The 2019-nCoV virus shows that we’ve built a better world

Summary: The hysterics have already begun to spread misinformation about the latest epidemic. The actual story is that so far we know little about it. The amazing news is the rapid and powerful response of our public health systems. This is evidence that we have built a better world, but it gets less attention than the number of characters allowed in a tweet. I will be posting updates in the comments.

Pandemic

You can read a dozen articles in the major news media and learn less than from reading the CDIC’s summary page about the latest epidemic. For busy people, here is an excerpt with the high points.

About the disease.

“CDC is closely monitoring an outbreak of respiratory illness caused by a novel (new) coronavirus (termed “2019-nCoV”) that was first detected in Wuhan City, Hubei Province, China and which continues to expand. Chinese health officials have reported hundreds of infections with 2019-nCoV in China, including outside of Hubei Province. Infections with 2019-nCoV also are being reported in a growing number of countries internationally, including the United States, where the first 2019-nCoV infection was detected in a traveler returning from Wuhan on January 21, 2020. …

“Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people such as has been seen with MERS and SARS. …Both MERS and SARS have been known to cause severe illness in people. The situation with regard to 2019-nCoV is still unclear. While severe illness, including illness resulting in a number of deaths has been reported in China, other patients have had milder illness and been discharged.”

Risk Assessment.

“Some viruses are highly contagious (like measles), while other viruses are less so. It’s not clear yet how easily 2019-nCoV spreads from person-to-person. It’s important to know this in order to better assess the risk posed by this virus. While CDC considers this is a very serious public health threat, based on current information, the immediate health risk from 2019-nCoV to the general American public is considered low at this time. Nevertheless, CDC is taking proactive preparedness precautions.”

Timeline of an epidemic

In the 21st century, epidemics are a race between the disease’s ability to spread and scientists’ efforts to identify and combat it. Modern transportation allows diseases to quickly spread globally. But modern communications and effective government agencies can react even faster, once alerted. This radically changes the nature of epidemics. This fantastic speed plus modern tech makes our response far more effective than in the early 1950s polio epidemic – and beyond anything imaginable during the 1918 influenza pandemic.

See the Wikipedia Timeline page for updates.

8 December 2019 – First case detected, although doctors did not know what it was.

30 December – An “urgent notice on the treatment of pneumonia of unknown cause” was issued by the Medical Administration and Medical Administration of Wuhan Municipal Health Committee. Hong Kong, Macau, and Taiwan tighten their inbound screening.

2 January – The WHO activated its incident management system at all three levels: national, regional, and headquarters.

3 January – Thailand and Singapore began screening inbound passengers.

5 January – Researchers ruled out seasonal flu, SARS, MERS, and bird flu as the cause. The number of suspected cases reached 59 with seven in a critical condition. All were quarantined and 163 contacts commenced monitoring. As yet, there were no reported cases of human-to-human transmission or presentations in healthcare workers.

6 January – The US CDC issued a travel watch at Level 1 (“Practice usual precautions”) for China.

7 January – CDC established a 2019-nCoV Incident Management group.

8 January – The CDC began alerting clinicians to watch for patients with respiratory symptoms and a history of travel to Wuhan.

9 January – Chinese investigators isolated a novel coronavirus from an infected patient. The first death occurred, a 61-year-old man with severe preexisting health problems.

10 January – Four groups of Chinese researchers post genetic sequences of the virus.

13 January – First reported case outside China, a 61 year-old-woman who arrived in Bangkok on January 8.

14 January – First reported case of probable human-to-human transmission of the virus.

15 January – Second death: a 69-year-old man in China.

16 January – Second case outside China: 30-year-old male Chinese national in Japan.

17 January – The CDC issued an updated interim Health Alert Notice (HAN) Advisory to inform state and local health departments and health care providers about this outbreak. It began screening of passengers on flights from Wuhan to five major US airports.

19 January – First two confirmed cases in China outside Wuhan: one in Guangdong province and two in Beijing. Third fatality. The number of laboratory-confirmed cases in China is 201.

20 January – First confirmed cases in South Korea and Shanghai. China’s National Health Commission confirmed that the coronavirus can be transmitted between humans. CDC releases a specific diagnostic test for the virus that uses a real-time reverse transcription-polymerase chain reaction (rRT-PCR). US researchers are growing the virus in cell cultures for further study.

21 January – Taiwan and the US (Washington) report their first cases. The US patient was quickly identified as a possible risk, isolated, and tested (details here). The CDC activates its Emergency Response System to support its response to 2019-nCoV, and deploys a team to Washington.

22 January – The World Health Organization holds an emergency meeting to determine if the virus is a “public health emergency of international concern (PHEIC)“. See the result below. The total number of laboratory-confirmed cases in China is 571, with a death toll of 17. China imposes a quarantine on Wuhan, although it is only slowly enforced.

23 January – CDC raises its travel alerts for China.

24 January – Provinces and municipalities and China begin declaring a level 1 public health emergency. More areas in China are quarantined. The first case reported in Europe (in France). A second case was reported in the US. To date, the CDC has investigated 63 people in 22 states: 2 have tested positive and 11 negative. They believe the virus’ incubation period is roughly two weeks. Dr. Nancy Messonnier said it is “premature to conclude that we know whether it is more or less infectious than SARS and more or less severe than SARS.

The World Health Organization’s verdict, so far

For details about the epidemic see the WHO’s January 23 report.

“Twenty five percent of confirmed cases reported by China have been classified by Chinese health authorities as seriously ill (from Wubei Province: 16% severely ill, 5% critically ill, and 4% having died).”

Their bottom line: “WHO assesses the risk of this event to be very high in China, high at the regional level and moderate at the global level.” The WHO developed a large package of protocols for surveillance, diagnosis, control, and treatment of cases. These embed the world’s accumulated knowledge, so that each nation need not prepare by themselves. They also coordinate the exchange of information.

The International Health Regulations (2005) Emergency Committee met on January 23-24. Here is the press release.

“Research gives a preliminary R0 estimate of 1.4-2.5. …Of confirmed cases, 25% are reported to be severe. The source is still unknown (most likely an animal reservoir) and the extent of human-to-human transmission is still not clear.”

The R0 (a measure of contagiousness) number gets attention but is probably of little use for laypeople. Wikipedia gives a good introduction to it. The CDC often cites a paper saying that it is “easily misrepresented, misinterpreted, and misapplied.”

The Committee concluded that it is too early to declare a “public health emergency of international concern (PHEIC).” They will meet again in ten days, or earlier if warranted by events.

As usual, extreme views get more attention

While agencies (eg, WHO, CDC) make careful statements about the coronavirus, too many experts talk like it’s the Black Death. Wild speculation about worst-case scenarios. For example, see this. This gets them their 15 minutes, but feeds public hysteria. This has begun happening with every epidemic. We could get a “boy who cried wolf” effect, hampering the response to a major pandemic.

As an example, it takes just one paper to get people excited. Such as “Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic predictions” by Jonathan Reed et al., a non-peer-reviewed paper posted on January 24 at medRxiv. Although speculative and contrary to information from the world’s public health agencies, some take it as gospel and have extreme reactions. This is what America’s liberals see today at Naked Capitalism – a Tweet sent on January 25 based on that paper (later deleted, see the thread here).

Tweet by Feigl Ding about coronavirus

Even worse was “Uncanny similarity of unique inserts in the 2019-nCoV spike protein to HIV-1 gp120 and Gag” by Prashant Pradhan et al., a not-peer-reviewed paper posted on January 31 at BioRxiv. It claimed to find similarities between the new coronavirus and HIV (the viral cause of AIDS). The word “uncanny” in the title and “unlikely to be fortuitous” in the abstract implied that the authors believed that the virus had been engineered – not evolved. The paper was published on Friday, quickly condemned by scientists, and formally withdrawn by the authors on Sunday. But it was widely quoted during the next week and helped incite the hysteria outside China.

Conclusions

Extreme libertarians tell us that governments can’t do anything right, and that we should “starve the beast.” Conservatives also hate the UN. Here we see an example of strong government agencies – national and international – providing a vital service. These are underfunded, as a horrific pandemic would reveal.

For More Information

Ideas! For some shopping ideas, see my recommended books and films at Amazon. Also, see a story about our future: Ultra Violence: Tales from Venus.

Please like us on Facebook and follow us on Twitter. Also see these posts …

  1. See the ugly cost of the next big flu pandemic. We can do more to prepare.
  2. Stratfor: The superbugs are coming. We have time to prepare.
  3. Posts debunking the hysteria about the 2009 swine flu in America.
  4. Posts debunking the hysteria about the 2015 ebola epidemic in America.

A great film about epidemics in the 21st century

Contagion (2011)
Available at Amazon.

Contagion (2011).

This shows the progress of a pandemic from patient Zero, through global devastation, to eventual victory by the world’s scientists. From the studio …

“When Beth Emhoff (Gwyneth Paltrow) returns to Minnesota from a Hong Kong business trip, she attributes the malaise she feels to jet lag. However, two days later, Beth is dead, and doctors tell her shocked husband (Matt Damon) that they have no idea what killed her. Soon, many others start to exhibit the same symptoms, and a global pandemic explodes. Doctors try to contain the lethal microbe, but society begins to collapse as a blogger (Jude Law) fans the flames of paranoia.”

 

32 thoughts on “The 2019-nCoV virus shows that we’ve built a better world”

  1. Update from the WHO on Jan 25

    Situation update:

    A total of 1,320 confirmed cases have been reported for novel coronavirus (2019-nCoV) globally.

    Of the 1,320 cases reported, 1,297 cases were reported from China, including Hong Kong, Macau, and Taipei. A total of 1,965 suspected cases have been reported from 20 Chinese provinces, regions and cities (excluding Hong Kong, Macau, and Taipei).

    23 confirmed cases have been reported outside of China in nine countries. Of these 23 confirmed cases, 21 had travel history to Wuhan City, China; one case in Australia had direct contact with a confirmed case from Wuhan while in China; and one confirmed case in Viet Nam had no travel history to any part of China (it is transmission within a family).

    Of the 1,287 confirmed cases (excluding Hong Kong, Macau, and Taipei), 237 cases have been reported as severely ill.

    41 deaths have been reported to date (39 deaths in Hubei province, one death in Hebei province and one in Heilongjiang province).

    On 25 January, the number of reported confirmed cases of 2019-nCoV has increased by 474 cases since the last situation report published on 24 January.

    WHO’s assessment of the risk of this event has not changed since the last update (22 Jan): very high in China, high at the regional level and moderate high** at the global level.

    ** This was previously reported by the WHO as “moderate”, and corrected on their Jan 26 report.

    https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200125-sitrep-5-2019-ncov.pdf?sfvrsn=429b143d_4

  2. Today’s nitpick: “Extreme libertarians tells us that governments can’t do anything right, and that we should “starve the beast.” Conservatives also hate the UN. Here we see an example of strong government agencies – NATIONAL and international – providing a vital service. These are underfunded, as a horrific pandemic would reveal.” All too true of many good agencies.

    Nor should we forget that although there is exaggeration of crises, the efforts by local and national environmental regulators have cleaned our air and water, and controlled pollution of land and groundwater. We should not confuse those who are doing good work, and those who do not, even if in the same agency.

    1. Shelly,

      Sad factoid: traffic this morning implies that this post will have the lowest pageviews of any recent post. Meanwhile, hysterical articles are flying around the internet. I added a section about an especially hysterical article.

      That’s our America! Star Trek technology, but we prefer to be ignorant.

  3. Typo alert: “15 January – Second death: a 69iyear-old man in China.”
    should probably be “15 January – Second death: a 69 year-old man in China.”

    I also agree with Shelley. In spite of our occasional arguments, you are helping to build a better world and I probably don’t tell you that frequently enough.

  4. The media loves a good panic to shake things up. If not a war, then a good old fashioned plague or pestilence does just as well.

    And they love thinking up ominous names for events attached to years. The 2003 SARS Outbreak. The 2009 Swine Flu Pandemic.

    Putting things into perspective, this new disease appears to be both less infectious and less virulent than SARS was. Of course, there are some bloggers claiming from anonymous friends of friends that tens of thousands are already dead, that corpses are strewn all over the streets, that it’s spreading like wildfire and China is just keep it under wraps.

    https://gellerreport.com/2020/01/coronavirus-death-toll.html/

    If that is the case, I guess we’ll know soon enough.

    1. Durasim,

      “this new disease appears to be both less infectious and less virulent than SARS was.”

      The CDC has explicitly said that it is too soon to draw such conclusions. From Friday’s CDC press conference, Dr. Messonnier speaking:

      “I think it is premature to judge that {2019-n-CoV} as being distinctly different because we are still in the learning phase of this novel pathogen that’s just emerged and been identified. …In terms of infectiousness and severity, I think it is premature to absolutely say whether it is similar or different than SARS or MERS or all the other human coronaviruses. …I think it would be premature to conclude that we know whether it is more or less infectious than SARS and more or less severe than SARS. It is just too early to say that.”

      1. Fair enough. Right now, with current information, the mortality rate is tracking at around 3%, but as more cases and tabulation comes in, sure it can change.

        What I’d really like to know now is how long the disease’s course lasts in a person.
        Since they’ve confirmed about 2,000 cases and around 50 deaths, I’m wondering how long it takes for the confirmed cases who haven’t died to be pronounced as “recovered.” Unless this is some kind of indefinite duration disease that has latency periods and then returns with lethal force. Then the statisticians have their work cut out for them.

      2. Durasim,

        These things are complex.

        A novel coronavirus outbreak of global health concern” by Chen Wang el al. in The Lancet, published 24 Jan 2020.

        “Hence, the case-fatality proportion in this cohort is approximately 14·6%, and the overall case fatality proportion appears to be closer to 3%. However, both of these estimates should be treated with great caution because not all patients have concluded their illness (ie, recovered or died) and the true number of infections and full disease spectrum are unknown. Importantly, in emerging viral infection outbreaks the case-fatality ratio is often overestimated in the early stages because case detection is highly biased towards the more severe cases.

        “As further data on the spectrum of mild or asymptomatic infection becomes available, one case of which was documented by Chan and colleagues, the case-fatality ratio is likely to decrease. Nevertheless, the 1918 influenza pandemic is estimated to have had a case-fatality ratio of less than 5% but had an enormous impact due to widespread transmission, so there is no room for complacency.”

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  6. WHO Situation Report #6 on Jan 26

    They provide updated numbers and this summary: “WHO’s assessment of the risk …has not changed since …22 January: very high in China, high at the regional level and high at the global level.”

    But they report that previous situation reports said in error that the global risk was “moderate.” Whoops.

    https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200126-sitrep-6-2019–ncov.pdf

  7. Update from the CDC

    Five confirmed cases in four States of the US (AZ, CA, IL, WA). All were travelers from Wuhan. Summary:

    “While CDC considers this is a very serious public health threat, based on current information, the immediate health risk from 2019-nCoV to the general American public is considered low at this time. Nevertheless, CDC is taking proactive preparedness precautions.”

    https://www.cdc.gov/coronavirus/2019-nCoV/summary.html

  8. The Reed paper is admittedly speculative, the evidence it is considering has large error margins, and it hasn’t had time to be peer-reviewed, but its by proper expert epidemiologists and its range of outcomes are worth taking seriously. We may get away with it this time. But they point out good reasons to think there is a real chance, not sure how great, of this becoming very bad.

    At least their view is testable. If their extreme scenarios are to happen we should see it happening beyond any doubt in the next couple of weeks. It doesn’t strike one as alarmist, its more a valid wakeup call. Lets hope.

  9. An interesting perspective. I agree.

    I think a lot of people think some kind of an epidemic would be entertaining, in a sense. I’ve known people who had this weird kind of disease fandom since I was a kid. They read the Hot Zone every year and get despair-gasms. Meanwhile, we now have, I am told, a literal vaccine for Ebola.

      1. They said before that they wouldn’t even be in a position to start vaccine trials for this new coronavirus until next year. Now they’re saying they can start trials in a few months.

        MERS has been identified since 2012, and SARS since 2003, and they still don’t have any effective vaccine for either. Why are they so optimistic about developing one so quickly for this new related virus?

      2. Durasim,

        “Why are they so optimistic about developing one so quickly for this new related virus?”

        I suspect that neither you nor I would understand the answer if we got it.

        Even relatively simple concepts to experts are difficult for laypeople to understand. As I learned years ago teaching a class of students about bond convexity.

    1. When I first heard about the Ebola virus as a kid, it sounded like the true doomsday plague. I thought any disease that requires airtight spacesuits must be an incurable death sentence.

      When I read about the different Ebola strains, and how Ebola Zaire was the worst strain and had a mortality rate of 50%-90%. That kind of surprised me, because that implied some people did not die and survived it. But of course, a lot of people disregarded the lower range of 50% and only read the 90% and interpreted that as pretty much a death sentence for any infected person.

      And then the 2014 Ebola outbreaks happened. And I noticed something strange. When Westerners got infected, they evacuated some of them to Europe or the US for treatment. Some of them still died, but a lot of them survived. Usually, the ones that died waited longer before being evacuated. And then some people in the West got infected while treating these Ebola patients. But they survived. I think all of them did. Granted, it was a small sample size, but it seemed that if somebody was in normal health and got immediate first world medical treatment, they had a decent chance of survival.

      Which makes me wonder how much of Ebola’s mortality rate is determined because of its natural virulence or because of third world health/medical conditions in which it often occurs?

      1. Durasim,

        “Which makes me wonder how much of Ebola’s mortality rate is determined because of its natural virulence or because of third world health/medical conditions in which it often occurs?”

        See the link I provide in the post to an article about R0. It discusses some of these issues. Epidemiology is complex.

  10. CDC coronavirus report Jan 27

    Excerpt – the bottom line:

    “Imported cases of 2019-nCoV infection in people have been detected in the U.S. No person-to-person spread has been detected with this virus at the time, and this virus is NOT currently spreading in the community in the United States.. …

    “For the general American public, who are unlikely to be exposed to this virus, the immediate health risk from 2019-nCoV is considered low.”

    https://www.cdc.gov/coronavirus/2019-nCoV/summary.html

  11. WHO Situation Report #7: 27 January

    Current estimates of the incubation period of the virus range from 2-10 days,

    The have been 37 cases identified outside of China. Their median age is 45 years, ranging from 2 to 74 years.

    Of these, 36 cases had travel history to China, of whom 34 had travel history in Wuhan city, or had an epidemiological link to a confirmed case with travel history to Wuhan. For the remaining two, investigations into their travel histories are ongoing. One additional case was the result of human-to-human transmission among close family contacts in Viet Nam.

    WHO’s risk assessment has not changed since 22 January: very high in China, high at the regional level, and high at the global level.

    https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200127-sitrep-7-2019–ncov.pdf

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