappropriately downplaying). The rate of transmission is so far as we can currently tell moderately higher, and the mortality rate is significantly higher.

How do you get to the conclusion that something which spreads easier than influenza while also being roughly 20x as deadly is a nothingburger?
posted by Justinian at 6:52 PM on February 27 [12 favorites]


Why, basically, do we care?

First, no one on Earth has existing immunity to the novel coronavirus (other than the ~80,000 people who have already been infected). Because of global mobility, that means that pretty much everyone will be susceptible to catching it; with the so-far-measured death rate that translates into millions of deaths.

Second, at the moment there is no treatment. A Z-pack is antibiotics; but they are useless against viral pneumonia. Severe flu can be treated with the antiviral Tamiflu (remember the hoarding during H1N1 a decade ago?); but it is useless against coronaviruses.
posted by heatherlogan at 6:54 PM on February 27 [4 favorites]


The point is the speed and ease of transmission, not the seriousness.

The seriousness is also a concern if the current numbers hold up (which they might not). The morality rate looks on the same order as Spanish Flu, though concentrated much much more heavily among the older population rather than the younger as with Spanish Flu.

It's possible mortality figures will come down after the fact if it appears that a lot more people contracted covid-19 than previously known and the mild cases simply weren't diagnosed, but that's a hindsight thing. Right now it looks pretty bad.
posted by Justinian at 6:54 PM on February 27 [1 favorite]


I did not see "morality rate" in time but I kind of like it.
posted by Justinian at 7:06 PM on February 27


'America's basically in the dark completely about the epidemic.' - Harvard epidemiologist Eric Ding
The patient in California had to wait days to be tested because their symptoms did not fit federal criteria for testing. The CDC has restricted testing to patients who have recently travelled to China or have come in contact with an infected person. [...]

America's main problem is right now we have no testing almost whatsoever. [...] CDC's kits were frozen and recalled because of a lab error. [...]

Right now if a doctor in the United States wants to test someone who is not travelling from China, they could not. [...] The person [diagnosed Thursday in California] was not tested for many, many days. They had demanded it. Finally California provided the test. The test did not come from the CDC. California is one of the few states that actually has testing capability, limited albeit, at this time. And they finally, after an extensive delay of CDC refusal, California tested it and, boom, discovered that person did have it. [...]

[B]ecause Trump has appointed Vice President Pence as the coordinating person, all these previous NIH directors and CDC directors who spoke to the public … are now prevented from speaking to the press. All communications must now go through the vice president's office, which, as you know, is a very political office, unlike a public health and scientific body like the NIH or CDC.
U.S. whistleblower: Federal workers had no protection while helping coronavirus evacuees
A government whistleblower has filed a complaint alleging that some federal workers did not have the necessary protective gear or training when they were deployed to help Americans evacuated from China during the coronavirus outbreak.

The complaint deals with Health and Human Services Department employees sent to Travis and March Air Force bases in California to assist the quarantined evacuees. [...]

The whistleblower was among a team of about a dozen employees from the agency who had been deployed to help connect the evacuees with social services that they might qualify for. The team was there from mid-January until earlier this month.

Although team members had gloves at times and at other times masks, they lacked full protective gear and received no training on how to protect themselves in a viral hot zone, according to a description provided by the congressional office. They had no respirators. While helping the evacuees, team members noticed that workers from the Centers for Disease Control and Prevention were in full gear to protect them from getting sick. [...]

[T]he high-ranking whistleblower complained to superiors and was given the choice of being reassigned or being fired.
posted by heatherlogan at 7:08 PM on February 27 [7 favorites]


After hours of digging I am struggling to find anything that suggests the coronavirus is worse than the annual rite of passage for most adults with significant exposure to the public, with nothing as yet indicating that is the case.

I don't know where you are getting you information, but coronavirus is nothing like the flu. For one thing, although numbers are still uncertain, it seems that coronavirus is 20 to 100 times more deadly than flu.

Second, flu is a primarily upper respiratory disease while coronavirus is a lower respiratory disease which goes deep into the lungs and can interfere with breathing, causing deadly pneumonia.

But your description of having the flu every year sounds suspicious. Most people misdiagnose colds as flu. The fact that you have a running nose leading to sinus problems suggests cold not flu, as the flu doesn't usually cause a running nose. Flu can be a very serious illness, nothing like a cold at all. High fever, chills, terrible painful bone and muscle aches, extreme fatigue where you can barely drag yourself out of bed for a full week or two. If you ever had the flu, you would never forget it. It is highly debilitating and painful. If you don't have these symptoms, then you probably just have a cold.

So if you are misdiagnosing your illness, you aren't comparing flu to coronavirus. You are comparing a simple cold to coronavirus. That may be why you think coronavirus is a big nothing because colds are a big nothing. But they aren't anything like the flu or even coronavirus.
posted by JackFlash at 7:39 PM on February 27 [18 favorites]


"Saudi Arabia announced that they are suspending all foreign Muslims from participating in the pilgrimage in the country. They are also banning all tourists from countries with #COVID19 outbreak to visit the country." Tweeted by journalist William Yang via Chinese language reporting, other media outlets have also reported on this.

"South Korea’s central committee on #COVIDー19 said 99 out of 102 patients from the psychiatric department of a hospital have all contracted #coronavirus and 7 of the 13 death cases come from there too. Experts say the high infection rate has something to do with the environment." Tweeted by William Yang.
posted by spamandkimchi at 8:31 PM on February 27 [1 favorite]


Hey folks, I appreciate the helpful answers but maybe not so much the pile on attacks: I test positive for the flu every year without fail when I go to urgent care - regardless of whether or not I get the shot that year - and presumably due to asthma complications it turns into bronchitis every single year, no matter what. If I try to tough out the bronchitis, I’ll have full-blown pneumonia after 8 to 10 days (3 for 3 attempts at toughing it out). Separately, head colds can also result in bronchitis for me but I don’t get them very often. I’m sorry if the diagnosis of the many, many different doctors who have treated me over the entirety of my adult life or their test results bother you but the facts aren’t really in dispute here and if you could drop the armchair diagnostics that would be super awesome, thanks.

As to the misperception on mortality: the CDC‘S numbers for influenza burden were generally in the range of 0.1~0.17% mortality, and the coronavirus numbers I was seeing for *healthy adults*, which is what I’d been searching for, were coming back 0.2% as seen earlier in this very thread, and with numbers likely to fall due to difficulty of diagnosis. I hadn’t been looking for stats on the elderly...probably because I don’t interact with anybody outside the 25-60 range other than at Christmas, and that particular narrow scope is my bad. The moment someone called my attention to them, I understood what the problem was (nursing homes with a 1-in-6 mortality rate, got it).

At any rate, that answers my question and I hope we can drop the derail at this point, because having total strangers calling bullshit on each others’ well-established medical history over the Internet is probably not a good use of anybody’s time.
posted by Ryvar at 8:44 PM on February 27 [4 favorites]


Here's Devi Sridhar, public health expert on why public health people are worried:
#COVID19 is not just bad flu. Spreads like flu & you're more likely to catch flu. But the health outcomes at population level are worse for COVID-19 (20% severe/critical state, 2% case fatality rate), we don't have a vaccine or antiviral, & we know much less about its spread.
posted by spamandkimchi at 9:36 PM on February 27 [2 favorites]


I'm unsure whether he means that the R0 for flu is higher (which doesn't match my understanding so far), he just made a typo, or he means you're more likely to catch flu right now since covid-19 is still mainly in east Asia, which is obviously true but kind of trivial. But I'm not a public health expert.
posted by Justinian at 9:50 PM on February 27


As to the misperception on mortality: the CDC‘S numbers for influenza burden were generally in the range of 0.1~0.17% mortality, and the coronavirus numbers I was seeing for *healthy adults*, which is what I’d been searching for, were coming back 0.2% as seen earlier in this very thread

Keep in mind that it's actually a bit worse than you possibly still might be thinking since the 0.1%-0.2% mortality numbers for influenza includes the healthy adults as well as the very young, sickly, and elderly. Which means that healthy adults have quite a bit lower than 0.1% mortality from influenza. So a 0.2% mortality rate in healthy adults for covid-19 likely represents a significantly higher mortality even for healthy adults.

You may well already see that, I just thought I'd make sure to emphasize it for people who are reading the thread.
posted by Justinian at 9:58 PM on February 27 [8 favorites]


Two scenarios if COVID19 is not contained. “It’s not too soon to talk about this,” said Dr. Amesh Adalja, an infectious disease specialist at the Johns Hopkins Center for Health Security. “We know that respiratory viruses are especially difficult to control, so I think it’s very possible that the current outbreak ends with the virus becoming endemic.”
posted by storybored at 10:18 PM on February 27 [3 favorites]


So a 0.2% mortality rate in healthy adults for covid-19 likely represents a significantly higher mortality even for healthy adults

Yeah, once I saw the coronavirus stats for the elderly it seemed likely that applied to the mortality distribution for the flu as well, so, uh...

1 in 7 with even the best nursing homes featuring numerous immunocompromised people in close proximity looks like a huge fucking problem with few or no solutions. I sincerely hope this plays out better than appears likely but Pence running the show inspires null confidence. Good luck to us all, I guess: I sarcastically anticipate enormous fun pointing out to exhausted medical professionals that 13 years of the same pattern indicates my lungs just need a little help kicking out whatever opportunistic shit inevitably comes along for the ride, and would you please give me a Z-pack for a viral infection, kthx. Because that’s totally standard treatment, right??
posted by Ryvar at 10:39 PM on February 27 [1 favorite]


'America's basically in the dark completely about the epidemic.' - Harvard epidemiologist Eric Ding

Incidentally I've found a number of credentialed epidemiologists on Twitter don't really love this guy. He may technically be a "Harvard epidemiologist" but his focus in that capacity is nutrition and health economics, not infectious disease, and folks who do specialize in infectious disease seem to think he tends to steal the spotlight and hype things up in the wrong way. He's not way out there like some people but I'd be wary.
posted by atoxyl at 11:53 PM on February 27 [9 favorites]


(I think he initially RTed the "HIV sequence" paper, for instance!)
posted by atoxyl at 11:59 PM on February 27


Thanks atoxyl, I didn't know. The case at the UC Davis Medical Center hits close to home because my parents and sister live there.
posted by heatherlogan at 5:30 AM on February 28


From Lawandcrime: A pair of stories broke late Thursday afternoon concerning a Health and Human Services (HHS) whistleblower with a fatal series of charges that, if true, means the Coronavirus outbreak in the United States was caused by the ineptitude of the Trump administration
posted by growabrain at 5:48 AM on February 28 [8 favorites]


New York Times: "The Chinese government silenced whistle-blowers, withheld information and played down the threat of the new coronavirus. Now the ruling Communist Party is trying to rehabilitate its image by rebranding itself as the leader in the fight against the virus."

I wonder if they realize they could have written this exact same story, word for word, about Trump and the U.S?
posted by JackFlash at 9:46 AM on February 28 [9 favorites]


WaPo is confirming a second case of unknown community transmission in California, this time in Santa Clare county. Note that the previous case was in Solano County.

Solana county is adjacent to SF/Oakland to the North. Santa Clara county is adjacent to SF/Oakland to the south. So that seems bad.

(Santa Clara is basically San Jose/Silicon Valley).
posted by Justinian at 2:59 PM on February 28 [1 favorite]


Note that it is 4 days until election day in California.
posted by Justinian at 3:51 PM on February 28


Oregon has just held a press conference announcing they have a confirmed case of unknown-origin community spread covid-19 and are also investigating a second possible case which has not been in contact with the confirmed case.

So this is clearly not confined to California if it ever was.
posted by Justinian at 6:40 PM on February 28 [2 favorites]


Joining California and Oregon, the Washington State Department of Health just announced two new “presumptively positive” cases in the state. One is a woman in King County (which includes Seattle) who traveled to South Korea. The other is a high school student from the Everett area (just north of Seattle) who has not traveled recently.

(via Seattle Times reporter Joe Sullivan)
posted by mbrubeck at 8:13 PM on February 28 [1 favorite]


It turns out “presumptive positive” means that a test result came back positive from the local Public Health Laboratory, but is still awaiting confirmation from the CDC.

Also, more info on the Oregon case:
The person had contact with people in Forest Hills Elementary School at Lake Oswego.

The person first had symptoms Feb. 19, the agency said in a statement. A sample from them was collected and sent to a laboratory in Hillsboro, which used a test kit provided by the U.S. Centers for Disease Control and Prevention.

Now, the school district is shutting Forest Hills, a school with 25 teachers on staff and about 430 students in kindergarten through fifth grade, until Wednesday, March 4. The school will undergo a deep clean and all activities will be canceled, district spokeswoman Mary Kay Larson said in a statement.
posted by mbrubeck at 8:27 PM on February 28 [2 favorites]


I’ve been following this really closely because I came down with a bad fever and cough last week. I live in Seattle and was visiting San Francisco at the time. I’m almost entirely recovered now, and I work from home so it’s been easy to minimize social contact since I got back from my trip (though of course I had to traverse two huge airports and spend two hours on an 737 to get home).

When I got sick I told myself not to worry much about Covid 19 because there were no known cases in the US besides quarantined travelers, so it seemed much more likely to be something else like influenza. Now, learning that there have been community cases in both the Bay Area and the Pacific Northwest for at least two weeks, but the patients weren’t tested until a few days ago, I’m much more suspicious. I’m still not sure if it’s likely I caught it, and I may never know for sure.
posted by mbrubeck at 9:35 AM on February 29 [2 favorites]


One person has died from COVID-19 in Washington State and there are more new confirmed and likely cases. The person who died is a 50-year-old man, and despite some confusion in earlier reports, it seems this is not related to either of the new cases announced yesterday.
The patient arrived at EvergreenHealth Medical Center in Kirkland with “serious respiratory issues” and tested positive for COVID-19, the hospital said in a statement. A second patient also tested positive and is currently in isolation and receiving treatment.

Two additional people have tested positive for coronavirus at the longterm care facility LifeCare Center in Kirkland. A resident in her 70s is in serious condition, and a health employee in her 40s is stable. The long-term facility in Kirkland has 108 residents and 180 employees, according to the CDC. Twenty-seven residents and 25 employees have symptoms, according to the CDC.

Over 50 other people associated with LifeCare are reportedly ill with respiratory symptoms or were hospitalized with pneumonia or other conditions, according to a statement from Public Health Seattle-King County. All are being tested for COVID-19, and “additional positive cases are expected,” according to public health officials.
posted by mbrubeck at 1:13 PM on February 29 [3 favorites]


Viral sequencing suggests the virus had been circulating in Washington for weeks. Infectious disease modeling estimates that if this is true, 150-1500 cases are currently undetected in Washington.
posted by medusa at 5:53 AM on March 1 [4 favorites]


It already is worldwide. The last week has demonstrated that it has existed within communities for weeks before it's noticed; if we've seen two or three examples, then there are certainly more.

A big question I have is how representative China has been. The first problem is that we don't know how reliable the official numbers are. The second problem is that in my opinion I don't think that the kind of lock-downs they've managed there are possible most elsewhere.

I think the 2% mortality rate is a big overestimate because I think the number of unreported and asymptomatic cases surely must be at least equal to those we know of, and may be a multiple. That's good news with regard to mortality, bad news with regard to containment.

Someone in the meta thread thought school closings were an overreaction because the mortality rate is apparently atypically lowest amongst even very small children. That's good in itself, but it means that children are most likely to be asymptomatic or mildly ill enough such that they don't stay at home. And children and schools are a hotbed of contagion. Schools are being closed because doing so is one of the more effective ways of reducing contagion.

I don't know if anyone has already linked this, but I visit this John's Hopkins page frequently for (nearly) up to the minute data.
posted by Ivan Fyodorovich at 8:49 AM on March 1 [7 favorites]


I think the number of unreported and asymptomatic cases surely must be at least equal to those we know of, and may be a multiple.

That's certainly the NEJM's position in their initial analysis and so they agree the initial mortality estimates may be quite a bit higher than what we'll eventually conclude. It's of course something we'll only know for sure in hindsight so I'm still gonna try to avoid this thing like, uh, the plague.
posted by Justinian at 9:11 AM on March 1 [1 favorite]


> Viral sequencing suggests the virus had been circulating in Washington for weeks. Infectious disease modeling estimates that if this is true, 150-1500 cases are currently undetected in Washington.

Given that Oregon had a similar community spread case of the virus, we're probably going to see something like that.

My fiancé just flew back to Northern Ireland via Dublin and there was still no screening when she got off the plane and they didn't do anything special handling her passport. The first case in Belfast was confirmed to be someone traveling from Italy via Dublin airport. There are probably many more that are just folks thinking its a winter cough because they hadn't left the country, but didn't realize they shared a bus / train / cab with someone who had come from an infected region OR had simply been in an international airport, which themselves should be considered a high risk zone.
posted by mrzarquon at 10:56 AM on March 1




Anybody else bothered by the CDC's weaselly statements about masks? The WHO doesn't agree with them, nor do other countries. So either they know better than everybody else in the world, basically, or... I don't know what. Why the quixotic doubling down?
posted by Justinian at 11:15 AM on March 1 [1 favorite]


I'm not sure which statement you mean, but these seem consistent to me.

CDC:
CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19. You should only wear a mask if a healthcare professional recommends it. A facemask should be used by people who have COVID-19 and are showing symptoms. This is to protect others from the risk of getting infected. The use of facemasks also is crucial for health workers and other people who are taking care of someone infected with COVID-19 in close settings (at home or in a health care facility).
WHO:
People with no respiratory symptoms, such as cough, do not need to wear a medical mask. WHO recommends the use of masks for people who have symptoms of COVID-19 and for those caring for individuals who have symptoms, such as cough and fever. The use of masks is crucial for health workers and people who are taking care of someone (at home or in a health care facility).

WHO advises rational use of medical masks to avoid unnecessary wastage of precious resources and mis-use of masks (see Advice on the use of masks). Use a mask only if you have respiratory symptoms (coughing or sneezing), have suspected COVID-19 infection with mild symptoms, or are caring for someone with suspected COVID-19 infection. A suspected COVID-19 infection is linked to travel in areas where cases have been reported, or close contact with someone who has travelled in these areas and has become ill.
NHS:
Face masks play a very important role in places like hospitals, but there is very little evidence of widespread benefit for members of the public.
posted by mbrubeck at 11:22 AM on March 1 [5 favorites]


Primarily the WHO report out of China in which they credit the widespread wearing of masks as one of the 3 most important methods of containing covid-19:
In the face of a previously unknown virus, China has rolled out perhaps the most ambitious, agile and aggressive disease containment effort in history.The strategy that underpinned this containment effort was initially a national approach that promoted universal temperature monitoring, masking,and hand washing.
"Universal masking".
posted by Justinian at 11:25 AM on March 1


The next sentence in that report is, “However, as the outbreak evolved,and knowledge was gained, a science and risk-based approach was taken to tailor implementation.”
posted by mbrubeck at 11:29 AM on March 1


...which continued to involve universal masking?
posted by Justinian at 11:30 AM on March 1


Anybody else bothered by the CDC's weaselly statements about masks?

As demand spikes for medical equipment, this Texas manufacturer is caught in coronavirus’s supply chain panic (WaPo, Feb. 15, 2020)
There is no global, centralized plan for fast-tracking production of what’s known as personal protective equipment. There is no streamlined process for deciding where to send masks, disposable gowns, goggles and gloves.

[...] In the United States, there is enough finished product to supply hospitals and other front-line health workers for the next four weeks, according to an industry expert who works with manufacturers but spoke on the condition of anonymity to share ongoing discussions.
Yes, it is worse than the flu: busting the coronavirus myths (Guardian)
Wearing a face mask is not an iron clad guarantee that you won’t get sick – viruses can also transmit through the eyes and tiny viral particles, known as aerosols, can still penetrate masks. However, masks are effective at capturing droplets, which is the main transmission route of coronavirus, and some studies have estimated a roughly five-fold protection versus no barrier. If you are likely to be in close contact with someone infected, a mask cuts the chance of the disease being passed on. If you’re just walking around town and not in close contact with others, wearing a mask is unlikely to make any difference.
Effectiveness of facemasks to reduce exposure hazards for airborne infections among general populations J R Soc Interface. 2012 May 7; 9(70): 938–948.
Under the pseudo-steady concentration environment, facemask protection was found to be 45 per cent, while under expiratory emissions, protection varied from 33 to 100 per cent. It was also observed that the separation between the source and the manikin was the most influential parameter affecting facemask protection. [...] If a number of infected persons cough in a ventilated indoor environment, i.e. waiting rooms of hospitals or private clinics, a number of episodic expiratory emissions occurring at different times can generate pseudo-steady pathogen concentrations. In this case, even if a susceptible victim is not physically close to infected persons, he would still be exposed to pseudo-steady concentrations and the facemasks he wears would be challenged by the pathogens.
posted by katra at 11:31 AM on March 1 [5 favorites]


> ...which continued to involve universal masking?

China has been rationing face masks since mid-February. And I believe in recent weeks, mandatory face mask policies in China have been local, not national.
posted by mbrubeck at 11:34 AM on March 1 [1 favorite]


(Should say at least since mid-February; I don’t know when the rationing started.)
posted by mbrubeck at 11:46 AM on March 1


The Seattle Times has disabled their paywall for their coronavirus coverage.

As expected, we’re seeing more confirmed cases in Washington now that they’ve started testing more people. The two new cases today, both of unknown origin, are being treated in Seattle in and in Renton (a suburb south of Seattle).
posted by mbrubeck at 11:55 AM on March 1 [4 favorites]


Pence warns that more coronavirus cases are coming (Politico)
Vice President Mike Pence on Sunday sought to reassure the public that the government is taking steps to slow the spread of coronavirus as new cases were reported in an Illinois health worker, a Rhode Island tourist and two Washington state men in their 60s. Authorities were also investigating possible wider spread in Washington state after the first recorded U.S. death there. "The reality ... is that for most people that contract the coronavirus, they will recover," Pence said on CNN’s “State of the Union." "But for people that have other conditions, that would militate toward a worse outcome, that we could have more sad news."

[...] The Association of Public Health Laboratories told POLITICO it understands there will be enough kits to test 75,000 patients by the end of the week. Former FDA Commissioner Scott Gottlieb said on CBS’ "Face the Nation" that by the end of the week, 10,000 people per day will be able to be screened. By the end of the following week, the capacity could double to 20,000 per day.
Coronavirus outbreak: US confirms cases in Chicago and Rhode Island (Guardian)
A researcher told the New York Times it is likely the coronavirus has been spreading undetected in Washington since mid-January and that there are hundreds more cases than have been identified in the state. [...] Health officials in California, Oregon and Washington are worried because a growing number of people are being infected despite not having visited an area where there was an outbreak, or apparently being in contact with anyone who had.
posted by katra at 1:22 PM on March 1


> I’m still not sure if it’s likely I caught it, and I may never know for sure.

I'm also Seattle-ish and also wondering about the illnesses the other Corpses and I had in the past six weeks; usually only one of us gets sick but this time all of us did. Fevers, body aches, chills, etc. And in that time one or the other of us has been to California, Nevada, New York, Massachusetts, and Vermont. So, uh, sorry everyone.
posted by The corpse in the library at 1:45 PM on March 1 [3 favorites]


> So, uh, sorry everyone.

Corpses gonna corpse.
posted by mrzarquon at 1:54 PM on March 1 [4 favorites]


Epidemics expert Jonathan Quick: ‘The worst-case scenario for coronavirus is likely’ (Guardian)
The worst-case scenario is looking increasingly likely. We’ve now seen cases on six continents, apparently “silent” – that is, at least partly asymptomatic – chains of human-to-human transmission both inside and outside China, with additional countries reporting cases within the last week – bringing the total to 47 – and new, accelerating outbreaks in Iran, Italy and South Korea. If it becomes a pandemic, the questions are, how bad will it get and how long will it last? [...]

We can mobilise more health officials and keep engaging the public, implementing sensible travel controls and ensuring that frontline health workers have ready access to diagnostic tests and are vigilant – that they don’t send anyone who may have been exposed home without testing them, for example. Judging by past experience, however, it’s likely that health officials and the public in much of the world remain unaware or unconvinced of the danger this virus poses.

[...] I’ve written about a hypothetical situation in which a new and dangerous pathogen emerges, a vaccine is developed, and you still get a pandemic, because large numbers of millennials refuse the vaccine. In the US, 20% of millennials believe that vaccines cause autism. The problem is bad information. As my students often remind me, news tends to be behind paywalls, while fake news is free.
Coronavirus rumors and chaos in Alabama point to big problems as U.S. seeks to contain virus (WaPo)
Rumor mill, lack of communication by federal officials undermines trust in plan to relocate quarantined patients
What happened here over the past week illustrates how poor planning by federal health officials and a rumor mill fueled by social media, polarized politics and a lack of clear communication can undermine public confidence in the response to the novel coronavirus, which causes the disease named covid-19. [...] In Anniston, local leaders were stunned to discover serious problems with the federal government’s plan for dealing with patients infected with the virus — starting with how the patients would get to Alabama, according to interviews with county and city officials, along with business leaders who dealt with the federal response.
posted by katra at 2:47 PM on March 1 [1 favorite]


What the Plague Can Teach Us About the Coronavirus (Hannah Marcus, NYT Opinion)
Since the eruption of the coronavirus, we have witnessed widespread anti-Asian discrimination and numerous acts of violence against Asians. We should learn from the past, identify these violent attacks as the scapegoating they are, and condemn them swiftly and harshly. [...] The predictable turn to xenophobia, racism and persecution represents the breakdown of our society’s laws and morals in the face of fear and disease. It, too, is a symptom of disease, if not a biological one.
Trump is pushing a dangerous, false spin on coronavirus — and the media is helping him spread it (Margaret Sullivan, WaPo Opinion)
Trump and his chosen spokespeople are attempting to dramatically play down the seriousness of the coronavirus and to blame the legitimate news media for doing their jobs of informing the public. In reporting what Trump has to say, the news media has a huge responsibility not to repeat and amplify his misleading spin — a spin that may serve his political interests but is not in the public interest.

It’s not always easy, though, for mainstream journalists to put his claims in the proper context. After all, it had always been normal to let a president have his say — to let his statements top the news while letting the fact checks follow. [...] That’s why we continue to see headlines and chyrons that parrot his words directly, no matter how misleading: That the virus will disappear, that it’s not inevitable that the disease will spread, that a vaccine is coming along “rapidly,” that the United States is “very, very ready” to deal with whatever happens.

[...] Some months ago, I wrote about the linguist George Lakoff’s prescription for handling the president’s false statements and lies, an approach that’s become known as the “truth sandwich.” Rather than lead with the falsehood and then try to debunk it, Lakoff — an expert on how propaganda works — suggested flipping that formula: Lead with the truth, air the falsehood, and then follow with the fact check. Avoid giving prominence to lies, he advises. Don’t put them in headlines, leads or tweets. It is that very amplification that gives them power, even if they are proclaimed false in the next beat.

[...] Trump’s tendency to spin out assertions untethered from reality becomes a recipe for disaster when combined with his disdain for scientists, medical experts, intelligence officials, journalists and others who deal in fact-based reality. Add in the dangers of a disease rapidly approaching pandemic proportions, and it becomes more important than ever to emphasize truthful information over false spin.
posted by katra at 3:25 PM on March 1 [4 favorites]


So, uh, sorry everyone.

Corpses gonna corpse.


On the internet, nobody knows you're a coronavirus.
posted by medusa at 3:54 PM on March 1 [3 favorites]


Among things getting screwed up: study abroad programs. Our university pulled the plug on the South Korea programs early last week; Italy just got pulled as well, as state department level 3 travel restrictions is apparently the drawing line.

So that's a whole bunch of students who were planning on a semester's worth of classes coming back without those credits and now worrying about graduating on time; we haven't gotten any guidance about what's going to happen with them. I'm sure the university will sort something out eventually, but in the meantime, I've got some panicking advisees.
posted by damayanti at 7:00 PM on March 1 [4 favorites]


Coronavirus in N.Y.: Manhattan Woman Is First Confirmed Case in State (NYT)
The woman, who is in her late 30s, is in Manhattan, according to state officials. She returned from Iran last week, and was tested after going to a hospital in the city; she has since been staying at home, officials said. [...] New York City’s Health Commissioner, Oxiris Barbot, said the agency had already identified “close contacts of the patient” who may have been exposed to the virus, officially known as Covid-19.

[...] By this weekend, many stores in the city had run out of sanitary supplies such as hand sanitizer, masks and antibacterial wipes.

[...] Over the last month, there have been obstacles to widespread testing that may have limited the ability of the authorities to detect cases. Until this weekend, New York State health authorities could not test patients locally and had to send samples to the C.D.C. Because of the C.D.C.’s narrow parameters on who was eligible for testing, the number of people tested was quite limited.
posted by katra at 7:55 PM on March 1


U.S. Plans ‘Radical Expansion’ of Coronavirus Testing (NYT)
Public health experts and hospital officials across the country have expressed frustration in the last few weeks at the inability to test for possible coronavirus cases. Until recently, the C.D.C. had insisted that only its test could be used on suspected cases, and only under limited circumstances — on people who had traveled to China within 14 days of developing symptoms or had contact with a known coronavirus case.

The C.D.C. decided not to adopt a test approved by the World Health Organization and instead forged ahead with its own test. In early February, the agency said it had shipped about 200 test kits, capable of producing results on 700 to 800 samples, to states and had hoped to ship more kits to more than 30 countries. But in mid-February, the agency announced that the tests were flawed, and should not be used. Instead, it told state health departments to send all samples to the central C.D.C. lab in Atlanta. That resulted in several days’ delay in getting results.

[...] “If we had the ability to test earlier, I’m sure we would have identified patients earlier,” said Dr. Jeff Duchin, the health officer for public health in Seattle and King County, Wash., where the first death was reported on Saturday. Both C.D.C. and the F.D.A. did have the option of adopting the test approved by the W.H.O., and public health experts said it was unclear why the agencies decided not to do so. “In retrospect, it seems like a bad decision,” said one high-ranking C.D.C. official who requested anonymity and was not authorized to talk to the news media.

[...] China and South Korea have been running thousands of tests per day and have even set up drive-through locations where people can get tested for the coronavirus without having to come in to hospitals, where they may infect other patients. The C.D.C. has conducted less than 500 tests so far, while health officials in Britain had tested more than 10,400 people as of Saturday and found 23 to have coronavirus infections.

[...] The C.D.C. test kit that New York City received had been more flawed than most, hampering officials’ ability to diagnose people quickly in the nation’s most populous city. In California, during the early contacts that the United States had with those evacuees from China who were quarantined, a woman who was infected was mistakenly discharged from a San Diego hospital because of mislabeled samples sent to the C.D.C.
posted by katra at 8:33 PM on March 1 [3 favorites]


Florida’s first coronavirus cases found in Hillsborough and Manatee counties (Tampa Bay Times)
The Hillsborough County case is an adult with a travel history to Italy. The Manatee patient is an adult Manatee County resident without a history of travel to restricted countries such as China or Iran.
The news comes two days after federal officials expanded testing criteria and Florida became capable of processing tests within the state.

On Saturday, all three Florida Department of Health labs — in Miami, Tampa and Jacksonville — became capable of testing for novel coronavirus, cutting the wait times for results to within 24 to 48 hours.
Coronavirus updates live: Second death confirmed in Washington state (NBC News)
Czech Republic, Scotland and Ireland declared their first cases of coronavirus on Sunday, as the outbreak has spread from China to at least 40 countries around the world, affecting markets and disrupting travel. A recent increase in cases in Italy, Iran and South Korea have heightened concerns about the ability to contain the spread of the virus.

[...] In Paris, the Louvre Museum closed its doors Sunday as coronavirus continue to spread globally.

[...] Health officials in the Dominican Republic and France on Sunday reported the first confirmed cases of the new coronavirus in the tourist-rich Caribbean, while British cruise ship passengers who had been trapped at sea due to virus fears were finally set to come home.

[...] Two health care workers in Northern California have tested positive for the coronavirus: one each in Alameda and Solano counties.
New virus has infected 88,000 people, caused 3,000 deaths (AP)
The latest figures reported by each government’s health authority
posted by katra at 8:52 PM on March 1


Quarantined patient in Texas was released, but later tested positive (WaPo)
The patient, who had been quarantined for weeks after returning from China’s Wuhan province, tested negative for the virus twice and was not showing any symptoms while being quarantined at the Texas Center for Infectious Disease in San Antonio.

The CDC released the person to a local hotel on Saturday but had to retrieve the person hours later when a third test sample was “determined to be weakly positive,” according to a CDC news release. “Out of an abundance of caution, CDC decided to bring the individual back into isolation.” Local health officials, including the San Antonio Metro Health District, are now tracing the patient’s steps and interactions.

[...] San Antonio Mayor Ron Nirenberg called the release of the coronavirus patient “unacceptable,” but he added that the exposure risk remains low for city and county residents. “This is exactly why we have been asking federal officials to accept the guidance of our medical community,” he said in a statement. [...] Bexar County Judge Nelson Wolff, who wrote letters with the mayor outlining their worries to federal officials, said additional protocols are needed to lower the risk of local transmission from the military and state facilities being used to isolate patients. “To date, no response or even acknowledgment of our concerns has been made,” he said in a statement on Saturday.
posted by katra at 9:04 PM on March 1


Guardian: Indonesia reports first cases of Covid-19
Indonesian President Joko Widodo said on Monday two Indonesians had tested positive for coronavirus, marking the first confirmed cases in the world’s fourth most populous country.
Guardian: South Australia plans to amend its Public Health Act to allow for the compulsory quarantine of people with coronavirus.
posted by katra at 9:15 PM on March 1


Quarantined patient in Texas was released, but later tested positive (WaPo)

It hasn’t been widely reported that several people have been in quarantine in San Antonio for the last week. This may be the vector that catapults it from the coast into the middle of the country. Not too thrilled about the level of competence on display here.
posted by Devils Rancher at 9:31 PM on March 1


Coronavirus Map: Tracking the Spread of the Outbreak (NYT)
As these maps show, the disease has been detected in at least 65 countries.
Also, according to this report, there are 11 confirmed cases in Texas, 13 in Nebraska, 3 in Illinois, 1 in Wisconsin, and 1 in Utah. So regardless of how "middle of the country" is defined, it looks like it has started to catapult.
posted by katra at 9:54 PM on March 1


"Also, according to this report, there are 11 confirmed cases in Texas, 13 in Nebraska, 3 in Illinois, 1 in Wisconsin, and 1 in Utah."

The Texas and Nebraska numbers there are misleading, as those are both facilities (San Antonio and Omaha) that are housing patients moved there, such as the cruise ship patients. The John's Hopkins map I linked to earlier is better in that it shows cases only where they were reported,not where patients were moved to. However, as per the above comment, one of the San Antonio patients was released but then later tested positive, so it may have entered the community.

I see there were four new cases reported in Ontario today (Toronto area), bringing the total to 15. Dr. David Williams, Ontario's Chief Medical Officer of Health said today there is "no community spread" (all cases so far correlate to travel), but given that many cases, I think this is unlikely. One of those cases is in London, but all the rest are in the Toronto metropolitan area. At the moment, there is no other city in the Americas with that many cases. Seattle is at thirteen, Vancouver is at eight. There are two, IIRC, community cases in Seattle, so the actual number there must be much higher. Toronto with that many cases but no community cases is exceptional right at this moment—but given what we're seeing this week, it's hard for me to believe it's not escaped beyond the traveler-related cases.
posted by Ivan Fyodorovich at 11:21 PM on March 1 [1 favorite]


MP Suggested U.K. Could Put Morgue in Hyde Park if Virus Hits
“We have contingency plans to open up a morgue in Hyde Park, in tents,” said Nickie Aiken, a councilor for the central London district which includes the open space, once a refuge from plague in the 17th century. “We would run the morgue for most of central London,” she said in an interview.
Hilariously, the article then goes on:
Later, Aiken -- a former leader of the council -- played down her comment after having a conversation with a local official. “There are no plans to turn Hyde Park into a morgue,” she said. “I’ve had that confirmed by Westminster City Council this evening.”

Westminster council had no immediate comment to make.
Presumably, while there are "plans" to turn Hyde Park into a morgue, there are no plans to do so.

At present.
posted by Joe in Australia at 4:28 AM on March 2 [1 favorite]


I mean, the morgue thing seems like an information control issue more than anything else - my assumption is that any minimally competent government has some kind of plan for dealing with epidemic deaths, because that's one of those worst-case scenario things that governments are supposed to plan for. I assume that Minneapolis has some kind of plan for what to do if, god forbid, we have a pandemic with an overwhelming number of deaths. It's much more that people need to have the common sense not to break out the "here is how we'll deal with lots of deaths" stuff until there is a fair certainty of lots of deaths.

Really, why not have a plan for this? Better to have a plan and not need it than have everything descend into chaos.
posted by Frowner at 7:03 AM on March 2 [1 favorite]


Really, why not have a plan for this? Better to have a plan and not need it than have everything descend into chaos.

Trump Has Sabotaged America’s Coronavirus Response (Foreign Policy, Jan. 31, 2020)
For the United States, the answers are especially worrying because the government has intentionally rendered itself incapable. In 2018, the Trump administration fired the government’s entire pandemic response chain of command, including the White House management infrastructure. In numerous phone calls and emails with key agencies across the U.S. government, the only consistent response I encountered was distressed confusion. If the United States still has a clear chain of command for pandemic response, the White House urgently needs to clarify what it is—not just for the public but for the government itself, which largely finds itself in the dark.
posted by katra at 7:24 AM on March 2 [7 favorites]


Worth bearing in mind that an awful lot of US pandemic response is going to be state- and city-based, so all is not totally lost. It seems to me that state-coordinated responses - even in badly governed states - are going to be better than the Federal response, purely because people won't be calculating everything based on how it affects the stock market and whether it benefits Trump. I'm not saying that I have total confidence in state and city responses, but there is still a lot that can be done at the local level.
posted by Frowner at 8:03 AM on March 2 [4 favorites]


Coronavirus threat gives strapped state health agencies a new crisis (Politico, Feb. 27, 2020)
The fumbled response to the first coronavirus case potentially contracted within a U.S. community, in California, shows how health professionals on the front lines can be quickly overmatched by the stealthy disease.

And the prospect of more widespread outbreaks could put major stress on state and local health departments that are underfunded and already grappling with a bad flu season, vaping-related illnesses and the ravages of the opioid epidemic. The departments have already seen the Centers for Disease Control and Prevention's budget for state and local emergency preparedness cut by a third from fiscal 2003 to 2019, with small increases the past two years not making up for the losses.

[...] The officials say it’s part of a longstanding pattern in both red and blue states: agencies that routinely are the stepchildren in state government being suddenly thrust into a new emergency with tight budgets and multiple missions.

“When it's functioning properly, you're not really sure what public health is doing. But then when there's a crisis, you realize that it’s so important,” said Vit Kraushaar, the Southern Nevada Health District’s medical investigator.
posted by katra at 8:21 AM on March 2 [2 favorites]


Yep, and yet no matter how badly funded or late to the party, the CA and WA governments aren't lying to soothe the stock market and they're not run by Mike Pence. CA is actually trying to be sorta proactive at this point. If the choice is between a federal response that is mostly about reelecting Trump and a state response that is at least organized by actual public health officials and doctors, I'll take the latter. Federal people can't talk to the media unless Pence's office signs off on what they say, so they're not trustworthy sources; state governments have a lot more leeway. State public health people also live much closer to the people they serve and have more immediate interest in preventing us all from dying.
posted by Frowner at 8:30 AM on March 2 [6 favorites]


Washington's Department of Health has a resource page, including a phone number to call if you're in Washington State and have questions.
posted by Margalo Epps at 8:30 AM on March 2 [3 favorites]


FEMA preparing for possible coronavirus emergency declaration (NBC News)
FEMA officials are preparing for an "infectious disease emergency declaration" by the president that would allow the agency to provide disaster relief funding to state and local governments, as well as federal assistance to support the coronavirus response, according to agency planning documents reviewed by NBC News.

[...] "To me this is another indication that the president and the White House are finally aware of the gravity of the situation," said Michael Coen, who was FEMA chief of staff during the Obama administration. "They need to consider all tools available to them and have contingencies for action."

[...] An emergency declaration would allow FEMA to provide disaster medical assistance teams, mobile hospitals and military transport, among other kinds of federal support, Manning said.

FEMA's disaster relief fund has a current balance of $34 billion, according to the latest agency update. "It's money that’s sitting there and ready," said another former FEMA official, who declined to be identified.
posted by katra at 9:37 AM on March 2


Four more cases here in King County, Washington were confirmed today, and three new deaths (including two of today’s new cases and one existing case). The total for the county is now 14 confirmed cases and 5 deaths.
King County is purchasing a motel to house isolated patients and setting up modular units to do the same, county executive Dow Constantine said in a news conference Monday.
posted by mbrubeck at 11:31 AM on March 2 [1 favorite]


There was also one additional death reported this morning in neighboring Snohomish County. The total for Washington State is now 6 deaths and at least 18 confirmed cases.
posted by mbrubeck at 11:41 AM on March 2


As Testing Quickly Ramps Up, Expect More U.S. Coronavirus Cases (NPR, Mar. 1, 2020)
More testing is sure to find more people with the virus — at least, those people who have been sickened by it. This surge in testing won't be able to tell how many people are infected but not showing symptoms.

Scott Becker, the head of the Association of Public Health Laboratories, says that more than 40 public health labs should be able to test for the virus by the end of the weekend. [...] "I certainly do wish that the testing was available sooner. There was this very unfortunate challenge in the production process and it did put us a few weeks behind," Becker told NPR. He noted that the availability of more testing and expanding who is eligible for that testing means that "we are going to start to see more and more cases pop up across the country."
Trump says it's safe to hold rallies amid coronavirus outbreak (The Hill)
The coronavirus outbreak has led a number of countries in Europe and Asia to take measures to mitigate the spread; Switzerland, for instance, has banned events of over 1,000 and Japan has implemented a country-wide school closure.

The United States currently has far fewer cases of the virus than other countries, but the developments overseas coupled with the expectation for further cases in the U.S. have raised questions about whether similar steps could be taken to lessen the spread domestically.
Nations should not give up on containing the virus, W.H.O. says. (NYT)
“Of course we can have concerns and worries, it’s understandable, but let’s really calm down and do the right things, and use the window of opportunity to contain this outbreak,” he said. He added, without identifying countries, that “in some places we are not seeing the level of response that we expected.” For that reason, he said, the W.H.O. was reminding the world “that the window of opportunity is narrowing and that we still have to do our best to catch up.”

Dr. Tedros said that there were “positive signals” that nations could contain the virus, such as the dozens of countries with fewer than 100 cases. He also cited the slowdown of infections in China as a sign that the virus could be contained.

“There is a point in any epidemic where you believe you can no longer contain the virus, or like it was influenza and you have to shift your resources to saving lives,” said Dr. Michael Ryan, the executive director of the W.H.O.’s health emergencies program. “Now W.H.O. does not believe that we’re there yet.”
posted by katra at 12:03 PM on March 2 [3 favorites]


CDC drops coronavirus testing numbers from their website (Mary Beth Griggs, The Verge)
The change comes as testing is expected to expand across the country
posted by ZeusHumms at 1:35 PM on March 2 [3 favorites]


Indications coronavirus ‘likely fairly widespread’ in Oregon communities, health officials say (Register-Guard)
A third presumptive positive case of COVID-19 has appeared in Oregon, and with the newest case appearing more than 100 miles away from the first two, state officials are suggesting this means the disease already is widespread across the state.

[...] This case of COVID-19, the disease caused by the new coronavirus, is not linked to travel, and there is no known link to another case. This is considered a case of “community transmission,” which indicates the disease is likely already in communities across Oregon.

“I think that having three cases in Oregon, none of which seem to share commonality and seem to have stemmed from community transmission can indicate this disease is likely fairly widespread in our community, as it is in many other communities as we’re seeing from our neighbors in Washington (State) and California,” said Dr. Dean Sidelinger, Oregon’s state health officer, during a news conference Monday afternoon.
Hundreds of Oregonians likely infected with coronavirus, state health officer says (Oregonian)
Oregon may now have 300 to 500 Oregonians who are or were unknowingly carrying the coronavirus, Dr. Dean Sidelinger, the state health officer and epidemiologist, acknowledged as officials announced the state’s third presumed coronavirus case. [...] Yet the state won’t take broad containment measures, such as recommending healthy people stay home, until or unless the number of confirmed cases or deaths dramatically increases, he said.

“I’m not pessimistic and giving up that it’s going to spread like wildfire,” Sidelinger said in an interview with The Oregonian/OregonLive. [...] To date, Oregon has tested only 19 people, with three positive, 11 negative and five results pending.

At some point, the state could attempt to intervene by recommending certain school closures, the cancellation of certain community events or requesting particularly vulnerable populations to stay home, Sidelinger said. [...] State authorities don’t ask family members of a person under monitoring to stay home. That’s because “we don’t want to unnecessarily burden them by having the entire household stay home,” Sidelinger said. [...] the Oregon Health Authority has about 1,500 coronavirus tests and the capacity to complete about 80 a day. At the current testing rate, Oregon has enough supplies to last months.
posted by katra at 5:55 PM on March 2 [1 favorite]


Close to a Million Could Be Tested for the Coronavirus This Week, Health Official Says (NYT)
Private companies and academic laboratories have been pulled in to develop and validate their own coronavirus tests, a move to get around a government bottleneck after a halting start, and to widen the range and number of Americans screened for the virus, Dr. Stephen Hahn, the commissioner of the Food and Drug Administration, said Monday at a White House briefing.

[...] In the briefing, which was conducted by phone, the officials said that only 337 additional C.D.C. test kits were made available for distribution on Tuesday and Wednesday, according to two people on the call and the person briefed on the discussion who were not authorized to discuss it publicly. Each of those tests would cover about 350 people, officials said. The officials added that they hoped that a private manufacturer could step in and provide 2,500 more kits by the end of the week. A spokesman for the Department of Health and Human Services said that public health labs currently can test 15,000 people, and could test up to 75,000 by the end of the week, numbers that fall well short of what Dr. Hahn indicated private labs could handle.
NYT: President Trump spoke about his efforts to limit the spread of coronavirus in the United States during a rally on Monday evening in Charlotte, N.C.:
"My administration is also taking the most aggressive action in modern history to protect Americans from the coronavirus. You know about this whole thing, horrible. Including sweeping travel restrictions. Today, we met with the big great pharmaceutical companies, and they’re really working hard and they’re working smart, and we had some — we had a great meeting today with a lot of the great companies and they could have vaccines I think relatively soon."
Trump considers new travel restrictions to prevent spread of coronavirus (CBS News)
Monday's disclosure came during a meeting he and Vice President Mike Pence were having with top pharmaceutical company representatives at the White House, as the federal government and private industry scramble to come up with a vaccine and treatment for coronavirus as quickly as possible. [...] Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, jumped in to say, "You won't have a vaccine — you'll have a vaccine to go into testing." Mr. Trump said, "And how long will that take?" Phase two "will take a few months before we can go into to phase three," Bancel said. "Like I've been telling you, Mr. President, a year to a year and a half," Fauci said.
posted by katra at 6:32 PM on March 2 [3 favorites]


Trump's team shifts tone from preventing coronavirus to containing it (Politico)
FDA Commissioner Stephen Hahn said there could be up to 1 million tests performed this week, though experts have cautioned that is unlikely and that the CDC is still playing catch up.

The CDC has faced scrutiny in recent days regarding problems with the initial diagnostic test, which has delayed the ability to identify suspected patients, as well as detect community spread. The agency on Monday removed a tally of how many people have been tested for coronavirus from its website but didn't respond to requests for comment on the change.

[...] Pence said therapeutics to treat the virus could be available as early as this summer, while a vaccine may not be ready until next year.
Guardian: "The pharmaceutical company Pfizer says it has identified certain antiviral compounds it had in development that have the potential to inhibit coronaviruses and is engaging with a third party to screen the compounds, Reuters reports.
The company said it hopes to have the results from that screening by the end of March and if any of the compounds are successful, it would hope start testing them by the end of the year.

Pfizer’ chief scientific officer, Mikael Dolsten, was one of a number of pharmaceutical executives who met with President Trump at the White House on Monday.
Guardian: WHO chief warns world is in 'unchartered territory'
The WHO boss, Tedros Adhanom Ghebreyesus, has warned that the world has “never seen a respiratory pathogen that is capable of community transmission, but which can be contained with the right measures”. He said containment must be the top priority for all countries and that there is “no one-size fits all approach”.
posted by katra at 6:54 PM on March 2 [1 favorite]


NH health officials confirm first positive case of coronavirus in state (WMUR auto-play video)
...the patient experienced mild symptoms of the virus after returning from a trip to Italy, where more than 1,000 cases of COVID-19 have been identified....
"We'll be working tirelessly to investigate this most recent identification and to identify any susceptible contacts who may need to themselves be placed under self-quarantine," state epidemiologist Dr. Benjamin Chan said. The patient did not return to work after coming back from Italy, officials said. Dartmouth-Hitchcock officials said they are taking precautions and have created an incident command center.
posted by jessamyn at 7:22 PM on March 2


Since the federal government is run by morons, we're going to have 50 different state-level response plans. It's going to be like running 50 simultaneous public health experiments.
posted by medusa at 7:42 PM on March 2 [5 favorites]




There are only 18 cases here in the Netherlands, supposedly. But what makes that odd is that Germany has hundreds of cases and most of them, about 100, are in North Rhine-Westphalia, the state which is just across the border from the Netherlands!

Almost all cases here are people who recently traveled from Northern Italy. That either means N. Italy is a huge vector or, I think, people who, say, just came from Germany and are feeling sick are not getting tested. A huge case of confirmation bias going on. True all over the world at the moment I believe where infection has already taken off locally and spreading among the population.
posted by vacapinta at 3:27 AM on March 3 [2 favorites]


It's going to be like running 50 simultaneous public health experiments.

The laboratory of democracy!
posted by thelonius at 4:37 AM on March 3 [3 favorites]


Scary and infuriating thread from a Seattle resident who has symptoms trying to find out how to get tested and getting no answers.
posted by octothorpe at 4:50 AM on March 3 [9 favorites]


Octothorpe, holy shit.
posted by medusa at 7:01 AM on March 3


> Scary and infuriating thread from a Seattle resident who has symptoms trying to find out how to get tested and getting no answers.

I'm going to be counting people in homeless shelters and encampments in the Seattle area for the census this month, so I'd love to know if I've already had COVID-19. Sounds like I'm out of luck.
posted by The corpse in the library at 7:58 AM on March 3 [1 favorite]


Major fail by the CDC. re: Seattle and other front line cities - shouldn't the health authorities be communicating up front about the availability of testing? Instead, they've got these clogged telephone lines. Panic happens when people want something and can't get it.
posted by storybored at 8:07 AM on March 3 [2 favorites]


Yeah, I think that puts the Toronto and Vancouver numbers in context: easily available testing in Canada in contrast with very little testing in the US.

South Korea is doing mass testing; with about 5,000 cases and 34 deaths, the mortality rate is currently at about 0.65%, or about 13 per 2,000. That's as compared to China, which is presently at about 3.7% mortality rate, or about 74 per 2,000. In my opinion, this represents two extremes.

China, which has scrambled to manage hospital cases and has otherwise locked-down the population, is showing an inflated rate, as there are many, many unreported cases which have been asymptomatic or mild.

In contrast, South Korea is doing mass testing but is in an early stage of hospitalized cases. Most of those cases have neither recovered nor died. So the mortality rate there is presently quite a bit lower than where it will end up.

If you want to average those two, even though it's not very meaningful, you get about 2.2%, or about 42.5 per 2,000. Even that South Korea underestimate is many, many times the US flu mortality rate, which is about 0.13%, or 2.6 per 2,000. Covid-19 is many times worse than the flu, even at that South Korea lower bound.
posted by Ivan Fyodorovich at 8:29 AM on March 3 [1 favorite]


Ivan F, that .65% mortality rate you calculated for S.Korea roughly matches the 0.6% rate from the Diamond Princess, calculated upthread.
posted by storybored at 8:45 AM on March 3


Sorry, the Diamond Princess fatality rate has increased in the meantime. The rate is no longer .6%. Two more passengers have died, giving a rate of 6/708 or .8%

posted by storybored at 8:50 AM on March 3 [1 favorite]


Yeah. SK is only reporting right now about the same number of recoveries as deaths, so it's very early. I think the Diamond Princess numbers are meaningful but I don't really know how to interpret them. It's not a representative population at all. And is the contagion rate comparable to elsewhere?

The CDC estimates between 3% and 11% of the total US population gets the flu each year, as a point of comparison.
posted by Ivan Fyodorovich at 8:58 AM on March 3


Just a terminology correction, because it it important to get these things right.

What some are describing above is not mortality rate. Mortality rate uses as its denominator an entire population. It indicates the probability of any individual in the population dying of a particular cause in a given year. For example the mortality rate for vehicle accidents or the mortality rate for a heart attack.

What you are describing is called the Case Fatality Ratio (too bad they didn't call it Fatality to Case Ratio). The hint is right there in the name. It is the number of fatalities divided by the number of symptomatic cases. The CDC is very clear that they use as the denominator the number of symptomatic cases. This not the same as the number of asymptomatic cases or the number of infections that are not symptomatic because there is no real way of determining that number. They are calling a case is what would be recognized by a doctor as symptoms of the disease (whether you see a doctor or not).

In layman terms sometimes you will hear "fatality rate" or "lethal rate". These are not scientific terms, but usually what they mean is CFR, Case Fatality Ratio. What this means is the probability of dying if you get the disease and show symptoms of having the disease. It is not the mortality rate, which is a much lower number because not everyone gets the disease.
posted by JackFlash at 9:21 AM on March 3 [14 favorites]


Coronavirus Is Loose in America. An Expert Explains Why You Shouldn’t Panic : 'Keep calm and wash your hands, a Columbia University virologist says. “The reality is we can’t just tell the whole world to stay home”' (Tim Dickinson, Rolling Stone)
And our travel restrictions have not been implemented sensibly. I disagree strongly with president Trump’s statement the other day that they, in fact, that worked. There’s no reason to expect that allowing U.S. citizens to come in, as opposed to foreign nationals from China, would not bring the virus in. I mean the virus doesn’t care what passport you’re carrying. It was not an effective way to prevent the spread.
posted by ZeusHumms at 9:47 AM on March 3 [5 favorites]


Scary and infuriating thread from a Seattle resident who has symptoms trying to find out how to get tested and getting no answers.

Seattle and other front line cities - shouldn't the health authorities be communicating up front about the availability of testing?

There are several links posted above about the currently limited supply of test kits, and medical providers also have online health portals that should have information posted or ways to ask questions. And there are news sources, e.g.

Oregon prepares to test new COVID-19 patients (KGW8 / MSN)
The state is following the CDC’s guidelines to decide who to test. As of Monday, that included patients who fell under one of three categories: People who've traveled to a country where COVID-19 is spreading rapidly, people showing symptoms and have had contact with someone diagnosed with COVID-19, or people hospitalized with severe respiratory symptoms and ruled out for other illnesses like the flu.
Of course, without widespread testing, it is difficult to know about "contact with someone diagnosed with COVID-19," even in states that are annoucing "community transmission." I think that as COVID-19 progresses in the US, it is going to be really important to be very careful about sharing Twitter panic from sources like @sketchylady, because it is a bad and scary situation right now, so we need context now more than ever.

There are currently not a lot of tests available. There does not appear to be a lot of coordination and support from the federal government. Faith in the superhero powers of state public health authorities may be misplaced. It appears urgent to remain calm and stay informed about the current situation based on credible and reliable sources, and take reasonable steps to get prepared for this to continue for awhile.
posted by katra at 9:47 AM on March 3 [1 favorite]


if you want detailed stats the Singapore website is something to behold. Too bad its only for Singapore cases. There are no deaths but you can see the current status of the hospitalized patients too.
posted by vacapinta at 10:24 AM on March 3 [2 favorites]


'You don't want to go to war with a president' (Politico)
Anthony Fauci might be the one person everyone in Washington trusts right now. But at 79, the director of the National Institute of Allergy and Infectious Diseases is in the thick of one of the biggest battles of 35 years in the role: The race to contain coronavirus when the nation is deeply polarized and misinformation can spread with one tweet — sometimes, from the president himself.

[...] Critics say the administration has already stumbled with a slow rollout of diagnostic tests and narrow guidelines for who uses them, meaning that some patients waited days to find out if they are infected and the virus began spreading. Fauci said that restricted guidance — specifically the idea that someone would not get tested if they had not been in known contact with infected people — was unwise.
posted by katra at 11:08 AM on March 3 [1 favorite]


The Official Coronavirus Numbers Are Wrong, and Everyone Knows It (Alexis C. Madrigal, The Atlantic)
'Because the U.S. data on coronavirus infections are so deeply flawed, the quantification of the outbreak obscures more than it illuminates.'

We know, irrefutably, one thing about the coronavirus in the United States: The number of cases reported in every chart and table is far too low.

The data are untrustworthy because the processes we used to get them were flawed. The Centers for Disease Control and Prevention’s testing procedures missed the bulk of the cases. They focused exclusively on travelers, rather than testing more broadly, because that seemed like the best way to catch cases entering the country.

Just days ago, it was not clear that the virus had spread solely from domestic contact at all. But then cases began popping up with no known international connection.
As a result, the US response has been stalled.
posted by ZeusHumms at 11:31 AM on March 3 [2 favorites]


Emerald City Comic Con will go on as planned amid growing coronavirus concerns around Seattle (Dyer Oxley, KUOW)
Emerald City Comic Con is slated to go on as planned in Seattle from March 12-15 at the Washington State Convention Center.

The event approaches at the same time health officials report growing cases of coronavirus in the region —including six fatalities — and urge people to consider avoiding large gatherings.

Among the features inherent to comic con conventions — like fans, celebrities, and comics — is the dreaded sickness often experienced by those traveling to the events.

So-called "con crud" is akin to the illnesses that arise after flying on an airplane. It's inevitable that bugs will be spread at a these highly-trafficked fandom conventions. But attendees often comment later that their post-event illness was well worth it to meet their heroes.

But comic con goers haven't yet faced the threat of the novel coronavirus, also known as COVID-19 — until now.
posted by ZeusHumms at 11:49 AM on March 3


A seventh death has been reported in Washington State (Seattle Times).
A Kirkland nursing home resident who died last week was found to have had COVID-19, the disease caused by a new coronavirus known officially as SARS-CoV-2, said Susan Gregg Harborview Medical Center spokesperson. The person died at Harborview on Feb. 26.

The 54-year-old man was brought to Harborview [Medical Center, in Seattle] on Feb. 24 had underlying health conditions. Hospital officials don’t believe any other patients were exposed to the virus, but Harborview is working with Public Health – Seattle & King County to determine if some healthcare workers in the intensive care unit were exposed while treating the patient, Gregg said in an emailed statement.
This patient died six days ago, but was not diagnosed with coronavirus until this week. This means he was actually the first person in the nation to die from COVID-19 (as far as we now know), but the seventh to be reported.
posted by mbrubeck at 11:49 AM on March 3 [2 favorites]


Coronavirus: health experts concerned US hospitals are not prepared (Guardian)
Health experts say there is good reason to be concerned, but not because people will not be able to get their hands on masks or have little time to stock up on food in case of a pandemic. Instead, what is slowly starting to keep them up at night is whether the US healthcare system is prepared to properly handle an influx of cases.

Experts say there is a worrying lack of training and coordination and that the system as a whole needs to be able to communicate more effectively. [...] The US Centers for Disease Control and Prevention (CDC) has released guidelines for hospitals and healthcare professionals to follow to prevent the spread of any infectious respiratory disease, including coronavirus.

[...] The protection of healthcare workers is the key concern for Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, Texas. “If they go down, the whole thing falls apart and destabilizes,” Hotez said. “That is the place where things could go wrong very quickly.” Hotez also emphasized that hospitals in rural areas should be getting funding to help handle a potential outbreak of the illness. “Some of the large counties [have] outstanding health departments. They’re well-staffed, well-run machines. Some of the rural counties are not going to have the capacity for this,” Hotez said.
Coronavirus in N.Y.: Second Case May Force Quarantine of Hospital Staff (NYT)
The authorities confirmed on Tuesday a second case of coronavirus in New York, a man in his 50s who lives in Westchester County, just outside New York City, suggesting that the virus may well have been spreading locally, and until now, undetected.

The man initially went to a hospital in Westchester about four or five days ago, before it was confirmed he had the virus, the authorities said, acknowledging that he may have exposed doctors, nurses and others to the illness. [...] Health authorities in New York are now scrambling to try to trace the chain of transmission in both directions. They are trying to learn how he was infected and who might have been infected because of him. [...] Mr. Cuomo said the news of the second New York patient should not be a cause for alarm, reiterating that health officials had expected that the virus would spread. [...] The authorities do not know how the man became ill. Though he traveled recently to Miami, he is not known to have traveled abroad or to any areas with widespread transmission. For New York, this means the new coronavirus can no longer be thought of as an external threat that has yet to arrive.
posted by katra at 11:50 AM on March 3 [1 favorite]


JackFlash, thanks for the clarification on terminology: What some are describing above is not mortality rate. Mortality rate uses as its denominator an entire population. It indicates the probability of any individual in the population dying of a particular cause in a given year....What you are describing is called the Case Fatality Ratio (too bad they didn't call it Fatality to Case Ratio).

Related: "Prevalence, in epidemiology, the proportion of a population with a disease or a particular condition at a specific point in time (point prevalence) or over a specified period of time (period prevalence). Prevalence is often confused with incidence, which is concerned only with the measure of new cases in a population over a given interval of time."
posted by storybored at 12:10 PM on March 3 [1 favorite]


Racist hate attacks happening in the UK now. Police are investigating an alleged race-hate attack on a Singaporean student in London by a group of people who are said to have shouted about the coronavirus before beating him up. One [of the attackers] tried to kick him in the head and told him: “I don’t want your coronavirus in my country.”
posted by stillmoving at 12:13 PM on March 3 [2 favorites]


How bad will the coronavirus outbreak get in the U.S.? (WaPo)
The many unknowns about the virus impede efforts to predict its trajectory. Modeling new diseases is inherently uncertain, and scientists have at times overestimated the severity of epidemics, including in 2009, when the H1N1 flu turned out to be milder than expected, and in 2014, when the Ebola outbreak in West Africa killed far fewer people than projected early in that crisis.

[...] Infectious disease experts in recent days have said the coronavirus could create a pandemic on a similar scale to, or even surpassing, the 1957 influenza contagion. That pandemic was caused by a virus related to one found in birds that entered the human population somewhere in Southeast Asia and sickened a quarter billion people, killing more than a million, including 70,000 in the United States.

[...] The ultimate impact of the new virus, officially named SARS-CoV-2, which causes the disease covid-19, depends on multiple factors that cannot be precisely calculated at present. They include how widely and quickly it spreads, its virulence (the degree to which is sickens and kills people), and the ability of health systems to handle illnesses. It also depends on individual behavior — the extent to which people follow best practices for hygiene, staying home when they’re sick, and avoiding close contact with people who could be infected.

[...] Howard Markel, a medical historian at the University of Michigan, cautioned that comparing flu to the coronavirus is “the viral equivalent of apples and oranges,” because the illnesses are caused by completely different viruses, and it’s too early to make clear predictions. “Nobody can truly predict the path of an epidemic while it’s still in midcourse,” Markel said. “Anyone who tells you they can is either lying or foolish.”
posted by katra at 12:19 PM on March 3 [3 favorites]


"Just a terminology correction, because it it important to get these things right."

Thanks for the correction and I apologize for the mistake. Everything I called a "mortality rate" in my comment were case fatality ratios.
posted by Ivan Fyodorovich at 1:11 PM on March 3 [1 favorite]


Emerald City Comic Con is slated to go on as planned in Seattle from March 12-15 at the Washington State Convention Center.

Reed-Pop is an arm of Reed-Elsevier, which was simultaneously running arms faires and publishing The Lancet until people pointed out this was inconsistent.
posted by sebastienbailard at 1:24 PM on March 3 [3 favorites]


Pence is having a "press" conference on Covid-19 right now. Press in quotes because audio and video recording is not permitted.
posted by Mitheral at 3:37 PM on March 3 [2 favorites]


Widespread coronavirus testing could still be weeks away (Politico)
FDA Commissioner Stephen Hahn said Monday that, by the end of the week, U.S. labs would have enough materials to perform close to 1 million tests. Public health experts say that figure is misleading because it is far larger than the number of samples that can be processed in labs in the coming weeks.

The realistic estimate is now likely around 5,000 each day, according to a public health lab industry group. “The number the public wants to know is the number of people that can be tested per day, not the number of tests sitting in a warehouse,” said Michael Mina, associate medical director of molecular diagnostics at Brigham and Women’s Hospital in Boston. “They really want to know how likely it is they can be tested if they show up at their doctor’s office.”

Democrats on Tuesday slammed the administration’s handling of the botched CDC tests, and the pace of efforts to increase testing capacity, after meeting Tuesday with Vice President Mike Pence and officials from CDC, FDA and HHS. “They could not answer how soon people will be able to get the test,” said Senate Minority Leader Chuck Schumer. Sen. Patty Murray, whose home state of Washington has seen nine deaths from the virus, was similarly blunt. “We know there are not enough tests out there,” she said. “People cannot get access to them.”

[...] Mina estimates that once all public health labs and 200 academic labs that have developed in-house tests are running at capacity, they will be able to process a maximum of 30,000 tests per day. But that assumption “is quite unreasonable at the moment,” he added, noting it will be weeks before most academic labs can begin analyzing patient samples.
posted by katra at 3:53 PM on March 3


> Press in quotes because audio and video recording is not permitted.

Just sketch artists, and bards commemorating the event.
posted by The corpse in the library at 4:19 PM on March 3 [8 favorites]


The "Brave Sir Robin ran away" sort of bards?
posted by jenfullmoon at 4:33 PM on March 3 [6 favorites]


I was thinking more "Throw a coin at your V.P." but either will do.
posted by The corpse in the library at 4:34 PM on March 3 [3 favorites]


Harborview is a public nonprofit hospital on the outskirts of Seattle's downtown. It serves some of our more vulnerable populations.

It's less than a mile from the convention center that ECCC is going to be at; a 12 minute walk at an average pace. Last year, ECCC brought in 98,000 attendees. Washington is already exporting the virus; the case in North Carolina was from someone who visited the Life Care Center nursing home in Kirkland that got hit.
posted by foxfirefey at 4:50 PM on March 3 [4 favorites]


Speaking of Life Care Center, there were two more deaths in Washington announced today just after the report I linked to above. Those two cases and the previously-announced one were all residents of Life Care. Now seven of the nine coronavirus deaths in the nation are residents of Life Care Center (and nine out nine have been in the greater Seattle area).

Amazon also just announced to employees that an employee at one of its downtown Seattle offices has been confirmed to have coronavirus.
posted by mbrubeck at 6:01 PM on March 3 [1 favorite]


I have some serious guilt that I hope the horrible mismanagement of this epidemic will finally make people realize how stupid and incompetent Trump is. I feel horrible for thinking about suffering and death in this way, but I still hope it moves the needle politically.

It's also seriously messing me up watching this slow-motion trainwreck happen. It's so predictable, and so tragic.
posted by medusa at 7:00 PM on March 3 [2 favorites]


Coronavirus triggers cancellations, closures and contingency planning across the country (WaPo)
Increasingly, organizations are opting to cancel large gatherings, encourage remote work or take other steps reflecting an abundance of caution about the virus, according to interviews with officials in several states. Others are making contingency plans about more-significant steps they might take in the case of a wider outbreak.

Washington Gov. Jay Inslee (D) said people should prepare for disruptions in their daily lives as a result of the novel coronavirus, which has killed nine people in the state. “Folks should begin to think about avoiding large events and assemblies,” Inslee said Monday. “We are not making a request formally right now for events to be canceled, but people should be prepared for that possibility.”

[...] President Trump, who has played down the risk posed by the outbreak, said he did not agree with contingency plans being considered for the NCAA’s March Madness basketball tournament, including a proposal to play games in empty arenas. “That’s a tough move. No, I’m not prepared for that,” Trump said Tuesday. “But let them do what they want to do. . . . I don’t think it would be necessary.”

With the lack of a coordinated national approach, local officials and individual communities are rushing to make their own plans. [...] Several of the country’s biggest tech companies, including Facebook, Google and Apple, announced a range of protective measures, canceling employee travel and events involving large gatherings, increasing office cleaning and asking employees to work remotely. Monday afternoon, Twitter became the first major technology company in the United States to advise employees to work from home. All employees around the world are being “strongly encouraged” to do so, said Jennifer Christie, Twitter’s head of human resources, in a tweet.

[...] The executive director of the American Association of School Administrators said his organization fielded at least 60 inquiries about closures from concerned superintendents over the past week. Daniel A. Domenech, the executive director, said he gave similar advice to each: The moment you must drop everything and close, he said, comes when students, parents or teachers contract the novel coronavirus. That holds true even if just one person is infected, Domenech said — because, in schools, infections can spread dangerously fast.

[...] At the University of Washington in Seattle, school leaders haven’t been advised by public health officials of what might trigger a suspension of operations on campus, said Denzil J. Suite, the vice president for student life. “We’re all in this with the rest of the country,” he said, “doing the best we can with information that seems to be changing hourly.”
posted by katra at 7:00 PM on March 3 [1 favorite]


The group behind the Seattle Flu Study (the reason we know there are community transmitted cases due to the limitations imposed on medical testing that didn't apply to research testing) made a very nice layperson accessible blog post about their current work to date: Cryptic transmission of novel coronavirus revealed by genomic epidemiology
posted by foxfirefey at 7:05 PM on March 3 [23 favorites]


That’s a fantastic piece of science writing.
posted by mbrubeck at 7:26 PM on March 3 [8 favorites]


Pence says every American can get a coronavirus test (WaPo)
“When I talked to some state officials, there was a sense that the tests would not be administered to people that were mildly symptomatic,” Vice President Pence told reporters in an off-camera White House briefing. “We’re issuing clear guidance that subject to doctors’ orders, any American can be tested.”

Pence’s comments perplexed some public health officials, as physicians already have discretion to order testing. The announcement also raised questions about whether the government can rapidly accelerate the production of testing kits, as well as how much patients will ultimately have to pay for getting tested.

[...] Pence said roughly 2,500 testing kits approved by the Centers for Disease Control and Prevention should be distributed by the end of the week, primarily to hospitals in affected areas as well as to others that have requested them. Those kits collectively represent about 1.5 million individual tests. Seema Verma, the administrator for the Centers for Medicare and Medicaid Services, said testing for the coronavirus is covered under Medicare, Medicaid and health-care exchanges established under the Affordable Care Act, but it remained unclear how the costs would be handled for the estimated 27 million Americans who are uninsured.

[...] The World Health Organization’s top official said Tuesday that the disease caused by the new coronavirus has killed about 3.4 percent of those diagnosed with the illness globally — higher than what has previously been estimated.
posted by katra at 7:43 PM on March 3


I work at a university on the east coast, and it's tricky: we can't forcibly restrain anyone, but we are asking travelers to "Level 3 countries" (see list here) to self-isolate for 14 days upon their return to the U.S. -- which is the CDC's guidance.

(OK, actually we could void the building access code on their ID cards and thus keep them out of the buildings, but they could tailgate in through the door behind someone who is authorized so it's not much of a barrier. Would keep them out of the dining halls, too, I guess....)

I am seeing a lot of study abroad programs at other universities (e.g., this news story about Connecticut schools) get cancelled, and mostly the students are being told to take the rest of their classes online. Not take the classes from the country they saved up to visit, mind you, and also not from the campus where they are nominally enrolled -- because often that dorm room is re-assigned, plus they're not enrolled in any classes on campus. Showing up mid-semester wouldn't work, and they can't simply abandon the courses they're in.

It's my understanding that many schools have a their study abroad run by a company -- so when that company ganks a program, the school can only shrug and say that the program does, indeed, apper to be cancelled.

The state department of health holds our fate in their hand, and we're trying to prepare without actually interrupting instruction. Luckily it's spring break this week, but...

My boss is also an adjunct, and he said that our employer already has a short class called "Winterizing Your Course" that explains how to suddenly converting an in-person class to deliver it online. There's a companion video for students, and I think a big part of our prep is having professors prepare their classes for online delivery, and students to get ready to take classes from anywhere, should conditions locally worsen and the DoH tell us to close down.

I am in IT, so we are examining our resources to let staff work from home. *shrug* We should be OK, but it's kind of spooky on campus. The administration is doing a good job of sharing daily updates, and they're being surprisingly transparent & honest, which makes it easier for everyone to be honest about their fears and expectations.

It sucks for these kids, I feel very bad for them because my semester abroad was a really amazing time and I wish they could all have that kind of experience.
posted by wenestvedt at 7:49 PM on March 3 [8 favorites]


Estimates Fall Short of F.D.A.’s Pledge for 1 Million Coronavirus Tests (NYT)
Public and private labs say they’re not even close to reaching the federal government’s promises that thousands, if not a million, tests for the virus could be “performed” soon.
“The process of getting a test kit out and putting it into production is not something that happens literally overnight, in particular when you’re talking about a million tests,” said Eric Blank, the chief program officer at the Association of Public Health Laboratories, which represents state and local government laboratories nationwide. “It’s a nice thing to say, and it’s a simple thing to say, but the reality is we are a couple of weeks away from being able to deploy a million tests through this process.”

[...] Dr. Hahn was not the only Trump administration official to promise radically expanded testing. Over the weekend, Vice President Mike Pence made similar claims, appearing on television to say that more than 15,000 test kits — which contain materials to test between 700 to 800 samples — were being shipped to labs.

In fact, the C.D.C. said Sunday that it had shipped about 47 such kits.

The H.H.S. spokeswoman said Tuesday that the 15,000 test kits cited by Mr. Pence referred to the number of people who could be tested by kits that were being shipped, and that by later this week, enough tests would be sent to public health labs to test about 75,000 people.

About 3,300 patient specimens had been tested by the C.D.C. since the start of the outbreak, she said. More than 1,200 people had been tested as of Tuesday, the spokeswoman said. On Monday, as the testing controversy continued, the C.D.C. removed its data on how many people had been tested from its website. The numbers were removed, the C.D.C. said, because states are reporting results quickly, and the information reported by the agency would not be representative of testing being done around the country.
posted by katra at 8:06 PM on March 3 [3 favorites]


This is blackly humourous. There's a paternalistic view that it's the public that is prone to panic. But as far as I can see the most notable example of panic is Vice President Pence's desperate attempts to whitewash incompetence.
posted by storybored at 10:04 PM on March 3 [11 favorites]


It's also seriously messing me up watching this slow-motion trainwreck happen. It's so predictable, and so tragic.

This Is Just To Say

I have been
messed up
watching this
health crisis

Which
you are planning
to blame
on others

It is a slow motion
train wreck
so predictable
and so tragic
posted by Joe in Australia at 12:33 AM on March 4 [21 favorites]


Nice one JiA.
posted by medusa at 5:04 AM on March 4


It's based on economic concerns instead of health concerns, but the new Bond film (No Time to Die) is being moved to a November release window instead of spring because of the impacts that COVID-19 is having on the Asian box office. China is reliably one of the, if not the absolute, biggest foreign markets, and typically accounts for a good portion of any summer blockbuster's take. Depending on how things go here and abroad, I wouldn't be surprised to see similar tentpoles moved accordingly. The linked article talks about some global theater impacts from the outbreak,
China alone is poised to lose more than $2 billion since shutting 70K theaters this year. The release dates for Universal’s Dolittle and 1917, Searchlight Pictures’ Jojo Rabbit, Paramount’s Sonic the Hedgehog, and Pixar’s Onward have all been postponed indefinitely. For the period of Jan. 1-March 3, Comscore reports that South Korea’s box office is -60%, Italy’s is off 70-75% with roughly half of its cinemas closed (through we’ve heard that’s bound to improve by this weekend), Taiwan is down 30% year on year, along with Singapore (-35%), Philippines (-35%) and Hong Kong (-55%). In total, the global box office is expected to see at least a $5B hit in 2020.
posted by codacorolla at 12:35 PM on March 4 [1 favorite]


The American Physical Society cancelled its flagship March Meeting, which was due to take place this week:
Thousands of delegates to the March Meeting of the American Physical Society (APS) in Denver have had to cancel flights to Colorado or rearrange their journeys home after the decision to cancel the world’s biggest physics meeting.

The APS’s decision to abandon the event was taken late on Saturday 29 February, less than 36 hours before the meeting in Denver was due to start. It was cancelled “with deep regret” due to what the society said were “rapidly escalating health concerns” over the spread of the coronavirus COVID-19.

[...]“I completely understand this decision taken, but the timing on this is appalling,” tweeted Ilana Wisb, chief executive of the UK firm Oxford Quantum Circuits. “Our team have just flown half way across the world to learn that this is cancelled on landing.”
posted by heatherlogan at 12:48 PM on March 4 [4 favorites]


An interesting article in the New England Journal of Medicine (sorry if this is paywalled). Two people evacuated from Hubei Province were found to have the virus but never really developed symptoms. Nobody else on the flight tested positive for virus (126 people in total), including a few with symptoms.
posted by exogenous at 1:39 PM on March 4 [1 favorite]


the WHO report out of China in which they credit the widespread wearing of masks as one of the 3 most important methods of containing covid-19

For anyone who might prefer to read a summary rather than the whole report, there's a thread on redditt that tries to summarize some of the important points in the report.
posted by 23skidoo at 2:14 PM on March 4 [6 favorites]




article in the New England Journal of Medicine

not paywalled from here, exogenous

interesting set of symptoms (in contrast with what i had understood were symptoms of concern) on the passenger survey:
Each passenger was asked to report current symptoms of fever, fatigue, sore throat*, cough, runny nose*, muscle aches, and diarrhea*, and each one was screened for signs of infection in the nose and throat.
asterisks mine, indicating symptoms i had thought were not of particular concern.
posted by 20 year lurk at 3:31 PM on March 4 [2 favorites]


symptoms from WHO report mentioned by Justinian and 23skidoo:
fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgia or arthralgia (14.8%), chills (11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%), and conjunctival congestion (0.8%).
posted by 20 year lurk at 3:58 PM on March 4 [9 favorites]


Amazon confirmed an employee in Seattle has a case of covid-19 and Microsoft is now asking all employees who can work from home to do so until March 24 according to NY Times reporter tweets. Seattle is having troubles.
posted by GuyZero at 5:21 PM on March 4


Microsoft announcement - covers both Seattle area and SF Bay Area. Wow.
posted by GuyZero at 5:23 PM on March 4 [2 favorites]


Another cruise ship: Grand Princess: 2,500 on board, some sick, exposed to coronavirus, test kits being air lifted to ship: “A cruise ship carrying about 2,500 passengers, some of whom have been exposed to the coronavirus and are experiencing flu-like symptoms, is being held off the coast of California Wednesday afternoon while public health officials figure out how to test the travelers and return them home, Gov. Gavin Newsom said.”
posted by sallybrown at 5:30 PM on March 4 [5 favorites]


We Are Ignoring One Obvious Way to Fight the Coronavirus (NYT Editorial Board)
At this point, the crisis also demands unorthodox solutions. To restrict the spread of the coronavirus, the government needs to put limits on commerce. The best way to protect people, and the economy, is to limit economic activity. That is an unfortunate but inescapable truth. Public health officials will need to impose quarantines, businesses will need to cancel meetings. And most of all, the problem now and going forward is making sure that sick workers stay home. That means not forcing employees to choose between penury and working while coughing.

Congress can help by mandating that workers receive paid time off if they fall ill, or if they need to care for an ailing family member. Such a policy is necessary both to impede the spread of the virus and its economic harm. Roughly one-quarter of workers in the private sector — about 32 million people — are not entitled to any paid sick days. Absent legislation, they face a choice between endangering the health of co-workers and customers and calling in sick and losing their wages and perhaps also their jobs.
White House's 'muzzled' coronavirus messaging is dangerous, experts say (Guardian)
Despite a wave of support from Republican lawmakers, there has been pushback to Trump’s subdued messaging in the conservative magazine National Review. The writer Michael Brendan Dougherty said: [...] “we’re getting Trump the market whisperer. We’re getting a Trump who is obviously bothered by the drop in the Dow Jones. We’re getting a Trump who plans to campaign on the conventional measures of success favored by his predecessors. We’re getting a Trump who is downplaying the seriousness of this disease, who is probably acting too late, and who is making promises he can’t keep.”
The U.S. health system is showing why it’s not ready for a coronavirus pandemic (WaPo)
Nationwide, worries are growing about a lack of hospital beds to quarantine and treat infected patients. Major medical centers are typically full even without a flood of coronavirus patients. “We just don’t have the capacity in the hospitals and health systems to deal with a massive influx of patients and keep them isolated,’’ said Gerard Anderson, a professor of health policy and management at Johns Hopkins University.

[...] The amount of federal funding given to state and local officials to prepare for health emergencies has been cut in half or more over the past couple of decades, according to Crystal Watson, senior scholar at Johns Hopkins’s Center for Health Security.
posted by katra at 5:38 PM on March 4 [3 favorites]


Coronavirus Testing Offered With Just a Doctor’s Approval, C.D.C. Says (NYT)
Federal health officials announced on Wednesday that anyone who wants a coronavirus test may get one if a doctor agrees. But the nation’s testing capacity is still so limited that experts feared clinics and hospitals could be overwhelmed by an avalanche of requests.

Under the new criteria, patients who have fevers, coughs or difficulty breathing qualify for diagnostic testing, depending on their doctor’s judgment. But with flu season in full swing, tens of millions of Americans have respiratory symptoms, and doctors have no way to discern who should be tested.

[...] “We are already overwhelmed with calls day and night,” said Dr. Julie Vaishampayan, public health officer of Stanislaus County in Modesto, Calif. Public health laboratories in California are already working seven days a week, she said.
Expanded coronavirus testing may overwhelm lab capacity, say some experts (WaPo)
The move drew praise from experts who said the previous guidelines from the Centers for Disease Control and Prevention were far too restrictive in the face of a virus that has spread to more than 75 countries and sickened more than 95,000 people. But other health experts warned the action might inadvertently send the wrong message, prompting a surge in demand for tests from people with mild symptoms who should simply stay home until they recover. They also noted that laboratory capacity for virus testing, while on the rise, is still lagging. Tests that can be done in doctor’s offices don’t exist.

“This means that right when we need to be careful and methodical about this new testing capacity, we may be overwhelmed,” said Lauren Sauer, who runs emergency preparedness for Johns Hopkins Medicine and the university health system.

Sixty public health labs are now running the just-fixed CDC test. In the next several days and weeks, testing capacity is expected to increase as more labs come online and private companies ship thousands of test kits. Pence’s announcement took many officials at the Department of Health and Human Services and the CDC by surprise, according to an HHS official who spoke on the condition of anonymity to discuss the matter frankly.

[...] Corinne Heinen, who works in a Seattle primary-care clinic, said Wednesday that Pence’s suggestion that any person could ask their doctor to get tested runs counter to strict guidance still in effect at University of Washington Medicine. Under those criteria, patients should be tested only under extremely limited circumstances. “Patients should not self-present for testing,” the guidance says in bold letters.
posted by katra at 6:31 PM on March 4 [1 favorite]


Medical screener at LAX airport tests positive for coronavirus (NBC News)
The person last worked screening air travelers for illness on Feb. 21, DHS said in a statement, which also said the medical professional had worn the proper protective gear while working. [...] According to DHS, the person began to exhibit cold-like symptoms Saturday and visited a primary care doctor Sunday. The person was tested for COVID-19, which came back positive Tuesday.

The person's last shift at LAX was Feb. 21, more than a week before the appearance of symptoms. According to the internal email, the screener worked at LAX from Feb. 14 to 21 and became symptomatic on Feb. 29.

[...] "At this time we do not know if this case is a result from community spread or through their work as a medical screener," DHS said. "There have been no positive COVID-19 detections reported from the LAX screened travelers. This is an evolving situation that the CDC, DHS and county public health officials continue to examine."
posted by katra at 8:12 PM on March 4 [2 favorites]


vacapinta: There are only 18 cases here in the Netherlands, supposedly.

Now there are 38; actually, that was yesterday. And there are 900 Dutch students on a ski vacation in the north of Italy. Fun times.

I'm not too worried about myself and Stoneshop. But both of my parents are over 80 and one of them has heart problems and diabetes.
posted by Too-Ticky at 3:31 AM on March 5 [4 favorites]


That's my situation too Too-Ticky - two parents over 80, one with hypertension. Hope your folks will be okay.
posted by storybored at 6:32 AM on March 5 [1 favorite]


Same here. My parents have been very lucky with their health as they’ve gotten older but looking at that case fatality rate by age is sobering.
posted by sallybrown at 6:42 AM on March 5 [2 favorites]


So a week and a half has passed and the question poised in the FPP still stands.

Why is Thailand seeing so few infections? (Currently 47 affected, 1 death).

Bangkok had the highest air traffic from Wuhan (16,202 passengers per month in 2019) more than triple the number going to Tokyo.

Alternative explanations:

1. It is underreporting. Except that Thailand is rated fairly highly for pandemic preparation.

2. It is the climate. Current temperature in Bangkok is 26-33 degrees, relative humidity 74%

The CDC says that we don't know if COVID-19 is affected by ambient temperatures and humidity. Fair enough. But it could be: How will warm weather affect the spread of COVID-19?
""It's not unreasonable to make the assumption" that cases will die down come spring, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told NPR. "We hope when the weather gets warmer it will diminish a bit.

The only study I could find was this one: Effects of Air Temperature and Relative Humidity on Coronavirus Survival on Surfaces.. It did identify an impact: At 4°C, infectious virus persisted for as long as 28 days, and the lowest level of inactivation occurred at 20% RH. Inactivation was more rapid at 20°C than at 4°C at all humidity levels; the viruses persisted for 5 to 28 days, and the slowest inactivation occurred at low RH. Both viruses were inactivated more rapidly at 40°C than at 20°C. The relationship between inactivation and RH was not monotonic, and there was greater survival or a greater protective effect at low RH (20%) and high RH (80%) than at moderate RH (50%).
. But despite the title this study was done on a surrogate virus not on a coronavirus (presumably a close analog).

Final question: IF there is reasonable circumstantial evidence for temperature and humidity effects, would it not also be reasonable to install humidifiers in high-risk common areas in retirement homes and senior health care facilities?
posted by storybored at 7:03 AM on March 5 [7 favorites]


Trump doubles down on on his Dunning-Kruger; denies the WHO numbers "on a hunch"; encourages people infected to suck it up and go to work.
posted by Mitheral at 7:55 AM on March 5 [3 favorites]


Best friend lives in Florence, she's a brittle asthmatic and had to go on her pulmonologists advice to the local ED when the private clinic in her healthplan refused to CT her and test her when pneumonia symptoms and coughing blood required ruling out COVID-19. In Spain where my daughter lives a mobile unit would have come out to test her to avoid her spreading it in the ED. She tested negative thankfully but the 70 yr old man who tested positive was ambulanced into the same ED that day so she's still not sure she was careful enough when touching surfaces and washing hands or what surfaces if any they may have shared. CT? But she says the hospital was spotless, staff incredibly careful although the ED was jammed.

Hubby had his FP3 mask fitted today as an ITU doctor and is expecting to be exposed. Son 22, books the elective surgeries so he'll be twiddling his thumbs for a few weeks as we expect all elective procedures to be cancelled as we go up to the peak and until we are over it, however long that will take. One of the models shows that during our annual trip to Malaga where we wanted to celebrate daughter's 30th. It's likely during the peak that all annual leave will be cancelled and even if it's not there is no-way we would go when 1/5 of the workforce is expected to get sick and I suspect that will be higher among frontline staff. Part of this will be because exhaustion will cause forced errors in hygiene but most of it is simply the job.

We have detailed plans for when he/they become infected. since neither is in a high-risk category health-wise we just think that may place them (and possibly me) in a better place for next winter's mutated version.
posted by Wilder at 9:18 AM on March 5 [4 favorites]


Should have clarified in above comment, we work for the English NHS. Its been interesting to have three country comparisons Italy, Spain England, and technically Ireland where they have taken a Father Ted approach to communication. TOTALLY farcical)

Oh a bit of COVID black humour, sons 23 yr old police trainee mate had to be shown how to plug in and use a landline as he'd never used one. Police here are checking their emergencies closet or whatever they are called because they're expecting interruptions to essential services as employees self-isolate with mild to moderate symptoms and those too ill are hospitalised and/or die. So mobile networks, power, gas etc., The preppers will be intolerable!

One thing I haven't seen in the basic stay safe info and which surprises me is to tell people who wear glasses to get used to tracking how often they adjust them and to regularly disinfect them. I was just with a friend and I tracked her 5 times in 5 minutes 3 of which touched skin near the eye (I hadn't told her in advance so as not to skew the info)
posted by Wilder at 9:27 AM on March 5 [7 favorites]


Guardian: Coronavirus likely to significantly spread in the UK
Prime minister Boris Johnson spokesperson warned the coronavirus was likely to spread significantly. Johnson was updated on the coronavirus by the chief medical officer and the chief scientific adviser as he opened an official Cobra meeting.
Guardian: NHS England have released a breakdown of where the coronavirus cases are in England.

Guardian: "The Scottish government has not raised the country’s coronavirus alert status from contain to delay, unlike health chiefs in England and Wales, because the number and type of Covid-19 cases are not yet significant enough. [...] The delay phase is focused on slowing the virus’s spread through the wider community, and could involve banning or delaying large scale public events, to buy time for medical supplies to be built up and reduce the risks of the coronavirus coinciding with the peak occurrence of routine winter illnesses.
Officials said they expected that to change a matter of hours or days. “We’re under no illusion that it’s only a matter of a short period of time before we move it to ‘delay’,” said a government spokeswoman.
posted by katra at 10:09 AM on March 5


Coronavirus Diaries: I Run an Online Store for Preppers - "The demand is out of control." (David Sanders, Slate Opinion)
posted by ZeusHumms at 10:13 AM on March 5


Israel severely restricts entry from Europe due to virus (AFP / Yahoo)
Israel on Wednesday imposed tough new travel restrictions on five European nations due to fears of coronavirus, barring entry to almost all non-residents of the Jewish state arriving from these affected countries.

Israel had earlier in the day ordered all citizens and residents returning from the five countries -- France, Germany, Spain, Austria and Switzerland -- into 14-day home quarantine upon entering the country. The measures come on top of restrictions previously imposed on arrivals from mainland China, Hong Kong, Thailand, Singapore, Macau, South Korea, Japan and Italy.

Guidelines issued by the health ministry on Wednesday afternoon declared that foreigners from the affected European countries "will not be able to enter Israeli territory unless they can prove they have a place to stay in quarantine".

The interior ministry issued a statement in the evening saying tourists from these countries "will not be able to enter Israel from Friday at 8:00 am (0600 GMT)". "Those who arrive before this date will not be turned back," the statement added. The ministry added that the restrictions did not apply to people who merely transitted through airports in one of the listed countries.
posted by katra at 10:17 AM on March 5 [1 favorite]


WHO urges globe to ‘pull out the stops’ against virus’ march (AP)
“This is not a drill. This is not the time for giving up. This is not a time of for excuses. This is a time for pulling out all the stops,” WHO Director-General Tedros Adhanom Ghebreyesus said at a daily briefing in Geneva. “Countries have been planning for scenarios like this for decades. Now is the time to act on those plans.”
COVID-19 epidemic can be pushed back with concerted approach: WHO (Reuters)
“We are calling on every country to act with speed, scale and clear-minded determination,” the WHO’s director general Tedros Adhanom Ghebreyesus, told a briefing at the U.N. health agency’s Geneva headquarters.

Tedros voiced concern that “some countries have either not taken this seriously enough, or have decided there is nothing they can do”.
Coronavirus disease (COVID-19) technical guidance: Points of entry and mass gatherings (WHO)

Coronavirus disease (COVID-19) technical guidance: Risk communication and community engagement (WHO)
posted by katra at 10:29 AM on March 5 [4 favorites]


Doing the math on Trump's gaslighting of the number of cases (129 cases/11 deaths) gives a Case Fatality Rate of 8.5%.
posted by Mitheral at 12:51 PM on March 5 [2 favorites]


Trump’s latest coronavirus lies have a galling subtext (Greg Sargent, WaPo Opinion)
So Trump is claiming that the number of reported cases does not reflect the number of actual cases, inflating the WHO death rate. The WHO statistic does, in fact, reflect reported cases, but that’s exactly how the number is advertised.

So the claim that this percentage is “false” on this basis is itself a lie. And there’s no earthly reason for Trump to say this, other than to minimize impressions of the public health threat we face. And we already know Trump has worked to minimize those impressions precisely because he feared they would rattle the markets, which Trump views as key to his reelection chances.

Worse, to buttress this latest claim, Trump added that a lot of people “get better” even if they go to work with the virus. That’s not quite a declaration that people should go to work if they suspect they have come down with it. But it does send a very strong message that people who do suspect this can go to work in the expectation that they’ll get better, which could make them more likely to do so.

This has already been widely pilloried as scandalously irresponsible, since it could mislead a lot of people and put them at greater risk. [...] As experts tell CNN’s John Harwood, Trump is shirking on a basic presidential responsibility to inform the American people. And this could have serious consequences.
posted by katra at 1:37 PM on March 5 [4 favorites]


U.S. official warns there isn’t capacity to quarantine all passengers from marooned cruise ship (WaPo)
Ken Cuccinelli, the acting deputy secretary of homeland security, said Thursday that there is inadequate capacity at health-care facilities in the United States to accommodate bringing large numbers of cruise ship passengers ashore for quarantine, leading lawmakers to question whether authorities would again seek to quarantine coronavirus cases on a ship held offshore.

The Grand Princess, which carries about 2,500 passengers, is marooned off California after a previous passenger died of coronavirus and workers aboard displayed symptoms. [...] “We don’t,” Cuccinelli responded. “There is a misconception about the capacity we could put together for quarantining. … This is an important misconception.”

Robert Kadlec, the assistant secretary for preparedness and Response at the Department of Health and Human Services, who also testified at the hearing, echoed Cuccinelli’s claim about a lack of capacity to quarantine coronavirus cases, and suggested that Congress consider creating more capacity for quarantines for future epidemics.
Cruise ship quarantine lessons not being learned, senator says (WaPo)
At the Senate Homeland Security and Governmental Affairs Committee hearing on Thursday, Sen. Maggie Hassan (D-N.H.) said she was worried that lessons from the earlier Diamond Princess cruise ship outbreak off the coast of Japan — in which people were kept on board too long and hundreds became infected — were not being applied to the latest cruise liner in limbo off California.

One passenger from this cruise ship, the Grand Princess, died of the virus after having disembarked. Some staff are now showing symptoms.

“We don’t seem to have a quarantine in place,” Hassan said. [...] Robert Kadlec, assistant Health and Human Services secretary for preparedness and response, told the committee, “We don’t have the quarantine capacities and treatment capacity. We maxed out that capacity at the University of Nebraska,” where the sickest Diamond Princess passengers were hospitalized.
posted by katra at 2:03 PM on March 5


Increased U.S. screening for coronavirus cases at borders (WaPo)
The United States is banning the entry of most foreign nationals who recently visited or departed China. U.S. citizens and permanent residents who recently visited China are subject to additional screening, and thousands of them — including those who have no symptoms of illness — have so far been referred for 14 days of self-monitoring and isolation at home.

[...] The largest group told they could not enter were Canadian nationals who had recently traveled to China, he said, followed by Chinese. “We have been very aware of it, and confronting it head on, and turning those folks back, frankly,” Cuccinelli added.

Cuccinelli said CBP official at airports and other ports of entry were giving “obviously a heightened focus” to any travelers who had visited China or Iran, “but also [South] Korea, Italy and Japan.” He said travel history is the “first and biggest flag” for CBP officials screening arrivals to the United States. He also said administration officials were daily reevaluating the possibility of an expanded travel ban.

Currently, individuals identified as having visited high-risk zones might be pulled aside for secondary screening; individuals deemed particularly at risk are referred for medical screenings by contractors on site at ports of entry; and potential cases are then referred to the CDC.
posted by katra at 2:08 PM on March 5 [1 favorite]


One of my tasks at my new job has been to weigh in with my opinions on the DIY hand sanitizer solution bottles we're making up for the staff; I have had enough hippie-crunchy-granola-DIY experience that I was able to authoritatively say that two parts alcohol to one part aloe vera gel would work perfectly. Add a little essential oil so it smells nice. We actually ended up with something that my boss actually got excited about (imagine me, my boss, and two other dudes all smearing this green gel into our hands and then sniffing them and saying "hey, this smells really good!"). My biggest problem may be in talking my boss out of his insistence that vetiver is the scent we should use (I like vetiver too, but it's an acquired taste, and I told the dude that was working on this that "maybe....keep the orange too just in case, so you can provide people with that choice").

But people are largely staying calm. I may be in better shape than average, because this new job is within walking distance, so I get to avoid the petri dish that is the subway system.
posted by EmpressCallipygos at 3:54 PM on March 5 [5 favorites]


A nurse who got sick after treating a coronavirus patient in California says CDC initially refused to test her, as doctor ordered, then said she had to wait because she wasn't yet sick enough to be a priority. The US is rationing care for *nurses* during a public health emergency
posted by adamvasco at 3:54 PM on March 5 [17 favorites]


First presumptive positive case in Colorado being announced by the governor at a press conference now.
posted by medusa at 4:08 PM on March 5


And the Colorado governor says live they got news of a second positive in Colorado as they were prepping the press conference.
posted by medusa at 4:09 PM on March 5


A coronavirus danger: Touching your face. Here is how to stop doing it (LA Times / MSN)
[...] keeping your hands clean is essential. Hand-washing with soap and water for 20 seconds is effective at killing germs. Bleach-based wipes also work — and wipe down your phone! Hand sanitizer with at least 60% alcohol can be effective in killing some viruses, including the new coronavirus, but can be ineffective with other viruses, UCLA's Yang said.
How to Stop Touching Your Face (NYT)
When you feel the urge to scratch an itch, rub your nose or adjust your glasses, grab a tissue and use that instead of your fingers.

[...] Pause throughout the day to notice compulsive behavior. Once you’re more aware of when and why you’re touching your face, addressing the root cause can be an effective solution. If you find yourself rubbing your eyes because they are dry, use moisturizing drops. If you are using your hand as a chin rest or to adjust your hair, be aware of that, Dr. Raabe said.

[...] Keeping your hands occupied with a stress ball or other object can reduce instances of touching your face and minimize triggers, doctors said. Of course, don’t forget to regularly clean and sanitize that object.

[...] As long as your hands are clean, touching your face isn’t catastrophic. “It’s a natural behavior we all do,” Dr. Shankman said. “It’s not the end of the world.”
posted by katra at 7:41 PM on March 5 [2 favorites]


A college closes, another cancels classes and others brace for coronavirus impact on campus (WaPo)
College health officials began intense work on preparations last month “like we were shot out of a cannon,” said Jean E. Chin, who leads an American College Health Association task force on coronavirus. On Wednesday, the group released guidelines for schools, warning the virus was a risk for colleges because of travel by people from schools and because of the potential for rapid transmission on campus. The group advised student health centers to quickly prepare for potentially infectious patients.

[...] Many campuses are wondering how they would implement a directive to quarantine people, said André Le Duc, chief resilience officer and associate vice president for safety and risk services at the University of Oregon. Le Duc, a leader of a network of hundreds of college officials sharing questions, ideas and resources about emergency planning online, said officials are weighing how they would handle a disruption to classes if that was necessary.

At the University of Oregon, more than 100 people are working on outbreak contingency planning, he said, including some focusing on travel advisories, housing, athletics and academic continuity. More than 23,000 people have signed an online petition calling on the University of Washington to close its Seattle campus to prevent people from spreading the virus in the school’s dorms, classrooms and dining halls. The university has had no confirmed infections, but deaths related to the coronavirus in the region sparked fears among students and others that infections might already be spreading there.

The campus never really closes, said Victor Balta, a spokesman for the public university, which includes a hospital and houses several thousand students. Public health officials have not advised the school to shut down or cancel large events. But for days, university leaders have been planning possible responses to the outbreak, including suspending classes and quarantining students, and trying to answer the many questions people have. Spring break is approaching, and officials are asking people to be mindful of health advisories and aware some countries have abruptly imposed travel restrictions.
posted by katra at 9:40 PM on March 5 [1 favorite]


Canada reports first case of community spread of coronavirus (WaPo)
Canada reported its first case of community transmission of the novel coronavirus Thursday, evidence that the deadly virus has potentially been circulating here undetected. The woman, who is in her 50s, lives in British Columbia and thought she had the flu. Bonnie Henry, the provincial health officer, told reporters that she has no recent travel history or known contact with anyone who has tested positive for the virus.
Guardian: Mike Pence admits shortage of coronavirus test kits
US Vice President Mike Pence has said there are too few coronavirus testing kits to be able to meet demand, CNN reports. Pence is leading the administration’s response to the spread of the virus. “We don’t have enough tests today to meet what we anticipate will be the demand going forward,” Pence told reporters while touring 3M facilities in Minnesota.
Guardian: Emmanuel Macron says epidemic is ‘inevitable’ in France
On Thursday the French health ministry reported three more deaths from the disease, bringing the country’s toll to seven. The country recorded 138 new virus cases in the biggest daily jump, bringing the total number nationwide to 423.
Guardian: "In Italy, the coronavirus death toll has risen by 41 over the past 24 hours to 148, the Civil Protection Agency said on Thursday, with the contagion still showing no sign of slowing.
The accumulative number of cases in the country, which is hardest hit by the virus in Europe, totalled 3,858, up from 3,089 on Wednesday. The head of the agency said that of those originally infected, 414 had fully recovered versus 276 the day before.
posted by katra at 9:51 PM on March 5 [1 favorite]


With the CDC dropping the ball on testing kits for COVID-19, here is perhaps some good news. CT provides best diagnosis for COVID-19.
Compared to RT-PCR, chest CT imaging may be a more reliable, practical and rapid method to diagnose and assess COVID-19, especially in the epidemic area," the authors wrote. Chest CT, a routine imaging tool for pneumonia diagnosis, is fast and relatively easy to perform. Recent research found that the sensitivity of CT for COVID-19 infection was 98% compared to RT-PCR sensitivity of 71%.
posted by storybored at 9:51 PM on March 5 [4 favorites]


> The US is rationing care for *nurses* during a public health emergency

I'm sure I'm missing the subtext entirely but when there isn't infinity of something and demand exceeds supply, it has to be rationed. Thus, it sounds like to me that they're making very hard decisions on who to test, given an extremely limited number of kits in existence.

What should they be doing instead?
posted by fragmede at 10:17 PM on March 5 [1 favorite]


I'm not at all clear on what a "test kit" even is. From reports, it's many hundreds of possible tests.

But is this something that, like a PH test strip, can be read more or less immediately, or at least in the field, or is this something that needs to be sent back to the lab for further analysis? Because, if the latter, resources at the lab(s) would bottleneck results.
posted by sjswitzer at 11:05 PM on March 5 [1 favorite]


I'm not at all clear on what a "test kit" even is. From reports, it's many hundreds of possible tests.

That was my understanding too, however I also get the impression that some of the reports are confusing the two, and either using "test kit" to mean the number of samples that can be tested, or using it correctly, but not defining it, so that it sounds like states could only do 50 tests.

But is this something that, like a PH test strip, can be read more or less immediately, or at least in the field, or is this something that needs to be sent back to the lab for further analysis?

They need to be sent to a lab - CNN has an explanation of the test. But so far it seems the problem is more a mixture of limited test kits and pretty strict rules on who could be tested.
posted by scorbet at 3:04 AM on March 6 [2 favorites]


Amid coronavirus outbreak, Trump-aligned pressure group pushes to stop medicine sales to Iran
posted by adamvasco at 3:11 AM on March 6 [2 favorites]


In Portugal (and probably other places) private labs are offering Coronavirus testing for 100-200 euros, no doctors orders needed.
posted by vacapinta at 3:54 AM on March 6 [1 favorite]


"Wash your hands like you've been chopping jalapenos and you need to change your contacts." Dr. Bonnie Henry, provincial health officer of British Columbia.
posted by heatherlogan at 3:56 AM on March 6 [12 favorites]


British Columbia has identified a presumptive case of the novel coronavirus in [a] patient [who] is a resident of Seattle who is visiting family in the Fraser Health region. This is being considered a case of known origin due to travel history.
posted by heatherlogan at 4:08 AM on March 6


128 people are registered as infected in the Netherlands now. Five of them are in hospital; the others are quarantined at home. And we've had our first patient who died: a 86-year old man in Rotterdam.
Most of our infected folks (101) have caught the virus abroad, or have been in contact with other known infected people.
posted by Too-Ticky at 5:26 AM on March 6


We've got 163 cases in the UK now, up 47 from yesterday's figure, which honestly feels like pretty scary territory to me.
posted by Mauve at 6:30 AM on March 6


Get political reporters off the coronavirus story because they don’t distinguish between right and wrong (Dan Froomkin, Press Watch h/t Salon)
One of the many ways the public is ill-served by the White House chokehold on information about the coronavirus crisis is that it gives way too big a role to the White House press corps, which sees most everything through a political lens – and a warped political lens, at that.

To get at the truth about this public-health threat, news organizations need to route around the White House. It is flatly insane that someone as uninformed, intellectually incurious and science-intolerant as Mike Pence is playing point-man here.

But news organizations also need to take political reporters – and perhaps even more importantly, political editors – entirely out of the loop on this story. It’s too damned important to be covered as a two-sided battle over who’s winning the narrative.
Most of them probably have marginal or poor training for science reporting in the first place.
posted by ZeusHumms at 7:16 AM on March 6 [22 favorites]


Maybe they should take the White House press corps off of political reporting, while they're at it.
posted by tobascodagama at 7:50 AM on March 6 [9 favorites]


We've got 163 cases in the UK now, up 47 from yesterday's figure, which honestly feels like pretty scary territory to me.
posted by Mauve at 2:30 PM on March 6 [+] [!]

@Mauve, honestly this is to be expected as all the close contacts are traced and tested. With the news that Modena is testing a potential vaccine, while it will take many months before it is proven, its an amazing achievement 42 days!
posted by Wilder at 9:33 AM on March 6 [3 favorites]


Exclusive: The Strongest Evidence Yet That America Is Botching Coronavirus Testing (Atlantic)
Through interviews with dozens of public-health officials and a survey of local data from across the country, The Atlantic could only verify that 1,895 people have been tested for the coronavirus in the United States, about 10 percent of whom have tested positive. And while the American capacity to test for the coronavirus has ramped up significantly over the past few days, local officials can still test only several thousand people a day, not the tens or hundreds of thousands indicated by the White House’s promises.

[...] The figures we gathered suggest that the American response to the coronavirus and the disease it causes, COVID-19, has been shockingly sluggish, especially compared with that of other developed countries. The CDC confirmed eight days ago that the virus was in community transmission in the United States—that it was infecting Americans who had neither traveled abroad nor were in contact with others who had. In South Korea, more than 66,650 people were tested within a week of its first case of community transmission, and it quickly became able to test 10,000 people a day. The United Kingdom, which has only 115 positive cases, has so far tested 18,083 people for the virus.

[...] These data come with an important caveat. Currently, most labs require two specimens to test one person. Single-specimen testing capability is being developed, but right now the top-line number of available tests should be cut in half. In other words, “1.5 million tests” should be able to test roughly 750,000 people. Some states, such as Colorado, told us how many specimens they could test a day (160), not how many patients (about 80). Other states shared the number of patients they could test, but not the number of specimens. In this story, we’ve standardized these numbers by dividing any specimen figure by two to give an estimate of the number of patients who can be tested.

[...] Today, more than a week after the country’s first case of community transmission, the most significant finding about the coronavirus’s spread in the United States has come from an independent genetic study, not from field data collected by the government. And no state or city has banned large gatherings or implemented the type of aggressive “social distancing” policies employed to battle the virus in Italy, Hong Kong, and other affluent places.

If the true extent of the outbreak were known through testing, the American situation would look worse. But health-care officials and providers would be better positioned to combat the virus. Hard decisions require data. For now, state and local governments don’t have the information they need.
posted by katra at 10:07 AM on March 6 [9 favorites]


Emerald City Comic Con [Seattle] finally postpones event, relenting to backlash amid coronavirus outbreak (Todd Bishop, Geekwire)
Facing an increasingly vocal public backlash, Emerald City Comic Con says it will postpone the giant Seattle fan convention to the summer amid growing public concern about the spread of the novel coronavirus in the Seattle region.

“We did everything that we could to run the event as planned, but ultimately, we are following the guidance of the local public health officials indicating that conventions should now be postponed,” ECCC organizer Reedpop said in an email to attendees and an online post minutes ago. The message said the decision was made “after many hours of conversation internally and consultation with local government officials and the tourism bureau.”
There's no way to win here. Insurance probably can't cover all the possible expenses associated with cancellation, let alone so close to the event date. Vendors depending on events like this for their income have to weigh that against health risks. And fans planning on going may have a lot invested in going that can't easily be refunded.
posted by ZeusHumms at 12:05 PM on March 6 [6 favorites]


> growing public concern about the spread of the novel coronavirus in the Seattle region

It kills me to do it, but I canceled the rest of my Girl Scout troop's cookie booths for this season. Deliberately interacting with as many people as possible in the suburbs of Seattle seems like a bad idea this month.
posted by The corpse in the library at 12:21 PM on March 6 [8 favorites]


Austin city officials juuuuust announced that they're cancelling this year's SXSW. (South by Southwest is a yearly 10-day music/tech/movie/other festival that attracts artists and attendees from around the world.)
posted by 23skidoo at 2:12 PM on March 6 [4 favorites]


SXSW 2020 was going to start next week.
posted by ZeusHumms at 3:38 PM on March 6 [1 favorite]


‘Wildly unprepared’: survey of US nurses highlights coronavirus concerns (Guardian)
Supply and staffing shortages, combined with conflicting guidance and lack of information, have created a perfect-storm situation that’s poised to perpetuate illness, they told the Guardian. National Nurses United (NNU) released results from a survey of more than 6,500 nurses across 48 states, Washington DC, and the Virgin Islands. Less than half of nurses surveyed – 44% – said their employers provided them information on novel coronavirus and “how to recognize and respond to possible cases”.

Just 63% of nurses surveyed had access to N95 respirators in their units, while a mere 27% had access to powered air purifying respirators. Only 30% of survey participants said that their employers had enough personal protective equipment (PPE) stocked in the event of a quick uptick in potential coronavirus patients, while 38% didn’t know.
Chaos at hospitals due to shortage of coronavirus tests (LA Times / MSN)
The shortage of test kits is creating chaos for doctors and nurses as their triage efforts are complicated by testing restrictions and shortfalls. [...] Though the Centers for Disease Control and Prevention on Wednesday lifted some guidelines so anyone with symptoms can be tested by their physician, local officials can’t take advantage of the looser restrictions because of the lack of test kits.
US coronavirus: Thousands of residents asked to 'self quarantine' by state governments (CNN / MSN)

So you’ve been asked to self-quarantine. Here’s what you should know. (WaPo)
The Centers for Disease Control and Prevention recommends 14 days to see whether flu-like symptoms develop. The 14-day incubation period is based on what researchers know about the incubation period of MERS, which is in the same family as the novel coronavirus.
posted by katra at 4:10 PM on March 6 [2 favorites]


Quarantine and Isolation Authorities in States Affected by COVID-19 (Lawfare)
As the virus continues to spread, we have also started to see stories of exposed persons violating recommended self-quarantines. But what powers do these states have to order compulsory quarantine of infected or exposed persons? Below, we provide a review of relevant state law authorizing quarantine or isolation. We have prioritized states by the date of first confirmed case—Washington, Illinois, California, Arizona, Massachusetts, Wisconsin, New York and Rhode Island—as of March 5, and we will continue to add summaries as more states announce new cases. A list of relevant statutory authority for all states is also available on the National Conference of State Legislatures website.
posted by katra at 4:41 PM on March 6 [2 favorites]


Coronavirus: South Korea’s aggressive testing gives clues to true fatality rate

With 140,000 people tested, the country’s mortality rate is just over 0.6 per cent compared to the 3.4 per cent global average reported by the WHO.
[South Korea’s] Centres for Disease Control and Prevention on Thursday reported 6,088 cases and 40 deaths, the mortality rate appears to be hovering around 0.65 per cent.
While this is still several times more lethal than seasonal influenza, which kills about 0.1 per cent of the people it infects – 30,000-40,000 people in the US alone each year – South Korea’s rate is far lower than that seen elsewhere.

“The only way to know the severity spectrum is to test large numbers of people"
posted by spamandkimchi at 6:34 PM on March 6 [7 favorites]


Trump a week ago: "When you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that's a pretty good job we've done."

Well, there are currently 15 confirmed deaths in the U.S. so I guess you have to give him credit for a perfect call.
posted by JackFlash at 7:28 PM on March 6 [5 favorites]


[South Korea’s] Centres for Disease Control and Prevention on Thursday reported 6,088 cases and 40 deaths, the mortality rate appears to be hovering around 0.65 per cent.
While this is still several times more lethal than seasonal influenza, which kills about 0.1 per cent of the people it infects – 30,000-40,000 people in the US alone each year – South Korea’s rate is far lower than that seen elsewhere.


When they factor in overall death rates, do they factor in that some countries don't have functioning healthcare systems? Or if functioning ones get completely overwhelmed? Or what happens when it hits somewhere like a refugee camp? Honest questions; I just feel that the numbers alone can't be the whole story in modelling death rates.
posted by lesbiassparrow at 8:32 PM on March 6 [1 favorite]


False cases of coronavirus have infected social media ... going viral and raising panic. (Cristina Tardáguila, Poynter.org)
Laura Del Río, who coordinates the team of fact-checkers at Maldito Bulo, in Madrid, told the IFCN that misinformers have started to use basically two methods to deceive people.

“They manipulate images or modify the HTML code of a certain website to change the headline of a story about the new coronavirus.”

The change may begin as a joke. The results, however, are panic and anxiety.
posted by ZeusHumms at 8:35 PM on March 6




Wash Your Hands - Rupert Beale, an immunologist at the Crick Institute writing for the London Review of Books.
In countries where rapid testing and isolation do not happen, the disease will at its peak rapidly overwhelm the ability of hospitals to cope, and the case fatality rate will be much higher. The global case fatality rate is above 3 per cent at the moment, and if – reasonable worst case scenario – 30-70 per cent of the 7.8 billion people on earth are infected, that means between 70 and 165 million deaths. It would be the worst disaster in human history in terms of total lives lost. Nobody expects this, because everyone expects that people will comply with efficient public health measures put in place by responsible governments
posted by ChuraChura at 5:54 AM on March 7 [3 favorites]


I think most people aren’t aware of the risk of systemic healthcare failure due to #COVID19 because they simply haven’t run the numbers yet. Let’s talk math. 1/n

Thread from Liz Specht, PhD biologist (not epidemiologist) and an engineer. Illustrates with numbers that economist graph (I think drawn by that Trevor epidemiologist dude?) that’s been going around about how early measures impact the load on our health care system. Tl;dr: without measures put in place now to slow the spread, and with conservative estimates, the US healthcare system is overwhelmed by early May.

At this point it seems like the US’s response is almost optimally terrible — no national leadership, clarity, or coordination, barely any testing, with states and localities left to fend for themselves. Some high profile events have been cancelled, but most continue, and people aren’t implementing social distancing measures because they are (angrily) insistent that this is not a big deal.

I can’t decide if NYC is a good place to be or a terrible place to be, given that we have a state and city government that has experience with disasters and gives a shit, but also given that it’s New York and there are 8 million of us on top of each other. I kind of hate that the crazy fucking preppers have been validated. And I have no idea what to do beyond “don’t get sick.”

I don’t know. Maybe contact your local representatives and urge them to cancel events, close schools (I know, I know), etc.
posted by schadenfrau at 6:26 AM on March 7 [10 favorites]


Nurse union issues grave warning on COVID-19: "The nation's hospitals are unprepared" (Nicole Karlis, Salon)
As novel coronavirus cases continue to grow in the United States, thousands of unionized nurses say that they find the lack of preparedness among their employers and hospitals alarming — and fear that they may be at risk for COVID-19 as a result.

On Thursday, at a press conference in Oakland, Calif., the National Nurses United (NNU) gave the result of a survey sent out to union members asking if they felt their employers were prepared for the ongoing outbreak. Pulling from recent responses from more than 6,500 nurses in 48 states, NNU said only an estimated 29 percent of nurses reported their employer had a plan in place to isolate a patient with a possible COVID-19 infection. Twenty-three percent said they "didn't know" if there was a plan in place at their hospital.

While 63 percent of the nurses surveyed said they had access to N95 respirators at their units, many said they haven't been fitted or trained on how to properly use them.

"The results of our national survey of more than 6,500 nurses is truly disturbing," Jane Thomason, an industrial hygienist for the union, said on Thursday. "They show that large percentages of the nation's hospitals are unprepared to safely handle COVID-19."
[...]
The NNU isn't the only union to be speaking out about institutional ill-preparedness for COVID-19. In a press conference hosted by Service Employees International Union–United Healthcare Workers West (SEIU-UHW), a healthcare justice union, one healthcare worker said San Francisco hospitals are understaffed and unprepared.

Moreover, in an SEIU-UHW press release, the union said that over the last couple weeks, 50 caregivers were sent home after coming into contact with infected patients. At least 10 of them were caregivers at Parkview Community Hospital Medical Center in Riverside, California, where a patient with related symptoms was not put in isolation until the next day.
posted by ZeusHumms at 6:51 AM on March 7 [4 favorites]


"Coronavirus: South Korea’s aggressive testing gives clues to true fatality rate"

This is true, but South Korea's numbers are currently underestimating the case fatality rate, just as the current Chinese is likely an overestimate.

The case fatality rate is the ratio of deaths to confirmed cases. This number is very sensitive to two things: how cases are found and reported, and the incubation period and progression of illness relative to the stage of the epidemic.

If you're relying on sick patients identifying themselves to health care workers and subsequently being tested/confirmed, then it's virtually certain that a large portion of cases will be unreported, making the fatality rate appear greater than it is. Conversely, at the other extreme, if you are testing the population randomly, you're going to get close to the true infection rate, which will include very mild or asymptomatic cases. No one as of yet has done any random population testing of this nature, though I read something this morning urging China to do this. Mass-testing a population, as is being done in South Korea, will result in something closer to the actual number and thus will provide a more accurate fatality rate—all else being equal. But all else isn't equal, because of the incubation period and progress of illness.

Because there's a lag between infection and recovery or death, early in an epidemic (in a given population) you'll have a lot of confirmed cases but few deaths or recoveries. Conversely, if you're caught by surprise by the epidemic and only start compiling numbers as your health care system is overwhelmed with symptomatic patients, especially the most severe, then a while later you're going to see a lot of those patients recovering or dying even as new infections decline.

Putting these two factors together, you can see that China's case fatality rate is right now probably near its maximum, underestimating the total number of infections while reporting of fatalities peaks. In contrast, South Korea with its mass-testing is going to count many more of the infected even though its fatalities are yet to peak.

I still feel that the case fatality rate, assuming adequate heath care, is most likely between 1% and 2%.

But how many people will be infected? Unless I've missed something, I'm not seeing any estimates of that yet, not even for, say, South Korea. As a benchmark, in the US every year between 3% and 14% of the total population get the flu.

From churachura's quote: "The global case fatality rate is above 3 per cent at the moment, and if – reasonable worst case scenario – 30-70 per cent of the 7.8 billion people on earth are infected, that means between 70 and 165 million deaths."

You can see that's very much the extreme worst case scenario. The global case fatality rate is unlikely to be as high as 3%, and a 30-70% infection is several times that of influenza. However, there is great concern about Africa—it could be that Sub-Saharan Africa may see a case fatality rate higher than 3%. And, as I wrote earlier, we don't really yet know what the infection rate of this is—because it's novel, it could be much higher than influenza. So those numbers are possible; but I consider them at the moment to represent the very worst case scenario.

The technical mortality rate is fatalities among the total population. If you google "influenza mortality rate", you're likely to find that number (IIRC, US is about 14 per 100,000 per year). Note that many sources with regard to covid-19, like myself above, are confusingly using "mortality rate" to mean something like the case fatality rate.

If you assume a greater-than-influenza infection rate in the US—say 20% which is high, but not as high as that earlier very worst case—and the upper end of 2% of my estimate of 1-2% case fatality rate, that results in 65 million people infected in the US, with 1.3 million fatalities, or 4%; 400 per 100,000. That's almost thirty times the flu. That is, by the way, approximately the same global mortality rate as the 1918 Spanish Flu. In my opinion, this is more realistically the worst case scenario. (Even if it were a whole order of magnitude more mild than that, it would still be three times worse than the flu.)

"When they factor in overall death rates, do they factor in that some countries don't have functioning healthcare systems? Or if functioning ones get completely overwhelmed? Or what happens when it hits somewhere like a refugee camp? Honest questions; I just feel that the numbers alone can't be the whole story in modelling death rates."

These aren't numbers from models, they're just the raw numbers for specific geographical areas. You're quite right that under the worst conditions we should expect the case fatality rate to be higher. How much higher is another question. I don't have the impression that supportive care is making that much of a difference, though I well could be mistaken. I do think that comorbidity is playing a large role, and so a population in particularly poor health will be disproportionately affected.
posted by Ivan Fyodorovich at 8:19 AM on March 7 [10 favorites]


You Might Be Buying a Hand Sanitizer That Won’t Work for Coronavirus (Marshall Allen and Lisa Song, ProPublica)

The CDC recommends that hand sanitizers contain a minimum of 60% alcohol to effectively kill coronavirus. Hand sanitizers that don't contain 60% alcohol or use a different ingredient are less effective. Regardless of whether or not sanitizers meet CDC recommendations, they are selling out everywhere.
posted by ZeusHumms at 8:24 AM on March 7


Trump, while touring the CDC, when asked about his decision to reduce funding for pandemic preparedness responds with semi coherent rambling that amounts to who would have thought this would happen especially when [and I am not making this up] the DOW was on trend to hit 30K.

I'm starting to freak out for you all and by extension Canada.
posted by Mitheral at 8:29 AM on March 7 [6 favorites]


The CDC has guidelines up for those of us at higher risk.
What to do if you are at higher risk:

Stay at home as much as possible.
Make sure you have access to several weeks of medications and supplies in case you need to stay home for prolonged periods of time.
When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.
Avoid crowds.
Stay up to date on CDC Travel Health Notices.
posted by MrVisible at 9:02 AM on March 7 [2 favorites]


I like how all the calm and reasonable prep docs are like
make sure you have access to several weeks of medications and supplies in case you need to stay home for prolonged periods of time.
and I'm like "insurance sometimes doesn't work that way in the US." My provider refuses to cover anything but a 30-day supply for some things so I have, on average, 15 days of meds at any time.

Unless the CDC is willing to just give me a few hundred bucks, I'm at the mercy of the insurance industry on this. I can't imagine I'm alone in this setup.
posted by introp at 9:46 AM on March 7 [22 favorites]


introp: a pharmacist acquaintance sent out some suggestions including possible workarounds.
" If your insurance says the medication is refill too soon, ask when the next available date is. If you can afford it, consider paying out of pocket. Shop different pharmacies as the price can differ. Many retail pharmacies offer $4-10 generics for a 90 day supply cash. Many insurances also offer a once per year per medication 'vacation' or 'lost/damaged' medication early refill. "
This will only help in a limited number of cases but I hope it is useful to some.
posted by Botanizer at 10:51 AM on March 7 [2 favorites]


A group at the University of Bern used some sophisticated statistical methods on the available data, attempting to account for the kinds of things I describe in my previous comment, and they've estimated the fatality rate to be 1.6%.

That's a highly synthetic number—we should be careful about what it could possibly represent. In the real world there are going to be big variations in testing and diagnosis, reporting, comorbidity, and available health care. And the contagion rate will vary depending upon social circumstance and governmental response. If contagion is elevated, then that might cause the case fatality rate to be elevated as well, as a result of a badly overburdened health care system. The case fatality rate may prove to vary significantly by location.

And that's not even accounting for the uneven distribution by age: the Bern group estimates a case fatality rate for those in their 70s to be about 10% of all infected (twice that for those who are symptomatic) and about 20% for those in their 80s (again, twice that among the symptomatic).

Many epidemiologists are estimating a contagion rate (per year) to be 30% or more; 50% is not unreasonable.

Therefore, while a 1.6% estimate is better news than 3-4%, in some localities and among some age groups it could be (and almost certainly is) much higher.

To my mind, what this indicates is that what we all should be most worried about is contagion to high risk populations. That is to say, all the precautions being recommended may have a huge impact on how badly those vulnerable populations are hit. Even if we're not hugely worried for ourselves, we should be very worried about the elderly and immune-compromised.
posted by Ivan Fyodorovich at 11:04 AM on March 7 [7 favorites]


Seattle health care providers scramble to ration medical supplies as coronavirus cases climb
UW Medicine on Wednesday dropped its level of precaution for health care workers interacting with COVID-19 patients, or those suspected of infection, from “airborne precautions,” in which respirators — such as N95 respirators or PAPR system — are required, to “droplet precautions.”
Virginia Mason attempted to restrict masks to patients only; amidst outcry will allow staff one mask per shift.
posted by Margalo Epps at 11:06 AM on March 7 [1 favorite]


My provider refuses to cover anything but a 30-day supply for some things so I have, on average, 15 days of meds at any time

Not much help at this point but: Call in a refill 27 days from the last fill date. Even with 30 day maximum scripts, they give you a couple days leeway. Even if you don't pick it up the moment it's filled, you've reset the clock on your next script. After a year, you've got a month saved up, completely legitimately.
posted by notsnot at 11:09 AM on March 7 [6 favorites]


> Unless the CDC is willing to just give me a few hundred bucks, I'm at the mercy of the insurance industry on this. I can't imagine I'm alone in this setup.

If you have an understanding physician, you may be able to get them to adjust your prescription to be twice daily (for 'reasons' - adjusting dosage, titration, etc) which essentially makes it a 60 day Rx that you can refill every 30 days. This of course only works if you're not at the maximum allowed dose since on paper you're doubling what you're taking every day.
posted by mrzarquon at 12:40 PM on March 7 [3 favorites]


Squandered time: How the Trump administration lost control of the coronavirus crisis (WaPo)
On Friday, visiting the CDC in Atlanta, the president spewed more falsehoods when he claimed, incorrectly, “Anybody that needs a test, gets a test. They’re there. They have the tests. And the tests are beautiful.”

[...] At a regularly scheduled media briefing for reporters on Feb. 25, Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, focused her remarks on community mitigation — such as closing schools or avoiding mass gatherings — rather than the detective work of tracking down and trying to contain existing cases. Messonnier told reporters that she had sat her children down and, over breakfast, told them that while they weren’t yet at risk, “as a family, we need to be preparing for significant disruption in our lives.”

CDC officials had informed HHS officials in advance of the theme of Messonnier’s comments, and no one from HHS gave any indication immediately afterward that there was any problem. “Nobody thought the messages were wrong,” the official said. But Trump, watching from abroad in India, was furious at what he viewed as her alarmist rhetoric, which he feared would further tank the already gyrating markets.
posted by katra at 1:23 PM on March 7 [2 favorites]


Watching Trump's response to the coronavirus, I can't help but think that all of America is Puerto Rico right now.
posted by dances_with_sneetches at 2:19 PM on March 7 [10 favorites]


Earlier, I wrote this:
If you assume a greater-than-influenza infection rate in the US—say 20% which is high, but not as high as that earlier very worst case—and the upper end of 2% of my estimate of 1-2% case fatality rate, that results in 65 million people infected in the US, with 1.3 million fatalities, or 4%; 400 per 100,000. That's almost thirty times the flu. That is, by the way, approximately the same global mortality rate as the 1918 Spanish Flu. In my opinion, this is more realistically the worst case scenario. (Even if it were a whole order of magnitude more mild than that, it would still be three times worse than the flu.)
I couldn't shake the sense I'd made a rudimentary math error. And of course I did.

That calculation of 1.3 million fatalities (based on a 2% case fatality rate and 20% of the population infected) is a 0.4% mortality rate for the US, or 40 per 100,000. That's three times worse than influenza. It's about one-tenth that of the global mortality rate of the 1918 Spanish Flu.

Per that University of Bern estimate and in the range I'm seeing mentioned, somewhere between a one and two percent case fatality rate for the global population seems likely. Bern estimated 1.6%. That's better than the 2% estimate I used.

On the other hand, there's the question of the size of the portion of the population that will be infected (over this first year). For comparison, with acquired immunity and vaccination influenza infects perhaps 8% of the US population per year. Covid-19's should be a much higher number than that, assuming similar transmissibility, given there's no existing acquired immunity and no vaccine. I picked 20% for the above calculation, but even 50% is reasonable. (However, I think the China numbers, though they most likely represent the best case of containment, imply that it won't be that high for the global population.)

So, likely not as bad as my previous comment wrongly said, but still considerably worse than the flu. A case fatality rate in double digits for the elderly and those with compromised immune system is something to be alarmed about.
posted by Ivan Fyodorovich at 2:29 PM on March 7 [4 favorites]


Thousands held on cruise ship off US west coast as scientists say: ‘This is now a pandemic’ (Guardian)
The total number of cases of infections around the world has topped six figures and on Saturday stood at 105,479. The global death toll has reached 3,555. The World Health Organization (WHO) called the spread of the virus “deeply concerning”, but continues to resist describing the outbreak as a pandemic, to the fury of senior scientists.

Researchers say the virus that was first identified in China is now spreading freely in four regions, has reached every continent but Antarctica, and its advance seems unavoidable. “I think it’s pretty clear we’re in a pandemic and I don’t know why WHO is resisting that,” said Michael Osterholm, director of the Centre for Infectious Disease Research and Policy at Minnesota University. Devi Sridhar, a professor of global public health at Edinburgh University, agreed. This outbreak meets all the definitions for a pandemic, she said.
posted by katra at 2:35 PM on March 7 [2 favorites]


Italy set to quarantine whole of Lombardy due to coronavirus [Lorenzo Tondo, The Guardian, 3/7/2020]
Italian authorities announced that a new decree containing draconian measures would be approved later on Saturday. It will include the power to impose fines on anyone caught entering or leaving Lombardy, the worst-affected region, until 3 April. People may be allowed in and out for serious reasons. The decree provides for banning all public events, closing cinemas, theatres, gyms, discos and pubs. Religious ceremonies such as funerals and weddings will also be banned.

Rome is also considering prolonging the closure of schools across the country until 3 April, while major sporting events, such as Serie A football games, will be played behind closed doors.

The number of coronavirus cases in Italy leapt by more than 1,200 in a 24-hour period, the civil protection agency said on Saturday. It is the biggest daily rise since the outbreak began two weeks ago.
posted by MrVisible at 2:44 PM on March 7 [4 favorites]


The global death toll has reached 3,555. The World Health Organization (WHO) called the spread of the virus “deeply concerning”, but continues to resist describing the outbreak as a pandemic, to the fury of senior scientists.

Kind of a dumb story. "Senior researchers?" What senior researchers? Do they have names? What organizations do they work for? There are millions of "researchers" around the world.

WHO has already officially stated that they simply no longer use the word "pandemic." It is a subjective term that connotes no new information.
posted by JackFlash at 3:15 PM on March 7 [3 favorites]


If you have an understanding physician, you may be able to get them to adjust your prescription to be twice daily

This is what I did with my very nice doctor a while back, we changed up my prescription so that it is at the maximum I take every day, because as I said to her, I don't like freelance adjusting my meds, I want to be able to say I am following the prescription, especially since it's a restricted medicine. But I don't take that much most days, so I was able to build up a backup prescription's worth, which is important as periodically my formulation becomes unavailable.
posted by tavella at 3:17 PM on March 7 [1 favorite]


Family members of Kirkland nursing home residents decry response to coronavirus outbreak (Asia Fields, Daniel Gilbert, Mary Hudetz and Katherine Khashimova Long; Seattle Times)
Testing has been a central issue for many of the residents’ families, who said they had been told that only those exhibiting both fevers and respiratory issues would be considered for testing at the hospital.

Despite their frustration, many of the residents’ family members who have spoken out said they don’t blame the nursing home or its workers.

“While we believe that the Life Care Center has been ineffective, we do not believe that they are to blame,” Connolly said at the families’ news conference. “They should never have been left to deal with this outbreak unsupported,” particularly by the federal government.
posted by ZeusHumms at 4:21 PM on March 7 [2 favorites]


Nursing home showed few signs it prepared for virus outbreak (AP)
A team of federal and state regulators planned to visit Life Care on Saturday, a move that could lead to sanctions, including a possible takeover of its management. The team will look at the home’s practices, including infection control.

In an outbreak like this, “it’s not business as usual, so business as usual is not going to be OK,” said Dr. Mark Dworkin, an epidemiologist at the University of Illinois at Chicago School of Public Health. “There needs to be some sort of mobilization within the facility for enhanced adherence to procedures. Infection control and visitors logging in. These things need to be translated out across the country.”
As coronavirus quietly spread, a nondescript nursing home became the deadliest hot spot in the U.S. (WaPo)
Speaking on behalf of a group of families, Connolly demanded that everyone in the facility undergo testing for the virus. They worried that the new director, who had been on the job just a few weeks, was overwhelmed by the spreading crisis and needed more help from the government.

[...] Basham said the nursing home is monitoring staff and residents but has not been able to trace how the virus reached the facility. “While we would like to understand how the virus entered our facility, right now our focus is on working to ensure a safe environment for our residents, families and associates,” she said in a statement late Wednesday that called the staffers who kept showing up to work “heroic.”
posted by katra at 4:59 PM on March 7 [1 favorite]


More about the Life Center nursing home outbreak, also from the Seattle Times: Coronavirus cases may be higher than reported at Kirkland nursing home; 70 of 180 employees have COVID-19 symptoms.

26 residents there have died in the past two and a half weeks. 15 deaths are known to be COVID-19 cases, while 11 are still awaiting post-mortem test results. 70 of the 180 staff currently have symptoms and are self-isolating. 54 of the 120 current residents have been hospitalized, and another 6 have possible COVID-19 symptoms but are still at the nursing home.

“Officials announced Wednesday that all Life Care residents would finally be tested. Killian said the facility received its first batch of 45 test kits on Thursday, but that the tests are not all completed and that results have not yet come back. He said the nursing home needed more test kits, but did not specify how many.”

Meanwhile, two other elder care facilities in the Seattle area each have one confirmed case of coronavirus. One of them is just a few blocks from where I grew up and went to elementary school; my class used to visit the residents there sometimes.
posted by mbrubeck at 5:01 PM on March 7 [8 favorites]


The inability to test is a scandal considering that other countries have been able to ramp up much faster. But the situation in the US is that even if you take swabs, there isn't sufficient capacity to test them.

Some of this is due to the fragmented healthcare system in America. Because there are literally thousands of independent entities, there's no effective system to marshall the available resources. And further, there's no incentives for them to pitch in even if they have relevant resources. How many pathology labs are there that are not recruited into this testing effort? I would venture to say most of them are not.

Secondly--and we'll probably have to wait until the dust settles to really discuss this--there's a philosophical question about what testing is for. Is testing to assess individuals and their treatment protocol, or is there an aspect of testing that has to do with epidemiology. In the US, AFIK, this second component is mostly concerned with STIs and diseases that are stigmatized.

If there's a bright side to this, we might learn that individual-focused policies are not serving us well (and, FWIW, always favor the privileged) and start to move to a more socially-focussed set of policies. I'm not optimistic, but it's an opportunity to create positive change.
posted by sjswitzer at 5:02 PM on March 7 [7 favorites]


Possible the Whitehouse will actually be taking more than thoughts and prayers level action soon:
Coronavirus detected in attendee at CPAC meeting, which many White House officials attended less than two weeks ago - Washington Post
posted by Mitheral at 5:04 PM on March 7 [3 favorites]


The coronavirus person at CPAC shook hands with Matt Schlapp, who then later shook hands with... Donald Trump.
posted by Justinian at 5:19 PM on March 7 [9 favorites]


Coronavirus continues its rapid spread, confounding efforts by global leaders (WaPo)
The virus’s exact reach remains unknown. Late Saturday, the American Conservative Union announced that an individual who attended the Conservative Political Action Conference less than two weeks ago had tested positive for the virus. President Trump, Vice President Pence and a number of other top White House officials had appeared at the four-day event in Maryland.

White House press secretary Stephanie Grisham said neither Trump nor Pence was in “close proximity to the attendee," but ACU chairman Matt Schlapp told The Washington Post on Saturday that he himself interacted with the infected person at the event. The precise chronology could not be learned, but Schlapp did shake Trump’s hand on the stage on the last day of the conference.

[...] “I’m not concerned at all,” Trump said as he met with Brazilian President Jair Bolsonaro for dinner. He also indicated that his campaign rallies, which draws thousands of supporters to large venues nationwide, will continue, saying: “we’ll hold tremendous rallies."

The virus has now spread to at least 29 U.S. states and 99 countries, according to a Washington Post analysis. At least six U.S. governors have declared states of emergency. There are now more than 100,000 infected people in the world and 370 confirmed cases in the United States, where there have been at least 19 deaths.

[...] At a White House news conference Saturday, Health and Human Services Secretary Alex Azar and Food and Drug Administration Commissioner Stephen Hahn were unable to say how many Americans had been tested for the novel coronavirus. The two officials had figures only from the Centers for Disease Control and Prevention and public health labs, and said the CDC so far has tested 1,583 people, and that the CDC and public health labs combined have performed 5,861 tests so far. By comparison, South Korea has reported testing 10,000 people per day.
posted by katra at 6:02 PM on March 7 [2 favorites]


Probably things will change quickly when senior US politicians start testing positive.
posted by medusa at 8:06 PM on March 7 [1 favorite]


What does it mean if coronavirus is declared a pandemic? (Guardian, Feb. 25, 2020)
Prof Mary-Louise McLaws, an infection control expert who has worked as an adviser to WHO, said declaring a pandemic was not always clear-cut because it could depend on the modelling used, which may differ between the WHO and other health organisations. Ultimately, the WHO gets the final say. [...] “WHO do things for lots of reasons but part of the reason for declaring a pandemic, if they do declare one, would be to get the critical mass on board to take it seriously and not ignore symptoms, and to get the finances required to help tackle and control it,” McLaws said.

However, if declaring a pandemic triggers global panic, this can defeat the purpose of trying to raise awareness. [...] The director of infectious diseases and immunology at the Menzies Health Institute in Queensland Prof Nigel McMillan, said it was concerning to see media reports over-sensationalising what a pandemic might mean. “We don’t wish to induce panic food or petrol stockpiling, when for 95% of the population, this will be a mild cold,” he said.

But a pandemic would mean travel bans would no longer be useful or make sense and would alert health authorities that they need to prepare for the next phase. “This includes preparing our hospitals for a large influx of patients, stockpiling any antivirals, and advising the public that when the time comes, they will need to think about things like staying at home if ill, social distancing, avoiding large gatherings etc,” McMillan said.

McLaws said this might prove the toughest part for governments – encouraging people to change their behaviours, such as forgoing or cancelling large social events if they are sick.
posted by katra at 8:36 PM on March 7 [1 favorite]


I'm finding that my longstanding dislike of cruises is even stronger now.
posted by medusa at 8:47 PM on March 7 [5 favorites]


Regulations and Laws That May Apply During a Pandemic (CDC)
During a pandemic, certain legal authorities, policies and regulations may apply and serve as the foundation for the US Department of Health and Human Services (HHS) to respond.
Previously: WHO Pandemic Declaration
On June 11, 2009, the World Health Organization (WHO) signaled that a global pandemic of novel influenza A (H1N1) was underway by raising the worldwide pandemic alert level to Phase 6. This action was a reflection of the spread of the new H1N1 virus, not the severity of illness caused by the virus. At the time, more than 70 countries had reported cases of novel influenza A (H1N1) infection and there were ongoing community level outbreaks of novel H1N1 in multiple parts of the world.
The coronavirus outbreak hasn't been declared a pandemic by the World Health Organization, despite concerns it is spreading rapidly. Here's why. (Business Insider, Mar. 2, 2020)
Global health experts at the WHO have said that because containment measures have worked well in China and other spots around the globe where the disease has spread, COVID-19 isn't being called a pandemic just yet. That could change soon if more containment measures were to fail.

"WHO will not hesitate to describe this as a pandemic if that's what the evidence suggests," the WHO's director-general, Tedros Adhanom Ghebreyesus, told reporters in Geneva on Monday.
posted by katra at 8:48 PM on March 7


Official: White House didn’t want to tell seniors not to fly (Mike Stobe, AP)
The White House overruled health officials who wanted to recommend that elderly and physically fragile Americans be advised not to fly on commercial airlines because of the new coronavirus, a federal official told The Associated Press.

The Centers for Disease Control and Prevention submitted the plan this week as a way of trying to control the virus, but White House officials ordered the air travel recommendation be removed, said the official who had direct knowledge of the plan. Trump administration officials have since suggested certain people should consider not traveling, but they have stopped short of the stronger guidance sought by the CDC.

The person who spoke to the AP on condition of anonymity did not have authorization to talk about the matter. The person did not have direct knowledge about why the decision to kill the language was made.

In a tweet, the press secretary for Vice President Mike Pence, Katie Miller, said that “it was never a recommendation to the Task Force” and called the AP story “complete fiction.”

On Friday, the CDC quietly updated its website to tell older adults and people with severe medical conditions such as heart, lung or kidney disease to “stay home as much as possible” and avoid crowds. It urges those people to “take actions to reduce your risk of exposure,” but it doesn’t specifically address flying.
posted by ZeusHumms at 9:10 PM on March 7 [6 favorites]


Israel has closed its borders to non-residents from a bunch of countries. IIUC those nations actually include most European and Asian countries with direct flights to Israel, so the true list effectively includes places like Australia.
[Israel] was the first country to urge its citizens to refrain from international travel entirely because of the outbreak.

Israel on Wednesday barred entry to almost all non-residents of the Jewish state arriving from France, Germany, Spain, Austria and Switzerland.

Earlier that day, it had already ordered citizens and Israeli residents from the same countries into quarantine.

The measures come on top of restrictions previously imposed on arrivals from mainland China, Hong Kong, Thailand, Singapore, Macau, South Korea, Japan and Italy.

On Friday reports said Israel was considering barring entry to US citizens, and forcing Israelis returning from the US into quarantine. Foreigners from the UK and the Netherlands are expected to be denied entry next week.

I suspect they're going to hold off on banning travel from the US for fear of the reaction from certain quarters, but if they want to get any benefit from their quarantine they're going to need to be consistent.
posted by Joe in Australia at 9:38 PM on March 7


Americans divided on party lines over risk from coronavirus: Reuters/Ipsos poll (Reuters)
Democrats are about twice as likely as Republicans to say the coronavirus poses an imminent threat to the United States, according to a Reuters/Ipsos poll conducted this week.

And more Democrats than Republicans say they are taking steps to be prepared, including washing their hands more often or limiting their travel plans. Poll respondents who described themselves as Republicans and did not see the coronavirus as a threat said it still felt remote because cases had not been detected close to home and their friends and neighbors did not seem to be worried, either.

[...] About four of every 10 Democrats said they thought the new coronavirus poses an imminent threat, compared to about two of every 10 Republicans. [...] About half of Democrats said they are washing their hands more often now because of the virus, compared to about four in 10 Republicans, according to the poll. About 8% of Democrats said they had changed their travel plans, compared to about 3% of Republicans.

More than half of Republicans, about 54%, said they had not altered their daily routines because of the virus, compared to about 40% of Democrats.
posted by katra at 12:05 AM on March 8 [5 favorites]


It's a little weird that they are polling stuff like that. Pandemics do not respond to polling.

I also can't believe so many people might die because republicans are deluded and possibly evil idiots.
posted by Justinian at 12:07 AM on March 8 [2 favorites]


Or more accurately, until either they, a family member, friend, or neighbor become deathly ill, it’s too remote and abstract to care about or take serious preventative measures for themselves. (And when it does hit their own households, trust that in addition to feeling blind-sighted there will somehow be an argument blaming Obama, the Democrats, and/or undocumented people, refugees, etc). Which explains pretty much everything else on fire that Republicans refuse to address, from global warming to the expansion/preservation of civil rights to economic and health care reform.
posted by blue suede stockings at 4:11 AM on March 8 [7 favorites]


This isn't great.

AIPAC warns Congress that two conference attendees have coronavirus
The conference routinely attracts Congress members and their staffers, as well as top administration officials, including this year Vice President Mike Pence and Secretary of State Mike Pompeo.

Additionally, on the last day of the conference, AIPAC activists visit virtually every congressional office to lobby.
As I understand it, AIPAC is basically an office, a database, and a large (20,000+) annual conference. The idea is to emphasise to US politicians that support for Israel is popular, non-partisan, etc. I appreciate that some people here disagree! So as part of that conference, the AIPAC staff arrange for attendees from across their country to visit their congresspeople. Senators, particularly, are liable to be visited by many attendees. E.g., there was a report that Elizabeth Warren was visited by 250 of them, and that Bernie Sanders was, too.

Just because two (the number is now three) people in a large group were carriers doesn't mean that many others were infected, and I expect that anyone infected wouldn't have been contagious for some time. But if you wanted an example of a network effect where a small outbreak could rapidly become a very large one, you could do no better than to situate your initial patient in a large political conference whose members then go and shake hands with basically every politician, even ones who didn't attend.
posted by Joe in Australia at 5:41 AM on March 8 [3 favorites]


If I'm reading this report for plans for the Grand Princess right, they're going to evacuate the passengers and leave most of the crew quarentined on the ship. Unbelivable.

https://www.sfchronicle.com/bayarea/article/Virus-concerns-leave-thousands-stranded-off-coast-15113601.phpz
posted by joeyh at 7:06 AM on March 8 [2 favorites]


At Harvard forum, three who know warn of ‘most daunting virus’ in half a century (Andrew Joseph, Stat News)
“It’s the most daunting virus that we’ve contended with in half a century or more,” Michael Mina, an epidemiologist at Harvard’s T.H. Chan School of Public Health, said at a panel discussion (YT) Friday at Harvard’s Kennedy School of Government.
posted by ZeusHumms at 8:02 AM on March 8 [3 favorites]


You know, Trump coming down with the virus is about the most competent public messaging that he is capable of.
posted by dances_with_sneetches at 8:45 AM on March 8 [9 favorites]


If they weren't complete morons, leaders of the US government would have looked at what is happening in Iran, Italy, and France and realized that politicians are at risk because they interact with large numbers of people in close quarters and travel a lot.

But they are in fact complete morons.
posted by medusa at 9:11 AM on March 8 [7 favorites]


I suspect that Trump and others think flying private is safe, forgetting about things like still being in close contact with people who also have been in contact with many others and who will, yes, be breathing the same air and touching things.

Plus, this is the disadvantage of insisting science does mean anything: you start to believe it.
posted by lesbiassparrow at 9:17 AM on March 8 [2 favorites]


Federal Agencies Prepare for Coronavirus Disruptions (WSJ)
Federal agencies are preparing to deploy emergency plans to maintain essential services—from directing air traffic to delivering mail and making Social Security payments—as the novel coronavirus epidemic widened and the nation’s capital diagnosed its first case.

Some agencies are canceling nonessential travel. All are planning for widespread absences and making provisions for working remotely. Some workers, like food-safety inspectors, won’t have that option; the challenge will be keeping them safe and healthy.

The U.S. Postal Service has activated its pandemic flu preparedness plan, a spokesman said, and has local continuity plans across the country to ensure mail delivery will continue or resume quickly in areas affected by an outbreak. There is no evidence that Covid-19 may be transmitted via mail, Surgeon General Jerome Adams said last week.

[...] The Office of Personnel Management last week issued guidance recommending agencies begin to reduce nonessential travel and review continuity plans to ensure that as many employees as possible are allowed to telework. The GAO estimated in 2009 that almost 40% of federal employees might miss work during a pandemic because they fall ill, fear infection or must care for a family member.
posted by katra at 10:02 AM on March 8 [1 favorite]




The race to unravel the United States’ biggest coronavirus outbreak (Amy Maxmen, Nature*)
'As cases in Washington state soar, virologists are working around the clock to diagnose cases, reveal routes of transmission and test treatments.'
[*Nature is usually paywalled, but articles on COVID-19 are outside of it.]
posted by ZeusHumms at 10:07 AM on March 8 [2 favorites]


San Francisco Bans Non-Essential Public Gatherings At City Facilities For 2 Weeks (CBS SF)
The City and County of San Francisco has banned “non-essential group events” at any city-owned facilities for the next two weeks because of concerns about the spread of coronavirus, according to an order Saturday signed by the county’s top health officer.

[...] “This order is issued on the basis of scientific evidence and best practices as currently known and available to protect vulnerable members of the public from avoidable risk of serious illness or death resulting from exposure to coronavirus Disease 2019 (COVID-19),” according to the order signed by Tomas Aragon, health officer with the City and County of San Francisco. “The age, condition and health of a significant portion of the population of the City and County of San Francisco places them at risk for serious health complications, including death, from COVID-19,” coronavirus.

[...] “Non-Essential Group Event” is defined as “any congregation of 50 or more people for any social, cultural, entertainment, or other special event or other non-essential purpose where people are not separated by physical space of at least four feet (which is slightly longer than an average arm’s length).”
WHO praises Italian lockdown of the north to stop virus spread (WaPo)
The World Health Organization is praising Italy for its “genuine sacrifices” after the country announced it would greatly restrict movement across its northern regions to contain its coronavirus outbreak.

“The government & the people of Italy are taking bold, courageous steps aimed at slowing the spread of the #coronavirus & protecting their country & world,” WHO Director General Tedros Adhanom Ghebreyesus said in a tweet on Sunday.

Italy overnight announced it would lock down three broad sections of the north, encompassing 85 percent of the country’s total coronavirus cases. As of Sunday afternoon, there was still plenty of confusion about how the measures would be carried out or enforced.
posted by katra at 10:09 AM on March 8 [3 favorites]


Leaked coronavirus plan to quarantine 16m sparks chaos in Italy (Guardian)
Thousands tried to flee south after decree to confine people until 3 April was revealed
posted by ZeusHumms at 10:22 AM on March 8 [3 favorites]


Even as behavioural researchers we couldn’t resist the urge to buy toilet paper (Liam Smith and Celine Klemm, Guardian OpEd)
There are at least three factors driving our response – scarcity, social proof, and regaining a sense of control. It’s scary how strong these influences are on our behaviour. Stockpiling is not needed, yet we still have the urge to do it. As behavioural researchers, we intimately know the forces acting on us, yet we’re helpless to resist them.
posted by ZeusHumms at 10:25 AM on March 8 [7 favorites]


‘We still have darkness’: the town [Austin, Indiana] where an HIV outbreak occurred under Mike Pence (Josh Wood, Guardian)
Public health experts who offered recommendations on combatting the HIV outbreak in Indiana have questioned whether Pence can put evidence ahead of his own beliefs.

In combatting Covid-19 “we need a leader who is not only data-driven, but somebody who understands evidence – and somebody who can communicate it. Neither one of those things is in Mike Pence’s skillset,” said Beth Meyerson, the co-director of Indiana University’s Rural Center for Aids/STD Prevention.
posted by ZeusHumms at 10:29 AM on March 8 [3 favorites]


You know, Trump coming down with the virus is about the most competent public messaging that he is capable of.

Ironically it's harder to imagine a more suitable vector for transmission than a series of Trump rallies. People who've come from and will be returning to a wide area packed in shoulder to shoulder with people who are touring around the country shaking hands with everyone they meet. The Olympics maybe because of the international aspect and all the fluid exchanges.
posted by Mitheral at 10:38 AM on March 8 [4 favorites]


"Thousands tried to flee south after decree to confine people until 3 April was revealed"

This is the kind of thing I expect to happen with regional quarantines in democracies. Of course the plans will be leaked to the press. Of course people will selfishly try to leave the quarantined area. I think that China's successful containment is not going to be easily repeated.

I noticed last evening when the first case here in Kansas City appeared on the Johns Hopkins site. This morning there's one in St. Louis. Covid-19 had been largely restricted to the coasts, but the rest of the map is filling in. The case here is a fiftysomething woman who had traveled to the "northeast US", got symptoms, and self-isolated. That's good, but where there's one case there are others.

The one very large metro area in the US that hasn't reported any cases yet is DFW, which seems odd.

Though tentative, this study indicates that while the case fatality rate for children is very, very low, they are being infected but experience mild symptoms. That they are infected at rates similar to other groups is significant in terms of containment.
posted by Ivan Fyodorovich at 10:54 AM on March 8 [2 favorites]


Gates-funded program will soon offer home-testing kits for new coronavirus (Sandi Doughton, Seattle Times).
Testing for the novel coronavirus in the Seattle area will get a huge boost in the coming weeks as a project funded by Bill Gates and his foundation begins offering home-testing kits that will allow people who fear they may be infected to swab their noses and send the samples back for analysis.

Results, which should be available in one to two days, will be shared with local health officials who will notify those who test positive. Via online forms, infected people can answer questions about their movements and contacts, making it easier for health officials to locate others who may need to be tested or quarantined, as well as to track the virus’ spread and identify possible hot spots.

Initially, the lab will be able to conduct about 400 tests a day, eventually expanding to thousands of tests a day, said Scott Dowell, leader of coronavirus response at the Bill & Melinda Gates Foundation.
More about the research group running the tests:
The initiative grew out of the Seattle Flu Study, a 2-year-old research project based at the University of Washington to track the spread of infectious diseases like influenza. Funded with $20 million from Bill Gates’ private office, the project recruited thousands of volunteers and sent them self-test kits. The focus has now shifted entirely to the new coronavirus, using similar methods to aid the public-health response.

The Seattle Flu Study already has contributed greatly to the understanding of COVID-19, the respiratory disease caused by the new coronavirus. As the outbreak started in China, the scientific team, co-led by Dr. Helen Chu, an infectious-disease specialist at UW Medicine, quickly developed a genetic test for the virus, similar to one they used for flu.

A physician who knew about the work sent in a sample from a teenage patient suspected of having the disease, and the lab was able to identify what was only the second case in the state at that time.
One of the reasons we knew about the community spread in Seattle earlier than anywhere else is that, as a research lab, the Seattle Flu Study was able to confirm the first case without going through the CDC with its restrictions on testing.
posted by mbrubeck at 10:58 AM on March 8 [11 favorites]


Trump's immigration policies may put people at risk of coronavirus – experts (Guardian)
Since 2017, Donald Trump has pushed a hardline immigration agenda that has sown confusion, fear and distrust among immigrant communities. Now, as the world deals with a public health emergency in the shape of the coronavirus outbreak, experts worry his immigration policies may put everyone at risk. There is a widespread fear that the president’s policies have sown such fear of deportation and wariness of any contact with US authorities among immigrants – who also have greater difficulty getting healthcare – that many of them will not seek help if they fall sick with the virus.

[...] Medical treatment and healthcare facilities are supposed to be “sensitive locations”, exempt from most immigration enforcement actions. But that has been undermined as reports from around the country have indicated Ice officers arrested or questioned people at or near hospitals. Last month, Ice brought a man in handcuffs out of a Brooklyn hospital after agents tasered and shot another person who tried to intervene in his arrest.

[...] It’s too soon to know how these trends will influence whether immigrants get screened or treated specifically for coronavirus, experts say, though some believe there’s cause for concern.

“If it hits the immigrant communities, I mean, I’m just sure that some people will not go to the hospitals because of fear of being deported and being separated from their loved ones,” said Ally Bolour, a Los Angeles- based immigration attorney who’s on the American Immigration Lawyers Association’s board of governors. “This is a national health emergency crisis. The government needs to come out, and just be out, and say, ‘We’re not going to deport you,’” Bolour said. “‘If you’re sick, come on in. We’ll take care of you.’ I mean, nobody’s saying any of that.”

[...] “If it goes into the detention facilities, it just boggles the mind how it’s gonna be handled. Because right now they can’t even handle, like, measles,” Bolour said. “So, imagine that to an extent of coronavirus where a lot of people are gonna get really, really sick very, very quickly, and they need to be isolated. Where?”
posted by katra at 10:59 AM on March 8 [8 favorites]


Health officials shift tone on coronavirus, say elderly and sick at risk (Politico)
The government's top infectious disease expert on Sunday said that the coronavirus outbreak is getting worse and warned elderly and sick people to think twice before traveling or circulating in crowds.

The remarks from Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, signaled a change in tone from health officials representing the Trump administration, making it clear that the outbreak is past the point where it can be prevented from spreading or easily tracked. That contrasted with the more measured language from some Trump officials including Vice President Mike Pence.

[...] "If you get infected, the risk of getting into trouble is considerable, so it’s our responsibility to protect the vulnerable," Fauci said on NBC's "Meet the Press." "When I say protect, I mean right now, not wait until things get worse, say 'no large crowds, no long trips, and above all, don’t get on a cruise ship.'" Fauci noted many of the newly confirmed cases showed signs of “community spread,” meaning they couldn’t be traced back to a single source and suggesting the outbreak is intensifying.

[...] Former Trump FDA commissioner Scott Gottlieb predicted the coming weeks will "change the complexion in this country," adding that lockdowns of certain states or cities "are going to need to happen" or health systems will get exhausted and fatalities will rise quickly.

"We have a narrow window of opportunity to implement tough measures to try to push down the scope of the epidemic," Gottlieb said on CBS' "Face the Nation," adding Americans are probably looking at two months of "difficulty" as the virus rapidly spreads the way it did in Italy and South Korea.
posted by katra at 12:13 PM on March 8 [1 favorite]


Once again I come back to the incredibly fragmented healthcare system in the US and how that has prevented efficient marshalling of resources to deal with the crisis. There are literally tens of thousands of separate entities operating at cross purposes to each other. There are so many testing labs that have the resources and equipment to be testing for the virus, but they are not being brought into the effort. The US response has been a scandal.

If anything good comes out of this looming disaster, it should be that having a coordinated national healthcare system is not optional. If this is not an argument for Medicare For All, nothing is.
posted by sjswitzer at 12:29 PM on March 8 [7 favorites]


If this is not an argument for Medicare For All, nothing is.

Nothing is. I'm seeing people say things like, Good thing this epidemic isn't being managed by lazy government workers like the clerks at the post office!
posted by medusa at 12:58 PM on March 8 [5 favorites]


Ivan F, calling China's massive quarantine experiments successful seems premature. And I am troubled by praise for China's actions -- their quarantines created sacrifice zones and sacrificial populations, migrant workers and patients with other illnesses.

Global narratives of China's action focus on their claims of decisive and effective action, with a whiff of wistfulness for such sweeping powers, without sufficient discussion of the immense costs or consideration for how effective such quarantines are. For example, this January 27th China Media Project report by a Wuhan journalist slammed the Chinese government for quarantine as security theater, given that government inaction and censorship allowed the virus to spread for months, and an estimated 1 million people left Wuhan before the quarantine cordon came down (not to mention there was an 8 hour gap between the quarantine announcement and implementation).
posted by spamandkimchi at 1:11 PM on March 8 [8 favorites]


Oh, I agree. I'm mostly responding to the sense I get from the media that people see China's containment very positively, as if that bodes well for everyone else. But I don't think any other large country could manage what they did. And, as you say, even if they do, it comes at great cost and it's very uncertain that the containment will stand.
posted by Ivan Fyodorovich at 2:24 PM on March 8 [1 favorite]


Bruce Aylward has been pointing out that China's response had two facets: 1) basic public health -- testing, contact tracing, and social distancing, and 2) harsh lockdowns and movement restrictions when (1) had been started too late. He basically says we should stop half-pining after draconian powers because that's not what really mattered.

Plenty of carriers did get out of Hubei and seed community transmission in the rest of China. And the rest of China was not shut down, but they had enough testing capacity and used it to screen and test contacts and isolate individual infected people rather than whole populations.

NPR interview:
But Aylward says other countries may be taking the wrong lesson from China by attributing its success to the government's unprecedented restrictions on daily life in several cities, most famously Wuhan, the city of 11 million people where the outbreak began.
[...]
"China has 31 provinces, thousands of cities," notes Aylward. "And it was only a few cities where they took those draconian measures. In the vast majority of them, they ... really went back to fundamentals of public health."

These included ensuring that there was enough testing capacity to quickly identify cases, isolating infected patients, tracing anyone who had contact with them and, when necessary, placing those contacts in quarantine facilities so they wouldn't get infected by the sick person or spread the disease further. Also, in places where clusters of cases were emerging, authorities prohibited mass gatherings.

"That's how they stopped it in the areas with over 1.3 billion people," says Aylward. "We spent two weeks on the ground looking at the data. Every other province [beyond Hubei, where Wuhan is located] had hundreds, if not thousands, of cases, not unlike the situation you see in European countries or in the U.S. These are massive provinces with tens and even a hundred million people in them."

In short, Aylward says, "it wasn't a lockdown everywhere. That's the wrong way to portray China's approach to the disease. And that's leading to some fundamental confusion and failure to do the right things."
posted by away for regrooving at 2:34 PM on March 8 [9 favorites]


tl,dr if your conditions allow exponential growth of infection, then only perfect containment protects you, and it's too late for that.
posted by away for regrooving at 2:40 PM on March 8 [2 favorites]


Even if this disease is destined to break out, as it appears to be, then the rate of growth still matters because (1) it could help keep healthcare systems from being overwhelmed and (2) the later the peak occurs, the more we'll know how to manage it.
posted by sjswitzer at 2:51 PM on March 8 [5 favorites]


Scott Gottlieb, Trump's former FDA commissioner, predicted the coming weeks will "change the complexion in this country"

please tell me this was just a transcription error and not the creepiest/ominous freudian slip of all time.
posted by mostly vowels at 2:56 PM on March 8


Changing the complexion of a situation is a commonly used phrase meaning to change the character of something. It does not refer to race. And particularly for a medical professional, the term complexion comes from Latin and pertains to the old idea of the balance of the four humors affecting health.
posted by JackFlash at 3:05 PM on March 8 [4 favorites]


Thanks JackFlash, that's news to me.
posted by mostly vowels at 3:10 PM on March 8


Health agencies’ funding cuts challenge coronavirus response (WaPo)
Since the coronavirus reached U.S. soil, thousands of local health officials across the country have been working nonstop and scrambling to prepare. [...] When an outbreak hits, public health departments are America’s front line of defense. They investigate the infected and trace their contacts with other people, take passengers’ temperatures at the airport, harangue the public to wash their hands. They advise local leaders on whether to cancel school, and they find facilities to isolate the sick from the healthy.

In the unfolding war against the coronavirus, they are already hamstrung — decades of budget cuts have left many local departments without the staff, equipment or plans to mount an adequate response. Local health departments say they’re already pulling employees from critical efforts such as opioid abuse prevention. A sudden burst of new cases could force them to choose where to divert resources and possibly endanger the public, experts said.

[...] Local public health agencies have lost almost a quarter of their overall workforce since 2008 — a cut of almost 60,000 workers, according to national associations of health officials. The agencies’ main source for federal funding — the Centers for Disease Control and Prevention’s emergency preparedness budget — has been cut 30 percent since 2003. “The biggest cuts came during the last recession, and while other parts of government were restored over time, public health never was,” said John Auerbach, who worked on health policy for Boston, the state of Massachusetts and the CDC. Instead, over the past decade, local health departments have seen annual rounds of cuts, punctuated with one-time splurges in the wake of crises like outbreaks of Zika, Ebola, measles and hepatitis. That short-term funding quickly dries up and does nothing to address the long-term problems of preparedness. “One-time, emergency money is great, but it’s not how you hire the right people or get the right supplies for future crises,” said Auerbach, who now leads the nonprofit Trust for America’s Health. “A forest fire is not the right time to start hiring firemen and buying firetrucks and equipment. It’s too late.”

[...] Crucial support came Wednesday when Congress passed an $8.3 billion emergency spending bill to combat the coronavirus. Roughly $950 million will help pay for an array of local response activities, including lab testing and infection control, and will reimburse state and local agencies for some of the work they’ve already done. But it could take months for that money to filter from the Department of Health and Human Services to CDC to states and finally to counties. In the wake of national disasters, some counties pointed out, federal reimbursement sometimes takes as long as three years to reach them.
posted by katra at 7:24 PM on March 8 [7 favorites]


Social Distancing Is New Coronavirus Buzz Phrase. Does It Work? (WSJ)
The concept of social distancing has been around for centuries, but its usefulness was bolstered after a landmark study in 2007, in the Journal of the American Medical Association, comparing how 43 different American cities fared during the Spanish flu pandemic of 1918. The researchers found that acting early with steps like quarantining the sick, closing schools and canceling public gatherings was associated with fewer deaths. Imposing several measures at once also helped. One of the slow responders, Philadelphia, suffered twice the death rate of St. Louis, where officials moved quickly. “Social distancing and quarantine is an ancient practice that has been tried and tested through the ages and has survived because it works,” said Osman Dar, a global health-systems expert at Chatham House, a U.K. think tank. “In the face of an unknown virus or illness it is the most effective means of interrupting and slowing transmission.”

Implemented too late, however, social distancing might be ineffective. [...] Another challenge: There is no clear consensus on the right moment to start with social distancing. “Hitting that sweet spot is very, very hard,” said Howard Markel, director of the Center for the History of Medicine at the University of Michigan, who led the 43-city study and was involved in the school-district research. “You’re getting your information a step or two behind the microbe’s spread. Early is better but you do risk being too early and costing a great deal of money.”

While it is widely accepted by global health experts that social distancing, when implemented early enough, limits death from serious infectious diseases, it is less clear whether it brings down the overall caseload. Still, simply spreading the cases out over a longer period—known by epidemiologists as “flattening the curve”—is valuable because it prevents a surge of patients from overwhelming clinics and hospitals.
posted by katra at 8:04 PM on March 8 [2 favorites]


Canada to repatriate citizens on coronavirus-hit cruise ship in California (CBC News).
Canada has secured a plane in its effort to repatriate Canadians on board the coronavirus-hit Grand Princess cruise ship which is currently quarantined off the coast of California, Global Affairs said in a statement on Sunday.

"The plane will bring passengers from San Francisco to Canadian Forces Base Trenton, after which they will be assessed and undergo a 14-day quarantine," the statement read.
posted by ZeusHumms at 8:46 PM on March 8 [2 favorites]


A California man who self-quarantined after returning home from China amid the coronavirus outbreak said he is '100x more concerned' for his health in the US than he was in China (Katie Canales, Business Insider)
A Bay Area resident visited Kunming, in China's Yunnan province — about 1,000 miles southwest of Wuhan, where the coronavirus outbreak originated — on January 25.

He said that he saw more safety precautions being taken in China than in the US and that officials understood the gravity of the situation.

Seeing how differently the Chinese and US governments handled the outbreak convinced him that he felt safer in China than he does on American soil.
posted by ZeusHumms at 8:55 PM on March 8 [4 favorites]


And in lovely Ireland nothing will stop the Paddy Day Parades, feckin' eejits! Can only hope that Leo Vradeker's bowl of Irish Shamrock tradition gift to trump is a petri dish! How are they going to sterilise a living plant??
posted by Wilder at 3:31 AM on March 9


Republican congressperson Ted Cruz has voluntarily entered quarantine, as has antisemitic Republican congressperson Paul Gosar and his staff (who should make better choices). This is apparently due to contact with an infected person at CPAC.

Israel is expected to close its borders to all non-residents and require all returning residents to enter quarantine. It's just one month until Passover, when many Jewish families get together and Jewish students return from abroad; in Jewish terms this is basically like cancelling Thanksgiving would be in the USA.

Weirdly, I know less about the situation here in Australia than I do about the situation in Israel. Infected people are being advised to self-quarantine, but the initial stages can be so mild that at least one doctor didn't realise he had it. I suspect we're at the same stage the US is in, with a certain amount of undiagnosed community transmission taking place, and things will explode in a week or so. I hope I'm wrong.
posted by Joe in Australia at 4:09 AM on March 9 [1 favorite]


If people are open to it, could we switch new comments and updates to the other coronavirus thread (on real time visualization) so there is just one active thread for discussion?
posted by medusa at 6:27 AM on March 9 [1 favorite]


I'm confused as to what should go where.
posted by Joe in Australia at 6:30 AM on March 9 [2 favorites]


What is the other thread please? There’s a few about Covid
posted by affectionateborg at 7:29 AM on March 9


The other thread is about visualization. I think this thread is more suited for general news.
posted by janell at 7:54 AM on March 9


Other COVID-19 threads on the blue: real-time visualisations, private chat rumor mills, collection of resources; on the green: best info sources; on the grey: check-in threads 1 and 2.
posted by progosk at 8:07 AM on March 9 [7 favorites]


This does seem like it would be a good situation for a megathread. Although people might just spend 500 comments relitigating the swine flu outbreak of 1976.
posted by Not A Thing at 8:17 AM on March 9 [3 favorites]


Yep, no megathreads. Make do with what is here please.
posted by jessamyn at 8:35 AM on March 9 [1 favorite]


> Ireland nothing will stop the Paddy Day Parades

It's just been announced as canceled in Dublin, Waterford, and Cork.

Also don't forget this lovely remix / psa of Blindboy's latest.
posted by mrzarquon at 9:12 AM on March 9 [4 favorites]


Ok, but is it maybe time to collect the current threads and put them in the sidebar?

I don't know if katra posted this one already, but worldometers has this page of coronavirus statistics that's apparently being updated in real-time.

Is it just me or did the media make a big pivot away from the virus itself and onto its effects on the stock market? Hopefully we won't see editorial censorship in the service of capitalism making the whole situation worse, but I am not hopeful. Ugh.

Also, when the hell did Ted Cruz get into Wolverine cosplay?
posted by sexyrobot at 9:14 AM on March 9 [3 favorites]


Another open COVID-19 thread on the Blue: You’re only as healthy as the least-insured person in society (coronavirus vs. public policy).
posted by mbrubeck at 9:23 AM on March 9 [1 favorite]


I don't know if katra posted this one already

I don't think so, but I am trying to corral threads and resources onto the MeFi Wiki Disaster Planning & Recovery page in the Medical/Pandemic section.
posted by katra at 10:22 AM on March 9 [3 favorites]


Why CNN is calling the novel coronavirus outbreak a pandemic (Dr. Sanjay Gupta, CNN)
Starting today, you will notice that CNN is using the term pandemic to describe the current coronavirus outbreak. It is not a decision we take lightly. While we know it sounds alarming, it should not cause panic. So why now? The World Health Organization hasn't called the coronavirus outbreak a pandemic. Nor has the US Centers for Disease Control and Prevention. But many epidemiologists and public health experts argue the world is already experiencing a pandemic because of the novel coronavirus.

[...] The specific criteria for a pandemic are not universally defined, but there are three general criteria: a virus that can cause illness or death; sustained person-to-person transmission of that virus; and evidence of spread throughout the world. The CDC says a pandemic is "an epidemic that has spread over several countries or continents, usually affecting a large number of people," while an epidemic is "an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area."

In late February, CDC's Dr. Nancy Messonnier said, "The fact that this virus has caused illness -- including illness that has resulted in death -- and sustained person-to-person spread is concerning. These factors meet two of the criteria for a pandemic." "As community spread is detected in more and more countries, the world moves closer towards meeting the third criteria: worldwide spread of the new virus." [...] While there may be areas of the United States where coronavirus is more easily contained, the CDC says it's likely that widespread transmission of the virus will occur in the United States.

[...] Now is the time to prepare for what may be ahead. That could mean quarantines, closed schools and cancelled events in your town. It might mean strain at work or taking a break from hobbies that usually bring you joy. It might mean putting off a family vacation or catching up over the phone instead of getting together.

Humanity has overcome pandemics before. In this globally connected world, we may be asked to add more social distance between each other, but that doesn't mean we can't still collectively come together as a nation and as a world. This is a crisis we can overcome if we can work together.
posted by katra at 11:24 AM on March 9 [2 favorites]


CDC warns against long plane trips and cruises as coronavirus cases mount (Politico)
New guidance from the CDC urges travelers, especially the elderly and those with compromised health, to avoid long plane trips “and especially” cruises — a stark shift in rhetoric from an administration that had previously appeared reluctant to discourage Americans from moving around the globe.

The CDC now recommends that travelers “defer all cruise ship travel worldwide” and notes that “cruise ship passengers are at increased risk of person-to-person spread of infectious diseases, including COVID-19.” The State Department on Sunday also recommended against cruise travel, citing an increased risk of coronavirus infection, and issued a warning that citizens should not rely on repatriation flights "as an option for U.S. citizens under the potential risk of quarantine by local authorities.”

The new CDC guidance, coupled with the State Department warning, suggests a seismic shift coming for the cruise industry in particular, which depends heavily on American tourists, and disproportionately older ones.
posted by katra at 2:05 PM on March 9


Don’t Panic: The comprehensive Ars Technica guide to the coronavirus (Beth Mole, Ars Technica)
This is a rapidly developing epidemic, and we will update this guide every day at 3pm EDT to keep you as prepared and informed as possible.

March 8: Initial publication of the document.
March 9, 3pm ET: Added three new question-and-answer sections and updated case counts.
Fairly straightforward.
posted by ZeusHumms at 2:20 PM on March 9 [3 favorites]


watching camera in white house press room as journalists await a briefing. awful lot of face touching going on in there. somewhat less coughing.
posted by 20 year lurk at 2:57 PM on March 9


If the number of reported confirmed cases of #COVID19 continues to slow down, the 2% fatality rate people have been quoting will appear to rise. But it will be a statistical illusion. Let me explain why....

Adam Kucharsk is a mathematician at the London School of Hygiene & Tropical Medicine, and he uses math to understand outbreaks of diseases like Ebola, SARS, influenza and now Covid-19.

An NYT interview with Kucharski: The Coronavirus, by the Numbers. In it he discusses R0 as well as why the first death from the virus in a particular region is significant.
posted by storybored at 5:43 PM on March 9 [3 favorites]


I'm finding that my longstanding dislike of cruises is even stronger now.

Likewise.

The Great Lakes used to have a lively cruise scene two generations ago. In 1949 the S.S. Noronic caught fire at the pier in Toronto, with over 100 deaths. It spelled the end to Great Lakes cruising. If COVID-19 sinks (as it were) the ridiculous excesses, the massive environmental impact, the general tackiness of cruise ships, no tears will be shed here.
posted by ricochet biscuit at 7:51 PM on March 9 [3 favorites]


On WA outbreak, genomic data suggests "large majority of current cases in WA derive from a single introduction event" and that it is genomically linked with the Grand Princess Cruise cases.
posted by spamandkimchi at 7:55 PM on March 9 [1 favorite]


American Enterprise Institute is now tracking nationwide (U.S.) COVID-19 testing capacity. As of 3 hours ago, a capacity of 7870 tests per day (If I am reading this correctly).
posted by spamandkimchi at 8:01 PM on March 9 [1 favorite]


The American Enterprise Institute is a right-wing think tank, and while I don't have any reason to think their numbers are wrong, I would assume that anything they say comes with an agenda. I'd rather get information from someone else.
posted by ArbitraryAndCapricious at 8:04 PM on March 9 [4 favorites]


AAC, I hear you on the AEI skepticism. Scott Gottlieb seems to have credibility among the epidemiologists I follow (e.g. Angie Rasmussen) so I decided to share anyway. CDC has testing data, but not current lab capacity.
posted by spamandkimchi at 8:18 PM on March 9 [1 favorite]


Epidemiologist @AntheaKatelaris
Here's a pre-print from me, @CraigBDalton & co. If you're short on time, the title sums it up: 😁
Pre-Emptive Low Cost Social Distancing and Enhanced Hygiene Implemented before Local #COVID19 Transmission Could Decrease the Number and Severity of Cases. https://tinyurl.com/rspb9xq
posted by spamandkimchi at 8:29 PM on March 9 [2 favorites]


WHO says threat of pandemic 'very real' (Guardian)
The World Health Organization warned Monday “the threat of a pandemic has become very real,” but stressed the virus could still be controlled. The WHO defines a pandemic as a situation in which “the whole world’s population would likely be exposed to this infection and potentially a proportion of them fall sick,” Michael Ryan, who heads the WHO’s emergencies programme, has said.

Infections worldwide have passed 110,000.

But he stressed, “even if we call it a pandemic, still we can contain it and control it.

“It would be the first pandemic in history that can be controlled,” he said. “We are not at the mercy of the virus.”

He pointed out that the situation varied widely in the 100-odd countries that have so far registered cases, with 93% of all cases being located in just four countries.

“Whether it is pandemic or not, the rule of the game is the same: never give up,” he said.
posted by katra at 8:39 PM on March 9 [1 favorite]


Guardian: "The Seattle-area nursing home at the epicenter of one of the biggest coronavirus outbreaks in the United States said on Monday it had no kits to test 65 employees showing symptoms of the respiratory illness that has killed at least 13 patients at the long-term care center, Reuters reports.
The staff in question, representing more than a third of the Life Care Center’s 180 employees, are out sick with symptoms consistent with coronavirus, and a federal strike team of nurses and doctors is helping to care for 53 patients remaining in the center.

With the facility in the Seattle suburb of Kirkland accounting for more than half of the known U.S. coronavirus deaths, and all its patients tested, it was unclear why Life Care lacked diagnostic kits for staff, even as the University of Washington offered to process test samples for them.

Twenty-six of 120 patients who were residing at the nursing home as of Feb. 19 have since died, with 13 of 15 autopsies carried conducted to date confirming coronavirus was the cause, Life Care officials said on Monday.

Among 53 residents still in the facility as of Monday, results for 31 out of 35 tested have so far come back positive for the coronavirus, they said.
posted by katra at 8:41 PM on March 9


They're testing so many people that they have not even tested Trump yet after his exposure.

https://www.reuters.com/article/us-health-coronavirus-trump-testing/trump-has-not-been-tested-for-coronavirus-white-house-idUSKBN20X06F
posted by joeyh at 8:56 PM on March 9 [1 favorite]


Some Hospitals Are Close to Running Out of Crucial Masks for Coronavirus (NYT)
As hospitals around the country prepare for an influx of highly infectious coronavirus cases, their supplies of a crucial type of respirator mask are dwindling fast. [...] With global supplies already depleted from the outbreak in China and manufacturers facing an explosion of new orders as the virus spreads, some hospitals in the United States have been unable to get new shipments of N95 masks or even an estimate of when they might become available.

[...] “It’s not just about the patients identified as having the virus,” said Dr. Wendy Armstrong, another infectious disease specialist at Grady, who is more accustomed to using N95 masks to evaluate patients who might have tuberculosis. “It’s also about the people you are evaluating to rule out the virus, and the testing is not instant.” Protecting health care workers from the virus is essential to managing the epidemic, to ensure hospitals, urgent care centers and other facilities can handle inevitable surges in sick patients. A number of doctors and nurses around the country have already been quarantined for two weeks after patients they interacted with tested positive for the virus; health care workers in China have gotten sick and even died amid extreme shortages of masks and other protective gear.

The federal government’s Strategic National Stockpile of medical supplies includes 12 million medical-grade N95 masks and 30 million surgical masks — only about one percent of the 3.5 billion that the Department of Health and Human Services estimates would be needed over the course of a year if the outbreak reaches pandemic levels.

[...] Dr. Ray of Grady Hospital said doctors there and at a number of other hospitals she had been in contact with were also concerned about running low on regular medical masks, to the point where Grady, one of the nation’s largest and busiest public hospitals, had made them harder to access. “Health care workers, visitors — if someone sees masks, they are grabbing and taking them,” she said. Under the new rules, she said, “If people need them, they’ll have to ask.”
posted by katra at 9:21 PM on March 9


The Trump Administration Is Stalling an Intel Report That Warns the U.S. Isn’t Ready for a Global Pandemic
The final draft of the report remains classified but the two officials who have read it say it contains warnings similar to those in the last installment, which was published on January 29, 2019. The 2019 report warns on page 29 that, “The United States will remain vulnerable to the next flu pandemic or large-scale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support.”
posted by Mitheral at 9:23 PM on March 9 [2 favorites]


U.S. Health Experts Say Stricter Measures Are Required to Limit Coronavirus’s Spread (NYT / MSN)
As the coronavirus spread to two-thirds of the states, Americans began to grasp the magnitude of the threat facing them. The weekend’s case tally ballooned, veering toward nearly 600 cases and close to 20 deaths. [...] Federal public health officials also signaled that the degree of community spread — new cases popping up with no known link to foreign travel — indicated that the virus was beyond so-called containment in some areas and that new, stricter measures should be considered.

It’s a concept in public health known as shifting from containment of an outbreak to “mitigation,” which means acknowledging that the tried-and-true public health measures of isolating the sick and quarantining their contacts are no longer enough. So steps must be taken to minimize deaths from the disease and to slow its spread so that hospitals are not overwhelmed.

[...] No one in the United States wants to use the word “lockdown,” in the manner of what Italy is doing in its northern regions to try to control the spread of the disease. But the specter of isolation — of telling people in affected areas not to go out — is hovering in big cities where the infection has taken hold.

[...] The greatest concern is for older people, particularly those who have underlying conditions like diabetes, heart disease, lung problems and weakened immunity. “Don’t go to crowded places, think twice before a long plane trip, and for goodness sake don’t go on any cruises,” Dr. Fauci said. For people who are particularly vulnerable, he said: “Don’t wait for community spread. Now is the time to do social distancing, whether there is spread in your community or not.” If community spread has already started, as in Seattle, he said, everyone should practice social distancing.
posted by katra at 9:27 PM on March 9 [1 favorite]


I suspect we're at the same stage the US is in, with a certain amount of undiagnosed community transmission taking place, and things will explode in a week or so. I hope I'm wrong.

And here we go, that was quick:
Victorians warned to brace for 'extreme' coronavirus response
Victorians have been warned authorities will take "extreme" and unprecedented action to try to control coronavirus, with schools to be closed, sporting events cancelled and whole sectors of the workforce told to stay home.

Premier Daniel Andrews said on Tuesday that any hope of containing the outbreak in the state was now gone and the pandemic phase of the crisis was now inevitable. [...]
It's worth reading the article; it's so refreshing to read something sensible from a politician. On the other hand, we're holding a Grand Prix next week and 300,000 people are expected to attend. Put it off? Hold it without spectators? Don't be silly:
‘No chance’ of Australian Grand Prix going behind closed doors – organisers
posted by Joe in Australia at 3:06 AM on March 10 [2 favorites]


Harvard is basically suspending all classes (moving them online) and telling students not to return from Spring Break.

As others have pointed out on Twitter, given that they have the advice of the School of Public Health, and Medical School, to rely upon, this is...worrying.
posted by vacapinta at 7:03 AM on March 10 [2 favorites]


given that they have the advice of the School of Public Health, and Medical School, to rely upon, this is...worrying.

I think it's a relief to see people behaving rationally. Harvard would certainly have a pandemic on campus and they're not set up to deal with it. Nobody else is either, but at least Harvard won't be the ones responsible for exposing their students to the virus.

Lots of other institutions are also turning to online education, and I really don't think they're going to return to the classic offline model when (if) the threat passes. Things were already shifting that way, but campuses are going to be very different when there are no lecture theatres, study halls, or the adjuncts paid to work with undergrads.
posted by Joe in Australia at 7:35 AM on March 10 [1 favorite]


this is...worrying.
On the contrary at least it shows that there are some adults in the room.
Corvid19 can't be contained but it can be slowed down thus taking the strain off the hospital and medical services which otherwise will reach meltdown fast as is being seen in N. Italy.
The decision about not cancelling the Australian Grand Prix and many other gatherings globally has nothing to do with contagion or for the good of the population as a whole but everything to with profit.
posted by adamvasco at 7:36 AM on March 10 [3 favorites]


'Flattening the curve' explained - How canceled events and self-quarantines save lives, in one chart (Eliza Barclay and Dylan Scott, Vox)

This chart is something that some have already seen.
posted by ZeusHumms at 7:37 AM on March 10 [4 favorites]




Lots of other institutions are also turning to online education, and I really don't think they're going to return to the classic offline model when (if) the threat passes.

Eh, if we shift to online for the rest of the semester I expect I'll be able to demonstrate fairly handily that outcomes declined rather promptly, especially for the intro-stats-for-undergrads course I'm teaching.

Elite schools will probably also really REALLY want to get back to in-person. There's not nearly as much point going to an online Harvard where you aren't actually with other Harvard students talking and networking -- it's not like they actually teach you more or better about almost anything. And the long-term health of someplace like Harvard depends in large part on pumping through a stream of undergrads who go on to do Big Things, often with each other.
posted by GCU Sweet and Full of Grace at 7:57 AM on March 10 [4 favorites]


My school is meeting to see what to do with the coronavirus this afternoon. Being a medical school shifting everything over to videos isn't an easy decision. Are we sufficiently preparing our students for the boards? This sucks.
posted by dances_with_sneetches at 8:15 AM on March 10 [1 favorite]


I am going to be really curious to see how online-only works. (I'm assuming we're going to online-only, although there hasn't been an announcement.) My hunch is that it won't work well. My office is trying to plan for what happens if we can't come to work, and it turns out that a couple of my co-workers don't have internet at home. I have internet, but it runs super slow during peak times, and I assume that every time is going to be a peak time if the main employer in town goes all online. Also, I'm really uncomfortable using my personal computer for work stuff, and I also don't know what the privacy implications of that would be. We have software to broadcast lectures online, but does it have the capacity to handle exponentially larger demand?

There's also a huge question that has to do with international students. Under the terms of their visas, they have to take a certain number of credits in the classroom. Ordinarily, I would be confident that the government would waive that requirement, but this is not an ordinary government. It's going to be a mess.
posted by ArbitraryAndCapricious at 8:56 AM on March 10


Harvard is basically suspending all classes (moving them online) and telling students not to return from Spring Break.
--
Amherst has done the same.


And I have it on authority that Princeton has also done this.
posted by EmpressCallipygos at 10:33 AM on March 10


Penn is readying to do it. It's only a matter of time.
posted by 8dot3 at 10:39 AM on March 10


Princeton has done it, starting after spring break.

"To facilitate social distancing, all lectures, seminars and precepts will move to virtual instruction beginning Monday, March 23. Academic classes and mid-term exams will continue the week of March 9 as planned, following social distancing protocols.

Faculty have received guidance and recommendations on online delivery methods for their courses. The McGraw Center will provide support to faculty, as detailed on its website, including instructional strategies, available tools and recommended best practices. "
posted by bridgebury at 10:49 AM on March 10 [1 favorite]


Although the Johns Hopkins site isn't showing cities anymore, it still looks to me like DFW and DC are outliers amongst the largest metro areas. In Dallas, I see there are now some cases within one family, because of traveling—but I can't help but think that both of those are weird. Texas, as a whole, doesn't have the number of cases you'd expect for its population.

I guess I'm trying to say that people are still pretty complacent because the numbers still seem relatively small. But there's no real containment in the US, insufficient and delayed testing, and it's now geographically widely distributed. The number of cases we know about implies quite a few more already there. It seems to me that many people are still sort of thinking than it will remain in, at most, double-digits in most North American cities when, really, I think we're less than a week away from seeing triple-digits in most of the large metro areas.
posted by Ivan Fyodorovich at 10:52 AM on March 10 [2 favorites]


It seems to me that many people are still sort of thinking than it will remain in, at most, double-digits in most North American cities when, really, I think we're less than a week away from seeing triple-digits in most of the large metro areas.

That's very much my sense as well. Fortunately, it seems like a lot of large cities with active cases have realised this and begun proactively canceling events. Boston just canceled the St. Patrick's Day Parade, for instance. I would be surprised if the Marathon doesn't get canceled as well, but that's not until the end of April so there's still time to make the call. We'll probably hit triple-digit confirmed cases by next week, and they'll definitely have to announce a cancellation at that point.
posted by tobascodagama at 12:06 PM on March 10


Isn't it already pretty warm in Texas? There was some talk that spread was lessened with warmer temperatures.
posted by Mitheral at 12:22 PM on March 10


Hey Mitheral - I'm in Frisco within a 5-mile radius of the recently confirmed infected family. Expected high temp today is 79F degrees, or 26.1C. Current temp is 75F, or 23.9C at my office.
posted by Unicorn on the cob at 12:26 PM on March 10


There was some talk that spread was lessened with warmer temperatures.

Will the New Coronavirus ‘Go Away’ in April? (Factcheck.org, Feb. 13, 2020)
President Donald Trump suggested that the new coronavirus would “go away” in April, as temperatures warm. While some viruses are seasonal, it’s not yet clear if the new virus will follow the same pattern — and experts caution against banking on the weather to resolve the outbreak.
Will Warm Weather Kill Coronavirus? (Snopes, Mar. 3, 2020)
It's too early to tell if the spread of the new coronavirus that causes COVID-19 will be dampened by warm weather.
posted by katra at 12:40 PM on March 10 [1 favorite]


Social distancing could buy U.S. valuable time against coronavirus (WaPo)
With coronavirus cases in 34 states and the District of Columbia already starting to strain limited resources, from masks to tests, the United States is at a make-or-break moment that will depend on one of the most basic, but inconvenient and disruptive, public health tools in the book: social distancing.

The best way to prevent a catastrophic explosion of new cases in the next few weeks, many experts think, is to break potential chains of transmission by preventing sick people from coming in close contact with healthy ones, whether it means canceling conferences or relying on individual decisions to avoid crowded public transportation or postpone weddings.

The goal isn’t to stop the virus, not anymore. It’s to slow it down. [...] “Whenever you see the virus, it’s moved on already — it will have infected other people by the time you become aware of it,” said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. “Slowing it down matters because it prevents the health service becoming overburdened. We have a limited number of beds; we have a limited number of ventilators; we have a limited number of all the things that are part of supportive care that the most severely affected people will require.”

[...] Social distancing won’t just require government-level decisions — individual people will need to take steps to change their daily routines, based on their own judgment and the local situation. By the time it stops feeling silly to consider major life changes, it may be too late.

[...] “The idea is that the sooner you stop that transmission chain, you are actually limiting an exponential growth,” said Yvonne Maldonado, an infectious disease epidemiologist at Stanford University. “That’s really important, because instead of preventing 1,000 cases, you might be preventing 100,000 cases — and a matter of days can make a difference.”
posted by katra at 1:24 PM on March 10 [7 favorites]


'We're not prepared': coronavirus could devastate homeless communities (Sam Levin, Guardian)
California’s homeless organizations say they lack the resources and government support to stop the spread of infections
posted by ZeusHumms at 1:26 PM on March 10 [1 favorite]


New York sends in national guard as US coronavirus death toll hits 29 (Guardian)
New York’s governor announced on Tuesday he is sending national guard troops into a New York City suburb to help tackle what is now believed to be the nation’s biggest cluster of coronavirus cases – one of the most dramatic actions yet to control the spread of the illness in the US.

Governor Andrew Cuomo announced a “containment” plan for New Rochelle, the city at the center of the coronavirus outbreak in the New York metro area, in what he called a “breathtaking” outbreak that is “a significant issue”. [...] The number of people in the US confirmed to be suffering from coronavirus, and the death toll, are being regularly revised and by Tuesday afternoon there were at least 900 cases, a number which has more than doubled in the last three days, and the death toll had risen to 29.

The news from New York came as Washington state in the Pacific north-west, known until Tuesday as the largest cluster of cases in the US, warned that there could be an exponential increase in the numbers catching the virus there without “real action” to stop the spread. [...] Washington’s governor, Jay Inslee, said on Tuesday that he was considering mandatory measures to prevent an increase there that he feared could reach 64,000 in the state in the next two months. Experts believe the number of actual cases in the state is much higher than 162.

“Whether it’s 500 today or 1,500 or 2,000, that just goes to a very large number, very quickly.” Inslee said. “The number of people who are infected in an epidemic like this will double in the state of Washington unless we take some real action here.”

“If the numbers are anything close to what I’m talking about, we’re going to have real challenges in our hospitals being able to deal with very sick people,” Inslee said.
posted by katra at 2:21 PM on March 10 [2 favorites]


State and local officials shift to more aggressive coronavirus measures (Politico)
Health officials in the heart of the Silicon Valley took the most dire coronavirus steps yet in the U.S. by banning large public gatherings for three weeks starting Wednesday. Across the country in New Rochelle, N.Y., the state on Tuesday created a one-mile-radius “containment area” to try to curb the outbreak. [...] And in Ohio, which just confirmed its first case Tuesday, Gov. Mike DeWine requested that indoor sporting events exclude spectators besides parents and essential personnel.

[...] The move in Silicon Valley’s Santa Clara County came after the jurisdiction announced its first death on Monday, a woman in her 60s with chronic health conditions who was the county’s first case of transmission without a known source. [...] The mandatory order applies to all events with at least 1,000 people and was issued by Sara Cody, Santa Clara County's health officer. Cody last week recommended that sporting events and other mass gatherings be canceled, but her advice was ignored by the NHL's San Jose Sharks, which played three home games since then, and the MLS' San Jose Earthquakes, which played Saturday at their home stadium.

"This is a big decision to issue a legal order such as this," Cody said at a press conference Monday evening. "We needed to carefully consider it. I think over the last five days, the uptick in cases, particularly those where we found no link to travel or other cases ... that is a tipping point for us and it's time to issue an order."

[...] Seattle and King County Director of Public Health Patty Hayes on Monday said the region’s public officials are “at the ready” to impose quarantines or cancellations of events as the state has prepared five levels of actions it could take for containment and mitigation, the Seattle Times reported.
posted by katra at 2:32 PM on March 10 [1 favorite]


Judges Were Told to ‘Remove’ CDC Coronavirus Warning Posters from Immigration Courts
Immigration attorney R. Andrew Free was askance of EOIR’s decision to remove the posters—telling Law&Crime that “the most generous explanation” for the order “is that they want to make sure to coordinate the message.”

”But rarely does the most generous explanation line up with reality,” he added.

posted by Mitheral at 2:44 PM on March 10 [3 favorites]


Why is Congress Conducting Business as Usual in the Face of Coronavirus? (Margaret Taylor, Benjamin Wittes, Lawfare)
In a normal situation, Congress is a Petri dish. There is large-scale public access to the Capitol complex. There are large numbers of tourists interacting with members and staff. There is a great deal of needless in-person human interaction that creates, in turn, needless vectors of possible transmission of disease. In the face of the current pandemic, the speaker of the House should be modeling organizational management designed to continue operations while minimizing physical presence and in-person interactions. She should be offering other organizations a highly visible example, which will legitimize early decisions by groups both private and public to think creatively in combating the virus.

At least so far, she’s not doing that. [...] Asked about the possibility of leaving Washington or remote voting, Pelosi reportedly dismissed the idea: “We are the captains of the ship. We are the last to leave.” [...] Lawmakers are right to be concerned that taking sudden, drastic action within the Capitol could cause panic among everyday Americans. They are also correct that the business of Congress needs to continue. They are dead wrong, however, that the Capitol needs to be open as usual to outsiders. It is dramatically irresponsible to allow members to be giving tours of the building to gaggles of people who will then fan out across the country. And it is also irresponsible to conduct hearings that don’t need to happen while an often lethal virus is spreading uncontrolled around the world.

More generally, the congressional leadership is wrong that the institution’s working presumption should be that staff and members should be congregating there for routine matters that don’t actually require physical presence. The presumption should be the opposite, as it should be for all organizations: the goal is to maximize social distancing in a fashion consistent with performing necessary operations. Staff who can work from home should do so. Members should be present only for votes and wholly necessary hearings.

Even recently, this would have been impossible. But modern telecommunications are a marvelous thing. [...] It’s certainly time to stop striking stalwartly fearless leadership poses. Leadership in this situation involves getting used to conference calls and teleconferences—and being seen to do so, to enable others to follow suit.
posted by katra at 3:23 PM on March 10 [6 favorites]


Cancel Everything (Yascha Mounk, Atlantic)
Yascha Mounk is an associate professor at Johns Hopkins University, a senior fellow at the German Marshall Fund, and a senior adviser at Protect Democracy.
We don’t yet know the full ramifications of the novel coronavirus. But three crucial facts have become clear in the first months of this extraordinary global event. And what they add up to is not an invocation to stay calm, as so many politicians around the globe are incessantly suggesting; it is, on the contrary, the case for changing our behavior in radical ways—right now.

The first fact is that, at least in the initial stages, documented cases of COVID-19 seem to increase in exponential fashion. On the 23rd of January, China’s Hubei province, which contains the city of Wuhan, had 444 confirmed COVID-19 cases. A week later, by the 30th of January, it had 4,903 cases. Another week later, by the 6th of February, it had 22,112. The same story is now playing out in other countries around the world. Italy had 62 identified cases of COVID-19 on the 22nd of February. It had 888 cases by the 29th of February, and 4,636 by the 6th of March.

Because the United States has been extremely sluggish in testing patients for the coronavirus, the official tally of 604 likely represents a fraction of the real caseload. But even if we take this number at face value, it suggests that we should prepare to have up to 10 times as many cases a week from today, and up to 100 times as many cases two weeks from today.

The second fact is that this disease is deadlier than the flu, to which the honestly ill-informed and the wantonly irresponsible insist on comparing it. Early guesstimates, made before data were widely available, suggested that the fatality rate for the coronavirus might wind up being about 1 percent. If that guess proves true, the coronavirus is 10 times as deadly as the flu.

[...] A few other countries have taken energetic steps to increase social distancing before the epidemic reached devastating proportions. In Singapore, for example, the government quickly canceled public events and installed medical stations to measure the body temperature of passersby while private companies handed out free hand sanitizer. As a result, the number of cases has grown much more slowly than in nearby countries. [...] This suggests that anyone in a position of power or authority, instead of downplaying the dangers of the coronavirus, should ask people to stay away from public places, cancel big gatherings, and restrict most forms of nonessential travel.
posted by katra at 4:19 PM on March 10 [8 favorites]


Sanders and Biden campaigns cancel events over coronavirus (Politico)
The two major Democratic presidential campaigns have canceled their evening events due to growing fears about the coronavirus outbreak, citing guidance from public health officials.

The moves by Bernie Sanders and Joe Biden represent the first concrete signs that the spreading virus, which has led at least 13 states to declare public emergencies, is affecting the 2020 race.
posted by katra at 4:36 PM on March 10 [2 favorites]


A March 9th translation of an Italian ICU doctor's front-line experiences in Bergamo
10/ the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us.

11/ Cases are multiplying, we arrive at a rate of 15-20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing.

12/ Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized.
...
16/ There are no more shifts, no more hours. Social life is suspended for us. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols.
posted by spamandkimchi at 5:53 PM on March 10 [4 favorites]


The argument for centralized quarantine from statistician Xihong Lin
3. Family transmission is common. Quarantine-at-home between 1/23-2/1 helped and did not work effectively (R=1.35>1), as family members and close contacts may be infected and might affect the neighborhood communities, e.g., going shopping. Centralized quarantine is critical.
posted by spamandkimchi at 5:59 PM on March 10


South Korea did not, so far as I am aware, use any centralized quarantine did they?
posted by Justinian at 6:33 PM on March 10


Uh, what is centralized quarantine?
posted by grandiloquiet at 6:36 PM on March 10 [1 favorite]


Purpose-built quarantine centers or hospitals/institutions designated for covid-19 only. Super problematic in my view, since it seems like most of them had insufficient medical personnel.

Justinian, no centralized quarantine in Korea as far as I know, but I've not been following the Korean media as much recently (I have to cut down on my obsessively reading covid-19 news somehow).
posted by spamandkimchi at 6:42 PM on March 10 [1 favorite]


Naomi O’Leary (Europe correspondent for the Irish Times) posted a really interesting collection of reporting on Twitter “about the response to the Covid-19 Coronavirus in the Netherlands: socially, in the media, and by authorities.”
  • March 5: Lawmaker Eva van Esch of @PartijvdDieren accuses the government of putting more focus on "preventing panic" than "preventing the spread of the disease." Van Esch says a friend and her partner struggled for a week to get tested after having symptoms on return from Italy, and were not advised to quarantine. Once found positive, they were told not to tell their contacts, or their work, but to keep the diagnosis quiet, van Esch says.
  • March 7: 900 students of university society Vindicat return to the Netherlands from a mass ski trip in Piedmont in Northern Italy. They arrive in a convoy of buses to Groningen, neighbouring Drenthe, which has yet to have any confirmed cases. Authorities test four students, who are found negative. The rest are told they do not need to self-quarantine if they have no symptoms, and can go to classes or out on the town if they wish.
  • March 8: A cleaning lady married to a Bannink Packaging employee tests positive. The director of the school she works at writes to parents to say "there is no reason to panic" and that children can go to school as normal.
There’s much more in the full Twitter thread, including links to original Dutch sources.
posted by mbrubeck at 7:09 PM on March 10 [4 favorites]


Sheri Fink and Mike Baker, New York Times: How Delays in Testing Set Back the U.S. Coronavirus Response.
Dr. Helen Y. Chu, an infectious disease expert in Seattle, knew that the United States did not have much time.

In late January, the first confirmed American case of the coronavirus had landed in her area. Critical questions needed answers: Had the man infected anyone else? Was the deadly virus already lurking in other communities and spreading?

As luck would have it, Dr. Chu had a way to monitor the region. For months, as part of a research project into the flu, she and a team of researchers had been collecting nasal swabs from residents experiencing symptoms throughout the Puget Sound region. […]

By Feb. 25, Dr. Chu and her colleagues could not bear to wait any longer. They began performing coronavirus tests, without government approval. What came back confirmed their worst fear. They quickly had a positive test from a local teenager with no recent travel history. […]

Dr. Chu and Dr. Lindquist tried repeatedly to wrangle approval to use the Seattle Flu Study. The answers were always no. “We felt like we were sitting, waiting for the pandemic to emerge,” Dr. Chu said. “We could help. We couldn’t do anything.” […]

Dr. Chu and her flu study colleagues, unwilling to wait any longer, decided to begin running samples.

A technician in the laboratory of Dr. Lea Starita who was testing samples soon got a hit. “I’m like, ‘Oh my God,”’ Dr. Starita said. “I just took off running” to the office of the study’s program managers. “We got one,” she told them. “What do we do?”

Members of the research group discussed the ethics of what to do next. “What we were allowed to do was to keep it to ourselves,” Dr. Chu said. “But what we felt like we needed to do was to tell public health.”
posted by mbrubeck at 7:33 PM on March 10 [9 favorites]


True number of U.S. coronavirus cases is far above official tally, scientists say (LA Times)
Their study, released Monday on the medRxiv website to discuss work that has not yet been submitted to a peer-reviewed journal, came as U.S. officials reported a total of 704 COVID-19 cases and 29 deaths in the United States. That is likely just the tip of a much larger iceberg, the mathematical modeling suggests.

Under their most optimistic assumptions, as few as 1,043 people in the United States have been infected with the novel coronavirus. Under a more realistic scenario, that number could easily be as high as 9,484.

That only accounts for U.S. residents whose infections originated with people carrying the virus directly from Wuhan, the epicenter of the outbreak in China. In reality, many more people likely have brought the virus here from other hot spots, including Italy, South Korea and the rest of Asia. Each virus carrier who arrived from those places would set off his or her own cascade of infections.

The model also stopped adding up infections as of March 1. But given its firm toehold in the United States by then, the virus could have racked up tens of thousands of new cases since that date.

[...] Dr. Donald S. Burke, a disease modeler at the University of Pittsburgh, added that the team’s assumptions about the coronavirus’ ability to jump from person to person is especially conservative. The new analysis assumed that each infected person will pass the virus along to 2.1 to 2.5 others over the course of their infection, a number epidemiologists call the reproductive rate. But estimates of the coronavirus’ reproductive rate in circumstances where it is spreading undetected has ranged between 5 and 6, so the researchers may have greatly underestimated the number of infections in the United States, Burke said.
posted by katra at 9:22 PM on March 10 [4 favorites]


Philadelphia says avoid large gatherings, but Wells Fargo Center says sporting events and concerts are still on (Philadelphia Inquirer)
On Tuesday, public health officials announced the first presumptive positive case in the city and recommended people avoid public gatherings of more than 5,000 people to tame the spread of the virus. Philadelphia Health Commissioner Thomas Farley said that while the city isn’t canceling events, it is asking organizations to urge attendees to stay home.

Comcast Spectacor, which owns the Wells Fargo Center, said in a statement before Tuesday’s Flyers matchup against the Bruins that the game would be played as scheduled, but ticket-holders who feel ill or have underlying health conditions should “consider not attending.” Ticket-holders can call the Wells Fargo Center on Tuesday night at 215-218-7825 and requests for a refund will be evaluated on a case-by-case basis.

The Wells Fargo Center, an arena that’s the home of the Sixers and the Flyers and is among the city’s largest concert venues, holds nearly 20,000 people. Over the next week, the schedule includes four Flyers games, three Sixers games, a professional lacrosse game, and two concerts, including a sold-out show on Friday featuring Grammy Award-winning singer Billie Eilish.

City officials didn’t estimate how long the recommendation would last, but Farley said if the spread of the virus worsens, the city may lower the 5,000-person threshold. Public health administrators and organizations across the country are facing pressure to limit gatherings in a process called “social distancing,” which experts say can delay and slow the spread of infectious disease. On Tuesday, Massachusetts announced 70 cases of the new coronavirus were tied to a single conference in Boston.

[...] Eilish hasn’t yet announced concert cancellations, but other artists have. Dozens of shows in Asia have been axed, Madonna canceled two shows in Paris, Ciara — who is pregnant — rescheduled a show in Texas, and Pearl Jam postponed the North American leg of its tour. Organizers of music festivals on the West Coast, including Coachella and Stagecoach, are postponing shows until the fall.
posted by katra at 10:19 PM on March 10 [2 favorites]


S Korea did massive widespread testing which is what made their response so good. That’s not happening in the US. Google for “ South Korea testing coronavirus“ to see all kinds of articles from different angles about how it brought down their overall infection right quickly by finding those who were infected.

They tested (and processed results) of more people in a matter of days than the entire US has done in all this time.
posted by affectionateborg at 10:24 PM on March 10 [3 favorites]


South Korea is watching quarantined citizens with a smartphone app (MIT Technology Review, Mar. 6, 2020)
With almost 6,300 cases and more than 40 reported deaths, South Korea has become home to the world’s largest coronavirus outbreak outside China. As a result, the government in Seoul has taken what it calls “maximum” action to contain the spread of the disease—including sending thousands of people into mandatory home quarantine.

Now it is launching its latest attempt to keep things from escalating further: a smartphone app that can monitor citizens on lockdown. The app, developed by the Ministry of the Interior and Safety, allows those who have been ordered not to leave home to stay in contact with case workers and report on their progress. It will also use GPS to keep track of their location to make sure they are not breaking their quarantine.

[...] Under current guidelines from the Korean Centers for Disease Control and Prevention, anyone who has come into contact with a confirmed coronavirus carrier is subject to a mandatory two-week self-quarantine. “Contact” is defined as having been within two meters of a confirmed carrier, or having been in the same room where a confirmed patient has coughed.

Once self-quarantine subjects receive an order from their local medical center, they are legally prohibited from leaving their quarantine areas—usually their homes—and are instructed to maintain strict separation from other people, including family members. Those in lockdown are assigned to a local government case officer, who checks in twice a day by phone to track the development of any symptoms, and mobile testing teams are deployed to collect samples if things escalate.

[...] The app joins a repertoire of other measures launched to combat the surge of new cases in South Korea, such as drive-through coronavirus testing stations, which contribute to the country’s roughly 15,000-a-day testing capacity. Enabled by the KCDC’s policy of rigorous transparency, a slew of privately developed map services tracking confirmed carriers have also emerged, while municipal and district governments are sending regular emergency alerts to people’s phones to inform them of any new coronavirus cases.
posted by katra at 10:38 PM on March 10 [3 favorites]


Exclusive: U.S. coronavirus testing threatened by shortage of critical lab materials (Politico)
CDC Director Robert Redfield told POLITICO on Tuesday that he is not confident that U.S. labs have an adequate stock of the supplies used to extract genetic material from any virus in a patient’s sample — a critical step in coronavirus testing. [...] Qiagen, a major supplier of the kits, confirmed that its product is backordered due to “the extraordinary pace” at which the world has increased coronavirus testing over the last few weeks.

[...] Mandy Cohen, North Carolina’s secretary of health, said that a shortage of extraction kits and other chemicals had hampered testing in her state. “Folks were saying, ‘We are sending you the [test] kits,’ and I don’t think they understood at first what exact part of the supply chain we needed,” she said. “We needed extraction kits.”

[...] Commercial labs, which have recently started running coronavirus tests, have not experienced any supply shortages, according to a spokesperson for the American Clinical Laboratory Association.
Exclusive: Email crash impeded HHS response to coronavirus (Politico)
POLITICO spoke with four individuals who confirmed the episode and described relevant documentation. They said the incident reflects the extent to which communication problems and discord continue to plague HHS, even while it confronts the unprecedented challenge posed by the coronavirus.
posted by katra at 10:55 PM on March 10 [2 favorites]


Health minister Nadine Dorries diagnosed with coronavirus
Conservative is first MP to test positive, and had recently been to reception with Boris Johnson


UK Health Minister diagnosed. Yet another politician / government minister diagnosed. Anyone seen any stats on politicians diagnosed? They would seem to disproportionately affected (or perhaps disproportionately diagnosed).
posted by roolya_boolya at 11:16 PM on March 10 [4 favorites]


Carey Baptist Grammar School here in Melbourne has closed temporarily after discovering a teacher had contracted COVID-19. A second teacher has now contracted it. Here's the timetable as I understand it from local reports:
Saturday 29th Feb: Dr Chris Higgins returns to Melbourne from the USA with symptoms of a cold. The partner of "a senior teacher" at Carey Baptist Grammar School is on his flight, and I presume this man contracted the virus from Dr Carey.

Monday 2nd March: Dr Higgins is feeling better and returns to work, treating about 70 patients.

Friday 6th March: Dr Higgins has himself tested and discovers that he is carrying the virus.

Tuesday 10th March: A "senior teacher" at Carey Baptist Grammar School is found to be carrying the virus, which I presume she contracted from her partner.
We can be very glad that Dr Higgins was in a position to have himself tested. I don't know if most people could or would have. Consequently, it appears that we can document a chain of initial exposure - transmission - - incubation - second exposure - incubation - detectable virus loads. This chain took no more than eleven days, so the period from infection to transmissibility is probably around five days. Anyone with more knowledge want to weigh in?
posted by Joe in Australia at 11:39 PM on March 10


Anyone seen any stats on politicians diagnosed? They would seem to disproportionately affected

Politicians meet a lot of people. They shake hands with them, sit across the desk from them, stand next to them for photo-ops etc. I'm really quite concerned for the health of the current Democratic candidates.
posted by Joe in Australia at 11:44 PM on March 10 [3 favorites]


How COVID-19 Spreads (CDC)
People are thought to be most contagious when they are most symptomatic (the sickest). Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.
posted by katra at 1:12 AM on March 11 [1 favorite]


Here in the Netherlands, everyone is being told that it is all fine. Go on about your business.
I know of one business (not in the news!) that had a visitor who subsequently tested positive. The Health Authority's recommendation was that staff who met with this visitor should work from home for a while - only if they show symptoms.

It takes a foreign journalist to call this out: How Dutch false sense of security helped coronavirus spread
posted by vacapinta at 3:51 AM on March 11 [7 favorites]




4 Recommendations for Dealing With the Coronavirus from a Public Health Dream Team (Will Peischel, Mother Jones)
On Friday, the liberal advocacy organization Center for American Progress hosted a four-person panel of public health experts focused on the emerging threat novel coronavirus poses to the American public. The panelists were heavyweights of Democratic policy circles, with expertise spanning from national security to epidemiology […]. Three worked in various capacities for the Obama Administration and Ronald Klain, who is now the general counsel for a company that invests in startups, was responsible for coordinating the US response to the 2014 Ebola outbreak.

[…] Without exaggerating the danger, all the panelists could foresee a widespread outbreak. Here are four recommendations they would like to see the Trump administration implement which they believe would not only mitigate the current coronavirus spread, but prevent future infectious disease outbreaks.
  • Vastly increase testing ASAP
    “When we hear the virus is in X states and not Y states, that’s largely because we haven’t tested in Y states,” Klain said. “That lack of competence is causing us to be completely blind as to where this virus is.”
  • Disease outbreaks should be framed as a national security issue
    ... the Trump Administration hasn’t had a dedicated infectious disease specialist on the NSC since May 2018. “I think it’s not crazy to say we ought to have a dedicated unit of professionals,” [Lisa Monaco, a homeland security advisor for the Obama Administration] said. “Working day in and day out in the NSC just like we have a counterterrorism director.” With those structures in place when the next pandemic hits, time won’t be wasted creating an organizational structure to respond—but rather mobilize one that is already in place to react immediately.
  • Consolidate centers of information
    “So many people are seeking information,” [Jennifer Nuzzo, an epidemiologist at Johns Hopkins Bloomberg School of Public Health] said. “And it’s because there’s no information to be found. The government websites on this are utterly abysmal.”
  • Retain scientists, don’t lose them
    For many of the government’s health experts, a career spent being ignored or contradicted could be an incentive to enter the private sector, especially when their areas of expertise are in high demand in sectors like academia and the pharmaceutical industry. More than a thousand scientists have left the federal government since 2017, while the Trump administration has made deep cuts to the sectors of the CDC that oversee pandemic mitigation.
Added formatting.
posted by ZeusHumms at 8:10 AM on March 11 [4 favorites]


Crisis communication researcher shares 5 key principles that officials should use in coronavirus (Matthew Seeger, The Conversation)
1. Credible sources are a must

2. To reduce rumors, be honest

3. Aim for meaningful actions

4. Draw from experts, not amateurs

5. Be consistent
posted by ZeusHumms at 9:22 AM on March 11 [3 favorites]


WHO has already officially stated that they simply no longer use the word "pandemic." It is a subjective term that connotes no new information.

This is incorrect. Pandemic is certainly a term they do still use. There are also pandemic preparedness documents on their website.

As of today, the WHO has declared Coronavirus a pandemic.
posted by Ahmad Khani at 10:10 AM on March 11 [7 favorites]


Exclusive: White House told federal health agency to classify coronavirus deliberations - sources

Because what you really want to do when trying to respond to a global pandemic is make sure information sharing is kept to a minimum.

This would be blatantly illegal if the US still adhered to any concept of the rule of law.
posted by tonycpsu at 10:29 AM on March 11 [16 favorites]


The NBA's Golden State Warriors will no longer permit fans to attend their home games, starting tomorrow against the Nets.
“We know that this order is disruptive, but it is an important step to support public health,” Mayor London Breed said in a statement. “We’re following the recommendations of public health officials to slow the spread of COVID-19 in our community.”
A crucial step in stemming this pandemic.
posted by Ahmad Khani at 10:59 AM on March 11 [4 favorites]


I'm a physician in the United States, working at a large academic medical center that you have definitely heard of. In an effort to practice social distancing, the university has told students to leave campus, all buildings except the emergency department are going to badge access only, all classes are being moved online, and has revoked travel approval for faculty, staff, and students, and has cancelled in-person events for the foreseeable future -- except for athletics. March Madness is indeed apt.

A clinic patient asked me on Monday for a face mask; we had none in the building, not even those rinky-dink paper masks with the earloops. One of my colleagues, a pediatrician, tells me her clinic intermittently loses running water and hand sanitizer dispensers are not refilled until days after they run dry. These are issues that run bigger and deeper than COVID-19, but it means that our supposedly top-notch institution is very poorly prepared for the shitstorm that's about to hit.

At a minimum, culturally, we are not going to be able to quarantine, mass-test, and monitor in any meaningful way, the way S Korea did. Every country has some people who are ill-informed, cavalier, or stupid, but American Exceptionalism is the national religion here.
posted by basalganglia at 11:05 AM on March 11 [27 favorites]


Italy
With demand outpacing supply of beds and respirators, medical workers are told to prioritize younger patients.
posted by adamvasco at 11:11 AM on March 11


30 staff members and many students at Seattle's Franklin High School are planning a "sick-out" protest
Franklin is one of four other south Seattle schools that the district said yesterday have been potentially exposed to the coronavirus. Franklin, Mercer Middle School and Rainier Beach High School were disinfected last night.... Franklin High School teacher Olivia Geffner said so many families at her school also have students at Aki Kurose that the district should have done more than just disinfected Franklin last night - it should have closed.
Schools are told to plan for closing, while gatherings over 250 people are prohibited in King, Snohomish, and Pierce countries.

No mention of the fact that schools gather hundreds of people every day, including 350-400 in the lunchroom of each school.
posted by Margalo Epps at 11:12 AM on March 11 [1 favorite]


the university has told students to leave campus
Is there any reasonable theory behind closing dorms beyond CYA run amok? I can see telling students to stay home if they already are home, but kicking them off campus en masse and making them travel? HooWHAT?
posted by Don Pepino at 11:13 AM on March 11


> No mention of the fact that schools gather hundreds of people every day

It was brought up a few times during the press conference. Basically: schools should be getting ready to close for weeks or maybe months, but it isn't coming from the state yet.
posted by The corpse in the library at 11:14 AM on March 11


Sorry, I should have said it wasn't mentioned in the article.
posted by Margalo Epps at 11:16 AM on March 11


Is there any reasonable theory behind closing dorms beyond CYA run amok?

There is probably a lot of CYA involved, but dorms and dining halls are fantastic vectors for droplet transmission. Most students live off-campus here, so it's more a matter of "hunker down in your apartment and sign into Coursera" than "go to the airport and fly back to your hometown."
posted by basalganglia at 11:21 AM on March 11 [5 favorites]


I should add -- they are making exceptions for on-campus students who don't have another option. The dorms and dining halls, and the university as a whole, is open but skeletonized. The idea is to thin out the population so that people aren't breathing and coughing and snotting all over each other.
posted by basalganglia at 11:26 AM on March 11 [3 favorites]


At the bank-you've-heard-of where I work, the CEO sent out communication today encouraging all employees in the US and Canada who can to work from home beginning Thursday and until further notice for social distancing purposes.

On a related note, Amazon Prime Now shows no toilet paper available for ordering in my ZIP code.
posted by emelenjr at 11:28 AM on March 11 [2 favorites]


Italy
With demand outpacing supply of beds and respirators, medical workers are told to prioritize younger patients.


Holy fucking shit.
posted by medusa at 11:30 AM on March 11


Italy
With demand outpacing supply of beds and respirators, medical workers are told to prioritize younger patients
.

This rumour/quote been making the rounds locally too, but has been repeatedly officially denied (see at 9.10 in today's Fatto Quotidiano liveblog).
posted by progosk at 11:36 AM on March 11 [3 favorites]


@tomaspueyo: "Coronavirus: Why You Must Act Now" (Medium) has a predictive tool (towards the end of the piece) for figuring out an org's likely exposure risk.

@PeterKolchinsky retweeted it with the comment, "I'm a virologist & I learned from this analysis."
posted by cybercoitus interruptus at 11:53 AM on March 11 [15 favorites]


On a related note, Amazon Prime Now shows no toilet paper available for ordering in my ZIP code.

I will be doing grocery shopping this Friday, and will be adding a small pack to my list even though we're fairly well stocked at home right now. I also confess to eyeing the restrooms at work, and noting how one stall I was in today had about five loose rolls in it, and that "you know, I bet no one would notice if I snuck one of these into my bag after work today, just in case....."

I wouldn't, but I did consider it.
posted by EmpressCallipygos at 11:56 AM on March 11 [1 favorite]




WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020
(Dr Tedros Adhanom Ghebreyesus): Good afternoon.

In the past two weeks, the number of cases of COVID-19 outside China has increased 13-fold, and the number of affected countries has tripled.

There are now more than 118,000 cases in 114 countries, and 4,291 people have lost their lives.

Thousands more are fighting for their lives in hospitals.

In the days and weeks ahead, we expect to see the number of cases, the number of deaths, and the number of affected countries climb even higher.

WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction.

We have therefore made the assessment that COVID-19 can be characterized as a pandemic.

Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.

Describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this virus. It doesn’t change what WHO is doing, and it doesn’t change what countries should do.

We have never before seen a pandemic sparked by a coronavirus. This is the first pandemic caused by a coronavirus.

And we have never before seen a pandemic that can be controlled, at the same time.

WHO has been in full response mode since we were notified of the first cases.

And we have called every day for countries to take urgent and aggressive action.

We have rung the alarm bell loud and clear.
posted by Ahmad Khani at 1:01 PM on March 11 [13 favorites]


Italy is closing all stores except pharmacies and grocery stores (Associated Press).
Premier Giuseppe Conte thanked the public for cooperating with the already unprecedented travel and social restrictions that took effect Tuesday. But he said Wednesday night on Facebook Live that Italy must “go another step” by closing all shops and businesses except for food stores, pharmacies and other shops selling “essential” items.
posted by mbrubeck at 2:16 PM on March 11 [2 favorites]


All public institutions were closed tonight in Denmark (link to Danish public television, in Danish), after the first case of corona-virus with no travel history was found in Aarhus this morning. Also gatherings of more than a 100 people. Public transportation is restricted. Denmark is still a "green" country, but basically travel is very limited.
I've been really badly hit by all sorts of vira this winter, and I'm thinking I'll self-quarantine at our family farm next week since I'm still not up to full lung capacity after an operation in November. I can't go to work and walking the dog is a heavy burden when you are down with every virus in sight.
posted by mumimor at 2:48 PM on March 11 [9 favorites]


In Poland, schools close and all mass events are cancelled. For the first time I'm positively surprised by this government.
posted by hat_eater at 2:48 PM on March 11 [8 favorites]


While I know there’s a lot more that could and should be happening, it’s still very heartening to see many, many people and organizations and countries making hard decisions and real sacrifices for the greater good. To everyone who has had to cancel trips and events, miss out on seeing loved ones, etc.: Thank you.
posted by mbrubeck at 2:50 PM on March 11 [7 favorites]


The Conference on Retroviruses and Opportunistic Infections (CROI) did a special session on COVID 19, which is available to view.

The whole conference was moved to a virtual conference online and other sessions will also be available, but this is the primary one on coronavirus. Features presentations from China and the CDC.
posted by gingerbeer at 3:03 PM on March 11 [2 favorites]


@tomaspueyo: "Coronavirus: Why You Must Act Now" (Medium) has a predictive tool (towards the end of the piece) for figuring out an org's likely exposure risk.

@PeterKolchinsky retweeted it with the comment, "I'm a virologist & I learned from this analysis."


This is one of the best written and scientifically motivated pieces I've read arguing why significant social distancing is needed.

It also scared the shit out of me.

Thanks. I hate you.
posted by medusa at 3:25 PM on March 11 [7 favorites]


i have it on good authority that the bishop of the episcopal diocese of washington dc has closed all churches, programs, ministries and activities until march 25, by which time further action or lack thereof will be determined.
posted by 20 year lurk at 4:02 PM on March 11


Wapo's live virus updates:

El Salvador begins nationwide quarantine despite having no confirmed cases

El Salvador’s president, Nayib Bukele, announced Wednesday that the country — which does not have a single confirmed coronavirus case — will begin a nationwide quarantine that will last for 30 days.

Schools will be closed for 21 days. “I know this will be criticized, but let’s put ourselves in Italy’s shoes. Italy wishes they could’ve done this before,” he said.

“Our health system is not at Italy’s level, it’s not at South Korea’s level,” he added.

posted by Don Pepino at 4:08 PM on March 11 [5 favorites]


better source:
I am directing that all public worship services and normal parish operations be cancelled within the Episcopal Diocese of Washington and parish buildings be closed for two weeks, effective Thursday March 12.
the bishop notes this directive does not affect "ministries that serve vulnerable populations such as those experiencing hunger or homelessness." everybody is invited to "virtual worship services" at www.cathedral.org.

it is worth noting that some of the bishop's statement directly contradicts that authority i described above as "good." mea culpa.
posted by 20 year lurk at 4:18 PM on March 11 [1 favorite]


[Comment and reply removed. Let's try and avoid max-grimness haruspicy of twitter threads.]
posted by cortex (staff) at 6:07 PM on March 11 [3 favorites]


We’re all reading these articles and twitter threads about what we need to be doing and what the consequences are of not doing it, and then I look outside and...no one is doing it. Even the most aggressive US officials are down playing it. Broadway shows go on (even though an usher tested positive), they haven’t canceled the N.Y. St Paddy’s parade, Disneyland is booked through. I feel like I’m taking crazy pills.
posted by schadenfrau at 6:15 PM on March 11 [8 favorites]


NYT Coronavirus Live Updates: U.S. Will Suspend Travel From Europe as Countries Tighten Lockdowns
posted by adamvasco at 6:21 PM on March 11 [1 favorite]


I am so confused about banning travel from Europe. Does that mean that US citizens currently in Europe are stranded there? Also, in what universe does that make any sense?

According to various seemingly-reputable news sources, Tom Hanks has tested positive for coronavirus and is hospitalized in Australia. I wonder if people will pay more attention now that there are celebrities involved.
posted by ArbitraryAndCapricious at 6:26 PM on March 11 [4 favorites]




Jesus fucking Christ that won’t do anything at this point. Actual science says that won’t do anything. We need to cancel public events, provide medical care and testing, and give people money so they don’t starve and can make rent while the economy ...takes a break.

But he’s just doing the thing he wants to do. Because of course he is.
posted by schadenfrau at 6:27 PM on March 11 [10 favorites]


C-SPAN, March 11, 2020
(Watch from beginning, text link below video)
President Trump addresses the nation from the Oval Office on the coronavirus outbreak.
He announces that all travel from Europe to the U.S. will be suspended for 30 days, except the U.K. The new restrictions go into effect Friday at midnight.
posted by cenoxo at 6:29 PM on March 11 [2 favorites]


An NBA game between the Oklahoma City Thunder and Utah Jazz was just cancelled moments before tip off. Players were on the floor, about to play, arena full of fans. Rumors circulating that a member of the Utah Jazz might have coronavirus. Here's the announcement from the PA announcer.
posted by Ahmad Khani at 6:30 PM on March 11 [3 favorites]


Wow.

Incredible what transpires over a couple minutes.

Rudy Gobert, of the Utah Jazz, has tested positive for coronavirus.

The NBA season has been suspended. It's assumed that the entire Utah Jazz team, and possibly the Toronto Raptors, who they recently played, will be quarantined.
posted by Ahmad Khani at 6:40 PM on March 11 [9 favorites]


[Comment removed, we don't need to dump the full text of speeches in here. Just link to it somewhere for longer texts.]
posted by cortex (staff) at 6:51 PM on March 11 [2 favorites]


The banning of flights ex Europe except from UK is total bullshit unless you are a BA shareholder.
Any European can travel to London to get on a plane with no restrictions.
posted by adamvasco at 7:00 PM on March 11 [4 favorites]


Earlier tonight I tried to guess what he was going to say. My money was on a grudging admission that this is a real problem, but that it's someone else's fault.

I didn't expect him to blame Europe, which in retrospect seems pretty obvious.

It sounds like he's still implicitly promising it won't get much worse. He just doesn't understand math.
posted by Ivan Fyodorovich at 7:02 PM on March 11 [4 favorites]


Seems like today is the montage scene of this disaster movie - airline travel canceled, sports leagues suspended / March Madness to go spectator-less, famous movie stars getting ill, more states declare an emergency. Will be curious to see if Ireland gets included in “Europe” given his golf course there.....
posted by inflatablekiwi at 7:07 PM on March 11 [5 favorites]


The European travel ban is Schengen rather than the EU or Europe, according to the DHS release. And it applies to almost all non-US nationals that were in the Schengen area in the previous 14 days.

Today President Donald J. Trump signed a Presidential Proclamation, which suspends the entry of most foreign nationals who have been in certain European countries at any point during the 14 days prior to their scheduled arrival to the United States. These countries, known as the Schengen Area, include: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, and Switzerland. This does not apply to legal permanent residents, (generally) immediate family members of U.S. citizens, and other individuals who are identified in the proclamation.
posted by scorbet at 7:08 PM on March 11 [4 favorites]


I'd say this is going to be Trump's Katrina, but he's already had like ten of them. If things are this bad in countries that have taken the threat seriously, I can't imagine what a shitshow this is going to be in the US. You'd think they'd understand that the most at risk population is their voting base.
posted by tonycpsu at 7:09 PM on March 11 [9 favorites]


The banning of flights ex Europe except from UK is total bullshit unless you are a BA shareholder.
Any European can travel to London to get on a plane with no restrictions.


Worse. Seeing on Twitter (want to say Matt Stoller?) that the cargo holds of those commercial flights often transport commercial cargo, like medical supplies, in particular supplies for drugs. Plus it will kill the airlines. So. Actively harmful, not just stupid. I can’t think of a reason to do this unless restricting travel is actually the point.

Best case scenario: no one in the room actually knew this or thought about it, because they’re all morons. But I think we know at least Stephen Miller is rubbing his little fascist hands together with glee.
posted by schadenfrau at 7:15 PM on March 11 [2 favorites]


Moreover: this is in lieu of the things that will actually help.

It will be entirely on state and local governments. Fuck.
posted by schadenfrau at 7:16 PM on March 11 [6 favorites]


Travel in Europe that isn't already locked down will probably be within the next 24 hours. So it isn't a big deal that Trump is closing US-EU travel. (The UK is really, really in a bad state, because they have little drug industry and depend on the EU and US for even simple stuff, which might be why Trump is trying to exempt them).
IMO tonycpsu has it. The US should be taking the precautions taken in Europe and then some because the healthcare system isn't as gearing to pandemics.
posted by mumimor at 7:18 PM on March 11 [1 favorite]


Yascha Mounk in The Atlantic:
The Extraordinary Decisions Facing Italian Doctors

Tl;dr: Italy is triaging patients; ones over 65 or with co-morbidities are being left untreated; the same train is barreling down the track to the USA and other countries.
posted by Joe in Australia at 7:20 PM on March 11 [6 favorites]


India quarantines itself from world for a month to fight coronavirus, The Times of India, Sushmi Dey, Updated: Mar 12, 2020, 07:14 IST:
NEW DELHI: With the rapid spread of Covid-19 across continents, and WHO formally terming the disease a pandemic, the government on Wednesday evening decided to virtually quarantine itself from the rest of the world, suspending all visas, except those issued for diplomatic, official, UN-international organisations, employment and projects till April 15....
posted by cenoxo at 7:20 PM on March 11


The markets are not taking this well - Dow stock futures down around 900 points already. Tomorrow looking umm...interesting. Plus side if you happen to be an individual or corporation with bad news to release that you want buried down to page 16 - it’s your golden window! And to think only a few months ago we were worrying that the ongoing grounding of the 737 Max was going to impact summer travel plans. Ahh - good times.
posted by inflatablekiwi at 7:24 PM on March 11


the same train is barreling down the track to the USA and other countries.

Yeah, actual real Death Panels brought you by the people who pretended to be afraid of Obamacare.
posted by great_radio at 7:27 PM on March 11 [12 favorites]



Tl;dr: Italy is triaging patients; ones over 65 or with co-morbidities are being left untreated; the same train is barreling down the track to the USA and other countries.

there's a word missing here, and it's "may".

Specifically (bolding mine):

The authors, who are medical doctors, then deduce a set of concrete recommendations for how to manage these impossible choices, including this: “It may become necessary to establish an age limit for access to intensive care.”

Those who are too old to have a high likelihood of recovery, or who have too low a number of “life-years” left even if they should survive, will be left to die. This sounds cruel, but the alternative, the document argues, is no better. “In case of a total saturation of resources, maintaining the criterion of ‘first come, first served’ would amount to a decision to exclude late-arriving patients from access to intensive care.”

posted by philip-random at 7:31 PM on March 11 [2 favorites]


Retired risk communication specialists Jody Lanard (@EIDGeek) and Peter Sandman have a list of recommended messages for public health authorities to use in an imminent pandemic. Posting the links here in case any of them help talk people down from panic. Also there's stuff to try, to alarm people into an appropriate and productive state.

Eg (written during a previous epidemic, but it still applies):
#9 "What matters most is how households, neighborhoods, community groups, and businesses prepare" because, Sandman and Lanard explain, "We hope every neighborhood group, every fraternal order, every Parent-Teacher Organization, every church and mosque and synagogue, every block association, every local company and local union and local grange, will be ready with its “here’s how we think we can help” messaging."

(scrolling down the page) Communication Phase 6: Pandemic Here: "In the middle of a crisis the most important communication tasks have to do with sustaining people’s ability to bear the unbearable. Validating how awful it is, demonstrating your candor and your determination (not your over-optimism), celebrating heroes and mourning victims – these are every bit as crucial as anything else. [America-centric eg:] 'We know that Americans will get through this. There may be very difficult times ahead. But America is a strong country. We have pulled together to get through tough times before and we will again.'"

For raising people's alarm in service of them taking appropriate measures: "Tell people about doubling. Maybe tell the story – and put out the image – of the pasha and the grains of rice on a chessboard. Yes, it’s true and worth saying that the risk to local residents right now is low – not as low as it looks, but low. But with exponential growth, things look small until very, very shortly before they look huge. The failure of imagination that keeps people thinking that small will remain small is important to counter. You hope you’re wrong, but you expect this to grow from small to huge, here and everywhere. You want people to prepare for it, emotionally and logistically; and you want people help you take action to mitigate it sooner rather than later."

Then, if you have successfully alarmed them: "There’s a step between “business as usual” and “the new normal” that can’t be skipped. People in my field often call it the adjustment reaction. Everybody else calls it an OMG moment. . . . [It] has to happen as people realize that this is a real crisis, not just a bad flu season. The goal is to help as many people as possible have their adjustment reaction before the crisis is full-blown, so that they’re ready to cope resiliently with what’s coming. And of course you want to guide people’s adjustment reaction so they choose wise rather than unwise precautions. . . . if you succeed in alerting the public sufficiently, you will get some pushback, ranging from shock to denial.

If you don’t get much pushback, it probably means you didn’t get through."
posted by cybercoitus interruptus at 7:38 PM on March 11 [11 favorites]


A staffer in Sen Maria Cantwell’s office has tested positive.

This probably has implications.
posted by schadenfrau at 7:41 PM on March 11 [3 favorites]


MetaFilter: This probably has implications.

More seriously, anything that weakens the legislative branch is a very bad thing at a time when the executive branch is mostly using this to conduct a smash-and-grab looting spree.
posted by tonycpsu at 7:46 PM on March 11 [2 favorites]


Nancy Pelosi is in the driver's seat for the emergency federal economic stimulus package. Nothing Trump wants can happens without her consent. I hope she has good economists giving her advice.

1. No payroll tax cut. That is a regressive handout to high income people. Instead direct equal payments to households.

2. Guaranteed sick pay assistance.

3. Block grants to state health agencies.
posted by JackFlash at 8:00 PM on March 11 [3 favorites]


I hope so, too, but Trump has a bigger noise machine, and Democrats aren't willing to shoot hostages. We've seen this before, and with time not on our side in the way it sometimes is with debt ceiling brinksmanship, I don't like our chances.
posted by tonycpsu at 8:06 PM on March 11 [2 favorites]


scorbet > The European travel ban is Schengen rather than the EU or Europe, according to the DHS release. And it applies to almost all non-US nationals that were in the Schengen area in the previous 14 days.

Today President Donald J. Trump signed a Presidential Proclamation, which suspends the entry of most foreign nationals who have been in certain European countries at any point during the 14 days prior to their scheduled arrival to the United States...


From the White House, here is Trump’s full Presidential Proclamation—Suspension of Entry as Immigrants and Nonimmigrants of Certain Additional Persons Who Pose a Risk of Transmitting 2019 Novel Coronavirus, March 11, 2020. Its Sec. 2. Scope of Suspension and Limitation on Entry lists who the proclamation does not apply to.

The Schengen Area (WP, with map) has a population of over 420 million in 26 European states.
posted by cenoxo at 8:11 PM on March 11


An NCAA basketball coach was visibly experiencing flulike symptoms during a game tonight and was taken to the hospital mid-game. It sounds like the team is being quarantined in the arena for now. If it does turn out that he's got coronavirus and has spread it to his whole team and who knows how many other people, that by itself ought to be enough reason to cancel March Madness.
posted by Copronymus at 8:39 PM on March 11 [4 favorites]


president horrorshow's statement,
These prohibitions will not only apply to the tremendous amount of trade and cargo, but various other things as we get approval. Anything coming from Europe to the United States is what we are discussing...,
is at odds with the proclamation, which, but for noting in the preamble,
The free flow of commerce between the United States and the Schengen Area countries remains an economic priority for the United States, and I remain committed to facilitating trade between our nations,
is silent as to cargo and trade goods. the principal text is focused on persons who are not u.s. persons, lawful permanent residents, close kin, asylum-seekers (ha!) or certain visa-holders, in short, "aliens."

i posit that passage of the statement is some jumbled, denture-slipping nonsense, and should have been read "these prohibitions will not apply to the tremendous amount of trade and cargo" from the teleprompter, while the balance is confused extemporizing. for, from whom would president horrorshow seek approval to ban entry of "various other things," both as a practical matter and one of psychology (if that's the right word). whereas, imported goods might plausibly require approval through whatever proper, statutory channels.

of course it is a mug's game to presume to parse president horrorshow as though meaning has meaning. paraphrasing feste: he is mad indeed who would match wits with a fool.
posted by 20 year lurk at 8:44 PM on March 11 [2 favorites]


Travel in Europe that isn't already locked down will probably be within the next 24 hours.

That'll be interesting. Geez imagine individual US states/Canadian Provinces closing their borders.
posted by Mitheral at 8:58 PM on March 11


Government of Canada CORVID-19 information page.
posted by Mitheral at 9:01 PM on March 11


Trump: "This is the most aggressive and comprehensive effort to confront a foreign virus in modern history."

Foreign virus? The dotard is flashing back on D-Day.
posted by JackFlash at 9:05 PM on March 11 [3 favorites]


I've been having trouble processing the racism about this. I mean, yeah, in one sense I know this. But really, I don't. It doesn't have a passport. It doesn't have an ethnicity. It's a fucking virus.
posted by Ivan Fyodorovich at 9:21 PM on March 11 [8 favorites]


The Institute for Disease Modeling in Bellevue, WA, along with the Gates Foundation and Seattle’s Fred Hutchinson Cancer Research Institute, released this working paper: Model-based estimates of COVID-19 burden in King and Snohomish counties through April 7,2020. Given some assumptions about the current state of the epidemic and the rate of transmission, they simulate its progress with different amounts of social distancing.

In their model, even moderate social distancing (25% contact reduction) slows the growth of the epidemic and dramatically reduces the number of infections and deaths after one month. However, much more comprehensive social distancing (75% contact reduction) is required to reverse the trend and cause the number of cases to shrink rather than grow during the simulated month.

I thought this bit was interesting:
We expect to start seeing evidence in data of the impacts of current social distancing efforts by March 20, but until then, we can make some general comments based on previous experience.

In the Seattle metro area in early 2019, the “Snowpocalypse” event caused impromptu school closures and generalized social distancing during the 2018-2019 flu season. The Seattle Flu Study team analyzed the impacts of this on transmission. For diseases with a broad age distribution (not specifically concentrated in kids, with more than 40% of regional hospital cases in adults), the largest impact we saw of combined school closures and snow-related adult social distancing was 52%, and the smallest was only 16% for typical human coronavirus.

With information from Facebook Data for Good on regional mobility showing a stable 50% reduction in weekday incoming traffic from other regions to Seattle and Eastside since March 5th, we think the mixing among workforces has been similarly disrupted, but without school closures that likely have an additional effect on reducing transmission. Thus, we think realistic impacts of recent policy changes will likely be between baseline and the 25% scenario, and we will be working with incoming data to measure this as soon as possible.
posted by mbrubeck at 9:31 PM on March 11 [6 favorites]


Trump cancels Nevada, Colorado, Wisconsin campaign events as coronavirus spreads, Politico, 03/11/2020.

Donald J. Trump for President (2020 Campaign HQ) > Events > Rallies: No rallies scheduled

No great loss without some gain.
posted by cenoxo at 10:04 PM on March 11 [3 favorites]


A quick update: the Nebraska basketball coach has influenza A, not coronavirus, which means he's just an incredibly selfish idiot who endangered others out of a twisted sense of pride, but without directly contributing to an international emergency.
posted by Copronymus at 10:36 PM on March 11 [4 favorites]


As a Washington resident with a planned trip at the end of the month up to BC for my son's water polo tournament...

Might Canada tell me to fuck off? Crazy times.
posted by Windopaene at 10:47 PM on March 11


...an incredibly selfish idiot who endangered others out of a twisted sense of pride...

In the coming weeks I think we'll find this is a comorbid condition for a lot of men.
posted by theory at 10:56 PM on March 11 [6 favorites]


WRT 20 year lurk’s comment above:
AP FACT CHECK: Trump misstates some of his virus actions, Associated Press, Calvin Woodward, 3/11/2020
...
TRUMP: “These prohibitions will not only apply to the tremendous amount of trade and cargo, but various other things as we get approval.”

THE FACT: That is also wrong. The White House quickly clarified that the restriction on movement from Europe “only applies to human beings, not goods and cargo.”
...
Other examples in the AP article. Apparently there’s no further clarification on what he meant by “...but various other things as we get approval.”
posted by cenoxo at 11:33 PM on March 11 [1 favorite]


philip-random: "there's a word missing here, and it's "may".

Specifically (bolding mine):

The authors, who are medical doctors, then deduce a set of concrete recommendations for how to manage these impossible choices, including this: “It may become necessary to establish an age limit for access to intensive care.”
"

That document was published March 6th. It's already happening there now according to the latest reports, like this one from ITV's European editor James Mates, who just returned from Italy:
'Healthcare on brink of collapsing': Doctors share stories from inside the Italy coronavirus quarantine

I start with a voice recording of two Milanese doctors speaking on WhatsApp about the situation at their hospitals. The first identifies herself as Martina, but I believe she is Martina Crivellari, an intensive care cardiac anaesthesiologist at the San Raffaele Hospital in Milan.

She said: "There are a lot of young people in our Intensive Care Units (ICUs) - our youngest is a 38-year-old who had had no comorbidities (underlying health problems). A lot of patients need help with breathing but there are not enough ventilators. They've told us that starting from now we'll have to choose who to intubate - priority will go to the young or those without comorbidities. At Niguarda, the other big hospital in Milan, they are not intubating anyone over 60, which is really, really young."

She added: "This virus is so infectious that the only way to avoid a 'massacre' is to have the least number possible getting infected over the longest possible timescale. Right now, if we get 10,000 people in Italy in need of ventilators - when we only have 3,000 in the country - 7,000 people will die. Rome right now is like where Milan was 10 days ago. In 10 days there has been an incredible escalation. Lombardy, which has the best healthcare in the country, is collapsing, so I don’t dare to think what would happen in less efficient regions."

The other voice on the recording is a male doctor who we have so far not been able to identify, except that he works at Niguarda Hospital in Milan, one of the biggest in the city.

"We have closed down entire wards, and reduced the number of beds in traditional wards. All operations have been cancelled, GP surgeries closed so the that the GPs can come in and be ward doctors. The number of ICU beds has been tripled. There was even pressure to take over our Cardiac ICU. All the resuscitation bays are full. They’re having to triage, deciding who to intubate and who to let die."

He added: "You have no idea how many young people are here, I mean even 20-year-olds with no underlying conditions, in need of assisted breathing because of horrible pneumonia. There aren’t the resources to screen doctors for Covid-19 anymore - they’re just telling them 'stay home if you have symptoms, otherwise come to work'."
The events of the last day or so have me officially scared; I'll be stocking up on food tomorrow and seeing about scaling back work for myself and immediate family as much as possible. Everybody here in AL acts like I'm paranoid, but they also act like universal healthcare is an unworkable fantasy despite it existing in multiple countries, and unfortunately this shit is starting to get just as real.
posted by Rhaomi at 11:44 PM on March 11 [12 favorites]


Even with acute awareness of all that's transpired so far, I can't believe Trump fucked up that statement so badly.
posted by feloniousmonk at 12:09 AM on March 12 [1 favorite]


I know Mefi has an allergic reaction to Joe Rogan, but yesterday's JRE podcast had an infectious disease expert on, and it was quite good. The discussion was frank, direct, and informed, and I at least found it provided helpful context.
posted by daveliepmann at 12:43 AM on March 12 [2 favorites]


'Healthcare on brink of collapsing': Doctors share stories from inside the Italy coronavirus quarantine
Man, that is scary. There's a storm brewing here, otherwise I'd be in my car and heading for the countryside already.
posted by mumimor at 1:57 AM on March 12 [1 favorite]


In their daily press briefing, Italian officialdom is being careful to explicitly deny that ICU triage is happening. But given what ultimately came out of doctors' direct accounts from inside Wuhan hospitals, and that recently published document the upthread Atlantic article references... social. distance. now. please.
posted by progosk at 2:14 AM on March 12 [6 favorites]


Ireland and Britain aren’t part of Trump’s coronavirus travel ban. This is why. Trump’s travel ban applies only to countries within the “Schengen area”, Washington Post, Henry Farrell, March 12, 2020:
In a speech Wednesday, President Trump announced a ban on travelers from Europe. This led to a lot of initial confusion over what Trump meant by “Europe,” and whether trade in goods was banned too (Trump said it was, but the White House quickly clarified that this was not the case). Trump also said that the United Kingdom would be exempted from the ban, prompting a lot of speculation as to what exactly was going on. It turns out that the ban — and the exception for the United Kingdom — is not quite as arbitrary as it sounds. Trump’s ban extends to countries in what’s known as the “Schengen area,” a region that includes most states that are members of the European Union (as well as Norway, Iceland and Switzerland). The Schengen area does not include the U.K. nor Ireland, whose prime minister is meeting Trump Thursday for the traditional presentation of a bowl of shamrock for St. Patrick’s Day.

So what is the Schengen area, and why has the Trump administration targeted it?
...
More social distancing on an international scale, except for our traditional allies (unless things get bad enough).
posted by cenoxo at 5:54 AM on March 12 [1 favorite]


The number of cases in Iran went up about ~2000 in the last 24hrs (source) (the 'new case' numbers in the chart are from midnight GMT on but I've been watching it for the past couple of days). They're now up there with Italy. (Oh, and the number of countries on that chart almost doubled yesterday too. The airplanes really just dropped it everywhere)
Here is what the Iranian Ministry of Health is asking for. Look at the numbers. Look at the top of the page. Look at number one on the list.
If the number of deaths per day keeps doubling every day, 10 days from now is...not pretty. And because of the incubation period, those infections are happening today.
Today.
Stay home.
Even if your boss is a dick. Stay home. After they see the next couple of days, nobody's getting fired.
If you need rent money call your parents (Although, after the next couple of days, I don't think anyone's getting evicted either.)
For the Love of God. Stay home.

(Oh, and the UK exception seems obvious. It's tactical. It's the escape route. It will be one of the last places planes take off from if there's a worldwide travel ban.)
posted by sexyrobot at 6:40 AM on March 12 [6 favorites]


It's not even flights or travel routes thou. It is only None US Citizens. It is enforced via DHS, not the FAA, pretty much the only thing the whitehouse has figured out is how to use the DHS to stop people they don't like from entering the country. Think about that for a second - not only are they massively racist to begin with, they don't know a none racist way to do this.

If there's a plane to get on, I can fly from France or Spain or even Italy (if allowed out of the country) because I'm a US Citizen. But my Fiance who isn't can't. If I'm flying from Dublin, we can both enter the US. If our flight isn't direct and we stop in Amsterdam, I can still enter the US, she can't.
posted by mrzarquon at 7:56 AM on March 12 [7 favorites]


> Will be curious to see if Ireland gets included in “Europe” given his golf course there.....

Trump’s travel ban sidesteps his own European resorts

Coincidental, I'm sure.
posted by tonycpsu at 8:25 AM on March 12 [5 favorites]


Here’s Trump and Pence in a photo, posted five days ago after meetings at Mar-a-lago, with a dude who just tested positive.
posted by schadenfrau at 8:35 AM on March 12 [11 favorites]


"foreign virus"

not only are they massively racist to begin with, they don't know a non racist way to do this.

I had assumed this was the same reason for targeting Schengen specifically -- incapable of conceptualizing contagion in terms that don't involve "dirty foreigners", Trump and his courtiers naturally went after the countries with freedom of movement first, irrespective of actual risk or evidence.
posted by Not A Thing at 8:38 AM on March 12


So what is the Schengen area, and why has the Trump administration targeted it?

That article explains nothing. The UK has 600 confirmed cases now, a higher rate of infection than the U.S.

The answer is that Trump hates the EU and anything associated with it and he loves the Brexiteers. That's it. Nothing else to wonder about.
posted by JackFlash at 8:42 AM on March 12 [11 favorites]


> Here’s Trump and Pence in a photo, posted five days ago after meetings at Mar-a-lago, with a dude who just tested positive.

Gosh, you hate to see it.
posted by tonycpsu at 8:42 AM on March 12 [5 favorites]


CNN: Trump address sparks chaos as coronavirus crisis deepens
President Donald Trump set out to steady a rattled nation and a diving economy in a solemn Oval Office address, but instead sowed more confusion and doubts that he is up to handling the fast-worsening coronavirus crisis.

Trump spoke to the nation at a fearful moment, when the rhythms of everyday American life are starting to shut down -- with schools closing, the NBA suspended, hospitals on high alert and movie icon Tom Hanks saying he and his wife have the disease....

The confusion was symptomatic of an administration that has often struggled to frame detailed policies and present them coherently. Trump's top assignment on Wednesday was to show that he was in charge and that he appreciated, finally, the grave nature of the weeks that lie ahead. But the confusion over the travel ban turned his speech into something of a debacle and may up exacerbating uncertainty over his leadership....

Pressing issues now revolve around how Americans should respond to the situation and to what extent they should change their daily patterns. Trump did advise halting nonessential visits to care homes for the elderly -- the highest risk group from the virus.

But he didn't explain how he would alleviate what health officials fear will be a crowding of hospitals, the continuing lack of proper testing or the coming strain on resources such as breathing machines needed to keep the sickest patients alive.

He argued that the threat was still "very low" for all but the old and infirm, on a day when one of his top public health officials, Dr. Anthony Fauci, predicted the current scenario -- with more than 1,200 people sick in the US and 38 dead, is "going to get worse."

To Trump's supporters, his address likely came across as a decisive and bold move to face up to a national challenge.

But to critics it followed a familiar playbook -- as he blamed others for the crisis, basked in self-congratulation and xenophobia, and misled the country about his actions so far.

"This is the most aggressive and comprehensive effort to confront a foreign virus in modern history," Trump said, misrepresenting his own and his administration's catalog of missteps.

The President did not mention, for example, the shortage of testing kits, which means officials cannot even get a strong read on how far the disease has spread across the nation.

Presidents use Oval Office addresses in moments of extremis, to bind Americans together to confront a challenge that threatens their collective security.

But Trump's toneless, almost resentful address as he faces a challenge from outside that could threaten his reelection hopes is unlikely to fulfill the soaring mission of the presidency.

His central remedy -- blaming China, where the crisis was spawned, and Europe for becoming afflicted with it -- was consistent with his political mantra of demonizing foreigners.

The idea that a virus that affects all humans and is a naturally occurring force was some kind of foreign-brewed threat sent to attack Americans is in itself staggering in its conception.
posted by medusa at 8:45 AM on March 12 [9 favorites]


Gosh, you hate to see it.

I mean, yes, there’s this. But also...there’s literal photographic proof that both the President and the Vice President have been exposed. And I’m not a Trump scholar because I don’t have the stomach to watch that dumb asshole be a dumb asshole, but people seem to think he looked and sounded sick during his speech (particularly short of breath).

I really just...like is a constitutional crisis on top of everything else a...i don’t even know. The best possible thing would be to have competent leadership! Yet I don’t see these authoritarian dickwads just voluntarily handing the reins to Pelosi.

Meanwhile the markets are down like 27% from recent highs, which is straight up depression territory. Last time we needed a world war to get out of the depression, and filling that 30% void with a military industrial complex left us with a massive addiction to war which has gone very poorly for everyone Maybe this time we can fill that void with something Green New Deal-y?

Just. Fuck.
posted by schadenfrau at 8:52 AM on March 12 [7 favorites]


a higher rate of infection than the U.S.
The USA doesn't know our rate of infection. The countries with high reported rates have the capacity to know their rates because they can test. We can't. Those countries are reporting because they're trying to cooperate with a global effort to stop a global crisis. We're not trying to cooperate and we're actively resisting help from outside. We're not learning from other countries and we're continuing to mill around frantically selling each other shit. Everything we do makes us more of a petri dish. That travel ban is therefore likely unnecessary because we probably look absolutely terrifying. Nobody in a country with any kind of functioning public health system would opt to travel to a country without one.

people seem to think he looked and sounded sick during his speech (particularly short of breath).
It would be too good, so I don't believe it. It's the usual: he can't see and won't wear glasses and they have to keep the teleprompter out of the frame and the camera far enough away from him that you can't see his dentures, his likely proprietary baldguy hair technologies, or his spraytan lines. So he's straining to see text that's too far away and thus misreading constantly and sounding halting. And that sniffing and snucking he does is the same sniffing and snucking he always does: not unusual and completely onbrand.
posted by Don Pepino at 9:02 AM on March 12 [16 favorites]


Meanwhile the markets are down like 27% from recent highs, which is straight up depression territory. Last time we needed a world war to get out of the depression, and filling that 30% void with a military industrial complex left us with a massive addiction to war which has gone very poorly for everyone Maybe this time we can fill that void with something Green New Deal-y?

There is no doubt that this will lead to a global economic crisis, but I'm hoping so much that there is the silver lining that this will catapult us into a Green New Deal. After all, pandemics are one predicted aspect of global warming, and this is not the last one if we don't change our ways radically.
posted by mumimor at 9:17 AM on March 12 [1 favorite]


Wow, that CNN article pulls no punches. Good to see some fact-checking and critical commentary in the mass media.
posted by rabbitrabbit at 9:19 AM on March 12 [1 favorite]


I'm hoping so much that there is the silver lining that this will catapult us into a Green New Deal

Me too, but we all need to take action for this to happen. Contact your congresscritter now to insist they promise not to bail out cruise ship companies, airlines, airports, or other fossil fuel companies, or the banks that fund them. Because that will be priority number one for the 1%, and unless we make a ruckus ASAP, they'll pass that bailout and some tax cuts while the rest of our grandparents die. Insist we funnel the money into green alternatives and emergency measures for the working class. AOC's list is pretty good:

- Extending Medicare/Medicaid coverage to all
- Eviction freezes
- No-strings UBI programs
- Eliminating work requirements for SNAP &other assistance
- Humanitarian provisions in prisons & decarceral policies

posted by daveliepmann at 9:33 AM on March 12 [8 favorites]


The markets are still up from 3 years ago, as of this morning. They were in a weird rally. Banks are still lending. There's still plenty of money in the economy. That alone makes this much MUCH better than the financial crisis. If you were planning on taking cash out of your 401k this quarter...you're still better off than you would have been just three years ago.

Oil being cheaper is also being pushed as a bad thing, but it's not bad at all. It's better for everyday Americans. Oil prices affect the prices we pay for food, goods, gas, everything, and American consumers have been squeezed horribly. The prices were artificially high to begin with. Lower prices will help get things up and running again when manufacturing and shipping start to rebound.

The economy is slower, that is 100% the case. Things like the stock market reflect that reality. But as of right now, there do not seem to be any issues with the stability or health of the global financial markets. This will be painful in the short-term, but it looks like everyone, including banks, who are lending their hearts out, is betting that there will be a recovery.
posted by internet fraud detective squad, station number 9 at 9:36 AM on March 12 [1 favorite]




I missed this earlier. New England Journal of Medicine articles on COVID-19, not paywalled.
posted by vacapinta at 9:39 AM on March 12 [3 favorites]


Trump's response to the Brazilian official's positive test is that he “isn’t concerned” which makes me concerned about continuity of government issues. Between this and the Senate staffer, Congress probably shouldn't be in regular session anymore.
posted by feloniousmonk at 9:40 AM on March 12


Anybody worried that Trump will try to use the crisis to delay/cancel the election? Actually, can he do that?
posted by WaterAndPixels at 9:41 AM on March 12 [1 favorite]


The markets are still up from 3 years ago, as of this morning. They were in a weird rally. Banks are still lending. There's still plenty of money in the economy. That alone makes this much MUCH better than the financial crisis. If you were planning on taking cash out of your 401k this quarter...you're still better off than you would have been just three years ago.

Yeah, but that doesn't help the people working in the service industry, travel and transportation, I just got a mail today about construction being hit. Big businesses and rich people will be able to handle this just fine. Millions of small business owners globally will not be able to make it through months of nothing. Nor will their employees.
Big companies should be forced to give their workers a paid sick leave if needed - they can easily afford it. But wait and see how many are pretending not to know how serious this is.
posted by mumimor at 9:42 AM on March 12 [2 favorites]


The answer to any "can he do that" question is always "who will stop him". The only person in the US who has that kind of power at this point is probably @jack.
posted by tonycpsu at 9:44 AM on March 12 [4 favorites]


Anybody worried that Trump will try to use the crisis to delay/cancel the election?

GO OUTSIDE TURN AROUND THREE TIMES AND CURSE AND SPIT RIGHT NOW FOR THE LOVE OF GOD MONTRESSOR.

…In other people-can-be-shits news - there are reportedly some hackers using "info sites about coronavirus" as lures for spreading malware.
posted by EmpressCallipygos at 9:45 AM on March 12 [1 favorite]


Anybody worried that Trump will try to use the crisis to delay/cancel the election? Actually, can he do that?
The extreme measures the Danish government have taken today violate basic civil rights. Most people are OK with it because they feel we can deal with it (I think there is a sundown clause). But if a Social Democratic government in Denmark can do something like that, I'd say it wouldn't be impossible for a Republican American president.
posted by mumimor at 9:49 AM on March 12 [2 favorites]


Insurance Industry Corrects Trump: Actually, We're Only Waiving Copays for Coronavirus Testing, Not Treatment; Common Dreams, Jake Johnson, March 12, 2020:
... President Donald Trump Wednesday night claimed that major U.S. insurance companies "have agreed to waive all copayments for coronavirus treatments" as the disease rapidly spreads across the nation.

A spokesperson for America's Health Insurance Plans (AHIP), a major insurance industry lobbying group, was quick to clarify that, actually, companies are only waiving copays for "testing." For those who test positive for COVID-19, any treatment will still come at a (potentially massive) cost.

"For testing. Not for treatment," the AHIP spokesperson told Politico healthcare reporter Sarah Owermohle after Trump delivered his prepared remarks...

A White House official also stepped in to correct Trump's claim that insurance companies agreed to waive copays for coronavirus treatment after meeting with the president at the White House on Tuesday.

The anonymous official told CNN's Jim Acosta that Trump, who read his remarks off a teleprompter, meant to say that insurance companies "have agreed to waive all copays on coronavirus testing."
...
posted by cenoxo at 9:51 AM on March 12 [2 favorites]




We’re all reading these articles and twitter threads about what we need to be doing and what the consequences are of not doing it, and then I look outside and...no one is doing it. Even the most aggressive US officials are down playing it. Broadway shows go on (even though an usher tested positive), they haven’t canceled the N.Y. St Paddy’s parade, Disneyland is booked through. I feel like I’m taking crazy pills.

‘If I’m Going to Get Sick and Die, I Might as Well Do It at Disney World’ - NYTimes has an article about Disney that reads like the first scene of a zombie movie. I live in an infected part of Cali, so I guess I've been low-key freaking out about this for 2 weeks, but Disney gets visitors from all over the country (and world). It's shocking to see people so blase about the risk of disease spread right when it seems to be hitting a fever pitch everywhere else. The sports leagues suspending their seasons instead of just playing to empty stadiums...that's a pretty clear sign, to me, of what actions are recommended when you actually care about the people at risk (elite athlete versus regular person who goes to theme parks).
posted by grandiloquiet at 9:55 AM on March 12 [7 favorites]


Yeah, but that doesn't help the people working in the service industry, travel and transportation, I just got a mail today about construction being hit. Big businesses and rich people will be able to handle this just fine. Millions of small business owners globally will not be able to make it through months of nothing. Nor will their employees.

100% agree. This will be difficult for many in the short-term, and probably the long term. However, this is not like the Great Depression, or even the financial crisis. When the overall economy is stable---if very slow---it provides a better platform for recovery. Low oil prices, similarly, will likely help ease the strain on the little guy. This is not to minimize the real harm that happens in a drastically slowed economy.

Big companies should be forced to give their workers a paid sick leave if needed - they can easily afford it. But wait and see how many are pretending not to know how serious this is.

100% agree again. We need robust social programs and reasonable measures that ensure everyone's safety. What we have is brutal and sociopathic wealth hoarding, which equates to safety hoarding, health hoarding, life hoarding.
posted by internet fraud detective squad, station number 9 at 9:58 AM on March 12 [3 favorites]


Air Travel and Disease (Patrick Smith, Ask The Pilot)
Forgive me if I don’t understand Trump’s logic. It’s so full of holes that it’s hard to take seriously. He cites COVID-19 clusters in the United States that were allegedly touched off by travelers from Europe. All right, but the virus is already here and uncontainable. What difference will flights from Europe make? Moreover, the ban applies only to foreign citizens, not to Americans. Are Americans traveling in Europe immune to coronavirus? And travel from the United Kingdom is strangely exempt, despite that country having more recorded cases than several of those on the banned list. And let me get this straight, I can fly to the United States from Asia but not from Europe? Or, I can fly from one of the banned countries to the UK (or to Canada, or elsewhere), and then to the U.S.? Am I missing something, or is this an idea he pulled out of the air, so to speak, in an effort to save face and sound “decisive”?

Assuming there’s reason to care. As COVID-19 spreads throughout the U.S., it’s only a matter of time before the rest of the world begins closing its doors to us.

The airlines have never faced anything like this. I’ve expanded my worst-case scenario prediction to one in which, a month from now, ninety percent of commercial flights are grounded. Carriers will essentially shut down and try to wait things out. Something like what we saw in the days just after the 2001 terrorist attacks, except this time running for weeks, or months, with hundreds of thousands of workers unemployed, and one (or possibly all) of the major airlines destroyed outright. No airline will survive this without massive amounts of government assistance (maybe China can pay for the bailout, eh?).
posted by ZeusHumms at 9:59 AM on March 12 [4 favorites]


When the overall economy is stable---if very slow---it provides a better platform for recovery.

The driver of the economy has been US consumer spending.

That is...not going to remain stable.
posted by schadenfrau at 9:59 AM on March 12 [9 favorites]


that T[nope], who read his remarks off a teleprompter, might better be said who _failed_ to read his remarks off a teleprompter. in my, admittedly inconsistent, observation of him, it is not unusual for him to struggle to read. that said, he did look like he was working hard last night. reminded me at moments of reagan failing to maintain. it was than frozen squinty eye as much as the denture-slipping or whatever. i think he actually snorted at one point. i don't sympathize with that fucker one bit, but his aspect was worrisome, somewhat more than usual.
posted by 20 year lurk at 10:04 AM on March 12 [1 favorite]


The driver of the economy has been US consumer spending.

That is...not going to remain stable.


Spending won't remain stable, no. You're 100% right. However, that is not what I mean about economic and financial systems being stable.

Think of the global economy as a car. Right now, the car is low on gas. It might even be close to out of gas. This is unquestionably bad, we want the car to run. What I am saying is that, as far as we can tell, the engine is working and in good shape. The transmission is working and in good shape. There is enough radiator fluid (long term) and enough oil (medium term) in the car. That means that when we put more gas in the car---meaning, when the economy is more active---the car will be able to go.

There are a lot of systems underlying the US economy and making everything work. Those seem to be doing absolutely fine right now. That is different from what happened in 1929 and in 2008.

I don't want to argue about this, I agree that this is a bad situation. I just would like to hopefully provide some context and lower people's anxiety a little bit.
posted by internet fraud detective squad, station number 9 at 10:07 AM on March 12 [3 favorites]


America shuts down (Politico)
From the Capitol to California, officials are taking aggressive new measures to limit social interactions.
Fauci told lawmakers that America’s test system "is failing,” noting that it’s not set up for mass testing like other countries.

“Do I think we should be? Yes,” Fauci said. “But we’re not.”

“That’s the reason why we’re not able to answer the broader questions of how many people in the country are infected right now,” he added. “We hope to get there reasonably soon, but we’re not there now.”
‘Massive Shock’ and Battered Airline Stocks in Europe With Trump’s Travel Ban (NYT)
“Considering all the other restrictions on movement already in place in Europe, in and of itself the ban is not a huge economic event,” said Holger Schmieding, chief economist at Berenberg Bank. “You could even argue that it is a blessing in disguise if it has the effect of slowing the spread in the United States,” he said.

Because the epidemic is a medical emergency, he added, the most important thing governments can do to to ensure economic recovery is to prevent the virus from spreading more widely, even if it inflicts financial pain on companies.

“At the moment, significant short-term economic costs should be incurred if it helps with the medical emergency.” he said. “If it slows the spread of the epidemic to give us enough time to cope, that would be very valuable.”
posted by katra at 10:10 AM on March 12 [3 favorites]


I've been thinking about the European travel ban because it made no sense to me, and even though the Trump administration is always irresponsible and stupid, there is mostly some inner logic to what they do.

Now I think that it was probably a preemptive stroke. The US approach to this pandemic is so off and plain wrong and dangerous that it may only be a couple of days before EU officials advise against traveling to the US and suggest that EU citizens come home, since even relatively low risk patients will be stuck with a breaking health system and inadequate insurances. Since the EU does diplomacy the normal way, they may have warned the Trump administration that this was going to happen, which again would have big consequences within the US: how would the US voting public react to the fact that Europe defines the US as a high risk area?

Here in Denmark, the immediate response to the travel ban has been to advise against travel to the US.
posted by mumimor at 10:12 AM on March 12 [16 favorites]


Bolsonaro aide tests positive for coronavirus days after Trump meeting.
Brazilian President Jair Bolsonaro's press secretary tested positive for coronavirus days after taking part in meetings with President Trump at Mar-a-Lago
posted by adamvasco at 10:16 AM on March 12 [1 favorite]


Here’s the Biggest Thing to Worry About With Coronavirus (NYT)
We don’t have enough ventilators and I.C.U. beds if there’s a significant surge of new cases. As with Italy, the health system could become overwhelmed.
The ability of the American health care system to absorb a shock — what experts call surge capacity — is much weaker than many believe.

As a medical doctor who analyzes health issues for The Upshot, I strive to place your fears in context and usually tell you that you shouldn’t be nearly as afraid as you are. But when it comes to the nation’s response to the new coronavirus, I cannot be so reassuring.

A crucial thing to understand about the coronavirus threat — and it’s playing out grimly in Italy — is the difference between the total number of people who might get sick and the number who might get sick at the same time. Our country has only 2.8 hospital beds per 1,000 people. That’s fewer than in Italy (3.2), China (4.3) and South Korea (12.3), all of which have had struggles. More important, there are only so many intensive care beds and ventilators.

It’s estimated that we have about 45,000 intensive care unit beds in the United States. In a moderate outbreak, about 200,000 Americans would need one. [...] The total number of infected people isn’t what scares many epidemiologists. It’s how many are infected at the same time.
Flattening the Coronavirus Curve (NYT)
One chart explains why slowing the spread of the infection is nearly as important as stopping it.

also, fyi The New York Times is providing free access on the global coronavirus crisis.
posted by katra at 10:19 AM on March 12 [17 favorites]


Please read the links on katra's comment above. They are essential.
posted by mumimor at 10:35 AM on March 12 [2 favorites]


According to the Guardian, who only has a headline right now on their liveblog, Trump is considering a travel ban within the US to CA and WA. I know the federal government has vast powers under its emergency authority but the implementation and enforcement of this sort of thing is really hard to imagine. Are they going to build a wall?
posted by feloniousmonk at 10:35 AM on March 12 [5 favorites]


The statements that The Guardian is referring to seemed more like one of Trump's patented "rambling nervous talking thing" word salads than anything that was official policy, as I understood it. But still worrisome.
posted by EmpressCallipygos at 10:45 AM on March 12


after taking part in meetings with President Trump at Mar-a-Lago
What if Trump's a superspreader? I just listened to three in a row updates from the NEJM (thank you, vacapinta) and heard that some of the highest-risk patients get sick relatively late. Early in the disease they have no overt symptoms and no fever so they stump around for days before they collapse and need ECMO.
posted by Don Pepino at 10:56 AM on March 12 [3 favorites]


What if Trump's a supermoron?
posted by medusa at 11:04 AM on March 12 [16 favorites]


[Long paste and a couple replies removed. On reflection, let's aim to marry anything with that kind of detail to an actual link and some sourcing/context; detailed info is great but without a way to ground it in anything it's a bit of a weird fit.]
posted by cortex (staff) at 11:54 AM on March 12 [5 favorites]


lancet article "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study" excerpt:
Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days.
nejm correspondence "Detection of Covid-19 in Children in Early January 2020 in Wuhan, China" excerpt:
The median age of the six patients was 3 years (range, 1 to 7) (Table 1). All six children had previously been completely healthy. Common clinical characteristics included high fever (>39°C) (in all six patients), cough (in all six), and vomiting (in four).
i post the latter mostly b/c little lurk had a high fever and vomiting and now has a cough. also because parents, objecting to school closure, offer "but children are unaffected by the virus" as though it is a verifiable fact. as far as i can tell, there is still no science-based information available on the capacity of asymptomatic children to spread the virus. (those parents, dear reader, may be starting to doubt my commitment to sparkle motion.)
posted by 20 year lurk at 11:57 AM on March 12 [6 favorites]


Coronavirus: many infections spread by people yet to show symptoms – scientists (Guardian)
Many coronavirus infections may be spread by people who have recently caught the virus and have not yet begun to show symptoms, scientists have found. An analysis of infections in Singapore and Tianjin in China revealed that two-thirds and three-quarters of people respectively appear to have caught it from others who were incubating the virus but still symptom-free. The finding has dismayed infectious disease researchers as it means that isolating people once they start to feel ill will be far less effective at slowing the pandemic than had been hoped.

[...] The finding confirms recent comments from Maria Van Kerkhove, head of the World Health Organization’s emerging diseases and zoonoses unit, who said preliminary data showed patients shed more virus in the early stages of the disease, including when presymptomatic.

[...] Rowland Kao, who studies infectious disease dynamics at the University of Edinburgh, said: “One of the factors that has distinguished this coronavirus pandemic from the Sars epidemic in 2003, is that Sars was infectious only after the development of clinical signs, which made it relatively easier to control. For the current pandemic, from very early on it was suspected that a substantial number of transmissions were arising before clinical signs appeared. “What is important to know is that, in their analysis, isolation can play an important and possibly crucial role but needs to be supplemented by other measures,” he added.
posted by katra at 12:18 PM on March 12 [7 favorites]




What if Trump's a supermoron?

Watching Trump’s subdued, monotone address last night, I think he realizes he can’t bullshit through this crisis, and as President, he can’t run away from it either. If he was a private citizen, he’d probably leave the USA to personally manage one of his hotels in the tax-sheltered Duchy of Grand Fenwick or wherever.

I wonder how his sons and daughters are dealing with foreign travel bans? Are their junkets under special exemptions?
posted by cenoxo at 12:34 PM on March 12 [2 favorites]


You know what Trump and Obama have in common? They both turned the economy around.
posted by dances_with_sneetches at 12:54 PM on March 12 [14 favorites]


An informative article on testing for the virus, written by a biology professor. Good news for the US is lots of new testing kits are on the way already.

She only discusses the relatively complex RT-PCR test, which I believe the only type currently approved in the US. The Wikipedia article mentions other types such as antibody-based/serological. I am not as familiar with that as I am with RT-PCR (I used it extensively back in grad school) but I suspect such tests would be faster and cheaper. More on this at the CDC website.
posted by exogenous at 12:54 PM on March 12 [3 favorites]


Reuters has a good comparison between Italy and Korea's situations, both in terms of the govt and health care responses. (via)
Italy and South Korea are more than 5,000 miles apart, but there are several similarities when it comes to coronavirus. Both countries’ main outbreaks were initially clustered in smaller cities or towns, rather than in a major metropolis - which meant the disease quickly threatened local health services. And both involved doctors who decided to ignore testing guidelines.
posted by spamandkimchi at 2:30 PM on March 12 [6 favorites]


This is interesting (from the Reuters article).
This includes enforcing a law that grants the government wide authority to access data: CCTV footage, GPS tracking data from phones and cars, credit card transactions, immigration entry information, and other personal details of people confirmed to have an infectious disease. The authorities can then make some of this public, so anyone who may have been exposed can get themselves - or their friends and family members - tested.

In addition to helping work out who to test, South Korea’s data-driven system helps hospitals manage their pipeline of cases. People found positive are placed in self-quarantine and monitored remotely through a smartphone app, or checked regularly in telephone calls, until a hospital bed becomes available. When a bed is available, an ambulance picks the person up and takes the patient to a hospital with air-sealed isolation rooms. All of this, including hospitalization, is free of charge.

...“Disclosing information about patients always comes with privacy infringement issues,” said Choi Jaewook, a preventive medicine professor at Korea University and a senior official at the Korean Medical Association. Disclosures “should be strictly limited” to patients’ movements, and “it shouldn’t be about their age, their sex, or their employers.”

Traditional responses such as locking down affected areas and isolating patients can be only modestly effective, and may cause problems in open societies, says South Korea’s Deputy Minister for Health and Welfare
posted by spamandkimchi at 2:34 PM on March 12 [3 favorites]


i am informed that the school the president's son attends "will transition to its Distance Learning Plan effective Monday, March 16," and does not anticipate reopening its campus before April 6.
posted by 20 year lurk at 6:10 PM on March 12 [1 favorite]


White House turns to Big Tech to fix coronavirus blunders while classifying previous conversations, The Register, Kieren McCarthy/San Francisco, 11 Mar 2020:
...
The White House Office of Science and Technology Policy held a meeting on Wednesday with representatives from Facebook, Google, Amazon, Twitter, Apple, Microsoft, Cisco, IBM and others in a bid to figure out how to get a handle on the problem.

Michael Kratsios, CTO at the White House said the federal government was hoping that Big Tech would be able to use AI and data tools to provide useful insights as it unveils new measures for tackling the crisis. “Cutting-edge technology companies and major online platforms will play a critical role in this all-hands-on-deck effort,” Kratsios said in a statement.

At the same time, however, it emerged the White House was also ordering all deliberations over covid-19 to be considered classified, effectively restricting discussions to only those with a top secret classification.

According to officials, dozens of classified discussions that covered issues like the size and scope of infections, quarantines and travel restrictions were held at a high-security meeting room at the Department of Health & Human Services (HHS). The upshot of that level of classification and secrecy has been that some acknowledged experts have not been allowed to attend meetings, a number of anonymous sources have said.

One such source told Reuters that the order to classify the information - a highly unusual request given the topic and the fact that it involves public health and not national security - came directly from the White House.
...
God help us: we’re in the hands of engineers.
posted by cenoxo at 7:12 PM on March 12 [12 favorites]


Anger grows at Trump administration's coronavirus testing failures (Guardian)
Andrew Cuomo, governor of New York, which is one of the states hardest hit by the disease so far, told CNN the US was “way behind on testing”. What he called a “federal bottleneck” was so bad that he had authorised New York authorities to contract out testing to private laboratories.

Cuomo said the paucity of testing not only prevented containment of localised outbreaks, it also gave the public a false sense of security by obscuring how prevalent the disease has already become. “It’s because we have no testing capacity, that’s why the numbers are low. If you actually had testing capacity you would see how high the numbers are already. As we do ramp up testing you are going to see those numbers go sky-high.”
posted by katra at 7:23 PM on March 12 [2 favorites]


Some updates from Canada

Ontario to extend March break and shut down publicly funded schools from March 14-April 5 (still no word on if teachers will be paid or eligible for EI during this period)

Also Sophie Gregoire Trudeau has tested positive for COVID 19 (Prime Minister Justin Trudeau's wife)
posted by devonia at 7:26 PM on March 12 [3 favorites]


From a CNN article about Trump's exposure to a carrier, Brazilian president's press secretary tests positive for coronavirus, days after meeting Trump.
The Brazilian press secretary attended the dinner Trump hosted at his Mar-a-Lago resort in Florida, took a photo with the US President and later stood feet away from Trump as he spoke during Kimberly Guilfoyle's birthday, the sources said.
White House press secretary Stephanie Grisham issued a statement Thursday saying: "Both the President and Vice President had almost no interactions with the individual who tested positive and do not require being tested at this time."
[my emphasis]

What macho nonsense. Of course they require testing. Everybody in the White House should be tested regularly, because it is a single point of failure for both the USA's Federal government and for the armed forces of the USA. IMO the place should be on lock-down, with as few people entering as possible. The President and VP should be isolated from each other, and they and all staffers should be tested daily until it is clear that none of them are infected. Otherwise there will indeed be a constitutional crisis, because according to Wikipedia "the offices of president and vice president have never been simultaneously vacant" and consequently the Presidential Succession Act has never been tested.

According to the Continuity of Government Commission established after the September 11th attacks there are serious questions regarding its validity and suitability, and I frankly do not believe that Republicans would acquiesce to (e.g.) Nancy Pelosi becoming Acting President or even Acting Vice President.
posted by Joe in Australia at 7:46 PM on March 12 [8 favorites]


Wow.

Sadness, disappointment and fury as Australian Grand Prix cancelled

It was due to start tomorrow. I could hear the cars practicing! I could even tell where they were on the track by the periods between acceleration. They were expecting 300,000 people! 12,000 staff! It's absolutely the right thing to do, and would have been even if one of the drivers hadn't been found to be infected, but still - wow!
posted by Joe in Australia at 7:51 PM on March 12 [5 favorites]


WRT Joe in Australia’s comment above: given that people 60 and older are the most vulnerable to CV, and as a condition of Trump’s fitness to fulfill the duties of the presidency, can Congress demand that he gets tested for coronavirus?

Can he order that all members of Congress be tested also?

Imagine the White House and Capitol Building under quarantine.
posted by cenoxo at 7:52 PM on March 12


Disney, Universal Studios Close All Theme Parks Amid Coronavirus Pandemic, Variety, March 12, 2020: “By Monday, all Disney theme parks worldwide and both Universal Studios in the U.S. will be closed in an effort to prevent the further spread of the novel coronavirus, or COVID-19.”
posted by cenoxo at 8:08 PM on March 12 [3 favorites]


Here in Ottawa, we have had our first, second and third confirmed case in the past three days. We are worried of course about the extent of the disease here. So there is a certain irony that these cases tells us a lot about the situation in Europe instead. Namely that it is a *lot* worse than the numbers indicate.

So our first Ottawa case came back from an Austria trip on March 2nd.
Austria claims 300 confirmed cases according to the John Hopkins COVID-19 webpage. Hard to believe that ten days ago, when the confirmed cases was < 100, the first Ottawa case just happen to run into one of those 100 people. Austria is seriously undercounting its cases.

Same deal with the UK. Sophie Trudeau, our third case (and wife of PM Justin Trudeau) has tested positive after a short trip there. London has a confirmed case count of 136. She was in London. In a city of 9 million, she just happened to come across some of those 136 people
Someone can probably do the stats and probabiilties of that and maybe come up with a range on the true number of infected people. I wouldn't be surprised if that number is one or two orders of magnitude higher.
posted by storybored at 9:17 PM on March 12 [6 favorites]


And what are they doing so well in Russia: disappearing the infected to a Siberian CV gulag? The current JHU Coronavirus COVID-19 Global Cases dashboard shows only 28 confirmed cases in the world’s largest country (+6.6 million square miles) with a broadly diverse population of +146 million.

There’s also a summary of cases (with 34 total confirmed) and preventive measures taken (including the rather ominous “...carrying raids on potential virus carriers and using facial recognition to impose quarantine measures.”) at 2020 coronavirus pandemic in Russia (WP).

These seem like amazingly small numbers.
posted by cenoxo at 9:59 PM on March 12 [8 favorites]



Coronavirus: many infections spread by people yet to show symptoms – scientists (Guardian)

This is perhaps the most critical research result so far. I don't know if the implications have settled in because the noise level is so high.

The primary piece of advice has been that people shouldn't go out or go to work if they are sick. The research shows this is not enough. Taking this advice will not stop the contagion.
posted by storybored at 9:59 PM on March 12 [7 favorites]


Coronavirus: Ten reasons why you ought not to panic

six days old but ...

What we certainly have is a pandemic of fear. The entire planet’s media is gripped by coronavirus. It is right that there is deep concern and mass planning for worst-case scenarios. And, of course, the repercussions move from the global health sphere into business and politics.

But it is also right that we must not panic. It would be wrong to say there is good news coming out of COVID-19, but there are causes for optimism; reasons to think there may be ways to contain and defeat the virus. And lessons to learn for the future.


The ten reasons (all offering links to relevant sources):

1. We know what it is

2. We know how to detect the virus

3. The situation is improving in China

4. 80% of cases are mild

5. People recover

6. Symptoms appear mild in children

7. The virus can be wiped clean

8. Science is on it, globally

9. There are already vaccine prototypes

10. Antiviral trials are underway
posted by philip-random at 10:42 PM on March 12 [3 favorites]


I think that I am tired of people saying the issue is us all going mad with panic, rather than government after government not taking this seriously enough early on for fear of panicking the markets.
posted by lesbiassparrow at 10:59 PM on March 12 [38 favorites]


Yeah, me too pretty much. I think everyone is clear that this isn't Captain Trips. Civilization is not going to end. It's not time to break out the shotguns and bottlecaps.

But at the same time... the real enemy here in the USA isn't fear, it's that our government has utterly failed us and we are as a society woefully unprepared and behind the curve. That undoubtedly isn't true for some non-American MeFites whose governments acted competently, but for most of us it is true.

The only thing we have to fear is fear itself. Well, that and abject incompetence at every level of the federal response.
posted by Justinian at 11:12 PM on March 12 [16 favorites]


Here in Victoria, Australia, it looks to me as if they're contemplating the closure of all State (i.e., public) schools from Monday. It's Friday afternoon at present, no announcement but I know that at least some kids have been asked to take their textbooks home. Public gatherings of 500 people or more are to be banned nationally from Monday.

This sounds inadequate to me. 500 people is a lot! Is the probability of infection really reduced significantly at that level?
posted by Joe in Australia at 11:23 PM on March 12




Imagine the White House and Capitol Building under quarantine.

One of the measures taken here in Denmark is that only half of Parliament can be in the room at the time. And we don't even have any known cases of politicians with the virus.

There are far more cases than we know. We know that for sure. That's why you have to stay home even if you just think you have a mild common cold. Even though it's not as bad as in the US, no countries have the means to test everyone who needs to be tested. I may have had it (any one of my students can have been in Austria skiing before it was known it was a risk, one third of my students were ill at the last class), but at the time my doctor said there was no reason to think it and only people who had personally traveled to high risk countries were tested. This is a huge challenge to our health care systems, even when everyone does what they think is right.
posted by mumimor at 12:02 AM on March 13 [8 favorites]


Andy Slavitt (Former Medicare, Medicaid & ACA head for Obama) twitter thread:
Currently experts expect over 1 million deaths in the U.S. since the virus was not contained & we cannot even test for it.
This will be recorded as a major preventable public health disaster. I will try to relate what I learned from a long day of calls about what is happening.
(His whole feed is worth reading.)
posted by growabrain at 1:56 AM on March 13 [7 favorites]


Andy Slavitt (Former Medicare, Medicaid & ACA head for Obama) twitter thread:
Currently experts expect over 1 million deaths in the U.S. since the virus was not contained & we cannot even test for it.
This will be recorded as a major preventable public health disaster. I will try to relate what I learned from a long day of calls about what is happening.


I tried to do the math as we are informed about it right now here in Denmark. The authorities are planning for a situation where 10% of the population are infected. Out of them, 10% are expected to need hospital care. Out of them, 10-20 % are expected to need intensive care and some of these patients will die, albeit with proper care, they may not. But here's the thing: right now, there are not enough intensive care beds for 6000 corona patients, on top of the normal intensive care patients. If we can delay the spread of the disease enough to establish more beds with ventilators and nurses to fit, there will be less fatalities. Right now the whole nation is struggling to achieve this.
When you look at the US numbers, I think 1 million deaths is a low estimate because intensive care is much more unevenly dispersed in the US and the system can not easily adapt. Today it was reported that someone found a lot of old but functional ventilators in a storage room here, and they will be put to work all over the country according to need, not provider. Because we have universal care the administration is relatively simple.
posted by mumimor at 3:32 AM on March 13 [4 favorites]


A statistic I've been eyeing over the last few days is the number of closed cases. The Worldometers dashboard has data that seems a little more current than the JHU one — the numbers are consistently higher on that site than the ones reported by JHU, at least. Over the last several weeks, the percentage of closed cases due to death sat at 6% (meaning 94% of the cases were closed because the patients recovered.) Today, as the number of fatalities crossed the 5K mark, the percentage of closed cases due to death edged up to 7%. It could be an anomaly, but it could mean things are getting worse.
posted by emelenjr at 5:40 AM on March 13 [1 favorite]


Terse, actionable, expert information:

Notes from UCSF Expert panel - March 10

Note especially their bolded portions, including:
  • Appears one can be infectious before being symptomatic. We don’t know how infectious before symptomatic, but know that highest level of virus prevalence coincides with symptoms. We currently think folks are infectious 2 days before through 14 days after onset of symptoms (T-2 to T+14 onset).
  • Anyone over 60 stay at home unless it’s critical [due to the elevated mortality rate in older adults]
(crossposted to the #staythefuckhome thread)
posted by Westringia F. at 6:41 AM on March 13 [5 favorites]


For UCSF - did they mean "anyone over sixty anywhere" or "anyone over sixty in California"? My dad, who is over sixty, was talking about making a short trip to see my brother later this week. They'd mostly be at home, he'd be in his car and it's very important to him to go - but he said he would reconsider if it seemed wise.
posted by Frowner at 6:55 AM on March 13


As coronavirus fears soar, Europe moves to ban wasteful "ghost flights" (Shannon Osaka, Salon)

'Ghost flights' are empty airplanes flown to meet the requirements of reserving and keeping arrival and departure times slots.
posted by ZeusHumms at 6:57 AM on March 13 [5 favorites]


The president of Brazil, Jair Bolsonaro, has tested positive for coronavirus, according to local media.
So I am guessing we are entering into near Military Dictatorship with General Hamilton Mourão taking over government.
posted by adamvasco at 7:25 AM on March 13 [5 favorites]




The FDA Is Forcing the CDC to Waste Time Double Testing Some Coronavirus Cases (Lydia DePillis and Caroline Chen; Pro Publica)
'The FDA’s strict guidance on test confirmations is one of several obstacles that has slowed the federal government’s response to COVID-19. The FDA could change its rules to speed things up, but hasn’t.'

Requiring confirmatory tests not only adds time to the process but also uses crucial chemicals needed to set up the tests. “You need some of the reagents that now are in short supply to prepare the tests,” said CDC Director Robert Redfield in a hearing before the House Oversight Committee on Thursday, explaining the difficulty in expanding capacity even as private labs received green lights to start testing.
posted by ZeusHumms at 7:38 AM on March 13


"Coronavirus: Ten reasons why you ought not to panic"

Everything in this article is correct but the problem with it (and with all the pieces I have seen on "panic") is that it doesn't define what panic is.

Is self-isolating without symptoms panic?
Is canceling meetings of less than a dozen people, panic?

This is an article telling us not to do something, without telling us what that something is. The kind of unfocussed piece that people write when panicking :).
posted by storybored at 7:38 AM on March 13 [12 favorites]


With regard to panic, I'm ironically worried, not comforted, by the huge elevation of concern in the US over the last two days.

First and foremost, while it's caused a lot of social-distancing to be undertaken at the local and private level, I fear the vast problems with the federal response mean that we're still far behind where we should be and most others countries are. So the big increase in taking this seriously hasn't translated into action as much as it should have.

Second, because the mood has changed so radically and because the inadequate response is nevertheless unprecedented and upsetting, and because people don't understand the epidemiology and math involved, they are expecting the response right now to make a difference that will be felt almost immediately. But there's about a twelve day lag while the infection doubling rate is about six days. And the true number of infections as of yesterday is at least an order of magnitude higher than those we are aware of.

All this means that, numerically, things will get much worse for twelve days before any of the changes now will be seen to have an affect and, during this time, the reported numbers are going to go up dramatically.

If people are this upset today, and they're not aware of what I just wrote, then how much more frightened are they going to become over the next twelve days?

So even as I am sounding the alarm to everyone who will listen, now I am actually worried about panic, too.

This is exactly where responsible, informed, and strong messaging from the very highest levels of US government is desperately needed. And the best were getting is Fauci. This is a travesty above and beyond that of the pandemic itself.
posted by Ivan Fyodorovich at 7:38 AM on March 13 [14 favorites]


Regarding virus having a limited lifetime on surfaces--this means that when spaces are vacated (businesses, schools, college classrooms, dorms) that having them be vacated for several days to a few weeks means that they decontaminate without incurring risk to custodial staff who would otherwise be doing decontamination cleaning.
posted by Sublimity at 7:51 AM on March 13 [11 favorites]


good thinking, Sublimity.
related: is that eponysterical?
posted by 20 year lurk at 7:58 AM on March 13 [3 favorites]


White House Knew Coronavirus Would Be A 'Major Threat' — But Response Fell Short. Politico reporter Dan Diamond says infighting at the Department of Health and Human Services and the need to flatter Trump impeded the response to the coronavirus. NPR Fresh Air, Terry Gross; March 12, 2020 (interview with transcript):
...
GROSS: This is FRESH AIR. And if you're just joining us, my guest is Dan Diamond, a reporter for Politico who investigates health care policy and politics, including the Trump administration's response to the coronavirus. So what is your assessment - since you cover the health agencies, what's your assessments of how much - that has gone wrong as a result of, like, bad political decisions, incompetence, just bad luck?

DIAMOND: I don't use this word lightly, Terry, but I'd say that this testing failure and the broader response to the coronavirus has been a catastrophe. The reasons it is a catastrophe, some are on the Trump administration itself; some are simply bureaucratic breakdowns. And if I'm apportioning blame - in the middle of a crisis, it's hard to tell at all times who made what decision when, but certainly, the Trump administration failed to plan for this moment. There were leadership failures, like failing to think through the implications of not having a testing strategy in place. There were leadership failures in allowing feuds to fester for months and months that - in the middle of a crisis, those cracks have widened and caused delays in making simple decisions.

At the same time, there are also low-level bureaucratic failures that are enough to make a person cry. There was a New York Times story this week about the team in Seattle of flu researchers who wanted to use their research to help uncover where coronavirus might be spreading, but because of complicated regulations, they were not technically supposed to use their data that had been collected for the flu to also search for coronavirus. And they tried for weeks to get permission from local leaders, from national leaders, especially, and just couldn't get it. They were being passed from bureaucrat to bureaucrat. Finally, they went ahead and helped uncover the Seattle coronavirus outbreak but then were told to knock it off.
...
What we have here is an epic failure to communicate at many levels, starting at the top with an egomaniacal, lying, untrustworthy, corrupt, jingoistic, inexperienced, willingly ignorant, impeachable President who, from the beginning of his unfortunate term, has set the United States apart from (and above) the rest of the world.

By surrounding himself with “loyal”, tip-toeing, expendable yes-staff saying only what he wants to hear, and by dismissing crucial advice of experienced professionals, scientists, diplomats, and entire government agencies, Trump has helped set the stage for the ongoing coronavirus disaster and its collateral damage to the USA.

Although he at least appeared to be serious in his all-of-10-minute Coronavirus address to America, he wasn’t competent enough to finish reading I t without significant errors. He cannot (or will not) do the job required of him, and must be removed from office in November 2020.

With a population of over 7 billion people, the world has grown too small for major countries to take off in their own misguided direction. We’re all in the same tiny blue lifeboat, and have to row together to stay alive.
posted by cenoxo at 8:23 AM on March 13 [16 favorites]


Everything in this article is correct but the problem with it (and with all the pieces I have seen on "panic") is that it doesn't define what panic is.

I posted the link, which first showed up on my Facebook. I also re-posted it on my Facebook and immediately got positive feedback from people who it had clearly helped insofar as it played against certain concerns that, in one case at least, were starting to overwhelm them. In that individual's case, the concern was manifesting in severe hording behavior, which they realized was basically symptomatic of panic. They said this in so many words.

Is self-isolating without symptoms panic?
Is canceling meetings of less than a dozen people, panic?


no.

If people are this upset today, and they're not aware of what I just wrote, then how much more frightened are they going to become over the next twelve days?

So even as I am sounding the alarm to everyone who will listen, now I am actually worried about panic, too.


As somebody said yesterday, we're at a very strange moment right now, unprecedented even. We're all either panicking too much, or not enough. Nobody knows where the balance lies. I cancelled a few things yesterday that, at the moment, felt like overkill, but by the time I was calling it a night to the bombshell news that the Prime Minister's wife had tested positive (I'm Canadian), felt prudent indeed. In fact, today will involve cancelling everything I don't absolutely NEED to do.

I am a caregiver, living with someone who's well into the most "under threat" age group, so even two weeks ago I was starting to make changes to the daily routines, backing up on certain supplies, rethinking a whole lotta assumptions as to what "normal life" means
posted by philip-random at 8:31 AM on March 13 [3 favorites]


USDC for District of Maryland restricting entry, as of March 12: A standing order bans from the courthouse persons who have traveled to high-risk countries, the state of Washington and New Rochelle, NY, per U.S. District Chief Judge Bredar. By separate order, Judge Bredar suspends all civil and criminal jury trials until April 24.
Civil and criminal jury trials in Circuit Courts in the state, scheduled to begin 3/16 through 4/3 suspended on emergency basis per March 12 order of Chief Judge Barbara. (Cases pending in that timeframe are subject to administrative hearings for various determinations such as new trial dates).
See generally: MD Courts, District of Maryland, MD Attorney General.
MD Department of Health shows 17 cases in the state. (Hopkins tracker lists 12).
posted by 20 year lurk at 9:08 AM on March 13 [1 favorite]


Someone on twitter relayed a saying whose source was reportedly a person deeply involved in combating infectious disease. It went something like: "Two weeks from now, what will I wish I had done two weeks ago?"

That's the key question and so far I don't think anyone wishes they had acted less aggressively in fighting this thing and there are plenty of people who rightly wish we'd acted more aggressively. I wouldn't expect that trend to change.

If you think "this seems the right balance to strike", you're probably not being aggressive enough. If you think "that seems really drastic" you may be in the right ballpark.
posted by Justinian at 9:08 AM on March 13 [9 favorites]


Coronavirus Is the Perfect Disaster for ‘Disaster Capitalism’ (Marie Solis, Vice News)
Naomi Klein explains how governments and the global elite will exploit a pandemic.
posted by ZeusHumms at 9:12 AM on March 13 [5 favorites]


Beijing is Pushing a Conspiracy Theory That the US Army Brought the Coronavirus to China (David Gilbert, Vice News)
'As the crisis eases inside China, Beijing is trying to deflect blame and position itself as the world's coronavirus savior.'

“Beijing is muddying the waters with multiple counter-narratives about the origin of the coronavirus,” Fergus Ryan, an analyst who studies Chinese social media at the Australian Strategic Policy Institute (ASPI), told VICE News.

This ‘flooding’ of information is designed to deluge Chinese citizens with a torrent of information with the aim of deflecting blame away from the Chinese Communist Party,” Ryan added. “Zhao may be posting on a social media platform that is banned in China, but screenshots of his tweets are circulating on WeChat and Weibo and being reported in domestic media.”
posted by ZeusHumms at 9:16 AM on March 13


Trump plans to declare national emergency over coronavirus pandemic (Dan Mangan, Christina Wilkie; CNBC)
  • President Donald Trump plans to declare a national emergency over the coronavirus pandemic, according to adminstration officials who spoke to NBC News.

  • The president has scheduled a 3 p.m. ET press conference Friday at the White House.

  • French President Emmanuel Macron said leaders of Group of 7 economic giant nations have “agreed to organize an extraordinary Leaders Summit by videoconference on Monday” on coronavirus.

  • Treasury Secretary Steven Mnuchin said the White House and Congress are nearing a deal that would provide stimulus to the U.S. economy amid the coronavirus outbreak.
  • posted by ZeusHumms at 9:27 AM on March 13 [1 favorite]


    Sanity checking myself:

    'The FDA’s strict guidance on test confirmations is one of several obstacles that has slowed the federal government’s response to COVID-19. The FDA could change its rules to speed things up, but hasn’t.'

    Is it possible that they have been asked not to change these rules because it would affect Trump's damn "numbers"?
    posted by EmpressCallipygos at 9:29 AM on March 13 [2 favorites]


    Coronavirus Is the Perfect Disaster for ‘Disaster Capitalism’ (Marie Solis, Vice News)

    yeah, this just showed up on my Facebook:

    The pandemic is spreading fast. But leaders have struggled to come to terms with the threat from covid-19—and few have faced anything like it. Read about this, and more, when you subscribe to The Economist. 50% off your first year
    posted by philip-random at 10:00 AM on March 13 [1 favorite]


    I am having a really hard time wrapping my head around the estimate of 1 million+ dead combined with what we are already learning is a deliberately slow-rolled and bungled response. If those estimates reflect what truly comes to pass, this is on another level from even Katrina. It's so far beyond the pale, it's so truly cruel and inhuman, I just can't.
    posted by feloniousmonk at 10:54 AM on March 13 [3 favorites]


    ...it doesn't define what panic is...

    It’s when someone or something, by commission or omission and without remedy or means of escape, takes away something vital to life itself. Here’s a brief, primitive example:

    Hungry monkeys brawl over food as coronavirus hits tourism in Thailand, The Guardian (YouTube), Published Mar 13, 2020. “A large crowd of monkeys has been filmed brawling over a pot of yoghurt in a street in Thailand. A fall in tourist numbers amid the Covid-19 outbreak has resulted in far fewer people offering them food. The video was filmed in Lopburi, a city north-east of Bangkok that is famed for its monkey population.”
    posted by cenoxo at 11:00 AM on March 13


    Virus can remain viable "in aerosols up to 3 hours,
    posted by sexyrobot at 7:32 AM on March 13


    That study artificially induced those aerosols (or something). At least two of the scientists I'm following on Twitter clarified for lay people when they posted the link that this does NOT apply to ordinary life sneezing, coughing, etc. If I can find those specific tweets I'll post links here, but I want to clarify that point ASAP.
    posted by cybercoitus interruptus at 11:20 AM on March 13 [8 favorites]


    The following is illustrative for those elsewhere:

    The Kansas City area yesterday had the first covid-19 death in either Kansas or Missouri. This case was in the Kansas side of the metro area, an elderly patient in a skilled nursing facility.

    This is also the first case here that's community spread.

    The first deaths due to covid-19 in an area that were "community spread infections" are very significant because they provide a view into what's actually been happening. The average length from infection until death for fatalities has been about 17 days. The case fatality rate has been anywhere from 0.7% to 6%, but I continue to believe that 2% is a reasonable conservative estimate*. Therefore, for every death there were likely 49 other cases at the time of infection approximately 17 days earlier. The infection doubling rate has been about 6.2 days, which over 17 days works out to be an increase by a factor of seven.

    Thus, one death of a community spread case today implies 350 (7 times 50) actual infections today.

    So, as of today, when the number of confirmed cases in the metro area is less than five, it's likely that there are in fact at least 350 infections.

    "At least two of the scientists I'm following on Twitter clarified for lay people when they posted the link that this does NOT apply to ordinary life sneezing, coughing, etc."

    Yes, there's still no strong evidence that the virus is contagious via the air as an aerosol. This reported lab result implies that it's possible. How frequently that ever happens in practice is still completely unknown. With an R-nought apparently around 2, that implies it may be spread via means other than droplets, but more than that we just don't know. If it were easily aerosolized and viable for long periods, then its R-nought would be much higher, such as tuberculosis's, which is 10... to keep things in perspective.

    * Italy's CFR has been much higher and given that this is sensitive to quality/availability of care, that the global rate has been about 3.5%, and that the US has been poorly prepared and has inadequately responded, there are strong arguments to be made that the CFR here may be 4% or 6%. If so, the numbers I calculated will end up being lower, as the chance of dying here would be relatively high and thus each death implies fewer total infections.
    posted by Ivan Fyodorovich at 12:10 PM on March 13 [9 favorites]


    Politico (3/13/2020), "Inside Jared Kushner’s coronavirus research: a wide net on a giant Facebook group":
    Just before midnight Wednesday, a doctor asked a group of fellow emergency room physicians on Facebook how they would combat the escalating coronavirus outbreak.

    “I have direct channel to person now in charge at White House,” Kurt Kloss wrote in his post.

    The next morning, after hundreds of doctors responded, Kloss explained why he sought the suggestions: Jared Kushner, President Donald Trump’s son-in-law and senior adviser, had asked him for recommendations.

    Kloss, whose daughter is married to Kushner’s brother, sent Kushner 12 recommendations Thursday morning.
    This article from The Spectator has screenshots from the FB group and notes that as of 10am Eastern time, the posts have been deleted from the group.
    posted by mhum at 12:26 PM on March 13 [5 favorites]


    on the panic/hysteria tip, I find this moment rather eloquent:

    When Rehearsal Becomes The Show: Stephen Colbert's First-Ever No-Audience Late Show Monologue
    posted by philip-random at 1:14 PM on March 13 [2 favorites]




    Mumimor, our local ITU unit is considering the impact of schools closing and HCP parents having to stay home. Also, because they will get sick up to a 1/5th having to self-isolate or even some of the most senior doctors being treated as inpatients. When you add that to the modelling I genuinely hope you only get 10% infected. As my husband will be one of the Doctors saying who gets ventilated and who doesn't, I'm grateful the NHS had the health service established the policy of the Three Wise Men (however misogynistic), so a group of three senior consultants get the status from the Dr and give their decision. a majority decision is taken freeing the individual from the enormous burden of guilt......a little.
    posted by Wilder at 2:42 PM on March 13 [3 favorites]


    @DrNeeltje: "Important: we experimentally generated aerosols and kept them afloat in a drum. This is not evidence of aerosol transmission."

    @Angie_Rasmussen: "Neither SARS-CoV classic nor SARS-CoV-2/HCoV19/COVID-19 normally form aerosols. These are only generated under very specific circumstances during certain hospital procedures (bronchoscopy, intubation)."

    @Angie_Rasmussen: "Experimentally generated aerosols are useful for understanding the virus, but they do not pertain to actual transmission methods (mostly respiratory droplets and fomites)."

    Ivan, agreed that scientists are having to course correct as they keep learning more about the virus.

    Quick overview of transmission methods and terms (I'm a lay person so somebody correct me if I get something wrong cuz I looked this stuff up last week for my own terminology clarity):

    "Fomite" I'm sure everybody here knows by now.

    "Airborne" is like measles where somebody with it walks into a room, walks out, and 30 min later others who walk into that room catch it. Measles's R0 (pronounced R-nought) is high, R12 (1 person can infect 12 people).

    "Aerosolized" can have different meanings depending on context(link goes to Ebola discussion), which is confusing. But for purposes of me understanding COVID-19 discussions, it happens during medical procedures like intubation, or in ordinary life it's viruses coughed, sneezed, talked out in droplets (one doc, Michael Osterholm, says breathing too, but I haven't looked up critiques of that).

    Or in a plume from toilet flushing (they've found bits of this virus in fecal samples, but last I read, some were saying no live infectious viruses, others said fecal transmission is possible, but low compared to other transmission routes. I've been closing the lid when I flush, since some fascinatingly revolting MeFi thread years ago about toilet plumes).

    ANYWAY. Droplet transmission through the air depends on size of droplets -- larger droplets fall to ground closer to the person who expelled them, smaller droplets go farther, but for COVID-19, they think not farther than 6 feet before falling. Currently they think this virus's R0 is between 2 and 3.

    So that's my context for saying Dr. Neeltje's experimentally-produced 3-hour life aerosols aren't extrapolatable to ordinary sneezing, coughing, etc. Scientists may indeed learn that the virus can hang out in the non-laboratory air for longer than it takes to fall to the ground within 6 feet, but not from this study.
    posted by cybercoitus interruptus at 2:49 PM on March 13 [6 favorites]


    4. 80% of cases are mild

    5. People recover


    Worst-Case Estimates for U.S. Coronavirus Deaths (NYT / MSN reprint)
    Officials at the U.S. Centers for Disease Control and Prevention and epidemic experts from universities around the world conferred last month about what might happen if the new coronavirus gained a foothold in the United States. How many people might die? How many would be infected and need hospitalization?

    [...] Between 160 million and 214 million people in the United States could be infected over the course of the epidemic, according to one projection. That could last months or even over a year, with infections concentrated in shorter periods, staggered across time in different communities, experts said. As many as 200,000 to 1.7 million people could die.

    And, the calculations based on the C.D.C.’s scenarios suggested, 2.4 million to 21 million people in the United States could require hospitalization, potentially crushing the nation’s medical system, which has only about 925,000 staffed hospital beds. Fewer than a tenth of those are for people who are critically ill.
    But it is also right that we must not panic.
    Studies of previous epidemics have shown that the longer officials waited to encourage people to distance and protect themselves, the less useful those measures were in saving lives and preventing infections.
    posted by katra at 9:37 PM on March 13 [10 favorites]


    As Europe Shuts Down, Britain Takes a Different, and Contentious, Approach
    Now I'm really worried for my family and UK mefites.
    posted by mumimor at 10:01 PM on March 13 [9 favorites]




    All of the the King’s horses and riders are out of the gate, heading for the first turn:See additional articles and commentary there and elsewhere, and remember that no battle plan survives first contact with the enemy.
    posted by cenoxo at 10:26 PM on March 13 [4 favorites]


    Just to chip in on the supposed backtracking/change-of-heart here in the UK re: social distancing and limiting groups of people in their hundreds-plus from associating. It's worth noting that this has been made explicit after criticism of the Johnson government approach and the actions of sporting bodies, etc to postpone/cancel major events, but despite how its being widely reported it doesn't remotely look like a change in how they are tackling the crisis.

    Previously: No school closures, no restrictions on large groups gathering, until we announce later (handwave)
    Now: No school closures, no restrictions on large groups gathering, but we will announce those later
    posted by I'm always feeling, Blue at 10:34 PM on March 13 [4 favorites]


    i noted dr. redfield as absent, despite being listed by c-span (at the who's who link above) as present, from the rose garden event. at least he wasn't among the people standing behind the podium. i watched again: there was one bald guy, not nearly as tall and lacking the goatee: that bald guy was introduced as thomas moriarty of cvs, not dr. redfield. in ultimately affirming rep. porter's demand, that was the best impression dr. redfield has made on this viewer throughout this crisis to date.
    posted by 20 year lurk at 10:45 PM on March 13 [2 favorites]


    WRT the lineup of people with assigned positions (some of them check the ground for their marks before the presser begins) around Trump during his CV Emergency speech, there’s a large photo of them at The Boston Globe taken by Erin Schaff, staff photographer for the New York Times.

    Robert R. Redfield, MD (bio, previous appearances) and recently appointed Director of the CDC, has a distinctive white beard (photo) and is clearly not in this group photo. Perhaps something more serious came up?
    posted by cenoxo at 12:29 AM on March 14 [1 favorite]


    Channel 4 news UK led with a story today of the first self-test available, but refused to release the name of the company for obvious reasons.
    Then the Irish Times this morning identified the company by name and location and the price of the self test at 137 Euros (by the time your private provider has these in USA think X10) so I am imagining the white vans full of Belfast and Dublin gangs in a race to see who can find Co Antrim first!


    Deliberately NOT linking to the companu's website as I'm expecting it to crash
    posted by Wilder at 5:37 AM on March 14


    March 3, 2020, Daily Beast, Defense Intelligence Agency Bans Some Domestic Travel, Sources Say
    It was one of the surest signs yet that the highest levels of the U.S. intelligence community were treating the coronavirus outbreak like a significant operational concern.
    March 13, 2020, Daily Beast, Pentagon Bans [All] Domestic Travel for Military, Department of Defense Personnel
    The Pentagon has banned all domestic travel for members of the military and Department of Defense personnel until May 11, according to a memo [see * below] released late Friday. In the memo, Deputy Secretary of Defense David Norquist announced that the new restrictions were “necessary” to combat the spread of the novel coronavirus pandemic. “All DoD military personnel will stop movement while this memorandum is in effect.

    In addition, DoD civilian personnel and DoD family members, whose transportation is government-funded, will also stop movement,” the memo reads. Exceptions will be made only in cases “determined to be mission essential,” “necessary for humanitarian reasons,” or “warranted due to extreme hardship.” The restrictions take effect on March 16.
    More details in Pentagon Bans Domestic Travel for Troops, Families As Coronavirus Spreads, Military.com, March 14, 2020:
    Pentagon officials announced sweeping travel restrictions for troops and their families late Friday night that will halt all domestic travel, including duty station moves and temporary assignments, for nearly two months as officials try to stem the spread of the deadly coronavirus.

    Starting Monday, service members, their families and Defense Department civilian workers will be restricted in how they can move about the U.S. and its territories. The unprecedented moves were approved by Deputy Defense Secretary David Norquist and extend through May 11.

    A memo [see * below] outlining the restrictions say the continuing spread of the new coronavirus, or COVID-19, necessitates immediate action. "These restrictions are necessary to preserve force readiness, limit the continuing spread of the virus, and preserve the health and welfare of Service members, DoD civilian employees, their families, and the local communities in which we live," the memo adds.
    ...
    *A copy of the DOD travel memo is shown in the Military Times article SECDEF issues global travel restrictions to help stop coronavirus spread, and here’s a direct link to the PDF file.
    posted by cenoxo at 5:43 AM on March 14 [2 favorites]


    And speaking of travel, what about Spring Break? Perhaps Coronavirus isn’t real until it walks in our front door.
    posted by cenoxo at 5:57 AM on March 14


    Why It Only Took One Player With Coronavirus To Shutter Sports (Jared Dubin and Anna Wiederkehr, FiveThirtyEight)
    [...] Even as teams play in different leagues, often in different cities and stadiums, American sports are highly interconnected, which underscores the need to take seriously how widely the virus can spread.

    Recent research suggests that the virus transmits most easily through “prolonged, unprotected contact,” so it’s not particularly likely that the virus was transmitted to any of the players or employees of the teams against which the Jazz played, nor those who work in their respective arenas. But it is possible, so the utmost caution is warranted. That’s especially true because while most professional athletes are not in the age range at risk of the most severe outcomes, many coaches, staffers and arena workers are. And the close quarters of athletic competition leaves people — players, coaches, executives, arena workers and fans alike — vulnerable to community spread.
    Teams from different sports may use the same locker rooms, gyms and workout facilities. They may even share flights or be in the same hotel at the same time.
    posted by ZeusHumms at 6:42 AM on March 14 [1 favorite]


    Re the self test virus that Randox says is the first in the world I only hope both HSE & NHS officials currently talking with the company (50 Italian areas have already been in touch and their product is being used in China Japan & the Philippines currently FWIW) have brought the security services!!! A product like this will cause chaos, they were ram-raiding a cash & carry last night in Leicester, for TOILET ROLL, which most peeps don't realise is working class tissues, a mate saw from his office window, I'm still looking for a local source of info on that.
    But I believe the first eye account of my sister who works in a Cork Musgraves cash & carry and fight broke out in the car park when someone accused another person of cutting in line.
    posted by Wilder at 7:46 AM on March 14


    Users of the Pittsburgh Supercomputing Center (and probably other XSEDE resources as well) just got an email saying that the NSF was commandeering the Bridges cluster for COVID-19 simulations and that other jobs may be killed as needed.

    GOOD. Arguably shoulda been done months ago, but GOOD.
    posted by Westringia F. at 9:26 AM on March 14 [15 favorites]


    dr. redfield again absent from ongoing task force press conference.
    posted by 20 year lurk at 9:52 AM on March 14 [1 favorite]


    in ultimately affirming rep. porter's demand, that was the best impression dr. redfield has made on this viewer throughout this crisis to date.

    Redfield sure did try to equivocate and avoid answering the Rep. Porter's questions before the very end, tho.
    posted by ishmael at 10:01 AM on March 14 [1 favorite]


    agreed, ishmael. my statement was not offered as praise.
    posted by 20 year lurk at 10:26 AM on March 14


    The mayor of New York City said that they are basically at the point of skipping FDA approval for new kinds of tests; search for "FDA" in that transcript. Sample:
    We want to do wide-scale testing. We cannot do it without the federal government coming in. There has been talk of localities taking matters into their own hands. I believe that that is what's going to happen if we don't get this federal approval. And I think this is bluntly the last chance. I think if the President [of the] United States and the FDA do not give us approval, I don't blame any locality, any company, anyone who just decides to do whatever kind of testing they can at this point. And we will work with all of them.
    posted by brainwane at 10:58 AM on March 14 [4 favorites]


    FDA permissions for NY came through yesterday.
    posted by save alive nothing that breatheth at 11:10 AM on March 14


    Trump officials cut testimony short at coronavirus hearing, The Hill, Jessie Hellmann/Brett Samuels; 03/11/20 11:58 AM EDT:
    Top Trump administration officials on Wednesday cut short their testimony at a House Oversight and Reform Committee hearing on the response to the coronavirus, with the White House saying they were needed at a meeting focused on the spreading virus.

    Committee Chairwoman Carolyn Maloney (D-N.Y.) said at the start of the hearing that it would end an hour and a half early because President Trump called an “emergency” meeting with the witnesses, who are leading the government’s coronavirus response.

    Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Dr. Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), were testifying at the hearing. Both are members of the coronavirus task force.
    White House says there is no emergency meeting on coronavirus, Reuters, March 11, 2020:
    WASHINGTON (Reuters) - The White House on Wednesday said it was not holding an emergency coronavirus meeting after a House panel chairwoman said she had to cut short a related hearing because two top U.S. health officials had been unexpectedly called to the White House.

    House Oversight and Reform Committee Chairwoman Carolyn Maloney said National Institute of Allergy and Infectious Diseases Director Anthony Fauci and Centers for Disease Control and Prevention Director Robert Redfield had been called to an “emergency meeting” at the White House, forcing her to end a lawmakers’ hearing before noon.

    “This meeting was scheduled yesterday and is part of the administration’s ongoing whole-of-government response to the coronavirus,” a White House official said.
    Twitter also noticed Redfield’s absence from yesterday’s National Emergency Press Conference.

    Just speculating of course, but perhaps Dr. Redfield was too forthcoming in his public testimony (and/or overstepped his authority WRT free testing) before checking with Executive management?
    posted by cenoxo at 11:12 AM on March 14


    or maybe he's got it.
    posted by valkane at 11:20 AM on March 14 [2 favorites]


    or maybe he's got it.
    I'm wondering about all the officials who have got it, all over the world. Why is that?
    I guess one thing is that they travel more than ordinary people, and some shake a lot of hands.
    posted by mumimor at 11:45 AM on March 14


    Or – given he just started a 7/24/365 job at the CDC – maybe he’s exhausted?

    Twitter search results for “robert redfield asleep”. These are comments about Redfield’s appearance during the Coronavirus Task Force Briefing (C-SPAN video) at the White House on March 9, 2020.
    posted by cenoxo at 12:22 PM on March 14


    > I'm wondering about all the officials who have got it, all over the world. Why is that?
    I guess one thing is that they travel more than ordinary people, and some shake a lot of hands.


    They also have much greater access to testing and confirmation than ordinary people, at least in the US.
    posted by Westringia F. at 2:11 PM on March 14 [4 favorites]


    Or – given he just started a 7/24/365 job at the CDC – maybe he’s exhausted?

    I don't know if you were joking, but it is actually a good point. Perhaps he isn't qualified to lead the CDC, even though he is a smart person with good medical credentials. This is a very different crisis from the AIDS crisis he has been working with for a lifetime.
    posted by mumimor at 3:51 PM on March 14


    Not joking, just proposing a plausible alternative. Redfield is facing the challenge of his life and career, and could be concentrating on the CDC’s mission to the exclusion of everything else. Other individuals like Anthony Fauci may be better at presenting a public face.

    However, Redfield was not at today’s President Trump and Coronavirus Task Force Hold News Conference (C-SPAN video, March 14, 2020), nor was he listed in “People In This Video” or “All Speakers”.
    posted by cenoxo at 5:33 PM on March 14


    Redfield’s Twitter account is active, but its tweets are so generic and canned that a CDC assistant or intern could be creating them. Again, his real responsibilities may be so complex and demanding that he can’t be bothered with such trivia (unlike the Supreme Leader Tweeter).
    posted by cenoxo at 5:57 PM on March 14


    Is Redfield even in DC still? The CDC HQ is in Atlanta, and he has an apartment there (source).
    posted by mbrubeck at 7:40 PM on March 14


    Queen quits Buckingham Palace over coronavirus fears as UK cases hit 1,140 and death toll doubles to 21

    Interesting. The Royal Family famously remained in the UK during WW2, even after Buckingham Palace was bombed by the Luftwaffe. The young Royals – including our present Queen – stayed in Windsor Castle IIRC. Windsor Castle is also the place where Her Majesty spends most of her time. So why are there plans for the Court to move to Sandringham House in Norfolk?

    I suspect it comes down to two reasons: staff, and land. Sandringham House usually has only a skeleton staff, and (in a pinch) the Royal Family could rough it in Wood Farm Cottage, a cosy little five-bedroom dwelling on the grounds of Sandringham House where Prince Phillip is already established. So a planned move to Sandringham immediately removes the Queen from potential exposure to literally hundreds of people and, if it should come to the worst, she would be on a nearly self-sufficient estate.
    posted by Joe in Australia at 8:01 PM on March 14 [4 favorites]


    Anti-inflammatories may aggravate Covid-19, France advises (Guardian). “French minister says patients should take paracetamol [acetaminophen/tylenol] rather than ibuprofen or cortisone.”
    posted by mbrubeck at 8:10 PM on March 14 [3 favorites]


    Queen Quits Buckingham Palace

    I should add: I definitely feel a bit "Well, nice for her", but the UK is a Constitutional Monarchy (as is Australia and most other Commonwealth countries) and in the UK is required to give at least nominal approval to legislation etc. Also, if the PM were out of action she would be needed to appoint his successor. In theory there's always a successor to the Crown, but annointing one could be constitutionally problematic if Parliament couldn't meet. For similar reasons, I hope that the USA doesn't have to deal with Presidential succession at a time when the legislature is forced into recess.

    IIUC Our Very Own Charles Stross has done considerable research on the intricacies of succession in a crisis, but let's hope it remains firmly within the realm of fantasy.
    posted by Joe in Australia at 8:18 PM on March 14


    Just to put some medical clarifications on that Guardian article. Dr. Rasmussen is a virologist working at Columbia and she says "Don't toss out your advil."
    posted by jessamyn at 8:25 PM on March 14 [8 favorites]


    Queen quits Buckingham Palace over coronavirus fears as UK cases hit 1,140 and death toll doubles to 21

    The messaging of confirmed case counts desperately needs revamping. In this headline, the casual reader would think "oh, 1140 cases". But going by S. Korea's case fatality ratio of 0.9% which is probably one of the most precise, those 21 UK deaths imply an approximate case count of 21/.009= ~2330 cases.

    And since the death toll has just doubled overnight, even this number is likely a gross underestimate.
    posted by storybored at 8:55 PM on March 14 [2 favorites]


    Wow.

    This is extraordinary, from Kuwait. The Muslim call to prayer contains the line Hayya ala al-Salah (come to prayer), imploring people to come to the mosque. Now, because of coronavirus, the muadhin (caller) says al-Salatu fi buyutikum (pray in your homes). Never heard that before

    Similar reports from the Palestinian Authority:
    To fight coronavirus, Palestinians suspend prayer at mosques and churches
    Al-Aqsa mosque is still open; it's controlled by the Jordanian-appointed Waqf, which will potentially be a problem: Israel can't impose controls without causing a religious and diplomatic incident.

    Israel's government has banned meetings of more than ten people. I don't know whether that includes prayer services, but complete Orthodox and Conservative Jewish prayer services – including funerals! – generally require a minyan of ten adults (adult men, for the Orthodox). This is going to be very tough for very many people, particularly at this time.

    I don't know what's going on in Iran, but two members of Iran's (smallish) Jewish community have reportedly died from the coronavirus, and "it remains unclear whether it will be possible to bring [the two] to a proper Jewish burial." Providing a Jewish burial for deceased persons is nearly the most fundamental duty of a Jewish community; if they're expressing any doubt about providing one then things must be pretty bad. Like, either government repression, or a health crisis worse than Italy's.
    posted by Joe in Australia at 9:13 PM on March 14 [10 favorites]


    Trump tests negative for coronavirus, White House doctor says, USA Today,
    Michael Collins/Courtney Subramanian/Deirdre Shesgreen; March 14, 2020:
    WASHINGTON – President Donald Trump has tested negative for the novel coronavirus, the White House announced on Saturday evening.

    The president’s physician, Sean P. Conley, said in a memo released by the White House that Trump decided to get tested on Friday after they conferred about matter. The virus is officially called COVID-19.

    “Last night after an in-depth discussion with the president regarding COVID-19 testing, he elected to proceed,” the president’s physician, Sean P. Conley, wrote in a memorandum released by the White House Saturday evening. “This evening I received confirmation that the test is negative,” Conley wrote.
    ...
    The meter is still running for many, many, other people though (2,951 confirmed cases and 57 deaths in the USA at this date and time).
    posted by cenoxo at 9:27 PM on March 14


    Catholic dioceses are cancelling Mass, not just some Masses but ALL the Masses, which I literally cannot get over, and have poked all my ecclesiology friends about. (Milan, during the Black Death, cancelled Mass -- that's the most recent analogue we've come up with so far.) I was honestly not aware it was an option under canon law, and I'm kinda freaked out now that I know it is (even though I am no longer Catholic). My diocese has halted all weddings and funerals (!!!!!!!!) and is encouraging priests to celebrate Mass privately and livestream it, but Mass itself, and the Eucharist, is not available to laypeople, and that is, to use the technical theological term, FUCKING NUTS.

    It's funny what freaks us out, my husband realized it was Very Real when the NCAA cancelled March Madness and suddenly he went from, "Well, let's just wash our hands a lot," to, "WE NEED TO PULL THE KIDS OUT OF SCHOOL." ("Good news, school got cancelled earlier today.")
    posted by Eyebrows McGee at 9:38 PM on March 14 [9 favorites]


    Queen Quits Buckingham Palace

    It's a family tradition. Elizabeth I fled London to Windsor Castle in 1563 and again in 1593 to avoid the plague. Supposedly she had a gallows erected on the grounds with orders to hang anyone coming from London. I'm guessing it was symbolic and effective.
    posted by JackFlash at 9:44 PM on March 14 [3 favorites]


    mbrubeck > Is Redfield even in DC still? The CDC HQ is in Atlanta, and he has an apartment there (source)

    Hard to say, but one can appreciate why he would rather be working back at CDC Atlanta, instead of attending hearings and press conferences in Washington, DC. Your cited source – C.D.C.’s Dr. Robert Redfield Confronts Coronavirus, and Anger (NYT, 3/13/2020) – is a good background article. Thanks!
    posted by cenoxo at 10:15 PM on March 14


    My diocese has halted all weddings and funerals (!!!!!!!!) and is encouraging priests to celebrate Mass privately and livestream it, but Mass itself, and the Eucharist, is not available to laypeople

    What about Confession and the Sacrament of Penance?
    posted by Joe in Australia at 10:18 PM on March 14


    "What about Confession and the Sacrament of Penance?"

    In Chicago, the ban is on public Masses (including weddings and funerals). Private Masses and sacraments are still allowed, so people can still receive Penance and Anointing of the Sick, and can still get married and baptized and buried, just not with anybody in attendance other than the principals and the priest. This is pretty common across European and North American dioceses that are enacting bans. (I can research Asian, African, and South American dioceses if people are interested; most of my friends in the hierarchy work in Europe or North America so I get that news faster.) Like, if you want to get married, it's you and your spouse, two legally-required witnesses, and the priest. If you want to get baptized, it's the parents, the baby, two godparents, and the priest. THAT'S IT.

    I cannot find a media source for this, but I'm told by a friend who works in the Vatican that the Pope offered a general absolution for EVERYONE IN ALL OF ITALY basically so they didn't have to go to Confession and risk infecting anyone. Pope Francis is doing all his Lenten-season prayers and Masses via livestream and reportedly he hates it but fully understands the importance of it. They're also struggling in Rome in particular to keep churches open to worshippers but closed to tourists. (The directive is that churches should be open their regular hours OR MORE so people can pray about the coronavirus, but at least 6 feet apart and with no public celebrations of Mass, and churches should bar people from entering (!!!!!!) if they can't be 6 feet apart.)

    I mean it's truly insane because Catholic life centers on the Eucharist as a communal experience and it's pretty freaking rare to shut down Mass even in a plague (literally Milan in the 1600s is the only thing my ecclesiology friends and I have come up with so far), so it's really just astonishing to see so many dioceses, and the Pope, shutting Mass down and performing it over livestream. It's also encouraging in some ways, because Catholics are urged to put their fellow man before all else, but the actual rules often put the rules above all else, so seeing Mass closed to save lives is really encouraging! But also INSANELY DISORIENTING because Catholics had access to the Eucharist during the freaking Black Plague and I even though I no longer commune I am like reeling from the weirdness of not having the Eucharist available. It's the right decision! But it's SO WEIRD.

    Like maybe to give a taste of the weirdness, when I was four or five years old, a priest who was a friend of my grandmother's was traveling through Chicago, and got stranded at our house by a blizzard. On Sunday morning, the snow was too deep for anybody to go anywhere, so my parents couldn't go to Mass. The priest said Mass -- the full, hour-long deal -- at our dining room table, and gave my parents communion at our dining room table. (I was not well-behaved; I have clear memories of trying to climb up the priest.) He didn't want my parents to be without the Eucharist on a Sunday (they would have had to go to confession about it! Despite the blizzard!) so our WHOLE DINING ROOM got turned into a church so they could receive communion.

    It is literal insanity that my parents can't receive communion. Neither of them has missed a week in SEVENTY YEARS. Literally the priest came to our house when my mom had babies so she wouldn't miss a Sunday. It's insane to me that for the first time in their lives they're not receiving communion. (I mean they're totally on board and I'm on board and the parish is on board, but it's INSANE.)
    posted by Eyebrows McGee at 10:44 PM on March 14 [13 favorites]


    The Catholic church at the end of our road seems to be having mass as usual today. When I drove past on my way to pick up my husband’s prescription from the chemist nearby, the typical Sunday mass parking madness was going on, and people were going in. Granted, I am in the UK, and Boris STILL hasn’t pulled the plug on most gatherings. Me, I just wanted to get his meds and go the fuck home and stay there, which I have now done.

    My mom said they stopped with bringing the sacrament to the Catholics in her assisted living residence, when they went into quarantine last week, and I am so glad they’re being sensible, but also kind of weirded out by it as well, and a little sad for mom that it’s come to this. Very happy my lovely and much-valued Mormon neighbours are staying put this morning, and am looking forward to chatting over the garden wall to them when we’re all out working in our back gardens.
    posted by skybluepink at 3:14 AM on March 15 [2 favorites]


    Walmart cuts hours at 24-hour stores and other locations nationwide starting Sunday due to coronavirus (Kelly Tyco, USA Today)
    Stores normally open 24 hours will be open from 6 a.m. to 11 p.m. until further notice, the company said late Saturday. Other stores, which are typically open until midnight, will also have reduced hours.

    "This will help ensure associates are able to stock the products our customers are looking for and to perform cleaning and sanitizing," Dacona Smith, executive vice president and chief operating officer, Walmart U.S., wrote in a blog post.

    [...] Grocery store chains including Florida-based Publix, New York-based Wegmans and H-E-B are among retailers closing earlier. Changes at more regional and national retailers are expected in the coming days.

    The coronavirus is spurring panicked shoppers to stock up on products ranging from cleansing wipes to peanut butter as they prepare to hunker down in the midst of the growing pandemic.
    posted by ZeusHumms at 3:31 AM on March 15 [4 favorites]


    Its all about the profit
    German officials alarmed over what they see as Trump's aggressive 1bn US$ bid to take over Tübingen-based biopharmaceutical company Curevac to secure possible COVID19 vaccine "just for US". Officials to offer incentives to Curevac & consider blocking sale
    posted by adamvasco at 3:44 AM on March 15 [5 favorites]


    German officials alarmed over what they see as Trump's aggressive 1bn US$ bid to take over Tübingen-based biopharmaceutical company Curevac to secure possible COVID19 vaccine "just for US".
    This is so extreme. It's a war. Trump is ending all international cooperation unilaterally. And it's not only extreme and totally unacceptable, it's also stupid.
    posted by mumimor at 4:26 AM on March 15 [23 favorites]


    Today the Danish government announced an agreement between the big industry organisations, the unions and the government themselves, to safeguard workers and businesses during the pandemic. The agreement includes businesses and workers that are not organized. The agreement ensures all workers can get paid, even if there is no work, up till June. This is a huge relief to everyone who works in hospitality or transportation, and really a historic agreement. I was quite moved when I heard the PM explain the deal on the radio, standing alongside industry and union leaders who were 100% supportive. It felt historic.

    Back in 1933, on January 30th, the Social Democratic PM, Thorvald Stauning negotiated a deal across the four major parties which led the country out of the depression and also created the foundation of the welfare state through social reform. The same day, Hitler was appointed Kansler in Germany. Staunings broad agreement created a foundation across the political aisle that was resistent to populism. Neither Fascism nor Communism found wider support in Denmark. IMO, the Stauning coalition made a lot of bad choices and were far from perfect, but they, and their successors were able to save the Danish population, including almost all the Danish Jews through the 30's and the war in relatively good shape. Because they put the country before the parties.
    I feel what happened today was something similar, and it feels great that the new "Stauning" is a young woman.
    posted by mumimor at 7:57 AM on March 15 [37 favorites]


    Catholic dioceses are cancelling Mass, not just some Masses but ALL the Masses, which I literally cannot get over, and have poked all my ecclesiology friends about.

    My Presbyterian church just had a lovely virtual service. It's easy to forget the contrast among Christians between those like us for whom preaching is central versus those like Catholics for whom the Eucharist is central until something like this reminds us all over again. I hope that everyone for whom religious practice is important finds a way to make it work through this.
    posted by hydropsyche at 9:05 AM on March 15 [1 favorite]


    Its all about the profit

    I, for one, would never, ever think that The Donald (or his children) have any intention of discreetly investing in deals he’s making, now or in the future. Fake News!

    It’s a war. Trump is ending all international cooperation unilaterally.

    Not all – Trump has a very good friend, the best friend ever, in Brazil:
    Brazil's Bolsonaro salutes negative virus test, RTHK.hk [Radio Television Hong Kong], 2020-03-14, AFP

    PHOTO:
    Jair Bolsonaro meets [and shakes hands with] Donald Trump in Florida last weekend. Photo: AP

    Brazilian President Jair Bolsonaro said on Friday he had tested negative for the new coronavirus, after a scare over a trip on which at least one infected member of his staff rubbed shoulders with Donald Trump.

    "The Armed Forces Hospital and (diagnostic laboratory) Sabin have returned a negative test result for Covid-19 for the President of the Republic Jair Bolsonaro," said a post on the far-right leader's Facebook page. It was accompanied by a picture of Bolsonaro flashing an obscene arm gesture at the press [Twitter link] "Don't believe in the fake news media!" said a second message.

    Media reports said earlier that Bolsonaro had tested positive for coronavirus and was awaiting the results of a second test to confirm.

    Bolsonaro, who had previously called coronavirus fears "overblown," was left in a delicate position on Thursday by news that his communications chief, Fabio Wajngarten, had tested positive for Covid-19. The test result came after a trip to the United States, during which both Bolsonaro and Wajngarten met Saturday with Trump, Vice President Mike Pence and a slate of top US officials.

    Bolsonaro took his test result as a personal victory. The image he chose to accompany his Facebook post neatly summed up the provocative persona of a president who has been dubbed the "Tropical Trump."

    Bolsonaro, a former army captain who is openly nostalgic for Brazil's military dictatorship (1964-1985), has repeatedly made the arm gesture – widely known as an "F-U," "Italian salute," "Iberian slap," "bras d'honneur" or, in Brazil, "banana" – at journalists, accusing the media of being biased against him.
    More test details and background in Brazilian President Jair Bolsonaro tests negative for coronavirus, after much confusion, Vox, March 13, 2020. Also, from Brazil's President Bolsonaro tests negative for coronavirus, ABC News, March 13, 2020:
    ... Bolsonaro’s meeting this week at Trump's Mar-a-Lago resort also included Trump’s daughter Ivanka Trump, son-in-law Jared Kushner, Brazil’s Foreign Minister Ernesto Araujo and Bolsonaro’s son Eduardo, who is a federal lawmaker, among others. Vice President Mike Pence and Trump’s personal lawyer Rudy Giuliani also went to Mar-a-Lago that evening. ...
    All fine examples of arrogance throwing caution to the winds, their behavior shows what they really think about CDC and WHO pandemic guidelines. Even if they all have negative test results, there’s no CV vaccine yet. They could still get infected by someone else, then (before displaying any symptoms) infect others around them.

    Holding high office is no inoculation against low intelligence. As mentioned previously on the Blue, don't believe what the Imperial Donald says, watch what he does.
    posted by cenoxo at 9:15 AM on March 15 [4 favorites]


    Medium analysis of CFR comparing South Korean numbers of diagnosed vs. mortality rates in demographic distribution to Italy with a look at German and French reporting.

    the sourcing of the Korean numbers given is thin (to a selection of screen shots that appear to be dated march 8) but the Korean numbers are of interest because they are the only country with widespread testing besides China. That gives a picture of population-wide infection rates, something that no other country has data on yet.
    posted by mwhybark at 9:54 AM on March 15


    Miami mayor tests positive for coronavirus after event with Bolsonaro and staffers, Miami Herald, Joey Flechas/Aaron Leibovitz, March 13, 2020:
    Miami Mayor Francis Suarez tested positive for COVID-19, the disease caused by the novel coronavirus, four days after the mayor attended a local event with a Brazilian government official who later tested positive for the virus. The 42-year old mayor became one of the first U.S. elected officials to learn he had COVID-19 and enter isolation.

    Suarez was one of several politicians, including Miami-Dade Mayor Carlos Gimenez, Sen. Rick Scott and President Donald Trump, who interacted with Brazilian President Jair Bolsonaro and his staff during a visit to South Florida last week. Fabio Wajngarten, press secretary to Bolsonaro, tested positive on Thursday after returning to Brazil, and Suarez went into isolation Thursday after learning of Wajngarten’s results. Suarez was in the same room as Wajngarten and Bolsonaro on two occasions Monday during the Brazilian delegation’s visit.
    ...
    So does this mean that Mar-a-Lago gets quarantined and um, completely disinfected of all pestilence? We can only hope...
    posted by cenoxo at 10:00 AM on March 15 [4 favorites]


    I am so tired of some officials (always Republicans ffs) who are glib and flippant on Twitter. At least Cruz pulled his head out of his ass retweeting AOC's good advice to JUST STAY HOME but John Cornyn and Kevin Stitt went straight to the top of my shit lists this morning.
    posted by Your Childhood Pet Rock at 10:08 AM on March 15


    Here's another example from the Republic Governor of Oklahoma. Apparently he's an anti-vaxxer too. LOL.
    posted by great_radio at 10:29 AM on March 15


    [Comment removed. Do not pull in the very worst people from the larger internet being the worst please.]
    posted by jessamyn (staff) at 11:05 AM on March 15 [5 favorites]


    Just some anecdata from the infection front-lines (not treatment, infection):

    Restaurant manager friend in downtown Fort Worth is on a wait right now. He estimates 200 people in the building. 1pm on Sunday.

    CostCo warehouse friend of mine in a different major Texas city went to a doc-in-a-box yesterday exhibiting flu-like symptoms. Was told they could not test him due to lack of direct exposure to someone who had traveled internationally recently. He is stocking shelves with a fever as I type.

    Amazon warehouse friend of mine in yet another major Texas city states Amazon is not "penalizing" people for not showing up to work for the remainder of Amazon. Everyone has to get paid, though, so everyone's working and planning to work if not sick and diagnosed.

    At least one public accounting firm in Wisconsin is still travelling basically as normal. I requested off a travel job this week with a flight that went through Detroit then Baltimore. Returning by the same journey Wednesday. My request was accepted, and I'll be working remotely. Manager is still going. The sooner the tax deadlines get extended the better.

    So whatever models you're currently relying on, I'd lean towards the the upper bounds.
    posted by avalonian at 11:19 AM on March 15 [5 favorites]


    On a Saturday Night in Florida, a Presidential Party Became a Coronavirus Hot Zone, New York Times, Peter Baker/Katie Rogers, March 15, 2020. “A weekend getaway at Mar-a-Lago put the president in contact with several people who later tested positive for the virus. The White House physician said the president had tested negative for the virus.”

    PHOTO: President Trump hosting President Jair Bolsonaro of Brazil, center left, last Saturday at his Mar-a-Lago estate. Three of Mr. Bolsonaro’s aides who accompanied him to that dinner later tested positive for the coronavirus. Credit...T.J. Kirkpatrick for The New York Times
    posted by cenoxo at 12:05 PM on March 15 [2 favorites]


    My wife is in her 40s and basically has borderline COPD. My biggest fear among all this is that she will be triaged out of advanced care if the peak gets too high so we're engaging in an abundance of caution both to do our bit in flattening the curve and hopefully delaying the infection as long as possible.

    Our new roommate, who we extended our house to in order to get him out of a shitty situation, is going out shopping. With every other motherfucker who's going out shopping. We have plenty of stuff in the house, we have a delivery order of supplies coming tomorrow, we have the ability to order food still. There are a million different avenues to all sorts of food that don't involve being among a crowd of people.

    4 billion years of evolution and the apex species on the planet is still thick as shit. America is going to collapse under the weight of its own bravado, stupidity, and selfishness.
    posted by Your Childhood Pet Rock at 12:36 PM on March 15 [7 favorites]


    A friend is a radio host for an english language sketch called Matagorda mash-up Vicki Mooney, she used to be on Ireland's version of the View before moving to Lanzarote, she's been posting shots of the people who swim off certain beaches EVERY day 365, and cyclists trying to stay healthy getting €500 euro fines because unless you have a medical reason or are going to work, you cannot be on the street. Prior to this supermarket/phamacy was OK but the Decree of 14/03/20 is much more serious.

    Images all over the INTARWEBS of people stopped and fined but the actual text of the decree and the Spanglish translation is painful. Will try to image from the private messages.
    posted by Wilder at 1:33 PM on March 15


    I just got a marketing email from the owner of a fat-friendly aerobics company who is still holding in person classes in Seattle and plans to travel to 4 different cities in California to teach classes in April. I sent a pleading email asking her to reconsider but I doubt she will.

    My partner’s mom dropped off some groceries for us yesterday, I told her I was keeping my distance because I was in DTW in the same terminal at the same time as someone who was diagnosed and because I had a fever earlier this week (not to mention I spent all last week in a hospital with a terminally ill friend and was on 4 planes in that week, decisions I now deeply regret) and she insisted on coming up and kissing my face several times and talking about how there was no way there was any risk. At the time I was just in shock but the more I think about it the more angry I am about the recklessness of her not taking this seriously.

    On the bright side, my yoga studio is moving to online streams for some classes and postponed a series I signed up for that was due to start next week. I asked them to go ahead and keep my payment and charge me again once they restart the series because I worry about them during this time. I worry about the financial impact on so many businesses I rely on and am still figuring out how to best support them.
    posted by the thorn bushes have roses at 1:35 PM on March 15 [6 favorites]


    My department chair is just acting like everything is normal despite the fact that all large classes are going on line and our university has told us that they can't get hand sanitizer for love or money but have our up posters everywhere telling us to wash our hands.

    We have a department meeting scheduled and she has advised us just to go with what makes us comfortable and feel free to have those meetings if we want.

    I just don't understand how in Canada every Canadian around me doesn't think it will really hit them and they don't personally need to worry
    posted by lesbiassparrow at 1:45 PM on March 15 [3 favorites]




    Yeah. That ruined our evening. I really hate being right about just how feckless and wickedly negligent a Tory government would be.
    posted by skybluepink at 3:20 PM on March 15 [3 favorites]


    yup, adult social care crisis settled in one cruelly inhuman step!
    posted by Wilder at 3:38 PM on March 15 [3 favorites]


    Fresh from the epidemiology twitters

    @melindacmills
    Due to #demographics #COVID19 #CoronavirusPandemic will result in dramatically different levels of death worldwide - see our paper https://t.co/9iVstdzhD5?amp=1

    @drjenndowd
    More recent age-specific #COVID19 case fatality rates for Italy: https://epicentro.iss.it/coronavirus/bollettino/Infografica_15marzo%20ENG.pdf
    @OxfordDemSci #epitwitter #poptwitter
    posted by spamandkimchi at 3:55 PM on March 15 [2 favorites]


    Case fatality rate from Italy from the @drjenndowd tweet I linked above
    12.5% for those 70-70
    19.7% for those 80-89
    22.7% for those over 90 years old

    I'm so glad my parents' church went to online-only services weeks ago. Their congregation is primarily in their 70s and 80s. I know the CFRs are significantly different in South Korea, 9.51% for the 80 years and older according to the Korean CDC data from March 15, but I assume that this was due in part to early screening.
    posted by spamandkimchi at 4:03 PM on March 15 [2 favorites]


    Those case fatality rates in Italy for the 50-69 age groups are almost exactly the same as those in China, but the 70-89 rates are much higher than China's.

    Compare the 80-89/80+ rates for South Korea, China, and Italy:

    SK: 9.5%
    China: 14.8%
    Italy: 19.7%

    South Korea's stats are for 80 and above, so they include those in their 90s, which the others do not.

    In 2017, in hospital beds per 1,000 people:

    South Korea: 12.27
    China: 4.34
    Italy: 3.18
    US: 2.77

    If you combine available hospital beds and rapidity and comprehensiveness of containment efforts, that could explain the differences in those three case fatality rates—and, if so, this bodes very badly for the US.

    (China CFR stats from its CDC, Italy's and South Korea’s CFR from the links in the previous comment. Hospital beds per capita from OECD.)
    posted by Ivan Fyodorovich at 5:15 PM on March 15 [5 favorites]


    NIH’s Fauci calls for “dramatic diminution” of personal interactions to fight coronavirus – Fauci said Americans “should be prepared that they’re going to have to hunker down significantly more than we as a country are doing.” Vox, Anya van Wagtendonkanyavw; Mar 15, 2020:
    ...
    Americans need to be more aggressive in their approach to halting the spread of the novel coronavirus, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said on Sunday.

    Fauci appeared on multiple news programs Sunday morning, and on each, he repeated a similar message: Americans need to do more to limit their social interactions to restrict the virus’s spread. He also said that young people are not inherently safe, simply because older and immunocompromised people are statistically at greater risk. “The virus is not a mathematical formula,” he said on CNN’s State of the Union. “There are going to be people who are young who are going to wind up getting seriously ill. So, protect yourself.”

    Fauci was also asked if he would like to see a national lockdown like those that have taken place in Spain and Italy — and he stopped short of expressing support for such a measure. “I would like to see a dramatic diminution of the personal interaction that we see in restaurants and in bars,” Fauci said. “Whatever it takes to do that, that’s what I’d like to see.”
    ...
    Hellooo Mar-a-Lago! Are you listening?
    posted by cenoxo at 7:10 PM on March 15 [5 favorites]


    Trump’s Florida sanctuary becomes a gilded petri dish for a global disease (Politico)
    At least three people who visited Mar-a-Lago in the past 10 days have tested positive for the deadly virus, and were spotted in photographs with the president and other club members. A top Brazilian official, Ambassador to the U.S. Nestor Forster, who was seated with the president at a Saturday night dinner at the club, tested positive for COVID-19. So did Fabio Wajngarten, the press secretary to President Jair Bolsonaro who was spotted standing next to Trump in an Instagram post. An email to Trump supporters who attended a fundraiser at the club last Sunday suggests there was now also a mysterious third person who was at the club last weekend with the virus.

    The chairwoman of the Republican National Committee, Ronna McDaniel, came down with flu-like symptoms on Friday and her doctor determined a test for coronavirus was necessary, a spokesman said.

    The handshakes, diplomatic huddles, cozy VIP photo-ops and meet-and-greets at Mar-a-Lago became a potential nexus for other cases — the mayor of Miami, Francis Suarez, tested positive after being in the same area as the Brazilian officials. Since last weekend, Miami-Dade Mayor Carlos Giménez and several Republican lawmakers close to the White House — Rep. Matt Gaetz, Sen. Rick Scott and Sen. Lindsey Graham — all self-quarantined as a precaution.

    The dark cloud over Mar-a-Lago, where Trump often spends holidays and hosts foreign leaders, threatens to mar its reputation as a social destination for elites after a mountain of headlines about an invisible disease spreading through the complex.

    [...] Despite the mounting attention, some members were still carrying on at the club. Jeff Greene, a Palm Beach real estate mogul and former member, had lunch with friends at the Beach Club on Saturday and noted it was “packed.”
    posted by katra at 7:19 PM on March 15 [5 favorites]


    Meanwhile, in France, Perfume giant LVMH to make hand sanitiser for French hospitals (can't some U.S. companies do this too?)
    posted by gudrun at 7:27 PM on March 15 [4 favorites]


    Washington state is shutting down all restaurants, bars, entertainment venues, and all gatherings over 50 are prohibited. Under 50 requires a comprehensive hygiene plan - Link is Washington Governor Inslee stating that .

    Washington Governor's Website with the same info (for sharing with none twitter folks)
    posted by mrzarquon at 7:43 PM on March 15 [5 favorites]


    Apparently no news shows for (or word about/from) CDC Director Robert Redfield again today.
    posted by cenoxo at 7:53 PM on March 15


    I think they are keeping Redfield out of the spotlight. Any time he shows up in a news conference, reporters start asking him how he screwed up testing so badly.
    posted by JackFlash at 7:58 PM on March 15


    These federal workers were exposed to the coronavirus while serving the public. Now they’re quarantined. (WaPo)
    The federal government has hundreds of thousands of workers who come in daily contact with the public — workplace inspectors, mail carriers, hospital workers, park rangers, passport processors, Social Security representatives, museum workers. Workers and union representatives from six different agencies — including the Social Security Administration, the Department of Veterans Affairs and the Consumer Financial Protection Bureau — said in interviews, emails and text messages with The Washington Post that [...] [t]hey or their co-workers [...] have been exposed to the virus and say their supervisors are not giving proper guidance or support.

    [...] Workers are told to not report to work if they are sick, but the SSA did not outline which symptoms should be of concern until Friday. “We’ve been asking the administration for information about what is going on in that office — it’s been nothing but crickets,” Dejuliis said.

    TSA workers have similar complaints. A notice to TSA employees, obtained by The Washington Post, directs workers to stay home if they are ill. However, the memo does not say what symptoms should prompt a worker to stay home. The notice also directed workers to wash their hands with warm soap and water if hand sanitizer and alcohol wipes are not available — something screeners can’t do without leaving their work station. “They are running out of hand sanitizer and alcohol wipes at some of the larger airports,” said Hydrick Thomas, president of the union representing TSA workers. “They don’t have the right sized gloves at others. They are too big for some people and they are rolling off of their hands. It’s unacceptable.”

    [...] In addition to the 160 Social Security field offices, the Social Security Administration has another 163 offices with hearing rooms, where sick and disabled people appeared before administrative law judges who rule on their requests for federal benefits. Judge Melissa McIntosh, who works in Tampa and is also union president for the judges, said people are showing up in hearing offices and courtrooms across the country with respiratory problems and fevers. In a Feb. 27 email, McIntosh asked SSA officials to give judges the authority to ask those who show up with these symptoms to consider doing the hearing over the telephone. A week later, an associate commissioner rejected her request, saying only SSA management can make such a suggestion, according to an email obtained by The Post.

    [...] “They show up sick because it can take months to get a hearing. Sometimes [they are] in the waiting room with other people for hours,” McIntosh said in an interview. “We would simply like the ability to give them the option so they don’t get other people sick, including us. It is stunning SSA refuses to respond to its judges and simply implement our common-sense suggestions.”
    posted by katra at 8:47 PM on March 15 [8 favorites]


    If they are keeping Redfield incommunicado with his nose to the grindstone, let him pop his head out briefly once in a while and tell us F2F how things are going. Don’t dwell on mistakes, they can be corrected with lessons learned.

    If the Director of the CDC is silent and invisible, its credibility and mission against coronavirus will suffer: fear, confusion and doubt spread quickly. And God knows, with a President like Trump we don’t need any further lack of credibility.
    posted by cenoxo at 9:20 PM on March 15 [1 favorite]


    Trump now needs the hospitals he's alienated (Adam Cancryn & Dan Diamond, Politico)
    "As coronavirus crisis deepens, hospital leaders seek more emergency help from an administration they distrust."

    Centers for Medicare and Medicaid Services Administrator Seema Verma on Friday announced new moves to roll back industry regulations, two days after hospitals pled their case to Verma in a White House meeting that left many unsatisfied. Among the changes: Streamlined deployment of doctors, fewer time-consuming inspections and less red tape around how hospitals run operations during a crisis. [...]

    But hospital leaders say that the new announcements only touch the surface of their needs, as they worry about shortages of crucial supplies, risks to their workers and the possibility of an industry bailout as coronavirus patients swarm their facilities. [...]
    Trump is avoiding meetings with hospital leaders as they beg for help with coronavirus crisis: report (Tom Boggioni, Alternet/Raw Story)
    Adding to their problems is the fact that leaders in the hospital industry have been unable to meet face to face with President Donald Trump who made a show of meeting with CEO’s representing the retail and financial sectors.
    posted by ZeusHumms at 9:51 PM on March 15 [5 favorites]


    that moment when you catch yourself about to unambiguously advocate for immediate regime change (by any means necessary) of the most powerful nation ever in human history, then think better of it, opting instead for a big and particularly strong bottle of beer and a bunch of Black Sabbath, because this shit's heavier than the black hole at the center of the universe, we shall overcome
    posted by philip-random at 10:08 PM on March 15 [1 favorite]


    Better info on droplets vs aerosols than I provided above:

    Wired: They Say Coronavirus Isn't Airborne -- But It's Definitely Borne By Air
    . . . This black-and-white division between droplets and aerosols doesn’t sit well with researchers who spend their lives studying the intricate patterns of airborne viral transmission. . . .
    posted by cybercoitus interruptus at 12:16 AM on March 16 [6 favorites]


    ISIS tells terrorists to steer clear of coronavirus-stricken Europe

    In the latest edition of the terrorist group’s al-Naba newsletter, the editors who normally urge followers to carry out attacks on the West instead ask them to "stay away from the land of the epidemic" for the time being.

    In a full-page infographic on the back cover, a list of pro-tips instructs militants on how to stop the pandemic's spread. ISIS members are advised to "put trust in God and seek refuge in Him from illnesses," but to also "cover the mouth when yawning and sneezing," and to wash their hands frequently.

    posted by roolya_boolya at 2:36 AM on March 16 [6 favorites]


    lesbiassparrow wrote:

    I just don't understand how in Canada every Canadian around me doesn't think it will really hit them and they don't personally need to worry

    There is this moment in the Mahabharata called the yaksha-prashna* -- a riddle contest with a disguised god. Yudhisthira has to answer a bunch of questions to rescue his brothers from death. Stuff like:

    What is heavier than a mountain?
  • Debt.
    What is faster than the wind?
  • Thought.
    What is bigger/heavier than the earth?
  • Mother [in that she is greater in her effects on our lives, in how much we love her, etc.].

    And the final riddle is:

    What is the most amazing thing in the universe?

    Answer:

  • Every day, we all see people around us fall ill, wither away, and die. And yet each of us, to ourselves, thinks: "I will live forever." That is the most amazing thing in the universe.

    (He answers all the riddles successfully and saves his brothers -- and it turns out that the crane is actually his father, Yama, the god of duty and death, whom he is meeting for the first time.)

    I read this in an Amar Chitra Katha comic book when I was a child and it has always stuck with me.... and it reverberates so powerfully now.

    * In case I misremember any of this --- uh, oral tradition! Right, folklore, always changing....

  • posted by brainwane at 4:05 AM on March 16 [29 favorites]


    gross numbers on the hopkins case-enumerating visualization suggest sometime this weekend the count in the rest of the world exceeded that count of cases to date in china (at present: 169,387/81,020).

    in my state, maryland, have heard county health service director report on radio that first three patients (of nile cruise, local nursing home/philly school visit fame) have recovered from covid; haven't seen it hit newspapers or state department of health tallies yet.
    posted by 20 year lurk at 4:19 AM on March 16 [2 favorites]


    gross numbers on the hopkins case-enumerating visualization suggest sometime this weekend the count in the rest of the world exceeded that count of cases to date in china (at present: 169,387/81,020).
    They said in the morning radio here that exactly that happened. I can't find an online source, though.
    posted by mumimor at 4:28 AM on March 16


    Tracking Every Coronavirus Case in the U.S.: Full Map, New York Times*; Mitch Smith, Karen Yourish, Amy Harmon, Keith Collins, Allison McCann, Jin Wu; Updated March 16, 2020, 7:19 AM, ET:
    The number of known coronavirus cases in the United States continues to surge. As of Monday morning, at least 3,602 people in 49 states, plus Washington, D.C. and three U.S. territories, have tested positive for the coronavirus, according to a New York Times database, and at least 66 patients with the virus have died.
    *As noted previously, the NYT is giving free access to their CV-related articles. You have to register with an email address and create a password.
    posted by cenoxo at 5:07 AM on March 16


    I lost a lot of enthusiasm for charting coronavirus cases a few days ago, when the enormous scale of difference between confirmed cases and the likely true number of cases became apparent. How can I sustain interest in making or inspecting maps like the NYT's, based on ~3600 cases, when the Ohio DOH thinks that 1% of the state – a hundred thousand people – are infected?
    posted by daveliepmann at 5:54 AM on March 16 [4 favorites]


    mumimor > ...I can't find an online source, though.

    Clarify, please.

    Math is not my strongest subject, but at this time the Johns Hopkins Coronavirus Map shows (world) Total Confirmed 169,387 minus China 81,020 equals 88,367 for the rest of the world, correct?
    posted by cenoxo at 5:57 AM on March 16 [1 favorite]


    Math is not my strongest subject, but at this time the Johns Hopkins Coronavirus Map shows (world) Total Confirmed 169,387 minus China 81,020 equals 88,367 for the rest of the world, correct?
    Yes, correct. I get up a lot earlier than you ;-) And I hadn't been online since I got up when I commented. My bad.
    posted by mumimor at 6:17 AM on March 16


    How can I sustain interest in making or inspecting maps...

    Worldwide statistics and maps on the growing CV pandemic are (and will likely remain) approximations compiled from many sources, some accurate, some rough, and some WAGs. Pick one overall source that seems credible, then get better local info from city, county, and state agencies.
    posted by cenoxo at 6:27 AM on March 16


    No apologies necessary, mumimor. Thank God for online calculators or I’d be lost.

    What’s the general CV situation in Denmark now? Is there a good Danish news source in English?
    posted by cenoxo at 6:39 AM on March 16


    Coronavirus risk by income in the NYT.

    Cancel your dental appointments.
    posted by Your Childhood Pet Rock at 6:49 AM on March 16 [4 favorites]


    So it’s loggers vs. lawyers in the post-CV apocalypse, then. I’ll go with the loggers – at least we’ll have log cabins to live in and fireplaces to keep warm.
    posted by cenoxo at 7:08 AM on March 16 [1 favorite]


    Is there a good Danish news source in English?
    The Danish version of The Local is pretty dependable.
    I check in now and then to see what they are saying and it is normally close to the official information. They are not very fast. There is a daily government press conference, this week it's at 2PM. I'm a bit surprised that the official sources aren't in English (and other relevant languages like Greenlandic and Turkish), but I guess that's an indication of how stressed out the whole system is.
    posted by mumimor at 7:11 AM on March 16


    What’s the general CV situation in Denmark now?
    The other day, they stopped testing people with no or weak symptoms, which means at this point we have no idea how many cases there are. I'm thinking in the tens of thousands, given how many completely unrelated people I know who are quarantined. 898 are officially registered as of today's briefing, 10 are in intensive care, 1-3 are dead (2 of these were already terminally ill, so it's impossible to say why exactly they died).
    All public institutions are closed down, but some work from home or have organized some form of emergency system. I work from home. The public radio/TVs have very few people keeping the thing running. My sisters are in different public functions, and they are working in different ways, except one who is quarantined.
    Private workplaces try to have alternate teams working from home and at the business if possible, to keep contamination low and ensure that not everyone gets ill at the same time. Obviously that isn't an option in manufacturing or in many services. Restaurants are still open here, but almost empty, and mostly doing takeout/delivery. People seem to be completely unable to stop having coffee and pastry (I guess that confirms whatever stereotypes anyone might have about Scandinavians). I've stopped, but when I walk my dog I see hundreds of people having their coffees. There's a lot of discussion of that on social media, I've been told, so it might end soon.
    Weirdly, my neighborhood is "hamstering" , stockpiling, more than any other in Denmark. It's so bad I shop elsewhere. I'm guessing there is a lot of fear spreading through the parent groups at local daycares and schools, since it doesn't seem to be nearly as bad in other parts of the country.
    Everyone I've talked with is very confident that the Government is doing the right thing. There is criticism, but mostly from people who are professional angry people. Surprisingly, industry is supporting the government 100%. My impression is that the hesitation to act we see in some European countries like the UK and Sweden comes from a fear of the economic consequences. The sentiment here is that there will be terrible economic consequences so we might as well take it head on. (Maybe look at Asterix and the Vikings for reference). One not-Asterix related reason for that may be that the economy here is really stable and there is only a small debt. So the Government can literally just write a check at this point. Things might look different in three months.
    posted by mumimor at 7:42 AM on March 16 [7 favorites]


    I lost a lot of enthusiasm for charting coronavirus cases a few days ago, when the enormous scale of difference between confirmed cases and the likely true number of cases became apparent. How can I sustain interest in making or inspecting maps like the NYT's, based on ~3600 cases, when the Ohio DOH thinks that 1% of the state – a hundred thousand people – are infected?

    Ex-Obama official warns US health system faces 'tsunami' over coronavirus (Guardian, Mar. 14, 2020) (via)
    Other medical experts have also warned the public to brace for an overwhelming number of coronavirus cases. “We’re about to experience the worst public health disaster since polio,” said Dr Martin Makary, professor at Johns Hopkins University’s Bloomberg School of Public Health, speaking to Yahoo Finance.

    “Don’t believe the numbers when you see, even on our Johns Hopkins website, that 1,600 Americans have the virus. No, that means 1,600 got the test, tested positive. “There are probably 25 to 50 people who have the virus for every one person who is confirmed. I think we have between 50,000 and half a million cases right now walking around in the United States.”
    posted by katra at 7:59 AM on March 16 [3 favorites]


    Mumimor, here’s a short article: Coronavirus deaths outside China have surpassed those in China, Quartz; Jane Li; March 16, 2020, 5 hours ago. It basically cites the Johns Hopkins Coronavirus Map data.
    posted by cenoxo at 8:04 AM on March 16 [2 favorites]


    The EU is shutting it’s borders to all non-essential traffic according to a tweet from RTÉ’s Tony Connolly: BREAKING: European Commission president announces "temporary restriction" on non-essential travel to EU for 30 days "in order not to place more strain on our health systems". Exemptions for EU citizens coming home, commuters, health professionals, researchers
    posted by scorbet at 8:30 AM on March 16 [1 favorite]


    Could Coronavirus Cause as Many Deaths as Cancer in the U.S.? Putting Estimates in Context (NYT)
    All of the estimates depend on two basic questions: How many Americans will be infected with the virus? And how many who are infected will end up dying? Our sliders allow you to consider a range of options.

    As The New York Times reported last week, epidemiologists at the Centers for Disease Control and Prevention recently prepared four scenarios. Their calculations showed a large range of possible fatalities in the United States: between 200,000 and 1.7 million Americans over the course of Covid-19, assuming minimal efforts to contain it.

    Few things kill anywhere near so many people in this country. These comparisons assume that the entire coronavirus pandemic runs its course in one year, though it could well take longer. [...] Marc Lipsitch, an epidemiologist at the Harvard School of Public Health, places a 20 percent infection share at the low end of what is likely. The governments in Britain and Germany are proceeding on the assumption that the virus may infect 60 percent to 70 percent of their populations.

    Many scientists and public health officials who have studied the data so far say they expect a fatality rate for Covid-19 of around 1 percent. But the documented fatality rate in most places is still higher. Places where a flood of sick patients have overwhelmed hospital capacity have had higher death rates than places where everyone who needs medical care can get it. [...]

    [Tom Frieden, who was director of the Centers for Disease Control and Prevention in the Obama administration,] has published his own estimates for the potential death toll. The top of his range assumes no more than half the U.S. population becomes infected. He puts the fatality rate at 1 percent, resulting in about 1.6 million deaths, though he noted that public health efforts could reduce that number.
    posted by katra at 8:53 AM on March 16


    More from Quartz: The WHO has changed its position on coronavirus and pets; Youyou Zhou; March 13, 2020:
    ...
    Yesterday, the WHO’s coronavirus myth-buster page [screenshot only] said there was no evidence that animals such as dogs or cats could be infected with virus. Today, that section is gone.

    The WHO told Quartz in an email that, “currently, there is no evidence that pets such as dogs and cats have infected humans with Covid-19.”

    The revised stance comes in the wake of an infected dog being found in Hong Kong. The dog tested positive after remaining with its owners who were sick with the virus. The dog wasn’t showing any clinical signs of the disease, according to a report from World Organisation for Animal Health [website]. There’s no evidence that dogs can spread the disease or that the disease can cause an animal to fall ill, the organization says, though further studies may bring new findings.
    ...
    Waiting for confirmation or denial of this.
    posted by cenoxo at 9:02 AM on March 16 [1 favorite]


    I wonder how that dog got tested.
    posted by lostburner at 9:14 AM on March 16 [1 favorite]




    So here is an update of Brazilian President Arsehole Bolsonazi and how it has moved on from a few days back.
    In the surreal world that is Brazil the following is noted as fact
    Just over a week ago he travelled to Florida to meet / grovel at the feet of the orange Emporer
    These people have tested positive and shared his 8 hour plane ride there and back
    Since then 12 of his entourage have tested Positive

    Eduardo Bolsonsaro confirmed to Fox news as per John Roberts FoxNews Chief White House Correspondent that his father had a preliminary POSITIVE test for coronavirus. Eduardo Bolsonaro then tells @FoxNews that the test was NEGATIVE.
    Local new sources published the first resulyt and were then attacked by the rightwing as Fake News purveyors and communist sympathisers.
    Bolsonaro is now having awaiting second test and is in isolation in Brasilia.
    Except that yesterday he left his isolation to mix with the loving crowd at one of the many sparesly attended rallies calling on Congress and the Supreme Court to be closed. He wore no face mask and shook hands and took people phones to take selfies. This is not a political movement it is an extremely dangerous fascist cult.
    In a further twist the Health Ministry is asking Cuba for 5,000 doctors.
    They are desparately needed the question now is will they come after being so unceremoniously thrown out of the country by the Bolsonzi only 15 months ago.
    It aint going to get any better soon.
    posted by adamvasco at 9:32 AM on March 16 [13 favorites]


    WHO let the dogs out.
    posted by JackFlash at 9:32 AM on March 16 [4 favorites]


    quick addition;
    The traficantes seem more on top of it all. Those who control the Rocinha favela of approx 100,000 people have announced that Favela tourism is banned. As of today there is no virus outbreak in any of the communities apart from the normal Dengue and Chikungunya, both debilitating.
    I fear it will be completely horrific and devastating when Covid-19 does arrive.
    posted by adamvasco at 9:48 AM on March 16 [3 favorites]


    Romney endorsing $1000 cash for every adult American.
    Senator Mitt Romney @SenatorRomney
    Every American adult should immediately receive a one-time check for $1,000 to help ensure families and workers can meet their short-term obligations and increase spending in the economy.
    Corporate America must be fucking terrified if ROMNEY of all people is proposing that big a stimulus.
    posted by Your Childhood Pet Rock at 9:53 AM on March 16 [16 favorites]


    People like Bolsonaro who've done the performative "look at me touching everyone" are going to have to live with themselves when one of those people dies and they have to worry that they gave covid-19 to them.

    I mean, Bolsonaro and Trump are incapable of feeling such responsibility and guilt, of course, but there are a hell of a lot of people who are deliberately, perfomatively flouting the social distancing recommendations.

    On the other hand, I keep wanting Trump supporters to feel responsibility and guilt and it appears that's never going to happen.
    posted by Ivan Fyodorovich at 10:13 AM on March 16 [1 favorite]


    Corporate America must be fucking terrified if ROMNEY of all people is proposing that big a stimulus.

    However, about a third of the responders are writing him off as a "traitor" so it'll probably not go through.
    posted by EmpressCallipygos at 10:21 AM on March 16 [2 favorites]


    Global restrictions rise, but so do the number of new infections. (NYT)
    [...] the number of new cases across the Continent continues to surge, and there is growing worry that the health care systems of Spain and France could soon face the kind of dire situation playing out in Italy — where doctors have had to make grim decisions about which patients to treat.

    There is a scramble across the Continent to step up production of ventilators, with leaders calling for the kind of effort seen in wartime to produce munitions. The Spanish government warned on Monday that it would probably extend the state of emergency and keep people indoors beyond the initial period of 15 days.

    Jérôme Salomon, a top official at the French health ministry, said the situation was “deteriorating very quickly.” He told France Inter radio on Monday that many people did not seem to be taking calls for social distancing seriously, and he tried to dispel the notion that the virus seriously threatens only the elderly. There are 300 to 400 people in intensive care in France, he said, and roughly half of them are under age 65.
    Trump tells governors to seek out respirators and other vital equipment on their own. (NYT)
    President Trump told a group of governors Monday morning that they should not wait for the federal government to fill the growing demand for respirators needed to help people diagnosed with coronavirus. “Respirators, ventilators, all of the equipment — try getting it yourselves,” Mr. Trump told the governors during the conference call, a recording of which was shared with The New York Times.

    “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.” The suggestion surprised some of the governors, who have been scrambling to contain the outbreak and are increasingly looking to the federal government for help with equipment, personnel and financial aid.
    posted by katra at 10:22 AM on March 16 [5 favorites]


    there are a hell of a lot of people who are deliberately, perfomatively flouting the social distancing recommendations.

    My partner's parents went to a comedy show in Houston Saturday night. My septuagenarian father went to a plant nursery with his septuagenarian wife in DFW over the weekend as well.

    I mean, it's still statistically improbable that my dad catches something at the present juncture, but the negative outcome is literally death? Sorry Dad, but me and the internet know more than your 70+ years of life because this is unprecedented.

    My partner's family going to the comedy show, honestly I blame how messaging in the U.S. functions, because I seem to be the only person in my orbit that is fairly certain we're looking at 50+% infection rate and 1-2M+ fatalities at a minimum. I'm guessing that information hasn't been hitting the cable news circuit like it's been hitting The Lancet and The Guardian?
    posted by avalonian at 10:26 AM on March 16 [7 favorites]


    and just one more:
    Edir Macedo, Rio born Brazilian evangelical bishop, founder of the Evangelical sect the Universal Church of the Kingdom of God and billionaire yesterday circulated a video to his approximately 7 million sheep stating that Coronavirus is inoffensive and that Satanists and the Media are promoting fear.
    We are so fucked.
    posted by adamvasco at 10:43 AM on March 16 [1 favorite]


    [few comments removed -- reload the thread if you need to -- absolutely no "This is God's plague on whoever" talk here. None.]
    posted by jessamyn (staff) at 11:02 AM on March 16 [31 favorites]


    Another update from Canada. Trudeau just announced Canada is closing its borders to non-citizens, with the exception of their immediate families, permanent residents, diplomats, air crews, and U.S. citizens at this time
    posted by devonia at 11:09 AM on March 16


    That US citizen exception seems like a pretty big exception. I understand that it would be extremely disruptive to close the border to US citizens, though, and even more so if the US did the same thing in the other direction.
    posted by ArbitraryAndCapricious at 11:12 AM on March 16 [3 favorites]


    Twitter takes down coronavirus tweets from John McAfee, David Clarke, and others (Kim Lyons, The Verge)
    Twitter has removed several tweets by prominent accounts that made misleading claims about the novel coronavirus pandemic, as the company says it’s following a “zero-tolerance approach to platform manipulation and any other attempts to abuse our service at this critical juncture.”
    posted by ZeusHumms at 11:13 AM on March 16 [8 favorites]


    “Respirators, ventilators, all of the equipment — try getting it yourselves,” Mr. Trump told the governors during the conference call, a recording of which was shared with The New York Times.
    The "I don’t take responsibility at all" party. Republicans don't actually want governance, they just want power.
    posted by Your Childhood Pet Rock at 11:14 AM on March 16 [15 favorites]




    Report: Mar-A-Lago Closed For Deep Cleaning After 3 Visitors Come Down With Coronavirus

    For the history books, here’s the Trump Administration’s defining photograph, recaptioned: The Imperial Donald and his admirers fiddle around at his gilded seaside palace while his country and the world burns up with fever.

    May he flee there alone to escape and find it empty.
    posted by cenoxo at 11:52 AM on March 16 [3 favorites]


    The UK Only Realised "In The Last Few Days" That Its Coronavirus Strategy Would "Likely Result In Hundreds of Thousands of Deaths"
    The UK only realised "in the last few days" that attempts to "mitigate" the impact of the coronavirus pandemic would not work, and that it needed to shift to a strategy to "suppress" the outbreak, according to a report by a team of experts who have been advising the government.

    The mitigation strategy "focuses on slowing but not necessarily stopping epidemic spread — reducing peak healthcare demand while protecting those most at risk of severe disease from infection", the report said, reflecting the UK strategy that was outlined last week by Boris Johnson and the chief scientific adviser Patrick Vallance.

    But the approach was found to be unworkable. "Our most significant conclusion is that mitigation is unlikely to be feasible without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over," perhaps by as much as eight times, the report said.
    You're telling me that trying to speedrun the disaster and letting 66 million people get infected with a virus that causes hospitalization in 10-20% of cases to build "herd immunity" wasn't the greatest idea? Perish the fucking thought.

    This is what happens when we elect complete fucking muppets to govern us out of spite. 250,000 unnecessary deaths.
    posted by Your Childhood Pet Rock at 2:32 PM on March 16 [20 favorites]


    And back home in Australia, Scotty from Marketing is dithering on shutting the fucking country down despite being given a 2 week reprieve. I hate conservatives.
    posted by Your Childhood Pet Rock at 2:35 PM on March 16 [1 favorite]


    You're telling me that trying to speedrun the disaster and letting 66 million people get infected with a virus that causes hospitalization in 10-20% of cases to build "herd immunity" wasn't the greatest idea? Perish the fucking thought.
    We doctors are scared of the coronavirus crisis. How could we not be?
    Anonymous
    and
    Brexit threatens UK’s ability to respond to a future pandemic
    Martin McKee, Anniek de Ruijter and Mark Flear
    posted by mumimor at 2:53 PM on March 16 [1 favorite]


    Illinois has primaries tomorrow, and Chicago (at least) is concerned that they might not have enough election judges:
    NOTICE: If you are a healthy and capable voter and find your precinct to be under-staffed and over-burdened, you are WELCOME and ENCOURAGED to offer to be sworn in as a Subsitute Judge to help the election run smoothly in that precinct. Those who are sworn in and serve Election Day will be paid $170 for the full day of 5 am through the close of polls, or on a pro-rated basis based on the number of hours that they serve.
    posted by Westringia F. at 3:16 PM on March 16 [4 favorites]


    This is the busiest point of Polish capital on Monday morning, the busiest time of the day. Only essential shops remain open, all who can switched to working from home. While the government's decision to act decisively and early is admirable, the number of tests performed remains low and many doctors warn that Polish health care, running at capacity even under normal conditions, is ill-prepared for the emergency. It suffers from years of underfunding, and while it isn't entirely the current administration fault, the ruling party voted recently to subsidize the national television with $500M against the protests of the opposition which demanded the money be spent on health care.
    posted by hat_eater at 3:21 PM on March 16 [1 favorite]


    "Republicans don't actually want governance, they just want power."

    In other news, scientists now believe that water is wet.
    posted by Ivan Fyodorovich at 3:30 PM on March 16 [4 favorites]


    You're telling me that trying to speedrun the disaster and letting 66 million people get infected with a virus that causes hospitalization in 10-20% of cases to build "herd immunity" wasn't the greatest idea? Perish the fucking thought.

    This is what happens when we elect complete fucking muppets to govern us out of spite. 250,000 unnecessary deaths.


    I don't understand, 250,000 deaths are what is not going to happen because of the decisions that those "muppets" have made based on the scientific advice they are receiving. Even the new data has hospitalisation rates of 10.2% for 50-59 yr olds, so to say that the rate was 10%-20% for the entire population just isn't right. What has changed the position is the higher than expected ICU rates which have been emerging from recent data in under 60s.

    The graph on page 10 of the Imperial paper is quite illuminating. Look at the green chart (five months suppression followed by a lifting of measures), look how much worse the second peak (after the suppression ends) is than in the orange mitigation strategy. The issue with that strategy is that it takes you up to 1.75x ICU surge capacity which obviously would lead to many excess deaths.

    You might well imagine that if previous estimates for ICU bed requirements were off by a factor of 2 (which I've seen hinted at elsewhere) that you would pick a version of that mitigate strategy. The data which led them to refine this model is the recent detailed data on hospitalisation and ICU rates in the Verity paper which was uploaded to pre-print last Friday. This paper was also produced to support UK government decision making.

    It looks like the hospitalisation and particularly the critical care rates in the demographic groups below the age of 60 were lower in the models they were running last week. The lower those rates are, the better a mitigation strategy works. Since those numbers are small, for instance the Imperial paper has 1.2% of 20-29 yr olds hospitalised and 5% of those needing critical care, relatively small changes can make huge differences in peak ICU utilisation rates.

    Let's assume for the moment that there is no vaccine coming any time soon (the assumption the government has made, probably correctly) then what do you do to minimise fatalities over the next 24 months? There are no easy answers here, what other countries are doing is also improvisational. Yes, we should do more tests. We don't have the capacity right now to do more tests. Yes, we need more ICU capacity urgently. Ventilators are hard to build and critical care nurses take a long time to train so we won't have it.
    posted by atrazine at 4:27 PM on March 16 [3 favorites]


    WHO > Coronavirus disease (COVID-19) advice for the public: Myth Busters. This an FAQ that dispels common notions and misinformation about CV.
    posted by cenoxo at 4:35 PM on March 16 [1 favorite]


    See Also: FAS has a page for debunking coronavirus misinformation (h/t peeedro), Coronavirus Disease 2019: Myth vs. Fact (Johns Hopkins), Covid-19 facts checked (Guardian), Snopes (Coronavirus), Factcheck.org (Coronavirus), COVID-19 Facts (Dettol & Lysol)

    via the MeFi Wiki Disaster Planning & Recovery page, Medical/Pandemic section
    posted by katra at 4:42 PM on March 16 [5 favorites]


    I don't understand, 250,000 deaths are what is not going to happen because of the decisions that those "muppets" have made based on the scientific advice they are receiving.

    I don't know if this vid's been posted here yet. Well it has now:

    Just an attempt to explain the UK government response to COVID19. Wasn't expecting it to go "viral" or I'd have worn a better shirt. This strategy is not my Idea, I'm a Podiatrist not an epidemiologist, but its a very good time to listen to, and amplify the people who ARE experts. By which I mean people like the excellent Prof Whitty and Sir Patrick Vallance (as opposed to all the overnight virologists I see in the comments).

    Made me a little less anxious
    posted by philip-random at 4:45 PM on March 16 [1 favorite]


    To put my comment in terms of the bucket analogy somewhat imperfectly:

    It turns out the hole in the bottom of that cut-off soda bottle is smaller than we thought and we therefore cannot tolerate more than a trickle without it overflowing.
    posted by atrazine at 5:00 PM on March 16 [2 favorites]


    The Dutch government seems to be adopting the "herd immunity" approach as well, again, based on the advice of experts. It's risky, but so is every other option currently on the table. Here's an excerpt from Prime Minister Rutte, earlier today:

    All in all, there are three possible scenarios. The first scenario is: maximally controlling the virus. This leads to controlled distribution among groups that are least at risk. That is our scenario of choice. Maximum control means that we try to use measures to level off and smooth the peak in the number of infections and spread it over a longer period. With this approach, in which most people will only get minor complaints, we build immunity and ensure that the healthcare system can handle it. With the aim that nursing homes, in-home care, hospitals, and especially intensive care units are not overloaded. So that there is always sufficient capacity to help the people who are most vulnerable.

    The second scenario is that we let the virus run unchecked. This would completely overload our healthcare system at the peak of contamination, leaving insufficient capacity to help vulnerable elderly and other high-risk patients. We must of course prevent that at all costs.

    The third scenario is that we endlessly try to stop the virus. That means completely locking down the country. Such a rigorous approach may seem attractive at first sight, but experts point out that it definitely would not be a matter of days or weeks. In that scenario, we would in fact have to shut down our country for a year or even longer, with all the consequences that entails. And even if it were practically possible — to only let people leave their homes with permission for such a long time — then the virus could immediately resurface if the measures were withdrawn.

    Full text of the National Address (in English)
    posted by monospace at 5:08 PM on March 16 [2 favorites]


    The problem with the herd immunity strategy is that the ICU admission rate in healthy people is too high. The max you can tolerate simultaneously infected is essentially 1/ICU rate x ICU beds.

    n.b. the Imperial paper assumes that 50% of people who end up in ICU die, regardless of age. It's based on expert clinical opinion so might overstate the numbers for younger people as they rarely end up in ICU with infectious disease so might not be as good an evidence base for that.

    Let's say the UK has an ICU surge capacity of about 8k beds (consistent with numbers in Imperial report)

    Let's take the numbers for 20 somethings as a very conservative example: 1.2% hospitalised of which 5% ICU = 0.06%

    1/0.06% = 1,667. So for every 1667 people infected, you need one ICU bed.

    Since you have 8k, you can deal with about 13 million simultaneously infected. That sounds pretty good, right? At that rate you get through your population quickly and if they're mostly immune for a while afterwards, your spread rate starts to drop off pretty sharpish.

    Now let's use numbers for 50-59 instead.
    10.2% * 12.2% = 1.24%
    1/1.24% = 80. So you need an ICU bed for every 80 infected.

    Maximum infected simultaneously = 640k.

    Obviously the actual number is between these two depending on demographic structure but at the higher end it takes you something 50 months to get to 50% of the population immune, which will slow but not stop transmission though herd immunity. Reaching "proper" herd immunity as targeted by vaccine programmes depends on R but will be much higher than that. All that, and hundreds of thousands dead despite ICU treatment.
    posted by atrazine at 5:34 PM on March 16 [7 favorites]


    Census Bureau Scrambles To Protect 2020 Count From Major Impacts Of COVID-19; TPM, Tierney Sneed, March 16, 2020:
    ...
    Around the same time that many Americans received mailers from the Census Bureau instructing them how to respond to the survey, they also are hearing pleas from public health officials that they avoid as much social contact as possible, putting in jeopardy the Census Bureau’s ability to do outreach to hard-to-count communities.

    While millions of Americans will opt to respond online — and, according to the Bureau, 5 million as of Sunday had — getting an accurate enumeration of the people who are unlikely to use that or other methods to participate in the survey looks even more at risk given the current outbreak.

    Commerce Secretary Wilbur Ross acknowledged over the weekend that the deadline for completing the collection of decennial census responses, July 31, may need to be changed.

    Already, local officials in areas hardest hit by the COVID-19 virus are stressing that such an extension must be treated as a real option, as they fret about how an inaccurate count could skew federal funding and political power away from their constituents.
    ...
    The pandemic has raised serious questions about the in-person operations the Census Bureau has planned. Those include its “non-response follow up” operation, known as NRFU, wherein in-person enumerators go door to door to get collect information from households that have failed to respond to the survey on their own.

    In a statement Saturday, Ross stressed the ability to respond to the survey online, on the phone, via the mail, “all without having to meet a census taker.”

    “[T]here will be no need for census takers to knock on your door” if you respond using one of those methods, Ross said, while touting the “$2 billion dollar contingency budget for circumstances like the COVID-19 outbreak.”

    “Currently, the planned completion date is July 31 — but that can and will be adjusted if necessary as the situation dictates in order to achieve a complete and accurate count,” Ross’ statement later added.
    ...
    For more info, see this Census Bureau Statement and take the 2020 Census online.
    posted by cenoxo at 7:28 PM on March 16 [4 favorites]


    I was wondering what the point in a delayed peak might be, given that it's likely that everyone will ultimately be infected and we'll still have a peak. I have no particular knowledge of this area, but but here are my thoughts:
    1. It gives us time to produce more ventilators, train more ICU staff, and so forth. That would allow us to better cope with the peak;
    2. All viruses mutate; there's a chance that a less-lethal virus will evolve and spread immunity to the lethal strain;
    3. We expect a vaccine to be developed at some point; the longer the peak is delayed, the more people will benefit;
    4. No matter how grim the prognosis, a delayed peak means a longer life for many people.
    Does this make sense?
    posted by Joe in Australia at 7:31 PM on March 16


    Yes, that does make sense. In the short term, it prevents overwhelm; reduces the danger to medical staff and

    5. There's a hope that summer might bring some relief because some virulence of some viruses seem to decline then. So if you can delay spread, there's a chance of saving more lives.
    posted by storybored at 7:42 PM on March 16


    The wider the peak, the lower the maximum.
    posted by Marticus at 7:52 PM on March 16 [2 favorites]


    The herd immunity "solution" forgets two things. The first is that disease spread is exponential so you could literally go from ICU-undercapacity to ICU-overcapacity overnight. Second, in order to even imagine doing this, you'd have to know how many people are infected, and the current R0 value. And judging from the poor statistics on "confirmed cases", they have as much visibility into that as I have of the dark side of the moon.
    posted by storybored at 7:52 PM on March 16 [5 favorites]


    How long will social distancing for coronavirus have to last? Depends on these factors. (William Wan, Washington Post)
    So it’s possible, even most likely, that after U.S. cases peak, Americans will still have to maintain some measures — such as isolating the infected, constant hand-washing, some degree of social distancing — until a viable vaccine is developed, which could take 12 to 18 months.
    I also just noticed that WaPo is now providing free access to its coronavirus coverage, like several other major news sites.
    posted by mbrubeck at 8:05 PM on March 16 [2 favorites]


    It's not just to delay the peak. It's also to decrease the size of the peak. There is a class of people who will have a medical emergency in the next year (related to COVID 19 or not) who would recover if given adequate care.

    In a high peak situation those people die because resources are already maxed out: they can't get a hospital bed; they can't get a respirator; their doctor is making mistakes because she hasn't had adequate rest; etc.

    In a low peak situation they don't.

    I think that is who we are trying to save at this point. It's not much. But it seems like this is the only possible difference to be made since containment is no longer possible.
    posted by great_radio at 8:13 PM on March 16 [15 favorites]


    Quarantine the cat? Disinfect the dog? The latest advice about the coronavirus and your pet; Science; David Grimm; March 12, 2020:
    When a Pomeranian in Hong Kong tested positive for SARS-CoV-2 last week, pets quickly became part of the coronavirus conversation. The case raised the alarming possibility that pets could become part of the transmission chain for the severe acute respiratory syndrome coronavirus 2, which could potentially harm both them and us. But many questions remain about this possibility and how best to respond.

    As Hong Kong’s Agriculture, Fisheries and Conservation Department (AFCD) explained in a fact sheet last week, the Pomeranian tested “weakly positive” for the virus in sensitive tests that detected viral RNA in nose and mouth samples. “The dog has a low-level of infection and it is likely to be a case of human-to-animal transmission,” AFCD wrote. “We strongly advise that mammalian pet animals including dogs and cats from households with … infected persons should be put under quarantine … to safeguard public and animal health.”

    Science talked with Shelley Rankin, a microbiologist at the University of Pennsylvania School of Veterinary Medicine, Philadelphia, about the risks of COVID-19 infection in pets. Her lab is part of the U.S. Food and Drug Administration’s Veterinary Laboratory Investigation and Response Network, a collective of veterinary diagnostic labs that could help determine the impact of the pandemic on pets and other animals. This interview has been edited for clarity and length.
    ...
    See also: COVID-19 What veterinarians need to know > (Section) SARS-CoV-2 and domestic animals, including pets; American Veterinary Medical Association, March 16, 2020.

    (Note my previous comment in this thread)
    posted by cenoxo at 8:25 PM on March 16 [5 favorites]


    A narrower/taller curve (where more people get sick at the same time) also has a second-order effect of lowering treatment capacity because more health care workers are sick at once.
    posted by mbrubeck at 8:26 PM on March 16 [3 favorites]


    ...There's a hope that summer might bring some relief because some virulence of some viruses seem to decline then.

    Per W.H.O.’s Coronavirus disease (COVID-19) advice for the public: Myth busters page:
    COVID-19 virus can be transmitted in areas with hot and humid climates

    From the evidence so far, the COVID-19 virus can be transmitted in ALL AREAS, including areas with hot and humid weather. Regardless of climate, adopt protective measures if you live in, or travel to an area reporting COVID-19. The best way to protect yourself against COVID-19 is by frequently cleaning your hands. By doing this you eliminate viruses that may be on your hands and avoid infection that could occur by then touching your eyes, mouth, and nose.
    See also their associated infographic (and review the other CV myths there).
    posted by cenoxo at 9:46 PM on March 16 [3 favorites]


    Does this make sense?

    Comprehensive Social Distancing Is Difficult And Necessary. Here's How To Keep Your Family Safe (Asaf Bitton, MD, MPH, WBUR) (via Harvard Chan School of Public Health)
    At this point, containment through contact tracing and increased testing is only part of the necessary strategy. We must move to pandemic mitigation through widespread, uncomfortable and comprehensive social distancing. That means not only shutting down schools, work (as much as possible), group gatherings, and public events, but also making daily choices to stay away from each other as much as possible to “flatten the curve,” detailed below.

    [“Flattening the epidemic curve,” in one chart. (Christina Animashaun/Vox, Source: CDC)]

    Our health system will not be able to cope with the projected numbers of people who will need acute care should we not muster the fortitude and will to socially distance each other starting now. On a regular day, we have about 45,000 staffed ICU beds nationally, which can be ramped up in a crisis to about 95,000. Even moderate projections suggest that if current infectious trends hold, our capacity (locally and nationally) may be overwhelmed as early as mid-late April. Thus, the only strategies that can get us off this concerning trajectory are those that enable us to work together as a community to maintain public health by staying apart.

    The wisdom, and necessity, of this more aggressive, early, and extreme form of social distancing can be found here. I would urge you to take a minute to walk through the interactive graphs — they will drive home the point about what we need to do now to avoid a worse crisis later. Historical lessons and experiences of countries worldwide have shown us that taking these actions early can have a dramatic impact on the magnitude of the outbreak.

    [...] Enhancing social distancing, even by one day, can make a large difference. We have a preemptive opportunity to save lives through the actions we take right now that we will not have in a few weeks. It is a public health imperative.
    posted by katra at 11:03 PM on March 16 [2 favorites]


    ...There's a hope that summer might bring some relief because some virulence of some viruses seem to decline then.

    Coronavirus reality check: 7 myths about social distancing, busted (USA Today, Mar. 16, 2020) (via) (emphasis mine)
    Reality: Unfortunately, the United States has nowhere near the number of tests we need. Until that changes, we can test only the sickest cases (and a fraction of all mild cases for surveillance and public health tracking). As the weather gets warmer, flu and colds will become less common, and COVID-19 will become an increasingly likely cause of respiratory infections. Over the next few months, the best advice will be for those with any respiratory infection to stay home and for employers to make that possible.
    posted by katra at 11:14 PM on March 16 [1 favorite]


    W.H.O.’s Coronavirus disease (COVID-19) advice for the public: Myth busters page:

    this has proven a strong resource for me. Good information that takes on most of the current WRONG positions with as few words as possible. Unfortunately, it only works on the rational.
    posted by philip-random at 11:21 PM on March 16


    From researchers at Imperial College:

    We show that in the UK and US context, suppression will minimally require a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members. This may need to be supplemented by school and university closures, though it should be recognised that such closures may have negative impacts on health systems due to increased absenteeism. The major challenge of suppression is that this type of intensive intervention package – or something equivalently effective at reducing transmission – will need to be maintained until a vaccine becomes available (potentially 18 months or more) – given that we predict that transmission will quickly rebound if interventions are relaxed.
    posted by modernnomad at 12:12 AM on March 17 [2 favorites]


    Unfortunately, it only works on the rational.

    But now, after only a few weeks, we’re living in the irrational: Misinformation and conspiracy theories related to the 2019–20 coronavirus pandemic (WP).

    Can rationality prevail against chaos?
    posted by cenoxo at 12:33 AM on March 17 [1 favorite]


    So this morning there are 914 confirmed cases and 4 dead in Denmark. I'm posting the link even though it's in Danish because there is an intersting graph showing the demographic distribution of the disease. Note that here only people who have serious symptoms are registered.
    The graph shows that far more men than women have serious symptoms (not that more men than woman have the virus, because we don't know that). I wonder why that is. In Denmark, there are as many women who smoke as men.
    Also in the article there is a hint that right now, the social distribution tilts towards middle class and upwards - because the first cases where people who could afford holidays in Italy and Austria. They seem to expect that to change.
    The article says that experts here estimate that the peak will be in late April. I have no idea how they are doing their numbers. But I'm guessing that since the country is almost completely closed down and closed off, and all Danes are registered in a central register, they can probably make some calculations based on information from the countries that are a few weeks ahead.

    I've never been really good at statistics, but my feeling is that the "herd immunity" discussion is really about weighing the economic losses up against the risk. The governments in the UK, The Netherlands, Sweden (elsewhere? I'm not counting the US because there is no plan) are hesitating because of the huge hit to the economy a total lockdown is. It's very clear here that the government has decided that the economic hit will happen regardless of what you do, so you might as well try to keep as many people alive as possible by keeping the healthcare system as functional as possible.
    They keep on reminding us that the lockdown is a political decision, and being very clear that it is not an evidence-based decision, because this is a new virus. The experiences from China, South Korea, Iran and Italy are very different and not exactly replicable. The experiences from other epidemics are similar while different, and there is clear evidence that lockdowns have worked, historically.
    Another thing is that in Denmark, the public sector is about half the economy. So when a Danish economist does the math, it might be completely different from how it looks in the UK, where the public sector is smaller.
    posted by mumimor at 12:35 AM on March 17 [6 favorites]


    "I think that is who we are trying to save at this point. It's not much."

    It's more than not much. The different case fatality rates in South Korea, China, and Italy correlate to the number of hospital beds per capita. It also correlates to the aggressiveness of the response, but in that South Korea isn't as much an outlier. Its CFRs are really, really low compared to China's; and Italy's are high compared to China's.

    I can't help but think that the big CFR differences between countries are even more a function of how over-stressed is the health care system than we've been thinking. If so, flattening the curve may reduce the CFRs quite a bit.

    The US has even fewer hospital beds per capita than Italy does.
    posted by Ivan Fyodorovich at 1:08 AM on March 17 [5 favorites]


    Just in: soon there will be universal testing in Denmark, as in South Korea.
    I'm heading for the family farm ASAP, and it's in the region where they are moving first on this. Very reassuring.
    posted by mumimor at 1:17 AM on March 17 [4 favorites]


    Some of the really useful data coming out of China shows that where there is impaired liver function, patients have more severe symptoms so could the Danish data be due to alcohol consumption perhaps?

    It is a very strange feeling today as my husband goes off to staff his ITU for a long shift (still no positive cases although the Eastbourne branch of the hospital had it's first positive yesterday) and EU borders close (while they say for 30 days we really have no idea how long), I'm thinking about Granny in her Hamburg Dementia Care home and my daughter due to celebrate her 30th birthday in Madrid on May 27th and I'm in tears. Will she know us when this is over, even if she survives? Will I get to share in my daughters special day?

    I'm also beyond frustrated right now, as I'm on a three month notice period due to get ill-health retirement from my NHS job due to spinal fractures that have healed badly and cannot be operated on, but other than pain which is well managed OH is a pain specialist, luckily) I'm other wise fit & well. I am in touch with the Chief Nurse of our local trust about plans to get staff in my area of the NHS re-purposed to support the frontline activities as we spend 50% or more of our time on training, introducing new models of care etc., none of which will be happening now, but I received an e-mail from HR warning that this activity can be considered work and therefore could jepordise me getting my pension!!!!!!! I need to get over to the fuckilty fuck thread ASAP.
    posted by Wilder at 1:44 AM on March 17 [7 favorites]


    On a regular day, we have about 45,000 staffed ICU beds nationally, which can be ramped up in a crisis to about 95,000

    Can someone help me work through a question about this? Let's say capacity ramps up to 100k ICU beds and all of them are reserved for COVID19 cases.

    Let's further say that 5% of those ill need ICU care. So that means we can't have more than 2 million ill at the same time to keep under capacity. And flattening the curve means that the curve is wider/longer.

    How wide/long does it have to be to keep it under 2 million ill?

    Rather than dusting off my own rusty and unreliable capacity to derive this, I'm eyeballing other people's models and with 2mil as a ceiling guessing six months to peak.

    I've been psychologically preparing myself for about 3 months to peak (and most people around me seem psychologically prepared for weeks) so I would love for someone to explain why I am wrong here.
    posted by wildblueyonder at 3:25 AM on March 17


    On Lockdown in Rome: A Preview of American Life in 11 Days – To slow the spread of the coronavirus, Italy has ordered its entire population to stay home. An Italian writer describes living in the surreal new normal that may be coming to the US.; WIRED, Michele Masnerio, 3.16.2020:
    ... Lockdown here came in progressively more restrictive stages. It all started at the end of January, when two Chinese tourists in Rome tested positive for the virus. So the first to close were Chinese outposts in Rome. But still, we thought, it was just un raffreddore, a flu. People were making fun of it even as we expressed solidarity with the Chinese community.

    Then the virus spread in Milan: On February 21, 16 new cases were detected in the Lombardy capital. On February 22, the number of cases in Italy rose to 79. Then, on March 8, Lombardy, the epicenter of the outbreak, was locked down. On the following day the same happened to all of Italy, placing more than 60 million people in quarantine. On March 11, Prime Minister Giuseppe Conte prohibited nearly all commercial activity.

    The stepwise tightening certainly helped Italians adapt to the idea of these restrictions. At the beginning, it was just “don’t socialize,” meaning don’t go to crowded spots, don’t shake hands. Then it was: Don’t take a train for Milan. Then it was: no school. And finally: Just stay home.

    Almost nobody was complying at the beginning. I visited Milan at the end of January and had dinner with friends. When we met up, we goofily avoided hugs and handshakes—like, hey, let’s follow the rules. But after dinner, when it was time to say goodbye, after relaxing and some booze, we were in a more fatalistic mood—like, let’s hug and kiss goodbye. After all, people seriously affected by the coronavirus are mainly elderly. It’s not going to happen to us.

    But soon attitudes shifted. The messages from local and central governments turned grave. “Milan doesn't stop,” the mayor of Italy’s finance and design capital had defiantly tweeted at the beginning of the outbreak. But as the epidemic accelerated, the hashtag suddenly changed to iorestoacasa—I stay home. The death toll rose. As of March 15, there have been 1,809 deaths and more than 20,000 confirmed cases.

    The turning point, for me at least, came when I learned that someone real, someone on the fringe of my immediate circle, was in mortal danger...
    (WIRED is providing unlimited free access to stories about the coronavirus pandemic.)
    posted by cenoxo at 4:31 AM on March 17 [6 favorites]


    scorbet > The EU is shutting it’s borders to all non-essential traffic according to a tweet from RTÉ’s Tony Connolly: BREAKING: European Commission president announces "temporary restriction" on non-essential travel to EU for 30 days "in order not to place more strain on our health systems". Exemptions for EU citizens coming home, commuters, health professionals, researchers

    For anyone wanting current EU information, go to the European Commission > Coronavirus response page and scroll down to see relevant links.
    posted by cenoxo at 5:17 AM on March 17 [2 favorites]


    https://www.wired.com/story/on-lockdown-in-rome-a-preview-of-american-life-in-11-days/

    Just to say (also from Rome): that article pretty much nails it.
    posted by progosk at 5:42 AM on March 17 [4 favorites]


    Ontario has declared a state of emergency until March 31.

    Essentially Ontario is now prohibiting events of 50+, closing private schools (public schools already closed), libraries, licensed child care centers, bars and restaurants (takeout and delivery permitted), theatres, cinemas and concert venues.
    posted by devonia at 6:45 AM on March 17 [1 favorite]


    Johns Hopkins Coronavirus Map > United States: 4661 confirmed cases, 85 deaths, 17 recovered (at this date & time).
    posted by cenoxo at 7:29 AM on March 17 [1 favorite]


    Progosk, would you share some of your experiences in Rome thus far?
    posted by cenoxo at 7:40 AM on March 17 [1 favorite]


    Update S. America
    Chile (181 cases / +25 new cases / 0 deaths):
    On March 16, 2020, the Chilean government announced the prohibition of entry to the country of all foreigners, allowing only the entry of Chileans or permanent residents in the country.

    Argentina (68/+3/2):
    On March 15, 2020, the government of Argentina has decreed a 15-day ban on entry to the country, effective March 16, 2020, for foreigners who are not residents of that country.

    Peru (117/+31/0):
    On March 15, the government of Peru announced the total closure of its borders for entry and exit to the country with effect from March 16, which will last for a period of 15 days. At the same time, the suspension of interprovincial air transport service has been declared on the same dates.
    posted by adamvasco at 7:45 AM on March 17


    Johns Hopkins Experts COVID-19 Webcast TODAY at 11:30 ET
    https://www.jhsph.edu/events/2020/covid-19/
    posted by cenoxo at 7:54 AM on March 17 [2 favorites]


    ...note on the JH Experts Webcast Page (above) that questions can be pre-submitted via their form.

    And “An edited recording with closed captioning and downloadable transcripts will be available later today. For more, subscribe on YouTube.”
    posted by cenoxo at 8:09 AM on March 17


    An explanation for Monday's White House Press Conference:

    NYTimes: White House Takes New Line After Dire Report on Death Toll
    Federal guidelines warned against gatherings of more than 10 people as a London report predicted high fatalities in the U.S. without drastic action.
    Talking Points Memo: READ: The Alarming Report That Seems To Have Jump-Started Trump’s COVID Response
    President Trump’s surprisingly sober press conference on Monday was reportedly sparked by a British study suggesting that the U.S. could face 2.2 million fatalities if the coronavirus epidemic goes unabated.

    The report – embedded below – was put together by a team of epidemiologists at Imperial College London.

    Though it has not been peer-reviewed, the report made shockwaves after being sent to the White House on Sunday, its lead author, epidemiologist Neil Ferguson told the Times.
    Imperial College London: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand (PDF)
    posted by ZeusHumms at 8:17 AM on March 17 [5 favorites]




    Costa Rica (41/0/0):
    The country will shut down its borders to foreigners and non-residents starting 11:59 p.m. on Wednesday, March 18. The restriction applies to the country’s ports of entry via land, air or sea.
    Starting immediately, citizens and residents who arrive in Costa Rica will be subjected to a mandatory 14-day quarantine, President Alvarado said.
    The travel restrictions will continue through at least Sunday, April 12 at 11:59 p.m.

    https://ticotimes.net/2020/03/16/costa-rica-declares-state-of-emergency-due-to-coronavirus-will-close-borders-to-foreigners-and-non-residents
    posted by affectionateborg at 8:21 AM on March 17


    Meanwhile, in Kentucky - a Coronavirus patient checked himself out of the hospital against medical advice, and local deputies surrounded his house and are going to stay there two weeks to make sure he stays there.
    posted by EmpressCallipygos at 8:24 AM on March 17 [10 favorites]


    Coronavirus will force hospital chiefs to make some terrible choices
    Polly Toynbee/The Guardian
    Horrible decisions will be made about who lives and who dies,” says the chief executive of a large hospital trust. “And I will be the one to make them. Liability sits with me.” This manager, somewhere in England, dare not say who he is – “Everyone is under a total media blackout” – but he doesn’t think silence a good policy. “Any vacuum will get filled by Twitter or the Daily Mail.”

    He has done the sums locally: he has 130,000 over-80s. He follows chief medical officer Chris Whitty’s high estimate of an 80% infection rate, with 10% needing a bed and 4% intensive care. Even extending his 15 intensive care beds, he will never have enough. His staff are anxious, needing to know every detail of what’s going on as he patrols his corridors.

    “The truth is we won’t cope. No one will. This is real. We will all get it and I just hope we won’t all get it at once.” He adds: “I’m dying to get it soon and get it over with.”

    Because those “horrible decisions” loom ahead darkly, he has set up an ethical group to advise him. He has recruited a senior cleric, a respected headteacher, several doctors and some lay people who are trusted in the community to consider the terrible choices ahead. “They will advise, but I know the final decisions sit with me.” And very final they will be.
    posted by mumimor at 8:26 AM on March 17 [8 favorites]


    JH Experts Webcast - "IBM Our servers encountered a temporary error. Our engineers are working to resolve the issue. Please try again later." Looks like they're getting overwhelmed.
    posted by cenoxo at 8:30 AM on March 17


    Progosk, would you share some of your experiences in Rome thus far?

    lots of lived COVID-19 experiences in the two MeFi check-in threads, cenoxo; happy to answer any specific questions you might have over there ;-)

    posted by progosk at 8:47 AM on March 17 [2 favorites]


    I don't usually watch the presidential press conferences, but I am looking at this a bit.
    And I suddenly realize that the reason Pence and other do this ridiculous brown-nosing thing is that Trump himself can't do his job. By repeating that the president is amazing while they present the government policy (which Trump doesn't know) they are are attempting to present Trump as a real leader rather than as an overweight and over-aged frat-boy. And obviously, the Trumpists will fall for it.

    In good news, there will be checks.
    posted by mumimor at 8:58 AM on March 17 [4 favorites]


    In their perspective, it may be less a Trump cult, and more keeping the whole circus together with gaffer tape and strings
    posted by mumimor at 9:07 AM on March 17 [4 favorites]


    When Trump acts like a host in these conferences, introducing experts and letting them speak and answer questions, he does OK. If he would just quit ad-libbing, rambling off the top of his head, and praising the virtues of the USA, he (and we) would do much better.

    Again, why is Anthony Fauci (Director of the National Institute of Allergy and Infectious Diseases) telling us what the CDC is doing? Where is CDC Director Robert Redfield?
    posted by cenoxo at 9:45 AM on March 17 [5 favorites]


    When Trump acts like a host in these conferences, introducing experts and letting them speak and answer questions, he does OK.

    It feels very Jerry Lewis Labour Day Telethon to me. I keep expecting him to suddenly call out for a "Tymp!"
    posted by mazola at 9:59 AM on March 17 [1 favorite]


    WE in the NHS are facing this in an environment of Corporate Manslaughter now on the books in the UK for any board member including Medical Director and Chief exec where negligence can be proven to be with knowledge aforethought, so that CEO that Mumimor references above from the Grauniad article is doing a wise thing going beyond the GMC recommendations of three wise men to make the final decision.Unless, he himself is medically qualified as our local one is, these decisions would normally be left to three medics but `i think it is really great practice to bring in community members and I sincerely hope different religious leaders are involved.
    posted by Wilder at 10:03 AM on March 17 [4 favorites]


    In good news, there will be checks.

    Don't forget that these checks have been promised by a businessman who's known to have bankrupted six of his companies.
    posted by EmpressCallipygos at 10:19 AM on March 17 [10 favorites]


    socialism for the win
    posted by 20 year lurk at 10:42 AM on March 17 [2 favorites]


    Kottke: "We May Be In This for the Long Haul"
    "The major challenge of suppression is that this type of intensive intervention package — or something equivalently effective at reducing transmission — will need to be maintained until a vaccine becomes available (potentially 18 months or more)"

    posted by CheesesOfBrazil at 10:46 AM on March 17 [2 favorites]


    Coronavirus: Infected people without symptoms are driving epidemic’s fast spread, says new study - “Stealth” transmission underscores the importance of “social distancing”: Mercury News; Lisa M. Krieger; March 17, 2020.
    People with mild or no symptoms of COVID-19 are the main drivers behind the spread of the coronavirus epidemic, according to an important new analysis of China’s outbreak released on Monday.

    These so-called “stealth” transmissions underscore the importance of “social distancing” measures that are now being enacted in communities across the U.S. and Europe, the researchers said. Unrecognized infections can expose a far greater portion of the population to virus than would otherwise occur. “We need to keep people apart,” said researcher Jeffrey Shaman of Columbia University Mailman School, who co-authored the study with colleague Sen Pei.

    The research is published in Monday’s issue of the journal Science, the same day 6 Bay Area counties announced strict new orders telling most of the region’s 7 million residents to stay home except for essential trips such as to the supermarket. The order takes effect at 12:01 a.m. March 17 and expires on April 7 unless extended.

    “This is different than what we’re used to seeing in Western democratic societies,” he conceded. “This virus thrives on people mingling and meeting each other.”

    Six of every seven infections – 86% — were undetected in China before January’s strict travel restrictions, according to the team’s computer modeling. That time of unfettered travel and visiting was similar to life in bustling U.S. and European cities prior to new guidelines and restrictions.

    “The majority of these infections are mild, with few symptoms at all,” but if transmitted they can kill the elderly or medically vulnerable, said Shaman. “People may not recognize it. Or they think they have a cold.”

    These undocumented infections are about half as contagious as documented infections because people are not coughing and sneezing. Yet they were found to be responsible for about two-thirds of documented infections – because they are so abundant. People with mild symptoms can transmit a disease that creates major disease in others, they said.

    These findings explain the rapid geographic spread of the disease and suggest that control could be difficult.
    ...
    Is containment a mobius loop — no matter what day we arrive, we're still two weeks from getting there?
    posted by cenoxo at 11:08 AM on March 17 [7 favorites]


    Among the 30 medicines the Chinese National Health Commission selected to fight the virus was a Cuban anti-viral drug Interferon Alpha 2b. .
    posted by adamvasco at 11:19 AM on March 17 [2 favorites]


    > Johns Hopkins Coronavirus Map > United States: 4661 confirmed cases, 85 deaths, 17 recovered (at this date & time).
    posted by cenoxo at 8:29 AM on March 17


    UPDATE:

    Johns Hopkins Coronavirus Map > United States: 5702 confirmed cases, 94 deaths, 17 recovered (at this date & time).

    Difference: +1041 ... +9 ... 0
    posted by cenoxo at 12:32 PM on March 17 [1 favorite]


    Worms & Germs blog: FAQ re COVID-19 and animals

    I am trying to develop a new habit of coming home, hand washing, THEN petting the cat. Not "come home, scritch the cat who's looping around my legs purring, then going to wash hands."
    posted by cybercoitus interruptus at 12:39 PM on March 17 [5 favorites]


    The American Veterinary Medical Association has U.S. pet ownership data from 2017-2018 for Companion Animals and Specialty Exotic Animals, along with formulas (and instructions) for estimating percentage of pet-owning households and pet population in your community.
    posted by cenoxo at 12:59 PM on March 17


    Meanwhile, in Kentucky - a Coronavirus patient checked himself out of the hospital against medical advice, and local deputies surrounded his house and are going to stay there two weeks to make sure he stays there.

    There is a solution that isn't going to scale.
    posted by Mitheral at 2:37 PM on March 17 [5 favorites]


    It may not scale, but what an asshole. Don't want that person in a jail with others, but, works for me.
    posted by Windopaene at 3:18 PM on March 17 [1 favorite]


    Person in Nelson County tests positive for COVID-19, The Kentucky Standard, March 15, 2020:
    Nelson County Sheriff Ramon Pineiroa confirmed deputies from his office are enforcing the isolation of a man who officials say tested positive for the novel coronavirus that causes the disease COVID-19.

    "We're going to be out here 24/7 for two weeks," he said in a phone interview with The Standard. He said he was on the scene personally when a reporter for The Standard spoke with him. He said the man "was cooperating now." He declined to give the location of the residence.

    The first confirmed case of COVID-19 in Nelson County was announced Saturday afternoon. Kentucky Gov. Andy Beshear at a press conference said a 53-year-old man from Nelson County tested positive and had resisted isolating himself. “We have had the first instance of a person who has refused to self-isolate, we have taken steps to force an isolation that will be in their home,” Beshear said.

    Beshear gave few details about the forced self-isolation, but said the man left against medical advice and refused to self-quarantine. He said the state worked with the county judges and others to force the isolation. “It’s a step I hoped I would never have to take but we can’t allow one person who we know has this virus to refuse to protect their neighbors,” Beshear said.

    Beshear, the former Kentucky Attorney General, said the state would take steps necessary to limit the spread of the disease, including enforcing measures against people who test positive and refuse to self-isolate. “There are judicial ways to handle that,” he said. “There are remedies.”
    Send lawyers, guns, and money.
    posted by cenoxo at 4:19 PM on March 17 [1 favorite]


    Kottke: "We May Be In This for the Long Haul"

    He has updated this with significant elements from a counteranalysis (by a trio at NECSI):
    "If I understand this correctly, Shen et al. are saying that some tactics not taken into account by the Imperial College analysis could be hyper-effective in containing the spread of COVID-19. The big if, particularly in countries like the US and Britain that are acting like failing states is if those measures can be implemented on the scale required."
    posted by progosk at 4:39 PM on March 17 [5 favorites]


    (by a trio at NECSI)

    Good news from epidemiologist... Nicholas Nassim Taleb?
    posted by atrazine at 4:48 PM on March 17 [4 favorites]


    Coronavirus confirmed in all 50 states and D.C. (WaPo live blog)
    Confirmed cases of the novel coronavirus, which has rapidly spread across the United States in a matter of weeks, have now been reported in all 50 states and the District of Columbia. West Virginia became the last state to confirm its first case Tuesday. At least 100 people infected with the virus have died in the U.S. — a toll that experts expect to rise quickly.
    Tracking the Coronavirus: How Crowded Asian Cities Tackled an Epidemic (NYT)
    Early intervention is key. So are painstaking tracking, enforced quarantines and meticulous social distancing — all coordinated by a leadership willing to act fast and be transparent.

    In Singapore, the details of where patients live, work and play are released quickly online, allowing others to protect themselves. Close contacts of patients are quarantined to limit the spread. The government further strengthened its borders this week to protect against a new wave of imported infections.

    Some of these lessons are too late for the United States and Europe, where contagion is raging as some governments delay and debate their response.
    posted by katra at 5:36 PM on March 17 [4 favorites]



    I lurk on r/medicine, and there's a thread right now on how physicians are being denied testing. Appalling.
    posted by velvet_n_purrs at 6:02 PM on March 17 [8 favorites]


    1. Johns Hopkins Coronavirus Map > United States: 4661 confirmed cases, 85 deaths, 17 recovered
    Posted by cenoxo at 8:29 AM on March 17

    2. Johns Hopkins Coronavirus Map > United States: 5702 confirmed cases, 94 deaths, 17 recovered
    Difference: +1041 ... +9 ... 0
    posted by cenoxo at 1:32 PM on March 17

    3. Johns Hopkins Coronavirus Map > United States: 6423 confirmed cases, 108 deaths, 17 recovered
    (at roughly this comment's date & time).
    Difference: +721 ... +14 ... 0

    Thus (if my math's correct) in about 10 hours today (March 17, 2020), the USA saw an increase of 1762 confirmed cases, 23 deaths, and 0 recovered.

    This is obviously a casual, too-short, rough example, but we all get the idea: this war won't be over by Christmas.
    posted by cenoxo at 6:11 PM on March 17 [3 favorites]


    Physicians, nurses, and respiratory therapists (among other high risk healthcare workers) being denied access to health care services is nothing new. I was a medical student in NYC during the H1N1 crisis. Guess who got first dibs on the vaccine? Investment bankers.

    As they say, money talks, others...are intubated.
    posted by basalganglia at 6:14 PM on March 17 [12 favorites]


    >He has updated this with significant elements from a counteranalysis (by a trio at NECSI):
    >Good news from epidemiologist... Nicholas Nassim Taleb?


    So the authors are a guy with a BA in Computer Science, a guy with a PhD in physics, and a guy with an MBA who is an options trader. None of them know a lick about epidemiology or its extensive literature.

    This is your classic "engineer's disease" -- technical people who think they possess expertise and key insights unknown to the actual experts in the field.
    posted by JackFlash at 7:37 PM on March 17 [23 favorites]


    Highlights of Expert Panel on COVID-19 from Harvard, MIT, Mass General Hospital (Dr. Melissa Bender, Just Security, Mar. 15, 2020)
    Epidemiologists talk about the “basic reproductive number,” which is the average number of secondary cases caused by each infected person in an unmitigated epidemic. Dr. Marc Lipsitch, a professor of epidemiology and Director of the Center for Communicable Disease Dynamics at Harvard’s school of public health, summarized available data for COVID-19, which currently suggests that the reproductive number is around 2 – similar to the infectiousness of pandemic flu of 1918. If this is the case, models of disease spread predict that around 50 percent of the population will need to become immune — either by way of infection or vaccine — before the disease will die out. Dr. Lipsitch cited data that about 1-2% of those who become symptomatic will die, with the bulk of the mortality risk occurring in the elderly and people with cancer, heart disease, or other chronic health conditions. Children, for the most part, appear to be spared by this disease.

    [...] People over the age of 60 and those with chronic medical conditions are the hardest hit, but they are not the only ones. Some young, healthy people with no known medical conditions are dying from this disease. On a grand scale, this virus could result in a great loss of life among Americans of all ages.

    [...] [Dr. Lipsitch] and many others have also warned that the United States is on track to have some health care systems overwhelmed as they have been in Northern Italy, and the curves demonstrate that we are perhaps only 10 days behind Italy in the course of our epidemic.

    [...] Access to testing is essential to diagnose those who become infected and to reassure those who are healthy that they can stay on the job. For more on this topic, see this reporting in Wired (“[H]ealth care workers are being sent home because the CDC’s strict testing guidelines and the low availability of the kits themselves mean they also can’t be tested.”)
    posted by katra at 8:32 PM on March 17 [6 favorites]


    And then there is this little snippet

    https://slate.com/news-and-politics/2020/03/polls-republicans-coronavirus-spread.html?via=taps_top

    In Australia, the local satirical website, thebetootaadvocate, pronounced our government's response as being prompted by the realisation that their voters were likely to be disproportionately affected.

    Remember when Art Buchwald wrote about retiring as a satirist during Watergate, because reality was outpacing his ability to make stuff up. That about sums it up.
    posted by Barbara Spitzer at 8:38 PM on March 17 [2 favorites]


    some discussion above inquired about potential treatments under evaluation.
    that open nejm site has a paper called Covid-19 -- Navigating the Uncharted i received some days ago through a different channel, which notes
    Therapy currently consists of supportive care while a variety of investigational approaches are being explored. Among these are the antiviral medication lopinavir–ritonavir, interferon-1β, the RNA polymerase inhibitor remdesivir, chloroquine, and a variety of traditional Chinese medicine products. (footnotes omitted)
    it was not the first oblique reference to "traditional Chinese medicine products" being evaluated, so the footnote caught my eye. took me a couple days to plug in the footnote's URL, but it leads to WHO R&D Blueprint, which is a little old, dating to Jan. 24. It details a number of therapeutic compounds under evaluation. Alas, it does not identify those TCM materials I was hoping to track down.

    I'd guess there's probably a more recent, authoritative publication about therapeutics of interest, but not from u.s. public health authorities.
    posted by 20 year lurk at 4:59 AM on March 18


    Johns Hopkins Coronavirus Map
    United States: 4661 confirmed cases, 85 deaths, 17 recovered
    Posted by cenoxo at 8:29 AM (Mountain Time) on March 17

    Johns Hopkins Coronavirus Map
    United States: 6519 confirmed cases, 115 deaths, 17 recovered
    Posted by cenoxo at 8:29 AM (Mountain Time) on March 18
    - - - - - - - - - - - - - - - - - - - - - -
    24 Hour Difference: 1858 confirmed cases ... 30 deaths ... 0 recovered
    posted by cenoxo at 7:29 AM on March 18 [1 favorite]


    So, that Johns Hopkins map shows 705 active cases in California while the major news sources in California that I'm following, such as the LA Times who has a live count tracker on their home page, have a much lower count of 472. I've been keeping an eye on this because I decided last week to watch the infection growth rate myself to look for doubling because I wasn't sure of the quality of coverage we're receiving. I'm really curious as to the source of this discrepancy. I have no reason to assume Johns Hopkins is lying but if they are right, California has more than doubled in 48 hours. If the LA Times etc data is right, it has not doubled.
    posted by feloniousmonk at 8:44 AM on March 18


    472 is the number on the CDPH website, but it's from two days ago:
    As of March 16, 2020, 6 p.m. Pacific Daylight Time, there are a total of 472 positive cases and eleven deaths in California (including one non-California resident). This total does not include passengers from the Grand Princess cruise ship currently docked in Oakland.
    I think we can rule out the possibility that there have been no new positive cases in two days...
    posted by Not A Thing at 8:51 AM on March 18 [2 favorites]


    I guess I can see an argument for why the LA Times etc would rely on state data, but they clearly present it as if it is current as of this morning. Let's hope statewide decision makers have awareness of the availability of more fully accurate data and are monitoring it and this is more of a mistake than a deception.
    posted by feloniousmonk at 8:56 AM on March 18


    yesterday democracynow! interviewed the developer of this tracker (https://ncov2019.live/data) on which the numbers are a bit lower than the hopkins one for those regions i'm watching. another source. developer, who started tracking in december, said it regularly scrapes sources he's found credible. at present it lists 636 cases for california. today mom was excited about the bing tracker.
    posted by 20 year lurk at 9:08 AM on March 18


    feloniousmonk - See this JHU Public Health article:
    Modeling 2019-nCoV
    Update January 31: Modeling the Spreading Risk of 2019-nCoV
    By Lauren Gardner, January 31, 2020

    Collaborators

    This work is being led by Lauren Gardner at Johns Hopkins University CSSE, in collaboration with Aleksa Zlojutro and David Rey at rCITI at UNSW Sydney, and Ensheng Dong at JHU CSSE. At JHU, we have previously developed an interactive dashboard mapping the outbreak in real-time, and a written a blog.

    Model Implementation

    This work builds on our previous analysis posted on January 26. We implemented a previously published model that integrates both outbreak dynamics and outbreak control into a decision-support tool for mitigating infectious disease pandemics at the onset of an outbreak through border control to evaluate the 2019-nCoV epidemic. A stochastic metapopulation epidemic simulation tool is used to simulate global outbreak dynamics, and the border control mechanism considered is passenger screening upon arrival at airports (entry screening), which is used to identify infected or at-risk individuals. A detailed description of the model is provided at the end of this section.

    Our metapopulation model is based on a global network of local, city-level, populations connected by edges representing passenger air travel between cities. At each node of the network, we locally model outbreak dynamics using a discrete-time Susceptible-Exposed-Infected-Recovered (SEIR) compartmental model. IATA monthly passenger travel volumes for all travel routes connecting airport pairs (including stopovers) is used to construct the weighted edges. The SEIR parameters are defined based on a 5-day incubation period, which aligns with an estimated incubation period of 5.2 days in a recent NEJM publication. The effective contact rate in our model corresponds to a reproductive number of 2, which aligns with an estimate from Imperial College London, reporting a range between 1.5 and 3.5, and the recent NEJM publication, which estimated an average R0 of 2.2. We set the recovery period to five days. We assume initial cases of 2019-nCoV are only present in Wuhan, and no border control is accounted for. The model results presented are based on an average of 250 runs.
    ...
    More details there.
    posted by cenoxo at 9:08 AM on March 18 [1 favorite]


    The JHU Coronavirus Map is now at 7324 total confirmed cases for the United States (vs. 6519 two hours ago).
    posted by cenoxo at 9:31 AM on March 18 [2 favorites]


    Scientists from the University of Oxford’s Engineering Science Department and the Oxford Suzhou Centre for Advanced Research (OSCAR) have developed a rapid testing technology for the novel corona virus SARS-CoV-2 (COVID-19). The team, led by Prof Zhanfeng Cui and Prof Wei Huang, have been working to improve test capabilities as the virus spreads internationally.
    The new test is much faster and does not need a complicated instrument. Previous viral RNA tests took 1.5 to 2 hours to give a result. The research team has developed a new test, based on a technique which is capable of giving results in just half an hour – over three times faster than the current method.
    posted by adamvasco at 9:39 AM on March 18 [5 favorites]


    > “Don’t believe the numbers when you see, even on our Johns Hopkins website, that 1,600 Americans have the virus. No, that means 1,600 got the test, tested positive. “There are probably 25 to 50 people who have the virus for every one person who is confirmed. I think we have between 50,000 and half a million cases right now walking around in the United States.”

    We know enough now to act decisively against Covid-19. Social distancing is a good place to start (Marc Lipsitch, STAT News, Mar. 18, 2020)
    We know enough to act; indeed, there is an imperative to act strongly and swiftly. It is true that we can’t be sure either how many infections there have been in any population or the risk of needing intensive care or the case fatality rate. These uncertainties are two sides of the same coin. Nonetheless, two things are clear.

    First, the number of severe cases — the product of these two unknowns — becomes fearsome in country after country if the infection is allowed to spread. In Italy, coffins of Covid-19 victims are accumulating in churches that have stopped holding funerals. In Wuhan, at the peak of the epidemic there, critical cases were so numerous that, if scaled up to the size of the U.S. population, they would have filled every intensive care bed in this country. That is what happens when a community waits until crisis hits to try to slow transmission. Intensive care demand lags new infections by about three weeks because it takes that long for a newly infected person to get critically ill. So acting before the crisis hits — as was done in some Chinese cities outside Wuhan, and in some of the small towns in Northern Italy — is essential to prevent a health system overload.

    Second, if we don’t apply control measures, the number of cases will keep going up exponentially beyond the already fearsome numbers we have seen. Scientists have estimated that the basic reproductive number of this virus is around 2. That means without control, case numbers will double, then quadruple, then be eight times as big, and so on, doubling with each “generation” of cases.

    [...] There are two options for Covid-19 at the moment: long-term social distancing or overwhelmed health care systems. That is the depressing conclusion many epidemiologists have been emphasizing for weeks, and which was detailed in an analysis released this week by the Imperial College London.
    posted by katra at 9:40 AM on March 18 [5 favorites]


    Trump will invoke Defense Production Act which would allow the administration to force American industry to ramp up production of medical supplies that are in short supply in the fight against the coronavirus pandemic.
    posted by adamvasco at 10:01 AM on March 18 [6 favorites]


    These Places Could Run Out of Hospital Beds as Coronavirus Spreads (NYT)
    A new Harvard analysis shows that many parts of the United States will have far too few hospital beds if the new coronavirus continues to spread widely and if nothing is done to expand capacity.

    In 40 percent of markets around the country, hospitals would not be able to make enough room for all the patients who became ill with Covid-19, even if they could empty their beds of other patients. That statistic assumes that 40 percent of adults become infected with the virus over 12 months, a scenario described as “moderate” by the team behind the calculations.

    These numbers are not exact predictions. In many ways, they reflect a worst-case scenario, since they do not take into account the efforts hospitals can make to quickly increase capacity during an emergency. Around the country, hospitals have begun canceling elective operations and speeding home patients with less critical ailments. Those efforts could increase the number of free beds available for coronavirus patients. In a half-dozen interviews, hospital executives estimated that they could increase their capacity between 20 percent and 70 percent.

    Yet the Harvard estimates suggest that the coronavirus outbreak could require significantly more resources than that. [...] “If we don’t make substantial changes, both in spreading the disease over time and expanding capacity, we’re going to run out of hospital beds,” said Dr. Ashish Jha, the director of the Harvard Global Health Institute, which produced the estimates.
    posted by katra at 10:51 AM on March 18 [3 favorites]


    One of the ways to really see just how much testing is lagging for those not showing severe symptoms; watch the percentage of the fatalities compared to positive cases. About a week ago it was 3.5%. It's now 4.1% . Meanwhile I've seen hypothesises that this number would be between 0.5-1% if all cases were discovered.

    So an 8724 (current) fatality count implies about 800,000 - 1.75 million people worldwide infected (if an overall fatality rate of 0.5-1% is assumed). Further as people don't die immediately, but symptoms get progressively more severe over a week+, this is a trailing number, so the infection/covid-19 positive number was 800k-1,750k about a week+ ago.

    One week ago the JHU map had 126k total positive tests confirmed. So about 1 in 10 were documented if it's one week from infection to death.
    posted by nobeagle at 10:58 AM on March 18 [3 favorites]


    Stop Saying That Everything Is Under Control. It Isn’t. (NYT Editorial Board, Mar. 17, 2020)
    Some cities and states have purchased hotels and turned them into quarantine facilities. Others are in bidding wars with one another for ventilators, I.C.U. beds and other essential equipment. If the current projections hold — and if countries in Europe and cities in China are any indication — neither these siloed efforts nor the nation’s federally maintained stash of medical supplies will be enough to face what’s coming.

    Worse still, pitting states against one another for limited and essential supplies leaves poorer states at the mercy of the rich ones, and the states hit first against those that will be hard hit in the coming weeks. Yet on Monday, Mr. Trump told a group of governors desperate for equipment like ventilators, “Try getting it yourselves.”

    Instead, the federal government needs to step in to sharply ramp up production of all these goods, just as it ramped up production of munitions during World War II. That will most likely necessitate the use of the Defense Production Act, a law that enables the president to mobilize domestic industries in times of crisis. President Trump has not demonstrated the democratic instincts or administrative competence to inspire the confidence that he ought to be trusted with even more executive authority. But he’s the only president America’s got, and this crisis requires White House action. It’s not hard to imagine, with proper organization and support, American factories producing ventilators, masks, hand sanitizer, coronavirus tests and other medical equipment at a scale that would meet what the crisis demands. But it won’t happen overnight, and it certainly won’t happen without leadership.

    “We could increase production fivefold in a 90- to 120-day period,” Chris Kiple, chief executive of Ventec Life Systems, a Washington State company that makes ventilators used in hospitals, homes and ambulances, told Forbes last week. Mr. Kiple estimated that current worldwide production capacity for ventilators is about 40,000 a year.

    The government will also need to deploy the National Guard or the Army to convert facilities like convention centers, hotels and parking lots into testing sites, isolation units and humane quarantines.
    posted by katra at 11:00 AM on March 18 [9 favorites]


    I think we need the 2020 version of the Works Progress Administration, established during the Great Depression as a job relief program. In addition to providing immediate cash to unemployed and underemployed Americans, as well as rent/mortgage relief, couldn't we begin to address the long term shifts in the economy and society by hiring some good percentage of people who are now jobless due to coronavirus restrictions? We could retrain some of the just laid-off 30,000+ Las Vegas casino workers as community health care aides, train others as nursing assistants, and others as construction workers to build up the number of available beds / critical care units available? If this is the new normal, at least for the next year and maybe for much longer, we should think about how to transition jobs and livelihoods to this new normal.
    posted by spamandkimchi at 11:31 AM on March 18 [11 favorites]


    In 40 percent of markets around the country, hospitals would not be able to make enough room for all the patients who became ill with Covid-19, even if they could empty their beds of other patients. That statistic assumes that 40 percent of adults become infected with the virus over 12 months, a scenario described as “moderate” by the team behind the calculations.

    It's so jarring to read the word markets in an article describing a health care emergency.
    posted by mumimor at 11:41 AM on March 18 [12 favorites]


    It's so jarring to read the word markets in an article describing a health care emergency.

    But that's really what this is all about, isn't it? When Trump fired the pandemic response team that obama instituted, he said,

    “some of the people we’ve cut they haven’t been used for many, many years and if we ever need them we can get them very quickly and rather then spending the money” and "I’m a business person, I don’t like having thousands of people around when you don’t need them,”
    posted by mikelieman at 12:03 PM on March 18 [16 favorites]


    If you haven't noticed it already, there's a scrolling footnote (hover its upper right corner to see zoom icon) underneath the JHU Coronavirus Map. It contains the following information, including links to their data sources and a downloadable "Novel Coronavirus (COVID-19) Cases" database:
    ...
    • Lancet Inf Dis Article: Here.
    • Mobile Version: Here.
    • Visualization: JHU CSSE.
    • Automation Support: Esri Living Atlas team and JHU APL.

    • Data sources: WHO, CDC, ECDC, NHC and DXY and local media reports.
    • Read more in this blog.
    Contact US [email].
    FAQ.
    • Downloadable database: GitHub: Here.
    • Feature layer: Here.

    Confirmed cases include presumptive positive cases.
    • Point level: Province/State level - China, US, Canada, Australia; Country level - other countries. All points shown on the map are based on geographic centroids, and are not representative of a specific address, building or any location at a spatial scale finer than a province/state.
    Active cases = total confirmed - total recovered - total deaths.
    Time Zones: lower-left corner indicator - your local time; lower-right corner plot - UTC.

    Visit the Johns Hopkins Coronavirus Resource Center where our experts help to advance understanding of the virus, inform the public, and brief policymakers in order to guide a response, improve care, and save lives.

    Note: All cases of COVID-19 in repatriated US citizens from the Diamond Princess are grouped together, and their location is currently designated at the ship’s port location off the coast of Japan. These individuals have been assigned to various quarantine locations (in military bases and hospitals) around the US. This grouping is consistent with the CDC.
    ...
    posted by cenoxo at 1:18 PM on March 18 [4 favorites]


    There Aren’t Enough Ventilators to Cope With the Coronavirus (NYT)
    As the United States braces for an onslaught of coronavirus cases, hospitals and governments are confronting a grim reality: There are not nearly enough lifesaving ventilator machines to go around, and there is no way to solve the problem before the disease reaches full throttle. [...] American and European manufacturers say they can’t speed up production enough to meet soaring demand, at least not anytime soon. And while the acute shortages are global, not just in the United States, some European governments are deploying wartime-mobilization tactics to get factories churning out more ventilators — and to stop domestic companies from exporting them.

    The United States, by contrast, has been slow to develop a national strategy for accelerating the production of ventilators. [...] “The reality is there is absolutely not enough,” said Andreas Wieland, the chief executive of Hamilton Medical in Switzerland, one of the world’s largest makers of ventilators. “We see that in Italy, we saw that in China, we see it in France and other countries. We could sell I don’t know how many.”

    Mr. Wieland’s company is shipping machines as fast it can get them off the assembly line. He has moved office workers to the factory and hired more employees. Even so, he can’t keep up with the crush of orders. “Italy wanted to order 4,000, but there’s not a chance,” he said. “We sent them something like 400.”

    [...] There are fewer than a dozen American companies — including giants like General Electric and Medtronic — that make ventilators, according to Greg Crist, a spokesman for AdvaMed, the trade group that represents American medical device makers. They are scrambling to accelerate production. But the machines are complicated, made up of hundreds of smaller parts produced by companies all over the world. There is no simple way to substantially increase the output.
    posted by katra at 1:48 PM on March 18 [4 favorites]


    by ncov2019.live tracker, the u.s. has just surpassed south korea in number of cases. by JHU tracker, the u.s. is within, ahem, spitting distance, and will overtake south korea within an update or two.
    posted by 20 year lurk at 3:08 PM on March 18


    Source, please.
    posted by cenoxo at 3:46 PM on March 18


    The source is right there. Johns Hopkins University tracker..? Or ncov2019.live depending on who you are questioning...
    posted by Windopaene at 4:24 PM on March 18 [1 favorite]


    Worldometer has the US in the #6 slot, 9,238 total cases, ahead of South Korea and France.
    posted by Iris Gambol at 4:33 PM on March 18


    nCoV2019.live
    https://ncov2019.live/
    posted by cenoxo at 4:38 PM on March 18 [1 favorite]


    Coronavirus map of the US: latest cases state by state (Guardian)
    There have been 7,697 confirmed cases across the US so far. The true number of cases is likely to be significantly higher.
    Younger Adults Comprise Big Portion of Coronavirus Hospitalizations in U.S. (NYT)
    American adults of all ages — not just those in their 70s, 80s and 90s — are being seriously sickened by the coronavirus, according to a report on nearly 2,500 of the first recorded cases in the United States.

    The report, issued Wednesday by the Centers for Disease Control and Prevention, found that — as in other countries — the oldest patients had the greatest likelihood of dying and of being hospitalized. But of the 508 patients known to have been hospitalized, 38 percent were notably younger — between 20 and 54. And nearly half of the 121 patients who were admitted to intensive care units were adults under 65, the C.D.C. reported.

    [...] The findings served to underscore an appeal issued Wednesday at a White House briefing by Dr. Deborah Birx, a physician and State Department official who is a leader of the administration’s coronavirus task force. Citing similar reports of young adults in Italy and in France being hospitalized and needing intensive care, Dr. Birx implored the millennial generation to stop socializing in groups and to take care to protect themselves and others.

    [...] In the C.D.C. report, 20 percent of the hospitalized patients and 12 percent of the intensive care patients were between the ages of 20 and 44, basically spanning the millennial generation. [...] The new data represents a preliminary look at the first significant wave of cases in the United States that does not include people who returned to the country from Wuhan, China, or from Japan, the authors reported.
    posted by katra at 4:50 PM on March 18 [8 favorites]


    These people wield huge influence and are part of the problem when they should be part of the solution. Except Elon Musk who is always an arsehole.
    The tech execs who don't agree with 'soul-stealing' coronavirus safety measures
    ‘If we wish to maintain our productivity, we need to continue working in [our] offices,’ one CEO told his staff in an email
    posted by adamvasco at 5:05 PM on March 18 [8 favorites]


    Iran to pardon 10,000 prisoners (The Guardian, March 18, 2020) Reuters is reporting that Iran’s Supreme Leader Ayatollah Ali Khamenei will pardon 10,000 prisoners including political ones in honour of the Iranian new year on Friday, state TV reported. “Those who will be pardoned will not return to jail ... almost half of those security-related prisoners will be pardoned as well,” judiciary spokesman Gholamhossein Esmaili told state TV on Wednesday.

    On Tuesday, Esmaili said Iran had temporarily freed about 85,000 people from jail, including political prisoners, in response to the coronavirus epidemic. “A large number of prisoners who have been temporarily freed do not need to return to jail after the leader’s pardon,” Esmaili said.

    “The unprecedented point is that the pardon also includes the security-related prisoners with less than five-year jail sentences,” Esmaili said.
    posted by Iris Gambol at 5:08 PM on March 18 [7 favorites]




    Gosh, that's nicer than the "New York State's New Hand Sanitizer Is Made By Prisoners Paid An Average 65 Cents An Hour" story (Gothamist, March 9, 2020) (And the distillery workers will be able to use the product themselves, whereas: "According to a DOCCS handbook for visitors of New York's prisons issued in December of 2019, inmates are not allowed to receive the kind of hand sanitizer produced by Corcraft because it contains alcohol.")
    posted by Iris Gambol at 5:41 PM on March 18 [6 favorites]


    Second congressman tests postive for coronavirus (WaPo)
    Rep. Ben McAdams (D-Utah) has tested positive for the coronavirus, he confirmed in a statement late Wednesday. He was the second member of Congress to announce they had tested positive for the illness.

    McAdams said he developed “mild cold-like symptoms” after returning home from Washington Saturday evening. He immediately went in isolation, where his symptoms got worse, including a “fever, a dry cough and labored breathing.” A local testing clinic confirmed that the symptoms were a result of covid-19.

    [...] Earlier Wednesday, Rep. Mario Diaz-Balart (R-Fla.) said he had tested positive for the coronavirus and also began feeling symptoms Saturday. In his statement, McAdams urged his constituents to take the coronavirus serious and follow CDC recommendations.
    posted by katra at 5:54 PM on March 18


    When Purell is Contraband, How Do You Contain Coronavirus? The Marshall Project, Keri Blakinger, Beth Schwartzapfel; March 6, 2020. Handwashing and sanitizers may make people on the outside safer. But in prison it can be impossible to follow public health advice.
    When Lauren Johnson reached for a squirt of hand sanitizer on her way out of the doctor’s office, she regretted it immediately. In the Central Texas prison where she was housed, alcohol-based hand sanitizer was against the rules—and the on-duty officer was quick to let her know it. “He screamed at me,” she said. Then, she said, he wrote her up and she lost her recreation and phone privileges for 10 days.

    The incident was a minor blip in Johnson’s last prison stay a decade ago, but the rules hold true today and underscore a potential problem for combating coronavirus: Behind bars, some of the most basic disease prevention measures are against the rules or simply impossible.

    “Jails and prisons are often dirty and have really very little in the way of infection control,” said Homer Venters, former chief medical officer at New York City’s notorious Rikers Island jail complex. “There are lots of people using a small number of bathrooms. Many of the sinks are broken or not in use. You may have access to water, but nothing to wipe your hands off with, or no access to soap.”

    [Click links for updated statistics] So far, the respiratory virus has sickened more than 97,000 people worldwide and at least 200 in the U.S. More than 3,300 people have died. As of late Thursday [March 5, 2020] there were no reported cases in American prisons, though experts say it’s just a matter of time.

    To minimize further spread, the Centers for Disease Control and Prevention suggests things like avoiding close contact with people who are sick, covering your mouth with a tissue when you cough or sneeze, disinfecting frequently-used surfaces and washing your hands or using alcohol-based hand sanitizer. But these recommendations run up against the reality of life in jails and prisons...
    More details in the article.
    posted by cenoxo at 6:42 PM on March 18 [8 favorites]


    That reminds me of when Otttawa would not send sanitizer to First Nations communities during the H1N1 outbreak because of the alcohol content. They sent body bags though.
    posted by lesbiassparrow at 7:05 PM on March 18 [5 favorites]


    Interactive online Coronavirus Graphs using data* provided by Johns Hopkins CSSE):
    The data for these charts is sourced from John Hopkins University who publish a daily time series of the data they have collected at *GitHub [download link]. The accuracy of our data depends on how quickly John Hopkins update their GitHub datafeed. We check this datafeed hourly for updates.

    The total number of recorded cases depends heavily on the extent of testing in each country. Testing varies widely between countries and this will have a significant impact on the numbers reported by each country.
    Very useful - explore the page for additional info and resource links.
    posted by cenoxo at 7:41 PM on March 18 [4 favorites]


    At the time of this comment, the JHU Coronavirus Map is now at 9249 total confirmed cases for the United States (vs. 7769 five hours ago). This raises us to 6th place behind Germany, Spain, Iran, Italy, and China.
    posted by cenoxo at 7:50 PM on March 18


    I stopped looking at ranks. The only reason I was checking the numbers originally was to see if the virus had gone to Europe and then to North America. The answer is yes and yes.
    posted by storybored at 8:14 PM on March 18


    The US count changed to 9345 while (or shortly after) I submitted my comment above.

    Look at Russia with only 147 confirmed cases (among a population of 146.7 million). If their case estimate is accurate, are they doing a remarkable job of containment, holding back their data, or what?
    posted by cenoxo at 8:17 PM on March 18


    or just not collecting any data...
    posted by snuffleupagus at 8:34 PM on March 18 [6 favorites]


    that is a magnificent tool, cenoxo
    posted by 20 year lurk at 9:24 PM on March 18


    > or just not collecting any data...

    https://www.cbc.ca/news/world/russia-coronavirus-government-1.5500248
    The Russian business publication RBC reported this week that Russia's official statistics agency, Rosstat, confirmed incidents of "community acquired pneumonia" increased by 37 per cent in Russia from January 2019 to January 2020.

    ...

    One family doctor who's been in practice for more than a decade in Moscow told CBC News their clinic has seen a number of patients recently who likely had coronavirus, but doctors did not report them to federal health authorities because they were concerned about the conditions inside the quarantine sites where they would be sent.

    ...


    But Vasiliyeva, with the medical union, said doctors from across the country are calling her and saying both the testing and the results are unreliable.

    "They don't really know if the tests work," she told CBC News, noting that some doctors have told her they have waited days to get test results returned but never received them.

    "They send them and they don't get the information back."
    posted by sebastienbailard at 9:54 PM on March 18 [5 favorites]


    Coronavirus surfaces in 19 elder care facilities in Florida (Politico)
    Nineteen long-term care facilities in Florida have either a suspected or confirmed case of the coronavirus, including two confirmed cases in Duval and Broward counties.

    Agency for Health Care Administration Secretary Mary Mayhew said she could not divulge the name or addresses of the nursing facilities, citing patient privacy requirements. She said she would look into providing more information in aggregate.
    Florida governor refuses to shut down beaches amid spread of coronavirus (NBC News)
    Florida Gov. Ron DeSantis refused to issue an order to close the state's beaches, despite fears regarding the spread of the coronavirus.

    He instead signed an order that would limit parties on beaches to 10 people per group and force any businesses authorized to sell liquor to reduce occupancy by half, DeSantis told reporters Tuesday. The governor said that local governments can make their own decisions but that his order would follow the latest guidance issued by the Centers for Disease Control and Prevention.

    [...] Panama City Beach City Council said Tuesday that there were no plans to close the beaches, despite the fact that it is an infamous spring break destination for college students and young people. [...] The mayors of Miami Beach and Fort Lauderdale, two of the most popular beach destinations in the state, issued orders to close their beaches Sunday.
    posted by katra at 10:03 PM on March 18 [1 favorite]


    Wary of official virus claims, Russians brace for worst (AFP)
    Putin said Wednesday that "the situation in our country looks a lot better" than in other European countries with thousands of cases. Touring a centre set up to monitor the pandemic on Tuesday he said the "situation is generally under control" in Russia and outbreaks of infection had been contained.

    Yet few of the measures being imposed are national in scale -- except the total closure of entry to foreigners in force from Wednesday. Moscow, the country's largest city with by far the highest number of cases, and a few other cities have limited the size of public gatherings and ordered school closures. But most Russians are not facing drastic changes to their way of life.

    [...] Nevertheless, the public anxiety is very real. Since the start of the week, images of empty supermarket shelves have circulated on social media and many have retreated to their dachas, traditional summer houses in the countryside. [...] Many question the official number of confirmed cases and believe it is an underestimate. Anastasia Vasilyeva, president of an independent trade union called the Doctors' Alliance and an ally of opposition leader Alexei Navalny, claims the health authorities are hiding cases by recording them as pneumonia or severe respiratory infections.

    [...] The testing methods are also under question. While the state health watchdog says that more than 110,000 tests have been carried out, Moskovsky Komsomolets popular daily questioned their reliability compared to those in other countries, saying that only the severest cases were testing positive. Sergei, a 29-year-old sports journalist emerging from a Moscow supermarket with two bags of food commented that "living in Russia forces you to think for yourself first of all, try to analyse information from different sources."
    posted by katra at 10:10 PM on March 18 [4 favorites]


    The pandemic began in China. Today, it reported no new local infections for the first time (CNN, March 19, 2020) Mainland China on Thursday reported no new locally transmitted coronavirus cases for the first time since the the pandemic began, marking a major turning point in the global battle to contain Covid-19.

    The country reported 34 new cases of coronavirus yesterday -- all imported from overseas.

    The milestone represents a turnaround for the Chinese government. Just last month, mainland China was reporting thousands of cases per day, and was considered the most high-risk infection area in the world.

    Now, after months of lockdowns and travel restrictions affecting hundreds of millions of citizens, strict home quarantines, and an unprecedented nationwide effort, the country is down to zero reported new locally transmitted cases.
    posted by Iris Gambol at 10:13 PM on March 18 [7 favorites]


    I was thinking about Russia the other day, suddenly noticing how I hadn't heard anything about cases there. Hmmmm...

    What is the healthcare system like there? I assumed they were not disclosing any real data. Where are they likely on the curve?
    posted by Windopaene at 10:27 PM on March 18


    The most interesting chart on that site is this one, which shows infections per 100k people starting from the date of first infection for several countries that have been notable in terms of how quickly / aggressively they instituted restrictions. China and South Korea have had a rough go of it, but assuming the data is correct, their restrictions have worked. Italy, the UK, and the US, meanwhile, not so much.
    posted by tonycpsu at 10:34 PM on March 18 [4 favorites]


    China and South Korea have had a rough go of it, but assuming the data is correct, their restrictions have worked. Italy, the UK, and the US, meanwhile, not so much.

    Italy only instituted a nationwide quarantine 10 days ago; the US has patchwork and piecemeal restrictons in effect in some places (and none at all in others); the UK only just announced school closures etc. The climb in the infection rate in Italy may be due to increased testing rather than a failure to contain transmission (especially given the incubation period being on average around 5 days with outliers around nearly 4 weeks, and 17-20% of cases being asymptomatic).
    posted by Pseudonymous Cognomen at 11:01 PM on March 18 [2 favorites]


    Yeah I meant "not so much" as in "they didn't act fast enough", not "their actions aren't working." Certainly, seeing other countries who've been in the shit longer reap rewards gives hope when we desperately need need some.
    posted by tonycpsu at 11:07 PM on March 18 [3 favorites]


    I was thinking about Russia the other day, suddenly noticing how I hadn't heard anything about cases there. Hmmmm...

    What is the healthcare system like there? I assumed they were not disclosing any real data. Where are they likely on the curve?


    It seems that there are huge differences. I know several experts on Russia, and they say that in Moscow and Petersburg, you can get world-class care. While in the smaller cities and towns it looks like the third world. Maybe this is more like in the US than in Europe, though there is public healthcare. People have supplementary insurances. The wiki site paints a grim picture, it seems like Russia is in for a really hard hit when it comes.
    posted by mumimor at 11:25 PM on March 18 [3 favorites]


    Scientists say mass tests in Italian town have halted Covid-19 there
    The small town of Vò, in northern Italy, where the first coronavirus death occurred in the country, has become a case study that demonstrates how scientists might neutralise the spread of Covid-19.

    A scientific study, rolled out by the University of Padua, with the help of the Veneto Region and the Red Cross, consisted of testing all 3,300 inhabitants of the town, including asymptomatic people. The goal was to study the natural history of the virus, the transmission dynamics and the categories at risk.

    The researchers explained they had tested the inhabitants twice and that the study led to the discovery of the decisive role in the spread of the coronavirus epidemic of asymptomatic people.

    When the study began, on 6 March, there were at least 90 infected in Vò. For days now, there have been no new cases.
    posted by mumimor at 5:38 AM on March 19 [13 favorites]


    The JHU Coronavirus Map currently shows 9415 confirmed cases for the United States (vs. 9249 about 10 hours ago).

    Using the same JHU Cv Map database, you can view, modify, and export (.png) many types of graphs at Coronavirus Charts. For example, here’s a simple line graph of Total Confirmed Cases for the United States: add other countries as desired.
    posted by cenoxo at 6:03 AM on March 19 [1 favorite]


    Trevor Bedford also believes that widespread testing can get us through this.
    posted by vacapinta at 6:04 AM on March 19 [3 favorites]


    Bedford’s tweet has a good graph of Flattening the Curve.
    posted by cenoxo at 6:31 AM on March 19


    Some people are turning on Christmas lights to spread cheer during coronavirus.
    posted by gudrun at 7:35 AM on March 19 [3 favorites]


    Younger Adults Make Up Big Portion of Coronavirus Hospitalizations in U.S. (Pam Belluck, New York Times)
    American adults of all ages — not just those in their 70s, 80s and 90s — are being seriously sickened by the coronavirus, according to a report on nearly 2,500 of the first recorded cases in the United States.

    The report, issued Wednesday by the Centers for Disease Control and Prevention, found that — as in other countries — the oldest patients had the greatest likelihood of dying and of being hospitalized. But of the 508 patients known to have been hospitalized, 38 percent were notably younger — between 20 and 54. And nearly half of the 121 patients who were admitted to intensive care units were adults under 65, the C.D.C. reported.

    “I think everyone should be paying attention to this,” said Stephen S. Morse, a professor of epidemiology at Columbia University’s Mailman School of Public Health. “It’s not just going to be the elderly. There will be people age 20 and up. They do have to be careful, even if they think that they’re young and healthy.” [...]

    In the C.D.C. report, 20 percent of the hospitalized patients and 12 percent of the intensive care patients were between the ages of 20 and 44, basically spanning the millennial generation.
    posted by ZeusHumms at 8:00 AM on March 19 [4 favorites]


    Coronavirus Outbreaks Spreading in Nursing Homes (WSJ)
    The coronavirus outbreak is spreading to vulnerable, elderly residents, with scores of cases at facilities around the U.S., from Illinois to Oregon and Wyoming, following the deadly outbreak in a Seattle-area nursing home. [...] Health officials and researchers say they expect to see more coronavirus cases in elder-care facilities, despite aggressive steps by the industry and federal nursing-home regulators to limit visitors and isolate residents to avoid transmission.

    [...] Among other challenges, nursing homes are currently struggling to secure enough protective equipment such as masks, while federal data show many have been cited for infection-control problems in the past. Elder-living facilities are also at risk because residents live in tight proximity, with staff interacting closely with them. Covid-19 can spread with few noticeable symptoms, or early symptoms that can mimic other conditions, such as influenza. As a result, one case can quickly swell into a major outbreak.

    [...] This week, a widespread outbreak was found at a nursing home in Willowbrook, Ill., a suburb southwest of Chicago, according to the Illinois public-health department. A case was identified this past weekend, and after aggressive testing at the Chateau Nursing and Rehabilitation Center, the state said 42 infections were found there by Wednesday, including 30 residents and 12 staff members. [...] In Oregon, an outbreak has infected 14 residents plus a staff member at a state-owned veterans home in the town of Lebanon. The first resident showed symptoms on March 8 and the first positive tests came back a few days later. [...] In New Orleans, there have been 13 confirmed coronavirus cases at Lambeth House, an upscale community that includes independent-living apartments, assisted living and a nursing home, according to state officials.

    [...] A survey by Premier Inc., a large group-purchasing organization and consulting firm, found that about a third of senior-living facilities had none of the protective N95 respirator masks, and 68% said they had little or no ability to get more. About 60% had little or no ability to obtain gowns. [...] Inspections of nursing homes have long turned up issues with infection control. A federal database shows there were nearly 7,200 infection-prevention issues among 15,672 nursing homes in fiscal 2019. [...] Assisted-living facilities, which tend to have less-frail patients than nursing homes, aren’t federally regulated and have fewer requirements for infection-control procedures. [...] Cross-contamination from staff was a factor behind the virus spreading to several long-term-care facilities, including assisted-living and retirement homes, in the Seattle area, the CDC said in a report Tuesday.
    posted by katra at 10:51 AM on March 19 [2 favorites]


    I've been putting on the Christmas lights. Feels good. We need as much light and color and possible right now.
    posted by Lyme Drop at 11:27 AM on March 19 [3 favorites]


    The corona virus is killing far more men than women WaPo live feed.
    I zoomed in on this: Studies have also found that estrogen was protective in female mice infected with the virus that caused the 2003 SARs outbreak. During that epidemic, human men had a much higher case fatality rate than women. because it may be a hint at why I have been so ill this winter: I had my ovaries removed in November. I'm almost relieved that there might be an explanation out there. And worried too.
    posted by mumimor at 11:32 AM on March 19 [5 favorites]


    The JHU Coronavirus Map currently shows 10,755 total confirmed cases for the United States (behind Germany, Spain, Iran, Italy, and China).

    A historical graph of U.S. cases alone looks explosive, but less so when compared to these five countries. At least China has flattened out. They're gathering much valuable experience (and data) that's hopefully being shared with others.
    posted by cenoxo at 12:24 PM on March 19


    Elon Musk volunteers Tesla to make ventilators for coronavirus patients 'if there is a shortage' (USA Today)
    Elon Musk, the SpaceX and Tesla CEO who once called panic over the coronavirus outbreak "dumb," has offered to make ventilators for patients if necessary.

    In a Twitter thread where Musk discussed the possibility of a drug used to treat malaria as an option for COVID-19 patients, a user who said he's a Tesla owner pleaded with the CEO to repurpose factories to make ventilators.

    "We will make ventilators if there is a shortage," Musk said in response.

    After Musk was informed ventilator shortages are already happening, he followed up seeking information on affected hospitals.

    "Tesla makes cars with sophisticated hvac systems," wrote Musk. "SpaceX makes spacecraft with life support systems. Ventilators are not difficult, but cannot be produced instantly."
    posted by katra at 12:44 PM on March 19


    cenexo, when directly comparing the US' curve to Italy's the only difference I see is US is 12 days behind Italy. The curve upwards from zero to 8,000 cases for each country is almost identical.
    posted by HyperBlue at 12:48 PM on March 19 [3 favorites]


    For a different view of comparing different countries' outbreak rates, Kevin Drum (blogging at Mother Jones) has been plotting several countries against Italy's trajectory. Here is the March 18th version (scroll down for the charts). Each chart starts its Day 0 as the day where the reported cases in that country exceded 100. So far, the US, as well as France and Germany, are pretty much on the exact same trajectory as Italy, according to those charts.
    posted by mhum at 1:16 PM on March 19 [10 favorites]


    Half Uruguay's coronavirus cases traced to a single guest at a society party (The Guardian 19 March 2020) Covid-19 struck 44 guests at a glamorous wedding after a designer attended despite having had a fever and just arriving from Spain

    Uruguay has been disproportionally hit by the Covid-19 pandemic. While its nextdoor neighbour Argentina (population 45 million), has registered 97 cases, Uruguay (population 3.5 million) has seen confirmed cases leap from four on 12 March to 79 on Wednesday, with another 392 suspected cases.

    That explosive growth can reportedly be traced back to a Montevideo socialite who decided to attend the 500-guest wedding on 7 March just hours after arriving from Spain.

    Fashion designer Carmela Hontou, 57 has defended her decision to attend the party, adding that she also had lunch with her 84-year-old mother upon arrival and went to another lunch the next day “where there were also a lot of people”. Asked by a reporter if she didn’t consider it unwise to mingle in large crowds having just arrived from Spain, Hontou answered: “That’s ridiculous! Plus, do you know how many people came on that plane?” [...]

    Hontou expressed surprise at the reaction against her. She may face legal charges under article 224 of Uruguay’s penal code regarding “the spreading of contagious diseases”, according to press reports. State prosecutors are also reportedly investigate her sons, who have allegedly been visiting their mother, breaching quarantine rules.
    posted by Iris Gambol at 2:01 PM on March 19 [8 favorites]


    mhum > For a different view of comparing different countries' outbreak rates, Kevin Drum (blogging at Mother Jones) has been plotting several countries against Italy's trajectory. Here is the March 18th version (scroll down for the charts). Each chart starts its Day 0 as the day where the reported cases in that country exceeded 100. So far, the US, as well as France and Germany, are pretty much on the exact same trajectory as Italy, according to those charts.

    Thanks for confirming that, mhum. The auto-generated graphs at Coronavirus Graphs and Kevin Drum's graphs in Mother Jones use the same Johns Hopkins University database, so we see similar graphing results.
    posted by cenoxo at 4:00 PM on March 19 [1 favorite]


    I don't know about the usefulness of tracking confirmed cases because of the limited testing coverage regimes. Is there a similar graph that tracks deaths instead?
    posted by storybored at 4:32 PM on March 19


    Before Virus Outbreak, a Cascade of Warnings Went Unheeded (NYT / MSN reprint)
    Government exercises, including one last year, made clear that the U.S. was not ready for a pandemic like the coronavirus. But little was done.
    The outbreak of the respiratory virus began in China and was quickly spread around the world by air travelers, who ran high fevers. In the United States, it was first detected in Chicago, and 47 days later, the World Health Organization declared a pandemic. By then it was too late: 110 million Americans were expected to become ill, leading to 7.7 million hospitalized and 586,000 dead.

    That scenario, code-named “Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration’s Department of Health and Human Services in a series of exercises that ran from last January to August.

    The simulation’s sobering results — contained in a draft report dated October 2019 that has not previously been reported — drove home just how underfunded, underprepared and uncoordinated the federal govern