Tag: Wuhan Coronavirus

Wuhan Coronavirus/2019-nCoV Update: February 7th, 2020

I took yesterday off from blogging about the 2019-nCoV virus (soon to receive an official name), and I do plan to take more breaks as necessary in the coming days and weeks, as a self-care measure.

Like many of you, I find myself worrying a lot about the current situation, and every so often I need to step away from all the news feeds and focus on other tasks on my “to-do” list for February.

So, don’t expect daily coronavirus updates from here on out.

Spread of the Wuhan coronavirus in mainland China (source: BBC)

Yesterday, The New York Times reported (archived copy) that the Chinese government was taking even more draconian measures to stem the spread of the 2019-nCoV virus at the outbreak’s epicenter in the city of Wuhan:

The Chinese authorities resorted to increasingly extreme measures in Wuhan on Thursday to try to halt the spread of the deadly coronavirus, ordering house-to-house searches, rounding up the sick and warehousing them in enormous quarantine centers.

The urgent, seemingly improvised steps come amid a worsening humanitarian crisis in Wuhan, one exacerbated by tactics that have left this city of 11 million with a death rate from the coronavirus of 4.1 percent as of Thursday — staggeringly higher than the rest of the country’s rate of 0.17 percent.

With the sick being herded into makeshift quarantine camps, with minimal medical care, a growing sense of abandonment and fear has taken hold in Wuhan, fueling the sense that the city and surrounding province of Hubei are being sacrificed for the greater good of China.

The harsh new moves in Wuhan, the epicenter of the outbreak, clearly signaled the ruling Communist Party’s alarm that it had failed to gain control of the coronavirus epidemic, which has overwhelmed the country’s health care system and threatened to paralyze China, the world’s most populous country and second-largest economy.

The steps were announced by the top official leading the country’s response to the virus, Vice Premier Sun Chunlan, as she visited Wuhan on Thursday. They evoked images of the emergency measures taken to combat the 1918 Spanish Flu pandemic that killed tens of millions people worldwide. Despite the severity of the new measures, however, they offered no guarantee of success.

Meanwhile, the number of cases on a cruise ship docked at Yokohama, Japan has reached 61, a testament to how easily the 2019-nCoV virus can be transmitted in close quarters. Among those infected are several Canadian tourists. All passengers on the cruise ship have been confined to their cabins in an attempt to stop further spread of the virus.

CBC interviewed some Canadian passengers in quarantine on the cruise ship:

Passengers from Toronto aboard a cruise ship quarantined off the coast of Japan after a coronavirus outbreak are questioning how they’ll cope for two weeks restricted to cramped cabins.

“We have no window. We have no daylight. They haven’t let us out yet for fresh air,” said Lana Chan.

“We’ve been cooped up in this little room for two and a half days now.”

Chan is travelling with three friends on the Diamond Princess, along with some 3,700 other people. She’s rooming with one of them in a 180-square-foot room in the ship’s interior.

Even worse, the World Health Organization has confirmed that the 14-day quarantine period resets every time a new infected person is found on the cruise ship. Those poor people may be cooped up in their tiny cabins for a long time!

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 5th, 2020

Yesterday, both the U.K. and French governments warned their citizens against travel to China, and advised their citizens already in the country to leave. Canada is now also officially advising Canadian citizens against travel to the whole of China, not just Hubei province (at the 2:18 point of the press conference below), as well as asking those Canadians within the country to leave China as soon as possible:

We can expect to see more such declarations by other nations about travel to and from China, but it remains to be seen whether or not such serious measures will have any significant impact on the spread of the 2019-nCoV virus. Most experts are saying it’s too late to contain the virus.

Today Bloomberg News reports:

Just a couple of weeks ago, scientists held out hope the new coronavirus could be largely contained within China. Now they know its spread can be minimized at best, and governments are planning for the worst.

“It is not a matter of if—it is a matter of when,” said Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security and a spokesman for the Infectious Diseases Society of America. “There is not a doubt this is going to end up in most countries eventually.”

…

Total containment isn’t in the cards, said Nancy Messonnier, director of the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases. “Given the nature of this virus and how it’s spreading, that would be impossible. Our goal is to slow this thing down.”

Measures taken in the U.S. have been criticized in China, where officials said the Americans are stoking fear and overreacting. The CDC responded that it has no choice. The infection is spreading rapidly and humans have no protection against it, Messonnier said. While most cases appear to be mild, the worry is that it will spread to a large number of people and turn deadly in those most vulnerable.

“This is an unprecedented situation and we are taking aggressive measures,” she said. “We are preparing as if this were the next pandemic.”

The Los Angeles Times has issued a similar news report today:

Despite all the colossal efforts to contain the virus, scientists are quietly preparing for a grim — and increasingly likely — outcome: A full-blown global pandemic.

Since the novel virus was isolated in December in the Chinese megacity of Wuhan, the pathogen has reached four continents and infected more than 24,000 people. At least 493 of them have died as a result. With the outbreak continuing to expand, authorities acknowledge that efforts will soon shift from trying to squelch the coronavirus to learning to live with it.

“We’re proceeding as if things go really sour on us in the coming weeks and months,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. “We’re working for the worst-case scenario.”

At this point all the experts are now saying the same thing: that the Wuhan coronavirus will continue to spread worldwide. It cannot be contained, either within the city of Wuhan, the country of China, or the region of south-east Asia. The best that countries outside China can do at this point is to use case isolation and contact tracing to slow down the spread of the virus within their countries, and buy more time in order to prepare. As Dr. Amesh Adalja says above, “It is not a matter of if—it is a matter of when”.

Remember, there is no vaccine against the Wuhan coronavirus, and there is unlikely to be one for at least a year. Also, no one has any natural immunity to the 2019-nCoV virus. Scientists still don’t know what percentage of the people who catch this virus will develop only mild symptoms, and what percentage of infected people will land up in hospital. It has already been reported by Dr. Anthony Fauci of NIAID that approximately one in four people who are hospitalized so far have severe cases, requiring intensive care. No hospital system, anywhere in the world, has enough intensive care beds to deal with a surge of tens of thousands of serious 2019-nCoV cases, as we have already seen in Wuhan, China.

As I have said before, what this means for you, reading this now, is that you need to prepare yourself and your family for the possibility that you will need to stay in your homes for a period of several weeks, avoiding contact with as many other people as possible, as a wave of illness caused by the Wuhan coronavirus sweeps through your community, forcing schools, businesses, and public transportation and public gathering places like movie theatres and shopping malls to close (as we already seen in Wuhan and many other cities in China). The time to prepare for this is NOW.

That means that you need to prepare by stocking up on food and other supplies to last you at least two or three weeks. Start by reviewing the Personal Health Preparedness lists provided by the U.S. Centers for Disease Control and Prevention here.

You will need to have on hand:

  • At least two weeks of food and other supplies (toilet paper, first aid supplies, soap and hand sanitizer, garbage bags, etc.).
  • Refills of all your presecription medications, plus a stock of over-the-counter medicines (talk to your doctor and pharmacist about creating an emergency supply of your prescription medication).
  • Power sources (flashlights, extra batteries, car chargers and adapters for your mobile devices, etc.).

Other things that you should do:

  • Sign up for any local alerts from your city, state/province, or federal government (or know where to find the information on the Internet). Find out what plans your employer is making.
  • If you haven’t yet, get your seasonal flu shot. It can’t hurt, and it will help to figure out whether or not you do have 2019-nCoV if/when you do become sick. Many areas now give out the flu shot for free.
  • Watch the following video from the World Health Organization on how wash your hands! (Yes, I know I have posted it before. Watch if anyways, you might learn something you didn’t know before. Proper hand hygiene will also help you avoid catching regular seasonal colds and influenza, so there’s a net benefit to society.)

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 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!