COVID-19

[Brightonian]

SXSW cancelled. (edit: ninja'd by dyqik)

My housemate who assists with events (she moves bands in and out of venues) must be getting very nervous as she only scrapes by on the income from that. I've mentioned her before and someone suggested I ask her how she's going to manage if there's widescale cancellations of events, but she's pretty clued up, and happened to bring it up anyway. She's doing all sorts of events in the next few days (a 17-hour day included), and I reckon she's just taking on all possible work at the moment so she will have something to tide her over if it all goes to the wall.

[Little waster]

You can all relax Rent-a-Gobshite Simon Jenkins says it'll be fine.

Not getting that message from the article. Getting more of a "the politicians and media are stoking fears of of a crisis, but all the medical experts are being more measured and calm" vibe. Which is true. If you believed the tabloids, we're currently facing an epidemic bigger and more deadly than the Black Death yet, let's be honest, the majority of us who get Covid-19 will feel crap for a few days then be fine again

CF

It’s more the smugly arrogant Govian way Simon Jenkins pontificates from a position of absolutely zero authority on anything and everything just because he’s a journalist. It is Catch 22 as well, as with Millennium Bug, if the countermeasures work then this will seized on as further proof that it was just more so-called experts panhandling.

Here’s hoping he is right though ...

[FlammableFlower]

It's that daft snowball effect. Once enough people start it others follow... Just in case.
MrsFF heard on the radio some woman who'd gone in to buy nappies for her child and saw there were 6 packs left so she bought all of them and all the remaining baby wipes - just in case, as her child was paramount, and if everyone kept panic buying there would definitely be none when she needed them, saw she was getting ahead.

If nothing else, we've possibly got about two dozen flannels, so them combined with a bucket of mild bleach and regular hot washes and very hot ironing could probably see us through a bog roll shortage if things got really bad...

I am a little concerned to read about the knock-on effects for UK universities of IELTS sitting down in China - (one for plodder) they are quite the cash cow for UK universities. Stuff home/EU students... These guys pay full whack (and then some, in some cases). E.g. for a one year MSc, a UK/EU student probably pays £9.5k, whereas an overseas student (most commonly Chinese) will pay £21.5k... undergrad it's about £14k/year. Every foreign postgrad taught student lost is the equivalent of 2 and a bit UK students and 1 and a bit for undergrads. As noted in the guardian, overseas students can be paying £60k for an Oxford business degree.

[mikeh]

If nothing else, we've possibly got about two dozen flannels, so them combined with a bucket of mild bleach and regular hot washes and very hot ironing could probably see us through a bog roll shortage if things got really bad...

I would estimate that bleach and hot ironing would indeed fit a conclusion of "things got really bad", in any wipe-based bog roll shortage.

I am a little concerned to read about the knock-on effects for UK universities of IELTS sitting down in China - (one for plodder) they are quite the cash cow for UK universities.

And less flippantly, very much this. Especially as we're telling all the cheaper (but more reliable, market-wise) EU ones to piss off and eyeing up more lucrative markets, turns out that lucrative market is particularly fragile. I did the occasional lecture on one of the MSc Computing units, turned up the first time to see about 120 students, of whom about 100 were Chinese. About 15 of the remaining 20 were middle-eastern. There's a lot of Chinese students here, and many more from other areas that might be impacted greatly by COVID (and future emerging infectious disease threats)

[raven]

https://www.theguardian.com/world/2020/ ... t-covid-19

Our GPs are ahead of the game then. When I last called up for an appointment, I was told there was a new system in place, and what would happen is I'd get a call back from my GP. In a fortnight.

(Then I discovered from the practise website that they've set up e-Consult. So I filled that out online, crossing my fingers that my data wouldn't be passed on anywhere dodgy, got a call back from a GP later that day, went in for a blood test the next. So...a mostly positive experience.)

Bit dubious about remote consultations for things that really need an examination though. But I can see how useful it'll be during a Covid-19 outbreak. We need to protect GPs as much as possible.

[Little waster]

If nothing else, we've possibly got about two dozen flannels, so them combined with a bucket of mild bleach and regular hot washes and very hot ironing could probably see us through a bog roll shortage if things got really bad...

I would estimate that bleach and hot ironing would indeed fit a conclusion of "things got really bad", in any wipe-based bog roll shortage.

You want something soft and absorbent?

Spoiler:

Wipe your arse with an Andrew puppy ref: Viz passim probably

[dyqik]

Western Washington State has just suspended ("continued") all court oral arguments and trials until further notice.

[mediocrity511]

It's that daft snowball effect. Once enough people start it others follow... Just in case.
MrsFF heard on the radio some woman who'd gone in to buy nappies for her child and saw there were 6 packs left so she bought all of them and all the remaining baby wipes - just in case, as her child was paramount, and if everyone kept panic buying there would definitely be none when she needed them, saw she was getting ahead.

If nothing else, we've possibly got about two dozen flannels, so them combined with a bucket of mild bleach and regular hot washes and very hot ironing could probably see us through a bog roll shortage if things got really bad...

I am a little concerned to read about the knock-on effects for UK universities of IELTS sitting down in China - (one for plodder) they are quite the cash cow for UK universities. Stuff home/EU students... These guys pay full whack (and then some, in some cases). E.g. for a one year MSc, a UK/EU student probably pays £9.5k, whereas an overseas student (most commonly Chinese) will pay £21.5k... undergrad it's about £14k/year. Every foreign postgrad taught student lost is the equivalent of 2 and a bit UK students and 1 and a bit for undergrads. As noted in the guardian, overseas students can be paying £60k for an Oxford business degree.

Bleach and hot ironing would likely be overkill. If it comes to it, look into routines for washing cloth nappies, which generally are a rinse cycle in the washing machine and then a really long washing cycle, using bio powder in preference to non bio. You'd want to be washing at 60C, no need for a boil wash.

[Woodchopper]

About a quarter of China’s new confirmed cases and almost all of those outside Wuhan originated outside of China.
https://www.theguardian.com/world/live/ ... df6d274e72

Something which illustrates the difficulty of preventing the spread of the infection.

Cases have been reported in the West Bank and Afghanistan.
https://www.theguardian.com/world/live/ ... df6d274ec8
https://www.reuters.com/article/us-heal ... SKBN20U085

If there is an epidemic in very poor countries with very limited public health facilities then the outcomes will be very bad - eg if there's an epidemic in the refugee camps full of Syrians.

[shpalman]

None of these "ancient Covid" claims make sense.

It's easy to backtrack to 1st Dec 2019 and a handful of cases. By 31 Dec there would have been in the region of 500 cases in Wuhan, including about 50 in the hospitals - and it was only at the end of Dec that any doctor noticed the anomoly, with that whistle-blower doctor. Of those 50, two-thirds were directly linked to the Wuhan market. It's simply impossible for that profile to fit in with any other origin.

Oh this wasn't doubting the Whuhan origin. There were a lot of Chinese in Qoms though. But as you say, it's not that likely that it got to Iran quite so early.

This is interesting on the origin:

https://nextstrain.org/narratives/ncov/ ... 03-04?n=11

Starting point mid November to mid December.

Italians today are all over the news that Germany found its patient zero with the idea that the this is the source of the Codogno outbreak. It's not clear to me if there was any contact between Munich and Codogno outside of unreferenced rumours spread by morons on facebook. But it's noted that there was asymptomatic transmission, and the rapid increase in the number of cases in the first few days supports the idea that there were actually about 60 cases in the Codogno area already on the 21st of February when we started counting.

Does https://nextstrain.org/narratives/ncov/ ... -03-04?n=5 or https://nextstrain.org/narratives/ncov/ ... -03-04?n=6 support that possibility? I can only assume the Munich (Bavaria) strain is "BavPat1" while the Codogno strain is "CDG1".

https://nextstrain.org/narratives/ncov/ ... -03-04?n=9 is more clear.

An analysis from 6 days ago of two cases in Brazil notes that one case (who had been to "Lombardy") fits with the sequence identified in Codogno but the other case (who had been to "Milan") fits into a completely different phylogenetic cluster "which contains sequences from several countries including China, England, Australia, France, USA, Singapore, Taiwan, and Sweden". Their conclusion is anyway that this second case caught the virus in Northern Italy which means that "the outbreak in Northern Italy was likely the result of multiple introductions to the region and from not a single source."

i.e. this patient has the virus from all over the place but not Italy -> wow Italy really has the virus from all over the place.

https://www.queryonline.it/2020/03/06/s ... us-padani/ discusses exactly that question, in Italian. First it points out that Germany found its patient zero ages ago and it's not news all of a sudden now and it's certainly not the case that Germany was hiding this information until now.

Then it explains how the whole NextStrain thing works.

A possible conclusion in the absence of new sequencing is that since we know who the patient zero was in the German case (so we know we have a viral strain direct from China in that case), and we observe that the strain sequenced from Italy's patient one is already mutated with respect to Chinese strains, we can suppose that the virus was already circulating in Italy at the point it arrived in Germany.

[raven]

https://www.queryonline.it/2020/03/06/s ... us-padani/ discusses exactly that question, in Italian. First it points out that Germany found its patient zero ages ago and it's not news all of a sudden now and it's certainly not the case that Germany was hiding this information until now.

Then it explains how the whole NextStrain thing works.

I guess that's the problem with having research online for anyone to read. People who don't understand it fully jump to conclusions. Brings to mind this that I found on Reuters graphics:

https://graphics.reuters.com/CHINA-HEAL ... index.html

[mikeh]

Brings to mind this that I found on Reuters graphics:

https://graphics.reuters.com/CHINA-HEAL ... index.html

It is a nice graphic, that.

I think the rapid provision of near-real time data is overwhelmingly helpful. The small number of poor studies don't seem to have been very influential in informing poor practice/guidance. And this perhaps shows that post-peer review works well when there's enough people flagging up new papers and enough expertise looking on to rapidly say yay or nay.

All this also supports the links between academics, clinicians, the media, and the general public, because explanations and policies can be based on real data rather than guesswork, and is perhaps more convincing and acceptable (for example self-isolate for 14 days, will people comply? It's based on pretty good data, with a new paper coming out on Monday that broadly backs this timeframe up, with some caveats).

The Science Media Centre seem rather pleased with the rapid dissemination of data, as it also allows those of us at a distance to provide informed comment to the press. Whilst we don't get reflected in many headlines, we're usually quoted in paragraph 4 and below, it allows the public narrative to be a little bit more rational than would otherwise be the case.

[Opti]

SXSW cancelled. (edit: ninja'd by dyqik)

My housemate who assists with events (she moves bands in and out of venues) must be getting very nervous as she only scrapes by on the income from that. I've mentioned her before and someone suggested I ask her how she's going to manage if there's widescale cancellations of events, but she's pretty clued up, and happened to bring it up anyway. She's doing all sorts of events in the next few days (a 17-hour day included), and I reckon she's just taking on all possible work at the moment so she will have something to tide her over if it all goes to the wall.

I know really quite a lot of people in the events industry who are pretty damn worried about the situation. Much of their income is from Jun/Jul/Aug and is lucrative enough to get by the rest of the year. HARD work, mind. Most of us couldn't cope with the demands.
So, Coronavirus and visa issues for EU bands has put a lot of people in a very insecure position. Not that the UK entertainment industry contributes much to the UK GDP. Just about 30 times the fishing industry.

[shpalman]

This https://www.ilsole24ore.com/art/coronav ... he-ADbdPTB (Italian again) discusses the possibility, attributed to virologist Ilaria Capua, that 99% of cases go untested and therefore undetected since they're asymptomatic or mild with no direct connection to a known infection.

It would mean that contagion is uncontrolled but 100 times less serious than it currently appears, while immunity in the population is building up.

[headshot]

SXSW cancelled. (edit: ninja'd by dyqik)

My housemate who assists with events (she moves bands in and out of venues) must be getting very nervous as she only scrapes by on the income from that. I've mentioned her before and someone suggested I ask her how she's going to manage if there's widescale cancellations of events, but she's pretty clued up, and happened to bring it up anyway. She's doing all sorts of events in the next few days (a 17-hour day included), and I reckon she's just taking on all possible work at the moment so she will have something to tide her over if it all goes to the wall.

I know really quite a lot of people in the events industry who are pretty damn worried about the situation. Much of their income is from Jun/Jul/Aug and is lucrative enough to get by the rest of the year. HARD work, mind. Most of us couldn't cope with the demands.
So, Coronavirus and visa issues for EU bands has put a lot of people in a very insecure position. Not that the UK entertainment industry contributes much to the UK GDP. Just about 30 times the fishing industry.

Hi! That’s me. I run an outdoor theatre company and all of my income is for activity between May-Sept.

I’m very worried at the moment. Even if the Govt doesn’t stop anything going ahead, people might stay away themselves.

Being outdoor helps though...but our audience is a majority of older folk.

[lpm]

This https://www.ilsole24ore.com/art/coronav ... he-ADbdPTB (Italian again) discusses the possibility, attributed to virologist Ilaria Capua, that 99% of cases go untested and therefore undetected since they're asymptomatic or mild with no direct connection to a known infection.

It would mean that contagion is uncontrolled but 100 times less serious than it currently appears, while immunity in the population is building up.

That doesn't seem to fit with what we are seeing. It would imply hospitalised/tested cases would pop up more randomly, out of large pools of asymptomatic people, with a big geographical range. A heat map would show as fairly even.

We actually see very clear local outbreaks and huge areas of zero cases. The heat map shows huge contrasts. And tracing is still possible - e.g. transmission in the UK linked to someone who's husband went to Italy. If the trail can still be followed in a large number of cases then surely it disproves the hypothesis that infections are coming from huge undetected pools?

Isn't it as simple as: if 50% of cases can be linked in a chain to known outbreaks and 50% are via unknown transmission, then about 50% of cases are going undetected?

[lpm]

Some bad maths from an NHS trust "boss" in this article...

https://www.theguardian.com/world/2020/ ... c-strategy

"The boss of another trust said: “About 17% of people who contract the virus need some sort of medical intervention. So if this properly catches hold you have a 17% increase in the number of people coming through the NHS’s door, and then everything falls over.”"

I keep seeing this error at the moment. For example, someone saying along the lines of “If people are buying 17% more toilet paper, inevitably there is going to be 17% fewer toilet rolls on supermarket shelves." And "The number of known cases has doubled since Monday, doubling the pressure on the NHS".

[shpalman]

The issue is that only people with symptoms and/or known contact to cases are generally being tested (and only about 10% are positive anyway). This biases towards seeing outbreaks.

The test is for the virus not the antibodies so you can't tell if someone already had the virus.

And then tourists get home from Milan, in which we only have a few cases, and the somehow turn out to be infected.

We still don't know where Codogno's patient 1 caught it from, it makes sense that it was already circulating here.

[jimbob]

The issue is that only people with symptoms and/or known contact to cases are generally being tested (and only about 10% are positive anyway). This biases towards seeing outbreaks.

The test is for the virus not the antibodies so you can't tell if someone already had the virus.

And then tourists get home from Milan, in which we only have a few cases, and the somehow turn out to be infected.

We still don't know where Codogno's patient 1 caught it from, it makes sense that it was already circulating here.

Yes but LPMs point still stands. You would expect those who were hospitalised to be mostly from the unknown carriers supposedly making up the majority of cases.

We have evidence, for example that it was probably circulating in Washington State for about 6 weeks before detection

[lpm]

But there wouldn't be a difference in hospitalisation rates, even if there's a difference in testing rates. The hypothesis requires not only that these "dark pools" are going untested, but also that they are going unhospitalised.

ETA as jimbob says

[lpm]

What's the best way to explain this "17% increase" error to people? It's the collision of exponential vs linear. For example, when talking about hospital beds.

Say beds are currently 90% occupied as the normal background level. If Covid cases increase by 20%, that not a problem at first because the 90% creeps up - the pressure isn't rising by 20%, it's handled normally as part of usual seasonal ups and downs. But then it starts to hit limits, say when beds are 98% occupied and you are trying to juggle turnaround times and local surpluses/deficits. A 20% rise in cases at this point causes a huge increase in pressure, going from coping to struggling to failing almost instantaneously. Bed numbers can grow in a linear way (trolleys, mattresses etc), they can't grow exponentially.

For everything exponential, there is a tipping point from coping OK to nothing - with a huge swing within days. Take drips to hydrate patients on ventilators. Presumably there are loads of bags of saline drips and manufacture can be increased. Yet at some point there will be zero. The demand for saline drips doubles at a different rate to the doubling of infections.

[shpalman]

Yes but LPMs point still stands. You would expect those who were hospitalised to be mostly from the unknown carriers supposedly making up the majority of cases.

You would still have needed to notice the anomalous hospitalizations and think to test for the virus:

... there was an anomalous peak of 40 cases of lung infection in the last week of 2019 in Piacenza, which isn't far from Codogno.

Links in Italian:

https://www.liberta.it/news/cronaca/201 ... settimana/

https://cattiviscienziati.com/2020/02/2 ... a-notizia/

(That's too early to have already been the coronavirus, but it must have been circulating here in January)

[shpalman]

Today's numbers - 4636 total infections of which 3916 are still infected - doesn't fit with the idea of a SIR model which is peaking (limited to something like a susceptible population of 6-7000), but rather with the idea that the exponential growth switched to a longer time constant 5 days ago as the containment measures took effect. So with that in mind the prediction for tomorrow's total infections would be about 5700.

Today's number is actually 5883, out of which 5061 are currently infected. So yeah it's still going up exponentially.

[shpalman]

https://www.theguardian.com/world/live/ ... df6d274472

In Hong Kong, Leung says: “We estimate the symptomatic fatality rate is 1.4%”

“There is still one remaining uncertainty - out of those infected, what is the proportion who show symptoms?”

Differences in this proportion would shift the rate by about 0.1% - which is still a lot of people.

1.4% is still a lot but it's less than 3.4%.

That's from a couple of days ago linked from https://www.theguardian.com/world/2020/ ... -reassured

[Fishnut]

Chinese quarantine centre collapses, leaving 70 trapped.