trueblu

To be fair, I can't argue with some of this.

China is an odd country: half super-developed, but half highly undeveloped.

Scenes like that market were also common in Europe 100 years ago...but things (rightly) changed...The problem is partly the massive rate of change...the people who have power were themselves from highly 'humble' backgrounds, and superstitions masquerading as tradition still highly embedded in most stratas of society.

It's now clear to me that the total number of confirmed cases will be much, much larger than SARS. And this is partly due to the nature of the beast, but also dropping the ball early by those in power. Agree with you that quarantining an entire province (which is what is slowly happening) is futile...

tb

invisible

Could you explain what makes you think so?

trueblu

900 confirmed cases so far, and increasing by 200+/ day with no sign of abatement. It's clear the number of cases in Wuhan is actually several thousands since their healthcare system cannot possibly be diagnosing all cases currently (for technical and infrastructure reasons).

With SARS, there was v. little human-human spread from most cases, but a small number of "super-spreaders" were responsible for many of the cases of transmission. Vigilant tracking and isolation of these few brought the outbreak under control. From the data available so far, that doesn't appear to be the case with 2019-nCoV. If each infected person in the new scenario can infect >1 person, the outbreak will essentially be almost impossible to bring under control. It _may_ peter out naturally, much like seasonal influenza.

With Ebola: almost all transmission was from close contact in the final stages of the disease (when patients were extremely contagious)...again, that makes it easier to bring under control. This appears to be droplet spread, at a time when symptoms may be relatively mild, e.g. low-grade fever and mild cough...i.e. identical to the cold or 'flu. Can't possibly isolate all cases of cold/ 'flu (millions of cases/ year in China and all other countries), so it's inevitable that cases will continue to transmit.

Of course, much of the above are assumptions or extrapolations....happy (and would prefer) to be proven wrong. If the out of Hubei cases truly are <200, then it's just about possible that a massive ring around Hubei will allow the outbreak to run its course, infect several hundred thousand in the province and then die out in the Spring. But there is absolutely zero precedent in being able to truly ring-fence such a huge area, and even with the considerable resources of the PRC, I just don't see it happening.

tb

wco81

Do people who survive SARS become immune?

Or maybe SARS-acquired immunity may give them immunity to this new variant? Or there can be some wide-range of different corona viruses?

trueblu

Reasonable questions...I don't personally know the answer. Extrapolating from some other viral infections, unlikely but not impossible to get cross-protection. But assuming of the people infected with SARS in 2002-3, about 5-6k still alive, it's frankly irrelevant for all intents and purposes.

As an example, of the 4 human Dengue virus strains, there is no cross-protection, indeed, prior infection with one strain would predispose to worse outcomes of infection with a second strain. But with 'flu, there is some evidence of cross-protection of closely related strains...

tb

STS-134

Yep, China is a land of contrasts. I flew into an airport that handles more passengers than any airport in my country except ATL, into a city with skyscrapers and a modern subway system that is larger than any in my country other than that of New York City. In the city, if I wanted to, I could shop at stores that in my country only exist in Beverly Hills, Las Vegas, and New York City. And then I drove down the G45 past some farms and I saw something I had literally never seen before: farmers working in the fields and harvesting grains by hand. This wasn't Mexican farm workers picking strawberries, mind you, it was people actually harvesting grains by hand, and I was so surprised, I took a few photos. I have literally never seen that anywhere in the US. Even in rural areas of Montana and Idaho, you'll see them using large machinery to harvest the grains.

If a virus like this got loose among those farm workers, it wouldn't spread very far or very fast. They'd have time to quarantine probably the few square miles of land that encompasses everyone those people interact with, and it would die out quickly. If it started to traverse the chain of people they sell their crops to, they can isolate those individuals as well. But when it gets loose in a city of 8-12 million people? Better hope the R0 is fairly low, otherwise there's no way to stop it.

Well, the good news is that the R0 of this thing is estimated to be 1.4-2.5, which is...well, let's just say it it could be much worse. R0 of SARS was around 2-5 so this thing is less contagious than SARS was, by initial WHO estimates.
https://www.who.int/news-room/detail...us-(2019-ncov)

trueblu

The reproduction number, i.e. R0, is an aggregated average, and doesn't tell the whole story. With SARS, super-spreaders infected dozens of people, most people didn't infect very many at all....that's much easier to bring under control (eventually, and with supreme effort) than if every person infects 2 other people at the early, mild stages of the illness.

There are ways to model this mathematically, but that's not my forte. so I won't try.

Having a clearer picture of the incubation period and when people start to become contagious (3 days before symptoms: very hard to control, 1 day after onset of symptoms, much easier to bring under control) will also allow modelling of whether we've truly lost containment at this point.

tb

anacapamalibu

Express.co.uk front page.
This has to be very embarrassing headline. Disaster from earthquake..flood..fire quite different.

nk15

Is this the exact bat soup where it all started, did we get video of patient zero?

helvetic

I don't understand news like that. There are no flights to Wuhan, the airport is shut down and the city is in lockdown… so how can people be announcing that they'll disinfect the planes that fly there?

They should disinfect all flights to China while this is ongoing.

Heck, I wouldn't mind if they just cancelled all flights to China for a while.

trueblu

no

helvetic

No it's just clickbait with a hint of racism / xenophobia.

This outbreak did not come from someone eating bat soup.

Some twat reporter just thought he could make some money by linking the idea that this virus may have originated in a bat before ending up in a different animal in a market… with a viral video of a bat. Because of course it'll sound dramatic to their tabloid audience [moderator edit].

helvetic

https://www.scmp.com/news/china/soci...nt-centre-1000

Building a hospital in 6 days? No problem. Not having disgusting markets where diseases fester… impossible

trueblu

Yep, welcome to China!

Hoyaheel

GIS data map from a colleague (who works in OneHealth) - confirmed & suspected cases https://gisanddata.maps.arcgis.com/a...23467b48e9ecf6