Month: February 2020

Wuhan Coronavirus/2019-nCoV Update: February 4th, 2020 (and Some Frank Talk About Proper Risk Communication by Governments During a Potential Pandemic by an Expert)

I can tell that a certain amount of “WuFlu fatigue” has already begun to set in among my readers, according to my WordPress viewer stats. That’s probably to be expected; nobody wants to keep reading bad news.

My Twitter feed, which I had taken such pride in ruthlessly pruning to follow only those people in social VR and virtual worlds, has suddenly become a rather bizarre mix of social VR/virtual worlds and various good, authoritative sources of information about the 2019-nCoV outbreak. (By the way, if you want a credible list of people to follow on Twitter, epidemiologist Dr. Ellie Murray has compiled a curated list of coronavirus experts that you can subscribe to.)

One of the people I am following is a brand new account called simply nCoV2019. There is no biography provided, zero information about who this person is, and there’s no way to learn their background or qualifications, but God damn it, whoever they are, I think they have been BANG. ON. THE. MONEY. lately in their coverage of the Wuhan coronavirus.

One of the things this person did yesterday was share several excerpts of a report from the 2009 H1N1 “swine flu” influenza pandemic about risk communication by governments, and a lot of what they are sharing is directly applicable to the current 2019-nCoV situation.

Here’s a quote from the paper by Dr. Peter M. Sandman and Dr. Jody Lanard, titled Containment as Signal: Swine Flu Risk Miscommunication, from the Peter Sandman Risk Communication website. Please note that the following quoted text is **NOT** about 2019-nCoV, but about the H1N1 influenza virus!

How should they explain the goals and endpoints of containment to their publics?

Many governments doing intense swine flu containment are signaling that the purpose of containment is to prevent local spread of the virus – not just slow it or reduce its impact, but actually prevent it. Many of these governments explicitly tell their people that this is the goal; some just signal it without actually saying so. In all cases, these signals and messages are misleading, since containment will eventually fail.

Thus governments are setting themselves up to be blamed, and setting their people up to be shocked and unprepared for imminent domestic epidemics.

The misleading signals and messages about containment violate a very basic risk communication principle for helping people cope with bad news that is likely to worsen: anticipatory guidance, telling people what to expect.

As I have reported in today’s and previous days’ updates, many infectious disease experts are now openly saying that we can expect a pandemic, as nCoV2019 has tweeted:

The message from many infectious disease experts, such as Dr. Michael Osterholm (which I blogged about here), Dr. Anthony Fauci (which I blogged about here) and Dr. Gregory Poland and Dr. Scott Gottlieb (which I blogged about here) could not be clearer:

Despite our best efforts, we here (in countries outside China) will probably NOT be able to successfully contain the 2019-nCoV virus, because it seems to be so easily transmissible. Eventually, it WILL begin to spread widely around the world.

Here’s another pertinent quote from that 2009 Sandman/Lanard swine flu paper (again, please note that the following quoted text is **NOT** about 2019-nCoV, but about the H1N1 influenza virus):

…we believe the combination of the containment strategy itself and the way that strategy is being communicated has had a huge impact on worldwide public understanding of the novel H1N1 pandemic, especially in the developing world. We think the containment signal has:

– led many publics to expect that swine flu will be prevented from entering or at least from spreading in their country;
– led many publics to believe that swine flu is currently more severe than it actually is (so far);
– led many governments to adopt containment measures that experts consider epidemiologically ineffective and economically harmful;
– led many governments to continue initially sensible containment measures long after they were no longer useful; and
– led many governments to beg the World Health Organization to delay declaring swine flu a pandemic, in part because they did not want to tell their people that swine flu’s continuing spread was unstoppable.

And when the swine flu containment strategy is ultimately abandoned, the risk communication signals sent by that strategy – if uncontradicted by explicit government communications – can lead many publics to become more mistrustful of their government and more alarmed about swine flu.

In other words, if governments and institutions do not do a proper job of risk communication in the face of a potential pandemic, they will only amplify public panic and reduce people’s trust in government, if/when things do become worse.

Peter Sandman has posted the text of an email message he shared with Canadian National Post journalist Sharon Kirkey on January 29th, 2020. (Sharon Kirkey later wrote an article on the coronavirus threat for the National Post, quoting part of what Peter wrote to her.)

I am going to quote Peter’s message at length, because I think it is required reading:

My most fervent risk communication complaint at the moment is the tendency of many top officials in the U.S., Canada, and Europe to overemphasize the fact that the risk of the novel Wuhan coronavirus here and now is tiny – as if that meant that people should (or could!) wait to worry until the risk here and now got bigger. “No reason for alarm,” is bad science as well as bad risk communication. Officials and experts are alarmed already – reason enough for the public to gird up its loins as well.

Worry is about the future. Telling people not to worry about an emerging infectious disease because it isn’t a significant risk here and now is foolish. We want people to worry about measles when there’s very little measles around, so they will take the precaution of vaccinating their children before it’s imminently necessary. We want people to worry about retirement when they’re years away from retiring, so they will start saving now.

Given the real possibility that the coronavirus might start spreading locally in North American cities, now is the right time to worry and prepare, at least emotionally and perhaps logistically as well. There’s not much reason to wear masks against the coronavirus in North America now. Masks may or may not turn out to be useful in the months ahead. In case they do turn out useful, buying them now is provident, not panicky.

Even more importantly, telling people they are foolish to worry about an emerging infectious disease is patronizing and contemptuous – when what is needed is empathy. When confronted with a risk that’s new and scary, people naturally go through what some risk communication professionals call an adjustment reaction. We temporarily overreact – feeling and imagining and even behaving as if this possible future threat were here and now. The adjustment reaction is unavoidable and usually pretty brief. It is also useful, an emotional rehearsal. It helps us prepare for the new normal that may be coming.

Instead of deriding people’s fears about the Wuhan coronavirus, I would advise officials and reporters to focus more on the high likelihood that things will get worse and the not-so-small possibility that they will get much worse. I think there is little need to ameliorate public over-reaction now. The bigger need is to reduce public over-reaction later to predictable bad news that will take people by surprise insofar as they weren’t sufficiently forewarned and didn’t get enough chance to rehearse emotionally. My wife and colleague Jody Lanard M.D. says to tell you that adjustment reactions are “like tabletop exercises for regular people.” Officials should help the public rehearse better, not tell people not to rehearse.

Good Sources of Information on 2019-nCoV

Here is my list of good, credible, authoritative resources to learn more about the Wuhan coronoavirus (more formally known as 2019-nCoV):

If you want a quick, up-to-date overview of the current situation, here are three good places to check:

Sources of Fast-Breaking News on 2019-nCoV (WARNING: News You Read Here May Not Be 100% Credible!)

PLEASE READ: In addition to the sources listed in the previous section, there are other places you can check, which might have reports (including translated links to local social media in China) that have not yet made the mainstream news media. Please keep in mind that the situation in China is chaotic, and that some of the information you find in the sources I list below might be gossip, rumours, hoaxes, conspiracy theories, misinformation, or disinformation! 

Please review the information and videos I posted in my blogpost about How to Spot Fake News, BEFORE using any of these links.

Stay healthy!

Wuhan Coronavirus/2019-nCoV Update: February 3rd, 2020

Waiting room at a Wuhan hospital, January 24, 2020 (source: Agence France-Presse)

As of noon today, there were 17,491 confirmed cases of patients infected with the 2019-nCoV virus, of which 17,308 were in mainland China. Three hundred and sixty-two people have died, including the first death occurring outside China, in the Philippines.

In a CNBC news report, Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID), said that approximately 25% of Chinese patients require intensive care:

Dr. Anthony Fauci of the National Institutes of Health told CNBC on Monday that a quarter of China’s coronavirus cases require intensive treatment.

“About 25% of them have very serious disease, requiring relatively intensive or really intensive care,” said the director of the NIH’s National Institute of Allergy and Infectious Diseases.

Cases of Wuhan Coronavirus Outside China (source: BBC)
2019-nCoV Global Cases (source)

Today, CNBC News interviewed Dr. Gregory Poland of the Mayo Clinic and Dr. Scott Gottlieb, former administrator of the U.S. FDA about how the United States should be responding to the 2019-nCoV outbreak:

Dr. Gottlieb wants the United States to broaden screening for the Wuhan coronavirus, which is currently only being done by the U.S. Centers for Disease Control. Dr. Poland asserts “we’re basically at a pandemic now”, and agrees that we need better point-of-care diagnostics in hospitals.

Testing to officially confirm the presence of the 2019-nCoV virus is also a bottleneck in many other countries, especially China, where the true number of infected patients is probably much higher than the official counts. The New York Times paints a dire picture of the current situation in Wuhan:

As countries race to deal with an outbreak that has begun spreading around the world, inciting panic and disrupting the global economy, the residents of Wuhan are waging a daily battle to survive an illness that has sickened more than 4,100 people and killed 224 in their city alone.

Last month, the government put Wuhan in a virtual lockdown, sealing off the city and banning most public transportation and private cars from its streets in a desperate effort to contain the outbreak. Now, many residents say it is nearly impossible to get the health care they need to treat — or even diagnose — the coronavirus.

Expressing exasperation, doctors say there is a shortage of testing kits and other medical supplies, and it is not clear why more are not available. The ban on transportation means some residents have to walk for hours to get to hospitals — if they are well enough to make the journey. Layers of bureaucracy stand between residents and help. And the long lines outside hospitals for testing and treatment suggest that the outbreak is spreading far beyond the official count of cases.

Ambulances, too, are hard to come by, residents say. In recent days, some say they have called 120, China’s equivalent of the emergency number 911, only to be told that there were already hundreds of people in the queue.

Those who do make it to the hospital say they are squeezed together for hours in waiting rooms, where infections are easily spread. But the shortages have meant that many are ultimately turned away and sent home to self-quarantine, potentially compounding the outbreak by exposing their families.

Good Sources of Information on 2019-nCoV

Here is my list of good, credible, authoritative resources to learn more about the Wuhan coronoavirus (more formally known as 2019-nCoV):

If you want a quick, up-to-date overview of the current situation, here are three good places to check:

Sources of Fast-Breaking News on 2019-nCoV (WARNING: News You Read Here May Not Be 100% Credible!)

PLEASE READ: In addition to the sources listed in the previous section, there are other places you can check, which might have reports (including translated links to local social media in China) that have not yet made the mainstream news media. Please keep in mind that the situation in China is chaotic, and that some of the information you find in the sources I list below might be gossip, rumours, hoaxes, conspiracy theories, misinformation, or disinformation! 

Please review the information and videos I posted in my blogpost about How to Spot Fake News, BEFORE using any of these links.

Stay healthy!

Editorial: My To-Do List for February

Photo by Glenn Carstens-Peters on Unsplash

I will be taking the entire month of February (four weeks) as vacation time from my paying job as a reference librarian at the University of Manitoba. And I’ve got a lot of things I plan to work on during that time off:

  • I have to work on my 45-minute presentation on Social VR and Libraries, which I will be giving at the 2020 Educators in VR International Summit, being held February 17th-22nd on various social VR platforms: AltspaceVR, ENGAGE, rumii, Mozilla Hubs, and Somnium Space. If you want to catch my presentation, it will be on Saturday, February 22nd, 2020 from 5:00 a.m. to 6:00 a.m. Pacific Time, from the virtual Bodleian Library in ENGAGE and livestreamed to the other platforms—so be sure to get up early and brew some extra-strong coffee to stay awake! 😉
  • I will be teaching myself how to use the Adobe Premiere Pro video-editing software, as I will be taking over from Andrew William as producer and video editor for my show, the Metaverse Newscast, which is currently on hiatus as I work my way up the learning curve.
  • I need to clean my apartment, which is a Red Cross disaster area!
  • I need to continue to prepare for a potential 2019-nCoV pandemic. (And I hope that you are preparing too! Hope for the best, but prepare for the worst.)
  • My blogging will probably be taking a bit of a back seat to these first four tasks, but I will continue to write sponsored blogposts for Sinespace, and I will blog at least one update per day on the rapidly-evolving Wuhan coronavirus/2019-nCoV situation. Click here to read all my previous blogposts about 2019-nCoV. Yes, I am going to try and cover two completely separate topics on my blog!

Welcome to the new normal, where it would seem that everybody needs to learn how to juggle priorities and multitask in the face of competing demands on their time, and factor in unexpected emergencies!

Image by TeroVesalainen from Pixabay

(Yes, I’m also going to find some time to rest, relax, and recharge before I have to go back to work, too.)

Wuhan Coronavirus/2019-nCoV Update: February 2nd, 2020

Photo by Michael Amadeus on Unsplash

Today, The New York Times reports:

The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe, according to many of the world’s leading infectious disease experts.

The prospect is daunting. A pandemic — an ongoing epidemic on two or more continents — may well have global consequences, despite the extraordinary travel restrictions and quarantines now imposed by China and other countries, including the United States.

Scientists do not yet know how lethal the new coronavirus is, however, so there is uncertainty about how much damage a pandemic might cause. But there is growing consensus that the pathogen is readily transmitted between humans.

The Wuhan coronavirus is spreading more like influenza, which is highly transmissible, than like its slow-moving viral cousins, SARS and MERS, scientists have found.

“It’s very, very transmissible, and it almost certainly is going to be a pandemic,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Disease. “But will it be catastrophic? I don’t know.”

…

It is “increasingly unlikely that the virus can be contained,” said Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention who now runs Resolve to Save Lives, a nonprofit devoted to fighting epidemics. “It is therefore likely that it will spread, as flu and other organisms do, but we still don’t know how far, wide or deadly it will be.”

One of the biggest questions about this new virus is how lethal it will be:

The biggest uncertainty now, experts said, is how many people around the world will die. SARS killed about 10 percent of those who got it, and MERS now kills about one of three.

The 1918 “Spanish flu” killed only about 2.5 percent of its victims — but because it infected so many people and medical care was much cruder then, 20 to 50 million died.

By contrast, the highly transmissible H1N1 “swine flu” pandemic of 2009 killed about 285,000, fewer than seasonal flu normally does, and had a relatively low fatality rate, estimated at .02 percent.

The mortality rate for known cases of the Wuhan coronavirus has been running about 2 percent, although that is likely to drop as more tests are done and more mild cases are found.

…

An accurate estimate of the virus’s lethality will not be possible until certain kinds of studies can be done: blood tests to see how many people have antibodies, household studies to learn how often it infects family members, and genetic sequencing to determine whether some strains are more dangerous than others.

Closing borders to highly infectious pathogens never succeeds completely, experts said, because all frontiers are somewhat porous. Nonetheless, closings and rigorous screening may slow the spread, which will buy time for the development of drug treatments and vaccines.

Other important unknowns include who is most at risk, whether coughing or contaminated surfaces are more likely to transmit the virus, how fast the virus can mutate and whether it will fade out when the weather warms.

However, it would appear that some doctors are having some success in treating severe cases of illness caused by the Wuhan coronavirus. Reuters reports that Thai doctors have had some success in treating patients infected with 2019-nCoV using a combination of HIV and influenza drugs:

Thai doctors have seen success in treating severe cases of the new coronavirus with combination of medications for flu and HIV, with initial results showing vast improvement 48 hours after applying the treatment, they said on Sunday.

…

The drug treatment includes a mixture of anti-HIV drugs lopinavir and ritonavir, in combination with flu drug oseltamivir in large doses.

The New York Times article I cited earlier says:

In China, several antiviral drugs are being prescribed. A common combination is pills containing lopinavir and ritonavir with infusions of interferon, a signaling protein that wakes up the immune system.

In the United States, the combination is sold as Kaletra by AbbVie for H.I.V. therapy, and it is relatively expensive. In India, a dozen generic makers produce the drugs at rock-bottom prices for use against H.I.V. in Africa, and their products are W.H.O.-approved.

Another option may be an experimental drug, remdesivir, on which the patent is held by Gilead. The drug has not yet been approved for use against any disease. Nonetheless, there is some evidence that it works against coronaviruses, and Gilead has donated doses to China.

Of course, it is still early days, and a great deal more testing and research needs to be done.

Good Sources of Information on 2019-nCoV

Here is my list of good, credible, authoritative resources to learn more about the Wuhan coronoavirus (more formally known as 2019-nCoV):

If you want a quick, up-to-date overview of the current situation, here are three good places to check:

Sources of Fast-Breaking News on 2019-nCoV (WARNING: News You Read Here May Not Be 100% Credible!)

PLEASE READ: In addition to the sources listed in the previous section, there are other places you can check, which might have reports (including translated links to local social media in China) that have not yet made the mainstream news media. Please keep in mind that the situation in China is chaotic, and that some of the information you find in the sources I list below might be gossip, rumours, hoaxes, conspiracy theories, misinformation, or disinformation! 

Please review the information and videos I posted in my blogpost about How to Spot Fake News, BEFORE using any of these links.

Stay healthy!