Summary: As usual, the news media (and even more so the bold internet amateur experts) ignore news from the front lines of the COVID-19 epidemic, focusing instead on the minutea. Here is important information you might not have seen.
COVID-19 numbers and remedies
As of yesterday’s WHO situation report – There are 87 thousand confirmed cases of COVID-19. Of those, 92% are in China. More importantly, 77% of the world’s cases are in Hubei Province; 84% of China’s cases are in Hubei. This is an epidemic centered in one of China’s 34 administrative areas. There are 14 thousand confirmed cases amidst the 1.4 billion people in the rest of China (i.e., outside Hubei).
The world’s public health agencies are working to keep it from spreading from Hubei. That is the core reality that is ignored by the press.
As the CDC’s February 29 status report said, “At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions would be the most important response strategy.” The international survey team found that China has successfully contained the epidemic (so far, at least) using those nonpharmaceutical methods, chiefly cordon sanitaires and quarantines. The survey team estimated the fatality rate in China outside Hubei Province (whose health care systems have collapsed) at 0.7%.
Only time will tell how many other nations have the wise leadership and social cohesion required to use these tools on the scale needed.
A status report from the Director-General of WHO
Excerpt from Media briefing on March 2 by Tedros Adhanom Ghebreyesus, Director-General of WHO.
The number of cases in China continues to decline. Yesterday, China reported 206 cases of COVID-19 to WHO, the lowest since the 22nd of January. Only 8 cases were reported outside Hubei province yesterday. Outside China, a total of 8739 cases of COVID-19 have been reported to WHO from 61 countries, with 127 deaths. In the last 24 hours there were almost 9 times more cases reported outside China than inside China.
The epidemics in the Republic of Korea, Italy, Iran, and Japan are our greatest concern. …
The Republic of Korea has now reported more than 4200 cases and 22 deaths, meaning it has more than half of all cases outside China. However, the cases in the Republic of Korea appear to be coming mostly from suspected cases from the 5 known clusters, rather than the community. That’s important because it indicates that surveillance measures are working and Korea’s epidemic can still be contained.
Knowing and understanding your epidemic is the first step to defeating it. Korea’s situation also underlines that this a unique virus with unique features. This virus is not influenza. We are in unchartered territory. We have never before seen a respiratory pathogen that is capable of community transmission, but which can also be contained with the right measures. If this was an influenza epidemic, we would have expected to see widespread community transmission across the globe by now, and efforts to slow it down or contain it would not be feasible.
Editor’s note – The Director explained that more clearly in his press conference. The COVID-19 virus appears to be less contagious than the usual influenza virus. Big news!
Containment of COVID-19 is feasible and must remain the top priority for all countries. With early, aggressive measures, countries can stop transmission and save lives. …
Of the 8739 cases reported outside China, 81% are from four countries. Of the other 57 affected countries, 38 have reported 10 cases or less, 19 have reported only one cases, and a good number of countries have already contained the virus and have not reported in the last two weeks. …
There is no one-size fits all approach. Different countries are in different scenarios. More than 130 countries have not detected any cases yet.
- Some just received their first cases yesterday.
- Some have clusters of cases, with transmission between family members and other close contacts.
- Some have rapidly expanding epidemics, with signs of community transmission.
- And some have declining epidemics, and have not reported a case for more than two weeks.
Some countries have more than one of these scenarios at the same time. For example, China had community transmission in Wuhan, but relatively small numbers of cases in other provinces. Other countries have a similar pattern.
WHO is advising countries on actions they can take for each of the “three Cs” scenarios – first case, first cluster, first evidence of community transmission. The basic actions in each scenario are the same, but the emphasis changes depending on which scenario a country is in.
Our message to all countries is: this is not a one-way street. We can push this virus back. Your actions now will determine the course of the outbreak in your country. There’s no choice but to act now.
———– End excerpt. ———–
The US took strong early steps, but current efforts are falling apart due to decentralized political structure (many agencies with overlapping mandates at Federal, State, and local levels) and partisan feuding. For example, see the bickering about who should pay for testing. That somebody should not test due to the cost is mad. It is a cost of business for the nation, and should be paid for accordingly.
Trump should stop tweeting and take strong action immediately. The clock is running; time is not on our side.
It’s easy to follow the coronavirus story
The World Health Organization provides daily information, from highly technical information to news for the general public.
- There is their daily situation report, with detailed numbers.
- The Director-General of WHO gives frequent briefings, which are quite insightful.
- Their daily press briefings have more information. An audio goes up quickly afterwards. A transcript is posted the next day.
Posts about the coronavirus epidemic.
- The 2019-nCoV virus shows that we’ve built a better world.
- Hidden news about the epidemic sweeping across America! – How fake news drives out good news.
- Amazing but hidden news about coronavirus – Update about the epidemic, and why so few know the good news.
- Lessons from the coronavirus about climate change.
- Cut thru myths to see facts about COVID-19.
- Blockbuster news from China about COVID-19.
- China shows us a future of the epidemic and the world.
- A devastating epidemic spreads across America.
- COVID-19 goes global. What works against it?
- Soon we’ll see if the US can defend itself again COVID-19.
- A situation report on the hidden news about COVID-19.
- The COVID-19 story: mistakes were made.
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 about epidemics…
- See the ugly cost of the next big flu pandemic. We can do more to prepare.
- Stratfor: The superbugs are coming. We have time to prepare.
- Posts debunking the hysteria about the 2009 swine flu in America.
- Posts debunking the hysteria about the 2015 ebola epidemic in America.
- Important: A vaccine against the fears that make us weak.
Books about epidemics
The Hot Zone
Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond
I think the hysteria is a tad overdone. Judging from the impact of Covid-19 on countries adjacent to China but with much warmer weather, I expect Covid-19 to at least somewhat resemble influenza in its reaction to the weather. We know that flu season correlates well to winter weather; that the influenza virus does best in cool to cold and dry conditions. It is possible to get colds in the summer, but they aren’t as common then as they are in winter.
Now look at Thailand and Singapore. Three million Chinese tourists visited Thailand during the Chinese New Year travel season this year. After an initial spike of cases, Covid-19 has eased off there and it’s business as usual although owing to the drop in tourists they are hurting financially. Same deal in Singapore. Both countries are in their hot seasons now. Plus Hong Kong is warming up as well.
But chilly weather is still very much on in places like Iran, Italy and Washington state. So we can expect the cases to continue escalating there at least until warmer weather arrives. So I expect this to recede a bit with the arrival of warmer weather and then it will likely make a comeback around October along with next season’s influenza strain(s).
I think it’s likely that Covid-19 joins influenza, et al as typical winter ailments and that our hygienic routines will have to adjust to keep it at a distance.
I appreciate the regular updates, Larry. I hope that we can un-screw our testing situation here. I suspect it will not be easy to do, but I will spare more explicitly partisan remarks.
It seems like many of the mystery cases may be explained by a larger-than-perceived number of asymptomatic cases, but I’m not sure how this accords with situations like Hubei province or that Japanese cruise liner.
SF,
“I hope that we can un-screw our testing situation here.”
I’m sure that is already solved.
“It seems like many of the mystery cases”
As the WHO staff have explained, contact tracing was the primary method of establishing quarantines in the generations before super-drugs. Now it is somewhat of a lost art – and more difficult in our highly mobile world. Local health agencies no longer have a team of people trained and experienced in this (it’s not easy). So by “mystery”, the probable more accurate description is “contact with an unidentified infected person.”
“how this accords with situations like Hubei province or that Japanese cruise liner.”
Neither are remotely mysterious. Both are in effect giant petri dishes, with ample opportunities for direct contact with infected people.
A follow-up to SF’s comment – about contact tracing.
I’m already seeing complaints about the slow response to COVID-19 by the US public health agencies. This is so modern American. Experts warn about threats, but we ignore them (we focus only on those that are here or are in the future but politically useful right now). Experts want funds to prepare defenses, but we mock them (“govts can’t do nothing). The threat becomes reality, and we whine that there are not massive public machinery ready to swing into action in my neighborhood.
The paradigm is air travel. A large fraction of the public buys the cheapest ticket, even if only a few dollars cheaper – forcing airlines to cut costs to the bone. Then we whine about the service.
This is not the people capable of maintaining a great nation. It is the behavior of a people who inherit a great nation and drive it off a cliff.
The striking thing in the latest WHO reports is how few cases there are in the rest of China, compared to the rapidity with which its spreading in Italy and Korea and starting to move into the rest of Europe from Italy.
Maybe the Chinese quarantine policy is the reason for this extraordinary success. But there must have been lots of travel of the infected before it was implemented.
Interesting and surprising. Compare the UK, as a for instance, with its relatively small number of travellers from infected regions, with some of the Chinese areas with high travel from the region. The UK appears to be on track, in the eyes of qualified people, for doubling of cases every week. Very different from what we see in the Chinese regions.
henrik,
“But there must have been lots of travel of the infected before it was implemented.”
It is not the least bit mysterious. There are sixty million people in Hubei Province. They instituted the travel restrictions when only a microscopic fraction were infected.
“Interesting and surprising.”
It’s neither.
“The UK appears to be on track, in the eyes of qualified people, for doubling of cases every week. ”
I hope you are kidding. I would be disappointed if I had to explain the math of small numbers. Doubling is easy when the number infected is 36. A few people infected, who infect their families and coworkers – almost impossible to stop. But these small clusters can be quickly identified and quarantined, stopping the spread.
No, you don’t have to explain the math of small numbers!
I hope you are right. The UK is about to publish its planning, today or tomorrow, and early leaks suggest it is getting ready for scenarios with very large numbers of cases as reasonably probable. Despite the fact that it currently has a very thorough test, track, isolate and treat program. Obviously they need to be prepared in case. Lets hope it proves unnecessary.
In the Middle East and Africa, it seems likely to proceed more or less unchecked, don’t you think? In the Middle East its a war zone with huge uncontrolled movements of people. If it gets a foothold there, it will run its natural course.
I don’t get this statement, Larry: “ We have never before seen a respiratory pathogen that is capable of community transmission, but which can also be contained with the right measures.”
SARS, MERS, common cold, most influenzas are respiratory pathogens that are capable of community transmission and are/were contained by the right measures. What am I missing?
COVID19 seems to have a morbidity and mortality rate on par with seasonal influenzas. As you’ve pointed out in other articles, flu is not news even if 500,000 people die from it. A new virus with a weird name is news and the media has whipped paranoia to a frenzy. No need to add an air of mystery to what I suspect will be a non-story in a few weeks and a forgotten footnote next year.
Kris,
I too wondered about that. I wondered if it is a grammatical error. After all, he is speaking extemporaneously in a foreign language – and English grammar is notoriously complex. Perhaps he meant to say “We have never before seen …has been contained with the right measures. Actors have scripts and still get their lines wrong (that’s why there are blooper reels).
“I suspect will be a non-story in a few weeks and a forgotten footnote next year.”
Too soon to say that. The fatality rate is not clear yet, but certainly much larger of that of the average flu. The CDC estimates that so far this season there have been at least 32 million flu illnesses, 310,000 hospitalizations and 18,000 deaths from flu. If COVID-19 breaks from containment and spreads across the globe – esp in the less developed nations – the death toll might be really large.
Follow-up to Kris –
In the transcript of the media briefing, he explained it more clearly.
So this is less contagious than the usual influenza. Big news.
Larry, here is some more “Hidden News”. Apparently over the past 2-3 years, articles have surfaced within medical journals concerning the cause and affect of non ending public and political chaos in the United States and how that affects patient health. It seems that Russia, Iran, North Korea, China and others have very sophisticated, deeply seeded in National Media and Internet operations that work endlessly creating information that will create endless chaos concerning almost every topic including but not limited to Politics, Healthcare, Climate Change, STD’s. Gay & Lesbian issues, Gender Issues, Public School education and many others. Extremely well educated men and women are involved and the intent is to destroy the United States.
Codetrader,
That sounds like malarky. Do you have some examples of these articles in medical journals?
I had a long comment prepared about the strategic failure of the US authorities (mostly due to locked orientation) that cost us a few precious weeks of containment, but this tweet thread sums it up better: https://twitter.com/JeremyKonyndyk/status/1234180123244580864
Broken OODA loops kill.
Scipio,
The comment threat is excellent. It’s not a broken OODA loop. Epidemics are like war. Mistakes are made. That’s life. Tomorrow’s post discusses this.
As for kits, they’re not magic wands. South Korea has tested tens of thousands (I read 75k in one article) – yet has a raging epidemic. Thousands of people came from China into the US during the early stages of the epidemic, yet we have few cases. Travel restrictions, contact screening, quarantines – the same kind of old fashioned tools China has successfully used.
The decision to early on restrict travel from China might have had much more effect than the limitations on the number of tests done.
Scipio,
Thanks again for pointing to that great Twitter feed! I added it to tomorrow’s post.
15 Days since the last comment. So what’s your take on it now? Can’t say I’ve seen ”hysteria” anywhere other than brit hotspots of course, and Australia 🙄
T&T businesses taking a massive hit.
Lack of appropriate state reaction is far more dangerous than over-reaction IMHO. Basically on lockdown here in Greece. Given that most households are likely to have at least one vulnerable member, caution is safest. Of course there’s no “everyone’s gonna die!” thing about it all. But Italy’s health system was overcome by numbers and doctors have been forced to decide who gets to be saved in some areas. No government should delay action so much that that becomes necessary. Especially in countries which do not by default ensure health coverage for all of their citizens.
Stay well.
Flatten,
“15 Days since the last comment.”
Because there have been 8 new posts about COVID-19. People comment on the new posts, not the old ones.
“Lack of appropriate state reaction is far more dangerous than over-reaction IMHO.”
Too simplistic. In the beginning, when the magnitude of the threat is poorly known, over-reaction has both economic costs and can reduce credibility (boy who cried wolf). Once the threat is known to be severe, under-reaction (as we’ve seen in the US) is the danger.
” doctors have been forced to decide who gets to be saved in some areas. No government should delay action so much that that becomes necessary.”
It’s unavoidable in a severe epidemic. Nobody has large amounts of excess health care resources because the annual cost would be fantastic. For example, I don’t know the cost of a fully equipped and staffed ICU bed – but I’ll bet it is big.
The US Strategic National Stockpile (drugs and equipment) is a drop in the bucket vs. a national epidemic, but it costs $600 million per year to maintain.
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