CORONA Main Coronavirus thread

View: https://twitter.com/a10000footView/status/1231086564681420803


Oye Vey@a10000footView
Replying to @jenniferatntd
12:21 AM · Feb 22, 2020

So it looks like Coronaviruses can survive in urine for 1-2 days at room temperature? What a terrifying thought...

View: https://twitter.com/intricate119/status/1231020076385652739/photo/1

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Friday, February 21, 2020
Today's CDC COVID-19 Briefing - Feb 21st (Audio)

A couple of hours ago the CDC held a teleconference on COVID-19, where Dr. Nancy Messonnier - Director of the National Center for Immunization and Respiratory Diseases - expressed, in no uncertain terms, how concerned the CDC is over COVID-19.

The audio file can be listened to at: CDC Media Telebriefing: Update on COVID-19

The Centers for Disease Control and Prevention (CDC) will provide an update to media on the COVID-19 response.

Friday, February 21, 2020, 12:15 p.m. ET Transcripts | Audio media icon[MP3 – 6 MB]

While COVID-19 isn't a pandemic yet, the CDC is rightfully preparing as if it might become one. And Dr. Meissonier warned that while we aren't seeing community spread in the United States right now, it is `. . . very possible, even likely, that will eventually happen.'

It is well worth your time to listen to the entire 35 minute recording.

At around the 10 minute mark, Dr. Meissonier suggested that everyone read the MMWR Community Mitigation Guidelines to Prevent Pandemic Influenza — United States, 2017, in order to get a good idea of what mitigation might look like in the United States if community spread begins.

This MMWR release is an abbreviated version of a much larger (160 page) pandemic planning document which I blogged about in April of 2017 (see CDC/HHS Community Pandemic Mitigation Plan - 2017).

In two other contemporaneous blogs (see PSAF Is The New Pandemic Severity Index and Community Pandemic Mitigation's Primary Goal : Flattening The Curve) we delved deeper into some of the details.

The goal of community mitigation is to `flatten the curve' by slowing the spread of the virus, in hopes that not everyone falls ill at the same time, which could crash the healthcare system.



Schools may close, perhaps even some businesses, during an epidemic wave. You may be asked to stay home, and avoid crowds. If you are mildly ill, you will probably have to be cared for at home, by your family, not in a hospital.

This is the standing advice from Ready.gov.

Pandemic

Before a Pandemic

• Store a two week supply of water and food.
• Periodically check your regular prescription drugs to ensure a continuous supply in your home.
• Have any nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
• Get copies and maintain electronic versions of health records from doctors, hospitals, pharmacies and other sources and store them, for personal reference. Get help accessing electronic health records.
• Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.

During a Pandemic

• Limit the Spread of Germs and Prevent Infection
• Avoid close contact with people who are sick.
• When you are sick, keep your distance from others to protect them from getting sick too.
• Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
• Washing your hands often will help protect you from germs.
• Avoid touching your eyes, nose or mouth.
• Practice other good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

Additional Resources

About Human Coronavirus (CDC) (link)
www.flu.gov (CDC) (link)
Emergency Preparedness & Response(CDC) (link)
U.S. Department of Health and Human Services (HHS) (link)

While we may still escape the worst of this epidemic, this weekend would be an excellent time to review your individual, family, and/or business pandemic plans. As we've seen the past couple of days in Iran and Italy, community transmission can occur rapidly, and with little warning.

A few past blogs to help you along include:

CDC Interim Guidance For Businesses & Employers On Novel Coronavirus
Does Your Company Have A CPO?
Why NPIs Will Be Our 1st Line Of Defense Against COVID-19
Not Too Soon To Be Thinking About Preparedness
Yes, We Have No Pandemic . . . But Line Up A Flu Buddy Anyway

Posted by Michael Coston at 4:21 PM

Links to this post

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Wuhan woman with no symptoms infects five relatives with coronavirus - study
Julie Steenhuysen
February 21, 2020 / 7:33 PM / Updated 8 hours ago

(Reuters) - A 20-year-old Chinese woman from Wuhan, the epicentre of the coronavirus outbreak, travelled 400 miles(675 km) north to Anyang where she infected five relatives, without ever showing signs of infection, Chinese scientists reported on Friday, offering new evidence that the virus can be spread asymptomatically.

The case study, published in the Journal of the American Medical Association, offered clues about how the coronavirus is spreading, and suggested why it may be difficult to stop.

“Scientists have been asking if you can have this infection and not be ill? The answer is apparently, yes,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Centre, who was not involved in the study.

China has reported a total of 75,567 cases of the virus known as COVID-19 to the World Health Organization (WHO) including 2,239 deaths, and the virus has already spread to 26 countries and territories outside of mainland China.

Researchers have reported sporadic accounts of individuals without any symptoms spreading the virus. What’s different in this study is that it offers a natural lab experiment of sorts, Schaffner said.

“You had this patient from Wuhan where the virus is, travelling to where the virus wasn’t. She remained asymptomatic and infected a bunch of family members and you had a group of physicians who immediately seized on the moment and tested everyone.”

According to the report by Dr. Meiyun Wang of the People’s Hospital of Zhengzhou University and colleagues, the woman travelled from Wuhan to Anyang on Jan. 10 and visited several relatives. When they started getting sick, doctors isolated the woman and tested her for coronavirus. Initially, the young woman tested negative for the virus, but a follow-up test was positive.

All five of her relatives developed COVID-19 pneumonia, but as of Feb. 11, the young woman still had not developed any symptoms, her chest CT remained normal and she had no fever, stomach or respiratory symptoms, such as cough or sore throat.

Scientists in the study said if the findings are replicated, “the prevention of COVID-19 infection could prove challenging.”

Key questions now, Schaffner said, are how often does this kind of transmission occur and when during the asymptomatic period does a person test positive for the virus.

This is the research study referenced in the above article for those who want to read it first hand.

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Research Letter

Presumed Asymptomatic Carrier Transmission of COVID-19
Yan Bai, MD1; Lingsheng Yao, MD2; Tao Wei, MD3; et al Fei Tian, MD4; Dong-Yan Jin, PhD5; Lijuan Chen, PhD1; Meiyun Wang, MD, PhD1
JAMA. Published online February 21, 2020. doi:10.1001/jama.2020.2565


A novel coronavirus has resulted in an ongoing outbreak of viral pneumonia in China.1-3 Person-to-person transmission has been demonstrated,1 but, to our knowledge, transmission of the novel coronavirus that causes coronavirus disease 2019 (COVID-19) from an asymptomatic carrier with normal chest computed tomography (CT) findings has not been reported.

Methods

In January 2020, we enrolled a familial cluster of 5 patients with fever and respiratory symptoms who were admitted to the Fifth People’s Hospital of Anyang, Anyang, China, and 1 asymptomatic family member. This study was approved by the local institutional review board, and written informed consent was obtained from all patients. A detailed analysis of patient records was performed.

All patients underwent chest CT imaging. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) tests for COVID-19 nucleic acid were performed using nasopharyngeal swabs (Novel Coronavirus PCR Fluorescence Diagnostic Kit, BioGerm Medical Biotechnology).

Results

Patient 1 (presumed asymptomatic carrier), a 20-year-old woman, lives in Wuhan and traveled to Anyang on January 10, 2020. She initially met with patients 2 and 3 on January 10. On January 13, she accompanied 5 relatives (patients 2 through 6) to visit another hospitalized relative in Anyang District Hospital (Figure). There was no report of COVID-19 at this hospital. After development of disease in her relatives, patient 1 was isolated and observed. As of February 11, she had no elevated temperature measured or self-reported fever and no gastrointestinal or respiratory symptoms, including cough and sore throat, reported or observed by the physicians. Chest CT images on January 27 and 31 showed no significant abnormalities. Her C-reactive protein level and lymphocyte count were normal (Table). Results of RT-PCR testing were negative on January 26, positive on January 28, and negative on February 5 and 8.

Patients 2 through 6 developed COVID-19. Four were women, and ages ranged from 42 to 57 years. None of the patients had visited Wuhan or been in contact with any other people who had traveled to Wuhan (except patient 1).

Patients 2 through 5 developed fever and respiratory symptoms between January 23 and January 26 and were admitted to the hospital on the same day. All patients had RT-PCR test results positive for COVID-19 within 1 day. Patient 6 developed fever and sore throat on January 17 and went to the local clinic for treatment. There was no report of COVID-19 at the clinic. Her symptoms improved over the next few days but worsened on January 24, when she was admitted to the hospital and confirmed to have COVID-19 on January 26. Two patients developed severe pneumonia; the other infections were moderate.

All symptomatic patients had multifocal ground-glass opacities on chest CT, and 1 also had subsegmental areas of consolidation and fibrosis. All the symptomatic patients had increased C-reactive protein levels and reduced lymphocyte counts (Table).

Discussion

A familial cluster of 5 patients with COVID-19 pneumonia in Anyang, China, had contact before their symptom onset with an asymptomatic family member who had traveled from the epidemic center of Wuhan. The sequence of events suggests that the coronavirus may have been transmitted by the asymptomatic carrier. The incubation period for patient 1 was 19 days, which is long but within the reported range of 0 to 24 days.4 Her first RT-PCR result was negative; false-negative results have been observed related to the quality of the kit, the collected sample, or performance of the test. RT-PCR has been widely deployed in diagnostic virology and has yielded few false-positive outcomes.5 Thus, her second RT-PCR result was unlikely to have been a false-positive and was used to define infection with the coronavirus that causes COVID-19.

One previous study reported an asymptomatic 10-year-old boy with COVID-19 infection, but he had abnormalities on chest CT.6 If the findings in this report of presumed transmission by an asymptomatic carrier are replicated, the prevention of COVID-19 infection would prove challenging. The mechanism by which asymptomatic carriers could acquire and transmit the coronavirus that causes COVID-19 requires further study.

Tokyo postpones training for Olympics volunteers over virus fears
Stanley White
February 21, 2020 / 9:56 PM / Updated 6 hours ago

TOKYO (Reuters) - Organizers for the Tokyo 2020 Summer Olympics have postponed training for volunteers because of the spread of the coronavirus in Japan.

Training was scheduled to be held starting Saturday but will be rescheduled, the organizing committee said in a statement released late Friday.

The postponement of training will not affect other preparations, and organizers are not considering cancelling the games, the statement said.

Japan is facing growing questions about whether it is doing enough to stop the coronavirus, SARS-CoV-2, which emerged in central China late last year and has spread to 24 other countries.

Some investors are starting to worry the epidemic could scupper the Olympics, which are scheduled to start in Tokyo on July 24.

More than 400 Japanese and foreign passengers are set to disembark from the virus-stricken Diamond Princess cruise ship near Tokyo after weeks aboard in quarantine.

More than 600 people on the cruise liner, which has been quarantined off Yokohama since arriving on Feb. 3 carrying 3,700 people, have been infected.

Two of them - both Japanese in their 80s - died on Thursday, and about 100 passengers are set to be transferred ashore in coming days for further quarantine.

Around Japan, more than 80 people have tested positive for the virus, which has killed more than 2,000 in mainland China.

View: https://twitter.com/BoboBichonFrise/status/1231043044109012994

Matt Quinn @BoboBichonFrise
9:28 PM · Feb 21, 2020

2020 Worldwide Tourism: Coronavirus to deal body blow to tourism industry. #coronavirus
Annual revenue:
-Casino $79 billion
-Conventions: $30 billion
-Cruise Industry: $35 billion
-Theme Parks: $29 billion (Disney parks)
-Tokyo Olympics: $7.3 fcst, $26 billion costs

View: https://twitter.com/ghoeberx/status/1231115223635025920

GHoeberX @ghoeberx
2:15 AM · Feb 22, 2020

UPDATE #COVID19


New confirmed cases: +190 (24 hours ago: +74)
Total suspected cases: 5481 (24 hours ago: 2707)

After weeks of reporting only 0 or 1 new cases, the explosion of virus infections in Korea is reality. No end in sight.

View: https://twitter.com/ScottGottliebMD/status/1231078493322018816

Scott Gottlieb, MD @ScottGottliebMD
11:49 PM · Feb 21, 2020

Very detailed #covid19 reporting from South Korean health officials. They have tested, or are awaiting results on, almost 20,000 individuals; demonstrating a significant diagnostic capability. They appear to have a current testing capacity of more than 3,000 cases a day.

View: https://twitter.com/spectatorindex/status/1231112046927761413

The Spectator Index @spectatorindex
2:02 AM · Feb 22, 2020

BREAKING: 18 confirmed cases of coronavirus in Iran, with around another 300 suspected cases.

Article from January. I wonder if they're going to regret the invitation. I don't know if this is where it started, just an interesting coincidence I picked up while going through the twitter feeds.

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'Security is not a problem': Tehran invites Chinese tourists to spend Lunar New Year in Iran
by Joel Gehrke
January 10, 2020 03:55 PM

Iran invited Chinese tourists to visit Tehran, just days after a military confrontation with the United States.

“Rest assured, Chinese friends can spend the New Year holiday in Iran,” the Iranian Embassy in Beijing announced on Friday, referring to China's Jan. 24 Lunar New Year Day. “Security is not a problem.”

Iranian officials coupled the invitation with a boast about the ballistic missile strike against U.S. troops in Iraq. The strike resulted in no casualties but was a high-profile response to the killing of Iranian Gen. Qassem Soleimani. In its online post, Iran reveled in how Chinese social media users denounced the U.S. and supported Tehran. “At this special moment, we deeply feel warm from the comments of Chinese internet users, and we’d like very much to say thank you,” the embassy wrote.

The travel invitation may not bring the desired results, one expert said.

“I don’t think too many Chinese tourists are going to be rushing to Iran after the Iranians downed, or apparently downed, that Ukrainian airline,” James Phillips, a Middle East analyst at the Heritage Foundation, told the Washington Examiner.

Iran denies responsibility for the incident, saying that the Ukrainian International Airlines jet crashed shortly after take-off from Tehran as a result of a mechanical failure. Western officials believe it was shot down by mistake. The plane carried 176 people, including more than 80 Iranians and dozens of Canadian citizens.

Still, the embassy's invitation underscores how Iran and China cooperate on the international stage, especially when given the chance to align against the U.S.. “We have delivered a slap in the face to the US’s military adventurism,” the Iranian embassy tweeted. “We have also exercised the utmost restraint.”

The tourism bid came just weeks after a joint naval exercise last month involving China, Russia, and Iran. Analysts caution, though, against reading too much into the theatrics.

“The Chinese are very calculating about their global interests,” Jon Alterman, director of the Middle East Program at the Center for Strategic and International Studies, told the Washington Examiner. “And while China is central to Iran, Iran is an afterthought to China.”

Merde....

South Korea numbers just jumped again, now at 433 total; plus more Diamond Princess passengers turning up positive for coronavirus only after they got home - to Australia this time. Yay.

Coronavirus outbreak: South Korea clusters drives huge jump in cases
Patients and staff at a hospital near Daegu account for bulk of 229 new cases as links to controversial ‘sect’ are investigated
Martin Farrer and agencies

Sat 22 Feb 2020 18.54 AEDT First published on Sat 22 Feb 2020 12.45 AEDT


South Korea has reported another huge jump in cases of coronavirus as the country fights to contain the spread of the deadly disease.

The number of infections has increased by 229 to 433, officials said on Saturday, with most of the cases linked to the city of Daegu and surrounding region two hours south of Seoul.

A 61-year-old woman in Daegu is believed to be at the heart of the rapid spread and is thought to have passed the infection to dozens, and possibly even hundreds, of fellow worshippers at the controversial Shincheonji Church of Jesus.
Of the new cases announced on Saturday, 92 have been traced to patients or staff at Cheongdo Daenam hospital near Daegu. “Most of the hospital’s patients who have been diagnosed are those who had been staying as inpatients for mental illnesses,” Seoul’s vice health minister, Kim Gang-lip, told a media briefing.

The area is, however, closely connected to the Shincheonji Church of Jesus. It is the birthplace of its founder, Lee Man-hee, who has donned the mantle of Jesus Christ and claims that he will take 144,000 people with him to Heaven, body and soul, on the Day of Judgement.

County officials said on Friday that a three-day funeral was held for Lee’s brother three weeks ago at a hall owned by the hospital.

South Korea’s president, Moon Jae-in, on Friday called for a “thorough investigation” of everyone who attended the funeral and Shincheonji services.

Kim said on Saturday that the outbreak had entered a serious new phase, but still expressed cautious optimism that it could be contained to the region surrounding Daegu, where the first case was reported on Tuesday.

By Saturday morning, the city of 2.5 million and nearby areas counted 283 cases, including South Korea’s first two fatalities in the Cheongdo hospital.

The central government has declared the area as a special management zone and is channeling support to ease a shortage in hospital beds, medical personnel and equipment.

“Although we are beginning to see some more cases nationwide, infections are still sporadic outside of the special management zone of Daegu and North Gyeongsang province,” Kim said during a briefing. He called for strong border controls to prevent infections from China and elsewhere from entering South Korea.

Cases in South Korea have risen elevenfold since the 61-year-old woman became the 31st case recorded by the Korean centers for disease control and prevention on Tuesday. She had not travelled overseas recently, officials said.

Busan, South Korea’s second biggest city, recorded its first two cases on Friday. Several cases have been confirmed in Seoul although the source of infections – what scientists call the index case – has not been traced.

Daegu is on full alert against the spread of the virus and has closed public buildings and delayed the start of the school term by a week. Its usually busy streets have been brought to a standstill. The exception was supermarkets where residents have been queueing to buy food and other supplies. Troops at South Korean and US military bases have been confined to barracks.

“Panic is taking hold,” Daegu resident Huh Mi-yeon told Associated Press. “People are scared of any situation where they would run into another person.”

In China, the national health commission said on Saturday that there were 397 new confirmed cases of coronavirus infections on Friday, down from 889 cases a day earlier.

That brings the total accumulated number of confirmed cases in mainland China so far to 76,288. The death toll in mainland China had reached 2,345 as of the end of Friday.

The central province of Hubei, the epicentre of the outbreak, reported 106 new deaths, while in the provincial capital of Wuhan 90 people died.

President Xi Jinping has, meanwhile, written a letter expressing thanks to the Bill & Melinda Gates Foundation for the organisation’s support in this month committing up to $100m for the global response to coronavirus, the official Xinhua news agency said on Saturday. “I deeply appreciate the act of generosity … and your letter of solidarity to the Chinese people at such an important moment,” Xi wrote.

Millions of people in China remain confined to their homes as the government tries to contain the spread of the virus, raising serious concerns about economy.

But Liu Guoqiang, deputy governor of the People’s Bank of China, said on Saturday that borrowing costs would be guided downwards to help businesses stay afloat and that the impact of the virus would be “limited”.

As the World Health Organization warned on Friday that the window of opportunity to stop the spread of the virus was narrowing, it appeared to be spreading more widely across the world. Four people have now died from the virus in Iran and Italy recorded its first fatal case on Friday night.

The British government said that an evacuation flight had left Japan on Saturday morning with 32 British and European passengers from the ship on board, as well as British government and medical staff.

The organisers of the Tokyo 2020 Olympic Games postponed training for their army of volunteers on Saturday due to the coronavirus outbreak, but said that there was “no consideration” of cancelling the Games.

Some 100 passengers who were in close contact with infected people on board began disembarking from the coronavirus-stricken Diamond Princess cruise ship in Yokohama on Saturday, local media said.

They included the last batch of Japanese passengers to leave the ship while some foreign passengers were still waiting on board for chartered aircraft to be sent by their governments. Around 970 passengers disembarked earlier this week, including Britons who are expected to arrive back in the UK on Saturday.

In Australia, six people evacuated back to Darwin from the Diamond Princess cruise ship in Japan have tested positive to Covid-19. Another three people who have developed symptoms were being tested on Saturday.

There were 170 Australians on the evacuation flight and all were checked for symptoms before leaving Yokohama, where they had been kept on the ship.
Reuters, AFP and Associated Press contributed to this report.

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mzkitty said:

Couldn't sleep yet. Caught up the last few pages. Wow. Gettin' real spooky out there now.



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You know why: They Want To Kill Us All:

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Next up, India. Or California:

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I believe the bases were meant for quarantine of otherwise healthy people while they waited- not sick people. The people they need to quarantine now have tested positive and must be medically treated. They are likely moving them to an interim facility where they can provide mass treatment, yet where it is closer to a larger hospital with a negative pressure facility for very serious cases.

There has also been talk about evacuating Armed Services families from S. Korea. They will need a place for them to quarantine before they are released.

jward said:

Health officials worry as untraceable virus clusters emerge

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Ok, that's funny. Maybe it's me.

marsh said:

They are likely moving them to an interim facility where they can provide mass treatment, yet where it is closer to a larger hospital with a negative pressure facility for very serious cases.

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Don't see the severity of the case matters, just whether the patient is shedding contagions. Did you mean a facility with respirators?

HD posted about C-19 can be in urine 1-2 days.

A few days ago when the CT scan pictures of the virus being in the testes, It was assumed that by using the urinals the droplets from others can go up thru the urethal into the testes and then the kidneys.

The doctors in China working 14 hrs. wore 1 diaper during that time, as to not expose themselves.

Negative room pressure is an isolation technique used in hospitals and medical centers to prevent cross-contaminations from room to room. It includes a ventilation that generates negative pressure to allow air to flow into the isolation room but not escape from the room, as air will naturally flow from areas with higher pressure to areas with lower pressure, thereby preventing contaminated air from escaping the room. This technique is used to isolate patients with airborne contagious diseases such as tuberculosis, measles, or chickenpox.

Luddite said:

Don't see the severity of the case matters, just whether the patient is shedding contagions. Did you mean a facility with respirators?

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Yes. If they need greater care than at home or "skilled nursing," they would have to go to the hospital (into a negative pressure room to prevent contagion) for that treatment (like a respirator.)

I think these cases are now state cases, not federal. This would be how the state of CA is going to handle this group's care - sort of like a tb facility. Otherwise, they would be sent back to their individual homes and each County Public Health and city's nearest appropriate level facility would have to deal with any bad cases. At this point, they probably want to control and ensure isolation of infectious people to hope they don't become community clusters spread all over.

That they are being sent to Costa Mesa likely means they are mostly southern CA people. (Just a guess.)

CnMO said:

HD posted about C-19 can be in urine 1-2 days.

A few days ago when the CT scan pictures of the virus being in the testes, It was assumed that by using the urinals the droplets from others can go up thru the urethal into the testes and then the kidneys.

The doctors in China working 14 hrs. wore 1 diaper during that time, as to not expose themselves.

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Do we have to worry about sterility in our younger generations?

Singapore ‘idiot’s guide’ to coronavirus crisis control: don’t do it like Hong Kong

Yonden Lhatoo strongly recommends listening to the recent rant by the city state’s trade minister, against panic-stricken citizens snapping up masks and stockpiling essential goods when there is no need to



If you haven’t yet heard that leaked audio clip of Singaporean Trade and Industry Minister Chan Chun Sing’s recent rant against “idiots” panic buying masks and stripping store shelves of daily essentials such as rice, noodles and toilet paper, I cannot recommend it enough.

It’s an appeal to common sense and a lament for the lack of it, as well as a contemptuous rebuke to mass hysteria, mob mentality and selfish, irrational behaviour triggered by the coronavirus crisis. And it’s all delivered in classic Singaporean style – thickly accented, punctuated regularly with Singlish slang, and simultaneously crude, hilarious and on point.

Chan explains his government’s initial decision to distribute four masks to every household as taking a “gamble to calm the nerves”, rather than a supreme necessity and right for each citizen.

“But to issue four to every family, I burn another 5 million masks from my limited stockpile. When China now asks for masks, right, China is burning at a rate of hundreds of millions a day. Which country, and even which production line, can meet China’s needs? Cannot, right?”

Hong Kong Chief Executive Carrie Lam Cheng Yuet-ngor’s handling of the crisis provides a handy guide for Chan on how not to do it, otherwise “I can guarantee you today our hospital system would have broken down”.


“If we issue surgical masks and give everybody surgical masks just to make them feel shiok shiok [immensely satisfied] because they say Carrie Lam wear mask, right? At the conference, right? Ah today you see newspaper. What is happening to Hong Kong now? What did South China Morning Post report about Hong Kong? They are down to less than one month’s supply of masks for their medical people. Which means that when the medical people don’t even get masks, you think they dare to go and take care of the sick people?”

He goes on to lambast Singaporeans stockpiling everything from masks and alcohol swabs to rice and even condoms, go figure.


“Actually, ah, this one, ah, I’m damn ashamed. You know why? Sia suay. I don’t know how to say in English. Eh, in English sia suay called what? We embarrass ourselves. Disgraceful. We disgrace ourselves. Don’t say Third World lah; Third World also some people quite nice one.”


Some delicious irony and sarcasm is reserved for those who have been hoarding bags of rice.

“Rice, since 1970, ah, we’ve been stockpiling. In fact I can tell you, ah, I’m very happy now. Finally got people turn over my rice stockpile ... So now, ah ... you buy all fresh stock. Because all the suckers have bought the old stock.”


On a more serious note, Chan stresses the need to position and plan ahead for a post-coronavirus economic recovery.

“I can tell you, Hong Kong, they’re not thinking about this because [they’re thinking about] only here and now.”

He boils it down to brass tacks for his own city: “Just a small group of people behaving like idiots like that, ah, will kill all of us ... Every country can behave like idiots. Singaporeans cannot behave like idiots.

Well, neither can we in Hong Kong. But who’s going to explain that to all the fine folks filling up their tiny flats with rolls of toilet paper and boxes of tissue stacked from floor to ceiling?

“You stock rice, stock noodles, I can tahan [tolerate], ah. Then why stock toilet paper? If you eat all the rice and instant noodles you confirm diarrhoea. You explain to me, lah. Then why Hong Kong people stock toilet paper? Because monkey see, monkey do.”

We could use a scolding like that to set us straight in Hong Kong, but it would require someone with the stomach for it as well as the trust and mandate of the people to pull it off. There’s no one like that here.


Yonden Lhatoo is the chief news editor at the Post

S. Korea's virus cases surge to 433 on church services, cluster outbreak at hospital

SEOUL, Feb. 22 (Yonhap) -- South Korea reported 229 new cases of the new coronavirus on Saturday, the largest spike in a single day since its first outbreak in late January, bringing the total number of infections in the nation to 433.

The number of COVID-19 infections here has soared in the past few days, with most infections traced to a hospital in the southeastern county of Cheongdo and a minor Christian sect in the southeastern city of Daegu, which constitute some 80 percent of the total infections here.

Daegu, where the 2.5 million inhabitants have been asked to stay indoors, and neighboring Cheongdo were designated as a "special management zone" on Friday.

Of the 229 new cases, 95 are related to Daenam Hospital in Cheongdo, where South Korea's first coronavirus fatality occurred, the Korea Centers for Disease Control and Prevention (KCDC) said.

A 63-year-old man, who died of pneumonia at the hospital on Wednesday, posthumously tested positive for the virus.

On Friday, another patient died from the coronavirus at a hospital in Busan after being transferred from Daenam Hospital, the second death from the virus in South Korea.

The public health agency said 62 new cases are tied to the minor Christian sect known as Shincheonji in Daegu, about 300 kilometers southeast of Seoul, and neighboring North Gyeongsang Province and other areas.

So far, a total of 114 virus cases -- nine hospital staff and 102 patients -- have been reported from Daenam Hospital, and so-called cohort isolation, the shutdown of an entire medical institution to prevent the spread of an infectious disease, was in place for the hospital, according to the health authorities.

The health authorities said 231 virus patients have been traced to the Shincheonji church's services in Daegu, according to the KCDC.

The KCDC said it has placed a total of 9,336 Shincheonji members in self-quarantine. Among them, 544 people suspected of having contracted the virus are being tested for the virus.

The country's 31st patient, a probable "super spreader," had attended the church's worship services in Daegu, and the 61-year-old South Korean woman, who tested positive for the virus earlier this week, is believed to have infected others.

But the health authorities said earlier that it is uncertain whether the patient is the source of the cluster outbreak.

The health authorities vowed to make more containment efforts as the potentially fatal illness spreads fast across the country.

The heath ministry said it will allow hospitals to separate respiratory patients from others in an effort to prevent human-to-human transmissions and will also check all pneumonia patients in Daegu hospitals.

Despite the surge in the number of infections here, the authorities said they will maintain the virus alert at the third-highest, or "orange," level, but the virus response will be carried out with an urgency appropriate to the "red" level.

"Community spread of infections began in some limited areas, and we believe that Daegu and North Gyeongsang Province are in a special situation," Vice Health and Welfare Minister Kim Kang-lip told reporters on Saturday.

In a sign that the virus may further spread nationwide, other provinces, including Jeju, Chungcheong and North Jeolla, reported cases. Gyeonggi Province also reported more new cases.

Four virus cases were reported in Busan, South Korea's second-largest city with a population of 3.4 million, the first cases in the city since the country reported the first case of COVID-19 on Jan. 20.

So far, South Korea has released 18 fully recovered novel coronavirus patients from hospitals, the KCDC said.

The number of people being checked for the virus and under quarantine came to 6,037 up from 5,481 on Saturday morning, KCDC said. The country has tested a total of 21,153 suspected cases, with 15,116 testing negative.

Most virus-infected patients are stable, but about nine patients with underlying illnesses are in relatively critical conditions, the health authorities said.

entropy@yna.co.kr

Japan confirms 14 more virus cases; school to be closed for 2 days
TOKYO

Japanese government officials confirmed 14 new cases of the coronavirus on Saturday as public health authorities struggle to contain a global epidemic.

Among the cases was a junior high school teacher in Chiba Prefecture just east of Tokyo, who went to work even though she had symptoms, raising fears the virus could spread among her students and co-workers.

In Hokkaido, a boy less than 10 years old was added to the list. On Friday, two brothers in an elementary school in Hokkaido were confirmed infected.

Children had been thought to possibly be less vulnerable to the new virus, with far fewer reported infections in much younger people.

Japan's government is facing growing questions about whether it is doing enough to stop the spread of the coronavirus as Tokyo prepares to host the 2020 Summer Olympics in July.

In Japan, more than 100 people have now tested positive for the flu-like illness, which has killed more than 2,300 in mainland China, where it emerged in the central Chinese city of Wuhan late last year.

In addition, more than 600 cases have also been reported on the Diamond Princess cruise ship that has been quarantined off Yokohama for more than two weeks.

Passengers who are not ill continued to leave the ship on Saturday, domestic media reported, but uncertainty is high due to concerns that quarantine procedures on the ship were not adequate.

Of the new cases reported on Saturday, eight were in Hokkaido, according to the prefectural government's web site, two were in Chiba Prefecture, one was in Tokyo, and another in Wakayama Prefecture in western Japan.

Two more cases, a man in his 60s and a man in his 50s, were also confirmed in Kumamoto prefecture in southern Japan.
The junior high school teacher in Chiba, in her 60s, first showed symptoms on Feb 12 and was hospitalised on Feb 19, according to media. She went to work while she had symptoms, so the local government will close her school for two days from Feb 25.

The second case was a woman in her 30s, also in Chiba prefecture, who has been hospitalised but is not showing any symptoms, the prefectural government official said.

There is no relationship between the two women and it is uncertain how either of them got the virus, the official said.

More than 200 cruise ship port calls in Japan canceled amid coronavirus outbreak

More than 200 port calls by international cruise ships have been canceled since the beginning of February because of the coronavirus outbreak, a survey showed Saturday.

The cancellation of so many visits is likely to incur losses of several billion yen, an industry body said, noting that passengers are estimated to collectively spend an average of 30 million to ¥40 million ($270,000 to $360,000) at each port.

The Kyodo News survey of governments hosting Japan’s top 10 ports for cruise ships found that at least 206 visits had been canceled as of Friday, with the figure is expected to grow through the rest of the year.

Among the 10 ports, Osaka has seen the largest number of cancellations at 37, followed by Hakata at 31 and Naha in Okinawa Prefecture at 25.

By month, 121 port calls for February have been dropped, along with 53 for March, 23 for April and nine planned for May through December.

In most cases, operators of international cruise ships notified Japanese ports that the scheduled tours had been called off.

The number of canceled calls accounts for about 16 percent of 1,305 visits at the 10 ports last year. Given that demand for port calls by international cruise ships usually peaks in summer, the fallout on tourism from the virus outbreak remains uncertain.

The city of Osaka’s port bureau said it has been notified almost daily of port call cancellations for March and April.

“It’s very unusual to receive cancellations one after another like this,” said an official at the bureau, which controls Osaka’s port. “We are worried whether the impact will drag on into the summer.”

Will Worldwide Drug Shortages Result from Coronavirus Chaos?

Is there a possibility of worldwide drug shortages? China makes key ingredients for many critical pharmaceuticals. Are we prepared for drug disruptions?

No one yet knows the consequences of the coronavirus “Global Health Emergency.” That’s what the World Health Organization now calls it. When we first wrote about this epidemic on Jan. 27, 2020, there were less than 3,000 cases and fewer than 100 deaths. Three days later (Jan. 30, 2020), there were 8,200 cases and more than 200 deaths. On Feb. 1, 2020, the number of cases exceeded 12,000 and deaths were approaching 300. By Monday, Feb. 3, 2020, the case count was over 17,000 and deaths were over 360. All but one of the deaths took place in China. Many planes have stopped flying into or out of China. This coronavirus chaos could lead to worldwide drug shortages! Could that become a health catastrophe quite separate from the prospect of rapid transmission of the virus?



Why Might There Be Worldwide Drug Shortages?

Consider this. China is a major supplier of active pharmaceutical ingredients (APIs) throughout the world. What is an API you might ask? An API is the key ingredient (raw material) in any medication. Take the brand name antidepressant Prozac. The active pharmaceutical ingredient is fluoxetine (the generic drug name). Its chemical name is N-methyl-3-phenyl-3-[(α,α,α-trifluoro-p-tolyl)oxy]propylamine hydrochloride. Yes, that is a mouthful.

Here is the molecular formula of fluoxetine hydrochloride: C17H18F3NO•HCl

There are almost always “inactive” ingredients in the pill or capsule along with the API. These are called excipients. They include binders, fillers, colors, etc.

In addition to APIs, China makes finished pills and ships them around the world. China also sells active pharmaceutical ingredients to generic drug makers in India and other countries. It has been estimated that pharmaceutical companies in India rely on China for 70 to 75% of the APIs that are used there to manufacture finished drug products.


What About Tariffs on China?

You may remember that the United States imposed significant tariffs on a tremendous number of Chinese products. Why, might you ask, were “pharmaceuticals, certain pharmaceutical inputs, and select medical goods” excluded?

Some insiders speculate that tariffs on pharmaceuticals might have disrupted the pharmaceutical supply chain in the United States. Whatever the reason, pharmaceuticals were excluded from embargoes or tariffs.


What Would Happen If APIs Stopped Flowing from China?

At this early stage in the coronavirus epidemic, no one knows if we are facing worldwide drug shortages. What we do know is that most airplane traffic into and out of China has been restricted if not suspended. Whether that applies to pharmaceuticals we don’t know.

We suspect the same thing is happening to other forms of transportation, including shipping. That could mean that Chinese APIs and pharmaceuticals are no longer flowing smoothly to India, Thailand, Brazil, Slovakia or the U.S. A colleague is on the ground in India. He carefully monitors Indian drug manufacturing issues. Today he told me that:

“I am already seeing some panic among drug formulation manufacturers about significant disruptions in their supply chain.”

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Worldwide Drug Shortages Already Exist:

Drug shortages are nothing new. Even before the coronavirus chaos, health professionals have been dealing with worldwide drug shortages. The FDA sends out a list of drug shortages almost every week. Here is a link to the most recent list.

You will see that the frequently prescribed blood pressure pill diltiazem is on that list. So is the life-saving injection, epinephrine. The injectable anesthetic drug ketamine is also “currently in shortage.” The anti-seizure medicine for epilepsy, levetiracetam, is in the same situation.

Worldwide drug shortages are already a crisis. All the FDA can do is list drug shortages on its website. The agency has no solution for existing shortages of critical medicines.

If the coronavirus epidemic leads to massive shortages in APIs, then worldwide drug shortages are sure to follow. You may want to stock up on critical medicines before we discover that this nightmare is actually unfolding.


Is the Coronavirus Chaos All a Tempest in a Teapot?

Many readers of our newsletter think the coronavirus scare is much ado about nothing. Here are just a few comments in response to our recent article:

Coronavirus Freak Out: Is It Justified or Overblown?
Coronavirus is capturing headlines. The World Health Organization just declared it a global health emergency. Is the coronavirus freak out justified?

Comments From Readers On Jan. 31, 2020:
Pam says:

“The media hype will continue, no matter what. It’s too bad we never know when to believe them.”

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Judi suggests that a positive attitude is the answer:

“When you dwell in fear you attract what it is that you fear. Eat healthy, think positive and enjoy your life.”

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Linda seems to imply the China virus story is fake news and links to a blog by Jon Rappoport that says in part:

“You automatically believe this Chinese coronavirus is a killer? You automatically believe the press when they ratchet up the fear? You automatically believe medical experts have found a virus and proved it’s causing human illness?
“You’re on the Gong Show on roller skates.”

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Lyn, on the other hand, is concerned:

“The CDC and NIH are in denial, while the WHO has declared a Global Health Emergency. It would behoove people to take precautionary measures and stay out of harm’s way, as I feel this is just the tip of the iceberg where the coronavirus is concerned. I hope that it doesn’t turn into a pandemic.”

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Are There Any Valid Scientific Projections About Coronavirus?
An intriguing article appeared in the highly credible medical journal, The Lancet (Jan. 31, 2020).

This research represents a modeling study based on available data:

“Authors caution that given the lack of a robust and detailed timeline of records of suspected, probable, and confirmed cases and close contacts, the true size of the epidemic and its pandemic potential remains unclear.”

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That said, here are their projections about the new coronavirus (2019-nCoV):

“In our baseline scenario, we estimated that the basic reproductive number for 2019-nCoV was 2·68 and that 75,815 individuals have been infected in Wuhan as of Jan 25, 2020. The epidemic doubling time was 6·4 days.”

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The researchers conclude:

“In this study, we have estimated the outbreak size of 2019-nCoV thus far in Wuhan and the probable extent of disease spread to other cities domestically. Our findings suggest that independent self-sustaining human-to-human spread is already present in multiple major Chinese cities, many of which are global transport hubs with huge numbers of both inbound and outbound passengers (eg, Beijing, Shanghai, Guangzhou, and Shenzhen).

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“Therefore, in the absence of substantial public health interventions that are immediately applied, further international seeding and subsequent local establishment of epidemics might become inevitable. On the present trajectory, 2019-nCoV could be about to become a global epidemic in the absence of mitigation.”

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The People’s Pharmacy Perspective:
The next few weeks will be critical in determining the extent of this epidemic. If the number of people infected with the coronavirus was actually 75,815 on January 25, 2020, instead of the official Chinese report of under 3,000, we could be in for a disaster of untold dimensions.

We certainly hope that the number of cases of coronavirus infection in China begin to taper off. If that does not happen, however, we would encourage people who must take essential medications to make sure they have an ample supply on hand. If a prescription is about to run out, this might be a good time to contact the pharmacy or physician and get a refill.

Share your thoughts about the possibility of worldwide drug shortages in the comment section below.

raven said:

well, more importantly I asked my girl friend what she would do.
She said "wait till he was asleep and smother him with a pillow"
So, tomorrow I am gonna throw the pillows away.

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vestige said:

Read the article at the link. Deceased was named Shen (I think). Possibly language barrier involved but... "unintelligible"... died... influenza...

Getting difficult to keep up.

Going to get a lot harder to keep up.

By tax day we will be like the Chinese woman at the funeral home/crematorium.

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I certainly hope not! I'll never forget that woman. But 90% of the United-states be be like her, and since we have guns and road rage and so on, it could get quite sporty in the States.

pops88 said:

This is what I'd do. Something I've considered often when dealing with situations requiring patience and sanity-
RT 3:46

View: https://www.youtube.com/watch?v=rVVGwJLGipA

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I think I'm gonna need you all to help me get that into my tiny efficiency apartment. That said, thank you very much for posting that, that made my morning.

Good info on elderberries and mega doses of vit. C.

Old Gray Mare said:

According to Scotty the coronavirus is shutting down car production world wide. The info on the coronavirus is in the first minute or two.

Fair use,
Worldwide Car Production is Shutting Down (Buy a New Car While You Still Can)
•Feb 21, 2020


Scotty Kilmer

Worldwide Car Production is Shutting Down (Buy a New Car While You Still Can), DIY and car repair with Scotty Kilmer. New car buying. Car manufacturers are having problems making new cars.. Car companies shutting down. Buying a new car. Car Advice. DIY car repair with Scotty Kilmer, an auto mechanic for the last 52 years.

Link to source:

View: https://www.youtube.com/watch?v=NaxpZfcmRQc

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So perhaps we should rename this the Corolla virus. That said, some deep Trivia here, Toyota used to make a Corona Sedan...

shane said:

Buy a new set of tires while you still can, stow them away if you don't need them right now.
Most tires come from china and region around there and those that don't won't be cheap if
even not in shortage, too. Antifreeze, oil filters, etc. also...

Panic Early, Beat the Rush!
- Shane

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Antifreeze! Hadn't thought about that. I've gotten some of the other stuff, and will probably also get a battery. When I was it auto zone common none of the battery said where they came from come on but probably China. I have to work today but early this evening I'm gonna go and see that the other cars parts stores if they have batteries with 'made in' stamped on them somewhere.

Just a thought.

I belong to a volunteer organization that trains us for medical emergencies. I know a little bit, not a lot, but enough to actually be excited by these changes. Not happy, but excited.

I met an elder with bleach, masks, and gloves in a shopping cart. I asked if elder was getting ready for the virus. Elder was startled and a little hesitant to talk about it with a total stranger. A smiling total stranger.

I identified my organization and told a little about what we do. Praised elder for being proactive with the purchases. Asked elder to consider the FEMA recommendation to stock up with three weeks of non-perishable food.

Elder hadn't thought of food. FEMA really does recommend three weeks. Or maybe that's DHS. Anyway, we had to part ways, but we agreed to meet again soon to go over more safety tips for pandemic.

No gloom and doom. Cheerful. Positive. Thoughtful. That's the way to talk to others to get them to listen. It makes them believe that they really can manage themselves, and that's important.

Went to our local Walgreens last night. Every single mask is gone from their shelves. The health employee person I talked to said all are on back order but she “thinks” a delivery truck is on the way.

Old Gray Mare said:

At one time were pressure canners used as autoclaves? I don't know for how long or at what pound of pressure? I don't think they would destroy prions.

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Sorry aboutthedelay...

12 minutes...15 pounds...SLOW cooldown.

Doc1 said:

This is NOT a reason to buy a new car now. You shouldn't want a new vehicle that has spare parts problem right out of the door! As I've said many times in these pages, buy a classic American car or truck from the '60s or (early) '70s. Yu can go a little older, but by and large parts become scarcer as you go back. There's no problem finding rebuilt or new parts for '60s and '70s (common) US vehicles. I could go on with endless recommendations for specific vehicles, but I'll throw out an example which shouldn't be too expensive. Try a 1974 Chevy or GMC half ton pickup with a straight six and a three or four speed manual transmission. Everything is available and inexpensive.

Best
Doc

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besides that, there are going to be plenty of low mileage used cars available in just a few months. market will be flooded and they will be cheap.

raven said:

besides that, there are going to be plenty of low mileage used cars available in just a few months. market will be flooded and they will be cheap.

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Raven, as I said earlier on this thread, I bow before your dark wit.

Hogwrench said:

Negative room pressure is an isolation technique used in hospitals and medical centers to prevent cross-contaminations from room to room. It includes a ventilation that generates negative pressure to allow air to flow into the isolation room but not escape from the room, as air will naturally flow from areas with higher pressure to areas with lower pressure, thereby preventing contaminated air from escaping the room. This technique is used to isolate patients with airborne contagious diseases such as tuberculosis, measles, or chickenpox.

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The hospital in the city closest to me has a few such rooms. Their pandemic plan is to use large fans to make one or more floors of the hospital in negative pressure areas to treat very large numbers of sick.

Thanks

Heliobas Disciple said:

https://twitter.com/i/web/status/1231112046927761413

View: https://twitter.com/spectatorindex/status/1231112046927761413

The Spectator Index @spectatorindex
2:02 AM · Feb 22, 2020

BREAKING: 18 confirmed cases of coronavirus in Iran, with around another 300 suspected cases.

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Heliobas Disciple said:

https://twitter.com/i/web/status/1231112046927761413

View: https://twitter.com/spectatorindex/status/1231112046927761413

The Spectator Index @spectatorindex
2:02 AM · Feb 22, 2020

BREAKING: 18 confirmed cases of coronavirus in Iran, with around another 300 suspected cases.

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This is blowing my mind What the actual F*** is our CDC doing Iran can test more people than we can

helen said:

Just a thought.

I belong to a volunteer organization that trains us for medical emergencies. I know a little bit, not a lot, but enough to actually be excited by these changes. Not happy, but excited.

I met an elder with bleach, masks, and gloves in a shopping cart. I asked if elder was getting ready for the virus. Elder was startled and a little hesitant to talk about it with a total stranger. A smiling total stranger.

I identified my organization and told a little about what we do. Praised elder for being proactive with the purchases. Asked elder to consider the FEMA recommendation to stock up with three weeks of non-perishable food.

Elder hadn't thought of food. FEMA really does recommend three weeks. Or maybe that's DHS. Anyway, we had to part ways, but we agreed to meet again soon to go over more safety tips for pandemic.

No gloom and doom. Cheerful. Positive. Thoughtful. That's the way to talk to others to get them to listen. It makes them believe that they really can manage themselves, and that's important.

Click to expand...

Way to go and you may have just saved not only the elder's life but their family members as well.

The food and supplies are useful even if they never have to isolate and during the Black Death and in 1918 many people died needlessly not of the bacteria or the virus, but because they ran out of food, clean water or caregivers (elderly, disabled, small children).

I'm not sure how we award trophies on the board (or if that just happens) but you should get one!

Dr. John says this is a video he doesn't want to make and now calling it the opening stages of a global pandemic.

View: https://youtu.be/VasccCzr2TY

RT 11 minutes

It all gets weirder, and weirder by the day.

Doesn’t it(?)