New COVID-19 cases reported across Japan | Hacker News Reader

New COVID-19 cases reported across Japan

japantimes.co.jp

148 pointsfspeech206 comments

WHO daily sitreps provide very clear stats on transmission outside China. The latest one for Feb 17: https://www.who.int/docs/default-source/coronaviruse/situati...

Japan (excluding the cruise ship): 59 confirmed cases (6 new), 26 cases with travel history to China, 33 cases (6 new) without (what they call “with possible or confirmed transmission outside China”).

Sadly I can upvote you once. This link should be the top comment on any thread about the Corona outbreak.

Another great resource is this map: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h... put together by John Hopkins University.

I learned about that one on HN, agree, it's a great resource as well!

Semi-related, but the map surprised me. In my euro-centric world most maps I see have Europe at the center with the US at the left. Took me a second to realize the US was actually on there. :)

Kind of like looking at British D-Day maps. They show France at the top, so upside down! But they are driving on the wrong side of the road, so...

You have any examples of that? Feels like it could be a urban legend and searching for "British D-Day maps" on Google Images show all the maps with France being below UK.

Not at hand, but way back the day I saw some in old books covering D-Day. My uncle had one lying around where it was shown this way, no idea what the title was. But I remember it, I always turned it upside down to understand the map and then back again to read the text.

Not sure if that was something that was down after the war or already during d-day, so.

Similarly, in the US, world maps also usually (or at least "often enough that it doesn't look weird to me") put the Americas in the center.

Splitting down the Atlantic is normal in much of the world, possibly even the majority by population.

Semi-related, here is a map of Japan: U+1F5FE

It is the only country that has a map in unicode afaik

(and HN does not support unicode?)

The chart showing cases outside China by date of onset of symptoms (Figure 2) looks reasonably reassuring: the peak seems to have remained in the same place (the end of January) for a week or so now.

On the other hand, they also say that this data is available for only about a quarter of the known cases.

Where is Figure 2? There ain't no pictures in the article.

Edit: oh sorry you were replying to another comment, not the original article. Figure2 is here: https://www.who.int/docs/default-source/coronaviruse/situati...

just wanna add to the discussion that there is a peer reviewed paper published today suggesting asymptomatic transmission is very likely.

https://academic.oup.com/jid/advance-article/doi/10.1093/inf...

Which is interesting because various sources reported very likely asymptotic transmission as far as 2 weeks ago. But proper research takes time. This virus is fast and unknown, and most likely will test every part of our world system in a very dramatic, Hollywood way.

it's hardly as remarkable or dramatic as you describe it (Hollywood). That's mainly the media upping the severity/alert level of the situation.

Even if asymptomatic people transmit the virus "asymptomatic transmission likely plays a minor role in the epidemic overall, WHO says. People who cough or sneeze are more likely to spread the virus, the agency wrote"[1]

[1] - https://www.sciencemag.org/news/2020/02/paper-non-symptomati...

This sounds reassuring until you realise that "People who cough and sneeze" = all humans.

It is reassuring. You can avoid and protect yourself against coughing/sneezing humans. You can't really avoid an invisible carrier.

You are shadow banned btw. Since this comment: https://news.ycombinator.com/item?id=22316460

He looks alright to me

New to the party -- what does that mean and how do you know they're shadow banned?

HN has an infamous feature called shadowbanning whereby mods can ban a user in such a way that they can't tell that their account is banned. As far as the user is concerned they are not banned, but the comments they submit are immediately marked as dead when they are posted and hidden.

This feature is supposed to be used for cases such as spam bots or crazy people. However for whatever reason sometimes normal users end up shadowbanned.

You can tell if a user is shadowbanned if you have showdead on and most of their comments are dead for seemingly no reason. Yet they continue to post new comments unaware that they are banned.

Shadow banning is not unique to HN.

https://en.m.wikipedia.org/wiki/Shadow_banning

It's also known as hell banning.

https://www.urbandictionary.com/define.php?term=hellban

Much better link, if you want to see the most up-to-date sitreps: https://www.who.int/emergencies/diseases/novel-coronavirus-2...

> very clear stats on transmission outside China

Nobody knows the transmission outside China because nobody is testing anyone unless they are coming from China and show symptoms. Even people with the right symptoms aren't tested, because the general assumption is that it's being contained. But we know it can spread before symptoms show up.

If you are not a scientist this doesn't mean you can't help fighting this particular or any other infectious and non-infectious disease. It is easy - just help to improve the tools that scientists and laboratories use. For example, something like BioJulia[1][2] and BioPython[3][4] - both have some issues[5][6] that need help with or accepting donations[7]. Or R packages, like survival[8]. There are many other tools that are used, feel free to list them in the comments.

[1] https://biojulia.net/

[2] https://github.com/BioJulia

[3] https://biopython.org/

[4] https://github.com/biopython/

[5] https://github.com/BioJulia/BioSequences.jl/issues

[6] https://github.com/biopython/biopython/issues?q=label%3A%22h...

[7] https://opencollective.com/biojulia#backer

[8] https://cran.r-project.org/web/packages/survival/index.html

Realistically, how well will someone with a nonspecialist knowledge of biology be able to contribute to these projects?

That statement's not intended to pass judgement; I'd really like to know as it'd be great to contribute to a good cause.

You can contribute some money to pay for the specialist's time: both BioJulia and BioPython (through its supporting foundation) have support / sponsorship links.

A lot of bioinformatics specialists aren't talented programmers, they are biologists who know how to program as a means to an end.

As a computer scientist you can add a lot of value by contributing to optimization and ease of use.

Not to mention correctness, which is often sorely lacking.

Realistically, contributions from naive computer scientist (naive = no biology training) would be expected to be net negative in the medium term, as the cost of training them to be useful would come at the cost of daily productivity (same argument as Brook's Mythical Man-Month).

I've worked directly in the area covered by computer science and biology through most of my career. One anti-pattern I see that comes up over and over is an expert in CS will come along, see some article in Scientific American or wherever, and build a tool around some clever algorithm that doesn't really solve problems that are useful to scientists. Often the problem is lack of Deep Knowledge of Biology. I've found that the CS people (and physicists) who spend at least a couple years reading up on modern biology are much more effective contributors.

Also have some such experience, and I don't doubt this. On the flip side, watching biologists try to write software is mildly horrifying.

I'm a biologist who writes software, and it is horrifying.

Most of bioinformatics is pattern matching text files and performing statistics. You don’t need to know anything about biology beyond a rough hs level to contribute to the tooling, even just polishing existing workflows. Most tools are not written by computer scientists so there is a lot of optimization to be done in most pipelines.

Some initial reading would be to start with the blast algorithim and the sam file specification.

Having helped pathology folks before (with absolutely no pathology knowledge), I would say testing and refactoring. Most of the people involved on these projects are not CS folk, so they write code that "works". Tons of repetitive, poorly tested, and usually inefficient approaches. Obviously you can't help much with domain specifics but a clean code base goes a long way. Or just fixing algorithmic or non-optimal approaches. For instance, fixing roundabout python code to use list comprehension, which is more idiomatic and more performant than most other raw python approaches.

It should also be noted that basically all the modeling groups working on this are, at the moment, doing it for free. You could get in touch with the universities in question to see about giving to the labs directly.

> So far, at least 616 people have tested positive for the virus in Japan, including 542 from the ship and eight other cases across the nation on Tuesday.

So basically the vast majority of Japan's cases are due to the colossal mismanagement of the quarantine on the ship.

A cruise ship is not an appropriate location for a quarantine -- it's a 3000 person cesspool. Many of the 500-odd passengers and crew who are now sick would not have been infected if everyone had been immediately sent to their home countries for quarantine on return, instead of being forced to wallow in improperly isolated rooms on the ship.

Also, you can't just quarantine for two weeks, you need to have a two week interval without any new infections. The two week counter should have been resetting every day that the "new infection count" wasn't zero.

Many of the passengers who tested negative are already infected, but they're going to send them home unencumbered anyway. This number is 50 times higher than it needed to be, and will cause this pandemic to fucking explode. I hope somebody goes to jail for this.

> I hope somebody goes to jail for this.

For incompetence?

Negligent homicide is a thing.

Maliciousness is not an inherent element of a crime. For example, many people believe themselves perfectly safe drunk drivers when they drive home, but their incompetence combined with taking actions that put others at risk result in penalties.

If you do not punish incompetence when lives are on the line, then you should expect more deaths due to incompetence. We send people to prison for far less than this.

> If you do not punish incompetence when lives are on the line, then you should expect more deaths due to incompetence. We send people to prison for far less than this.

The difference here (vs drunk driving) is the situation that led to this particular kind of incompetence is unlikely to be repeated. The situation also involved significant unknowns and gaps in basic understanding of the danger.

IMHO, it would be wrong to put anyone in jail for the handling of the cruise ship quarantine. That would be unnecessarily punitive. Might as well just kill a literal scapegoat. This seems like more a situation for a fault-free retrospective aimed at improving procedures and training for future epidemics.

Cruise ships are notorious for norovirus transmission. They are not built for a quarantine. Whomever made the decision should be stripped of their credentials along with jail time, which is what the passengers had to go through as is, in order to make an example of what should happen to anyone in authority making such an ignorant, if not publicly malicious, decision in the future.

A public health / pandemic expert should know that "quarantining" 3000 people on a cruise ship only gets you from 10 cases to 3000 cases.

It's a leaky, filthy sieve with 3000 bodies and no isolated airflow.

For exercising authority (especially government authority) incompetently? Absolutely.

What would be a better alternative?

- Disembark everyone and send them home immediately for quarantine there.

- Disembark everyone and send them to hospitals for quarantine there.

- Disembark everyone and quarantine them in smaller groups off-ship.

Basically anything other than leaving 3000 people to simmer with the virus. Isolation on the ship is so bad that if they continued the quarantine as they are doing now for another few weeks, all 3000 would basically be guaranteed to catch it.

It is just a mini https://en.m.wikipedia.org/wiki/Unit_731 it isn’t a quarantine, it is a plague ship.

Authorities didn’t know what to do, so letting everyone on the ship get infected was the second best option.

I would have setup make shift tents on a military base 25m apart and measured temp continuously and PCR once a day.

I think (hope) that's a hyperbolic comparison. Having decision paralysis, not knowing how to handle the situation and letting it get out of control, is a lot different from the depraved acts of Unit 731 where atrocities were being committed deliberately. To be properly analogous, the Japanese government would have to be deliberately making the situation on the ship worse. It's the difference between depraved maliciousness and incompetence.

Unit 731 is human experimentation, the ship is just gross political incompetence.

> Also, you can't just quarantine for two weeks, you need to have a two week interval without any new infections. The two week counter should have been resetting every day that the "new infection count" wasn't zero.

Also 14 days might be too low an estimate, it might actually take up to 24 days for symptoms to appear: https://www.businessinsider.com/wuhan-coronavirus-symptoms-2...

I read the study that the 24 day timeline comes from - it's a rather uncertain worst case scenario. IIRC it comes from a single case report and it's more likely there's a gap in the transmission path that makes the incubation period look longer than it is.

A more recent study from Chinese researchers (so I don't know how much it can be trusted) studied 1099 infections and reported a more reassuring mean incubation period of 3 days.

TBH, the 70 cases that are not related to the cruise ship is what is more worrying.

According to recent study by Chinese CDC, there are 100 cases in China at the end of last year, and the outbreaks came like 3 weeks later.

Japan had this precious time window to tackle this issue RIGHT NOW, before it gets out of hand. But so far it doesn't seem to me that their government is taking this with the deserved severity.

[1] https://www.globaltimes.cn/content/1180059.shtml

Japan's cases are more diffuse and they have a test now. The population is also much more aware of the disease now. There are some drugs that show promises. These are the positives. Hopefully it is enough to make the spreading slower in Japan, though it seems they failed to learn much from China's experience. They are telling people with symptoms to stay home and wait for four days. Really they need to find and treat people from very early on. Home isolation does not work. And once patients covert to the serious stage it could quickly overload the medical system even if 80% recover without much treatment.

The problem with this approach is that many people who have the common cold or influenza A will end up going to a hospital and catching coronavirus there. Sometimes the best thing to do is avoid hospitals entirely and if you have to go to the hospital, do everything possible to avoid getting anyone else sick on the ride from your home to the hospital.

The big issue right now is the asymptomatic transmission where a caretaker can be very careful yet still catch the disease and spread it before they know they've been contaminated.

The hardest part is isolation in a way that protects caretakers.

It is a good thing they are telling people to call the hotlines instead of going to the hospital, but someone should do a follow-up to test people at home (on a triage or a random sampling basis). They can't just wait for things to burst open. The available drugs (Remdesivir is not widely available) are non-specific and likely only effective at the onset. Hopefully it is still early and most callers just have flu or cold.

In Japan, it works a bit differently. People who have a cold go to the local clinic. If the clinic is worried, then they send the patient to the hospital. It's also pretty normal to go to the clinic even if your symptoms aren't severe -- just for a cold. I suspect the "stay at home for 4 days" is meant to stop people from congregating at the clinic.

Ideally however you deliver a mask to them before they very outside their home so they don't infect taxi drivers, bus drivers, uber drivers and other passengers.

Only people driving to the clinic in their own car are less likely to infect their compatriots

I strongly suspect those cheap little surgical masks most people wear are close to useless, as they are incredibly porous and allow completely unfiltered air to get in through the sides of the mask.

A P100 or at least an N95 respirator would be far more effective, but most people aren't going to wear those, unfortunately.

They're meant to prevent already sick people from spreading particulate when they cough or sneeze.

Single biggest fck up in this whole thing. The PCR protocol should be pushed everywhere and test everyone that is symptomatic for any corona virus, meaning if you have a cold you should stay home until it passes.

Iwata Kentaro, an infectious disease specialist, released a video with his criticisms of the ships quarantine.

TL:DR bureaucracy is getting in the way of proper containment. There were no green/red containment areas. Personnel not wearing proper gear.

He believes that bureaucrats in charge of the quarantine are actively blocking disease specialist from helping.

I really hope they actually plan to quarantine everyone from the ship for two weeks, individually, and any talk about "passengers who tested negative are free to go home" is just a big misunderstanding.

Otherwise they're basically asking for the worst outcome. What are they even thinking.

A Japanese infection prevention specialist has a video report after visiting the ship[1]. (Direct video in English[2].) No separation of red and green zones. PPE on and PPE off indiscriminantly. No infection control specialist in charge. Massively botched.

[1] https://www.reddit.com/r/Coronavirus/comments/f5s6fq/infecti...

[2] https://www.youtube.com/watch?v=vtHYZkLuKcI&feature=youtu.be

This somehow resembles both Fukushima and Korean Sewol disaster 'recovery efforts', https://www.youtube.com/watch?v=5_A8dq2fA5o. Social norms (face, status) above common sense.

Hashimoto Gaku, Ministry of Health Vice Minister, has since objected to that account on Twitter[1] -- with a picture of what seems to be supposed to be a decontamination hall or a hall used as a hallway, with two parallel entry and exit marked as "decontaminated route" and "contaminated route", separated by barriers, guess what barriers, fucking queue barriers. Checkout line ropes. Classy ones, yeah. Coronavirus are respectable beings, you know. After questions as to whether this is a novel method of self-whistleblowing started to mound up, Vice Minister deleted the picture.

https://www.itmedia.co.jp/news/articles/2002/20/news123.html

It appears to be spreading in the community now, which makes me think stopping a pandemic at this point will be very hard. One can only wonder what happens when it reaches places with much weaker health infrastructure, such as Africa and also many parts of India.

This seems to me like an accurate assessment of the situation: https://news.harvard.edu/gazette/story/2020/02/harvard-exper...

Let alone the United States, a country in which people delay healthcare until the latest possible moment to avoid the costs. This strategy is advantageous to the individual but disadvantageous to the group. The individual may survive without treatment, but without quarantine they proceed to infect those around them. Those around them may be in similar financial conditions.

my understanding is that the CDC can and will resort to extreme measures to contain any dangerous disease, but what I don't understand is who is paying for treatment of individuals that are affected by those measures. (disclaimer: European here)

I'm sure the government would likely kick in to quarantine people.

The problem are all the people who will wait until they're really sick before checking in, or won't go to a doctor at all, and they've already spread it by that point.

People will still most likely be stuck with the price of their care unless we get to the point that the CDC and the government at large are opening quarantine and treatment facilities of their own to deal with a true outbreak. Short of that most people will just wind up in the normal hospital and healthcare system which means they'd be paying for their own care.

It'd be a sad but ultimately useful twist if a big outbreak hitting the US pushed us to finally adopt a reasonable centralized healthcare system. I could see it happening but I could also just see a block of money being set aside to pay for peoples' care too.

It's highly likely that in such a mass event the US would have a debt forgiveness program or work with healthcare providers to subsidize costs. At that point it would become a national security emergency which would open up federal spending flood gates.

"Americans can always be counted on to do the right thing…after they have exhausted all other possibilities."

-- Meme

The United States has already been handling the few cases it has pretty aggressively, and following up with anyone who might have come into contact with each person. This feels like you're just jumping on the opportunity to say "US healthcare is bad, guys", which doesn't really make sense when comparing our handling of an outbreak (in which the CDC will mobilize and largely bypass the issues in our healthcare system to mitigate disaster) to India and Africa not having anywhere near the infrastructure to handle this.

People are still dying of swine flu in India, a decade later. There's really no comparison, no matter how much you may dislike the US healthcare situation

Infected people in the US so far were wealthy (traveling back from China) and so didn't have the cost concerns mentioned above.

Logic would dictate that that would continue to be true, since the cost of flying from China is unlikely to get drastically cheaper. So I'm not sure what you're getting at.

You don't have to be wealthy to have traveled on a cruise ship. The US is also pretty well organized, and generally very transparent about this sort of thing. While China is...not. The US, on a relative basis is also a much cleaner and sanitary country than China.

Replace "wealthy" with "not poor" and the grandparent's point stands.

Or even just interpret "wealthy" in a global context instead of local.

Its also worth noting that Japan's response has been roundly criticized both from within and without. They've kept these citizens in a cruise ship sized pitri dish and the effects are now playing out. On the other hand, they have been more hands off when it comes to monitoring and quarantining people traveling to and from China via air. Most other countries, including the US, seem to be reacting with stronger measures, which may make a big difference.

There's a discussion on this Twitter thread about why it could become a problem: https://twitter.com/SuperMugatu/status/1229229188273627136

The CDC has just had its budget cut by 16%, is still forbidden from using the terms "evidence-based" and "science-based", and has dragged its feet long enough that containment is very unlikely at this point.

Trump proposed cutting the CDC's budget by 16%, but given that Congress sets the budgets this is not meaningful at this time.

I'm curious what you mean by the CDC having "dragged its feet". I know a dozen people at the CDC, they've all - ALL - been aggressively sidelining their previous projects to focus on COVID-19 for some time. They certainly don't feel internally the way you do.

I'm curious as to what exactly "some time" means for the 12 people that you know. Is it greater than 4 weeks?

12 people may not be a lot, but his anecdote of 12 people seems stronger than what you've offered up so far. What actual evidence is there that the CDC has dragged their feet on this?

January 24th is quite late to the game relative to what we've known publicly for quite some time.

https://www.cdc.gov/media/releases/2020/archives.html

https://www.cdc.gov/media/releases/2019/archives.html

Testing delays and scheduling issues for testing before the CDC distributed kits were also critical missteps.

I have texted the seven people of those 12 who I'm on "texting terms" with. Three of them began shifting some of their time in mid-November, two in mid-December, one in January, one no response. Four of the seven have traveled to US ports beginning in January to begin testing and monitoring efforts.

The CDC has finally issued a level 1 travel advisory for Hong Kong as of February 21st.

That's what I call "dragging feet."

Anothet example of CDC dragging its feet during the same time period.

https://www.reddit.com/r/nyc/comments/fayko1/my_covid19_stor...

This is my experience as well. I'm on three different conference calls per week with CDC folks, and I'm only peripherally involved.

Us health care hasn’t had to deal with something like the Spanish flu since the creation of the modern health insurance system. It’ll be interesting to see how well it handles millions of people who need extremely expensive ICU care all at the same time.

I expect we’ll see one or more insurance companies collapse or need a government bail out.

The information release so fare makes this look more like a bad flu with a 2.5% mortality rate, nothing like the Spanish Flu's 10%~20%. The Spanish Flu was also especially bad because it effected young adults disproportionately[1]. This caused massive problems because that was the age group of most care givers.

1. as appose to 0.1~0.2 for regular flu 2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734171/

> People are still dying of swine flu in India, a decade later.

In the 2017-2018 flu season over 70,000 people died in the US, and the main strain was H3N2 - a type of Swine Flu.

The A(H1N1pdm09) strain is still circulating in the US and still causes death there too. https://www.cdc.gov/flu/weekly/index.htm

https://www.cdc.gov/flu/pandemic-resources/burden-of-h1n1.ht...

> CDC estimates that from 2009 through 2018, influenza A H1N1pdm09 has caused at least: 100.5 million illnesses, 936,000 hospitalizations, and 75,000 deaths.

Bill Gates (among others) has a pessimistic view in that regard. He thinks it could be devastating if we’re not lucky.

> One can only wonder what happens when it reaches places with much weaker health infrastructure, such as Africa

https://www.theguardian.com/world/live/2020/feb/14/coronavir...

Hopefully it doesn't spread as readily in warmer places without air conditioning.

> Those who test negative will be allowed to leave between Wednesday and Friday, while those who test positive will be hospitalized. The same measures will apply to crew members. Most of the passengers to be released on Wednesday will be Japanese, with priority being given to the elderly.

How is this enforced? Do they shepherd the infected straight into quarantine after the test, or is it more of a "we trust that you go there now" kind of a situation?

And how is that enforced on those that don't have health insurance - is covid automatically covered?

I wonder (not so much about Japan, where things tend to go down mostly orderly) about other countries with poor healthcare. How is it "managed" in areas where people are already misinformed and/or maybe who rather take the risk (to themselves and others) of sitting it out, because they fear costs or other drawbacks (losing your job etc).

Everyone in Japan is covered. Even if they find out you weren’t paying, you just owe the back payments for the public option but they never consider your coverage lapsed.

Still need to have an insurance card from city hall though. You are not ‘automatically’ covered.

I doubt you’d be turned away under these circumstances

Oh, yeah. I think Corona patients get free care from the moment they test as positive.

Strangely enough you still need to pay for the test, but meh :P

Just looked it up and yeah, you’re right; it is possible to be totally uninsured. Fortunately, even worst case you’d only pay 3 times the insured cost and be able to deduct from taxes, so it’d still be cheaper than somewhere like the US.

To some extend, you’d be able to sign up at city hall and still get a discount regardless of whether you’ve paid the premium (which would be like 6000 yen per year if you have no income).

I think city hall would come after you after about a year or so, and then you could call them and set up a deferred payment plan (or get the cost completely rescinded maybe).

>Those who test negative will be allowed to leave between Wednesday and Friday

Are the people designing these policies not aware that current test kits have upwards of 50% false negative rate?

Edit: I can't find the source so take this with a grain of salt.

> current test kits have upwards of 50% false negative rate

Is there any source for this?

The virus infects the lung. Swabbing upper respiratory tracts may not detect it at the early stage.

COVID-19 is automatically covered, even for foreigners since it was declared as a 指定感染症. You have to be tested positive before get covered, though.

Those Tokyo cases. I hope they are connected to existing known cases or its gone communal.

Gone communal: "Authorities also confirmed two more cases: a doctor in his 50s who works at a hospital in western Japan and a man in his 20s who lives in Chiba, near Tokyo. None had a record of travelling abroad in recent weeks or contacts with Chinese nationals – a possible sign that the virus is spreading inside the country." https://www.theguardian.com/world/2020/feb/13/japan-reports-...

The virus can spread between asymptomatic hosts for as long as 8 days before showing signs of infection.

Most of those claims have been walked back, as far as I know. There were initial reports that the virus can be spread asymptomatically, but since then there has been more skepticism about the data around those claims. Right now I don't think anyone knows for sure if the virus can be spread in asymptomatic hosts or not.

https://academic.oup.com/jid/advance-article/doi/10.1093/inf...

Was the German claim walked back? What about the folks in Japan right now?

Doubt is good, but asymmetric doubt is foolish.

The German claim was walked back - the original authors didn't interview the actual person they were claiming were asymptomatic.

> Doubt is good, but asymmetric doubt is foolish.

That's a great idea. Yours?

42 days

https://www.express.co.uk/news/world/1243873/Coronavirus-lat...

PS: if you downvote at least comment why

> PS: if you downvote at least comment why

You're citing a tabloid with a long history of conspiracy theories, shoddy science reporting (for example: https://www.express.co.uk/news/weird/1071197/nasa-alien-admi..., https://www.express.co.uk/news/science/1141139/Yellowstone-v...), and false news stories.

Because what can not be allowed to be real, can not be.

Its cancel cultures final act, denial of reality and then death of those afflicted with it by it.

I really hope this can make it to market quickly as it would make it easier to protect ourselves. https://www.nature.com/articles/srep39956

I think its more likely than not that COVID-19 will progress into a global pandemic. I don't think its a bad or rash idea to begin preparing to self-isolate/quarantine before panic-buying of supplies begins. Having a stock of non-perishable food, medication, masks, and disinfectants will definitely make things easier if COVID-19 can not be contained.

There's two elements of prep work that anybody can and should do: 1. The cheap stuff that you may never use, but if you don't, isn't that big a deal: First aid kits, a supply of disinfectant, masks if it isn't already too late for that, etc. 2. Stuff you're going to buy anyhow, like canned food you already use, stuff you can easily freeze in advance without it being too big a deal, etc., that, again, you would have used anyhow. This is just pulling purchases forward rather than spending new money.

After all, just because COVID-19 may in fact end up contained doesn't mean you're not going to be in a serious earthquake next week or something. Having this stuff widely distributed greatly increases the resiliency of society against all sorts of issues, means you'll be one less person draining valuable resources in case of some disaster, etc. Being at least a bit prepped is the socially responsible thing to do.

Also, don't forget some of the specialized things for an extended in-home stay, which a lot of prep lists don't necessarily focus on (as a lot of them are assuming the problem is that you don't have a home anymore): Toilet paper, paper towels, salt & spices, etc. Anything you don't want to have to suddenly run out and get.

> masks if it isn't already too late for that, etc.

I don't know about surgical masks, but N95 respirators have been nearly totally sold out at retailers for a couple weeks.

I know there are questions abut the use of N95 respirators to prevent infection when used by nonprofessionals, but they seem more widely available to consumers (at hardware stores) compared to surgical masks, due to their use in construction.

I went to a paint supply store and they had a good number of N95's in stock.

http://multimedia.3m.com/mws/media/601997O/respirator-compar...

> I went to a paint supply store and they had a good number of N95's in stock.

What store was that? I just called my local Sherman Williams, and they're sold out. Was it a store that's little known to consumers?

Personally, I managed to buy about 40 3M respirators about two weeks ago (shipped most to relatives in China). I've been keeping an eye on the stock at Home Depot ever since during my normal shipping, and they're totally picked clean at this point.

It was a Benjamin Moore store. I must've been lucky.

>The cheap stuff that you may never use, but if you don't, isn't that big a deal

Not a bad idea to stock up on rice and beans. The proteins in rice and beans are individually to incomplete but together are sufficient for long term survival, and they're cheap and last for years if kept in a cool damp pantry. On a developer's salary you really don't have an excuse not to spend a couple hundred dollars on months worth of emergency food that will keep you (and possibly your community) prepared for years.

Don't forget that such preparations are for any unforseeable future event. It's just good to do if you have the space and cash.

Can't edit now but it should read "cool, dry pantry", not damp.

I whole-heartedly second this. I'm reluctant to describe myself as "a prepper" because some of the connotations of that term get pretty "out there" (see the "Doomsday Preppers" show for example), but a certain measure of preparedness is a Good Thing. And there are plenty of very realistic situations that could come to pass, where that preparedness would be beneficial, without reaching into the realm of EMP attacks, etc. Natural disasters of all sorts (growing up in the Southeast, hurricanes are something I've had quite a bit of experience with), pandemics, global supply chain disruptions (caused by any number of thins, possibly including the aforementioned pandemic) and so on, are all real things.

I strongly encourage everyone to stock non-perishable food, drinking water and whatever supplies needed to survive at least a month as a matter of course.

Do I need to stock on drinking water if I live in a country where tap water is drinkable?

In case of natural disasters the water supply is one of the first services to go.

If there's an earthquake or hurricane or other disaster you might suddenly not have tap water any more. Having enough water to survive for a month is just good practice in general and this pandemic is a good opportunity to do that.

>Having enough water to survive for a month

While I don't necessarily disagree with the general philosophy, that probably translates into something like 50 gallons of water/person, or about 10 big jerry cans/water bottles which is a lot for most people to store along with everything else for a month.

Check out LifeStraws (and similar devices) if you have concerns about being able to store enough water for a crisis.

I actually have water filtration for backpacking as well as iodine. But, if you don't have fresh water, a lot of people won't have access to water at all. I'm just up from a river myself but that's not typical.

True enough. In those cases I see the LifeStraw as more of a "last ditch" solution. Think drinking out of clogged gutters or rain puddles with it as a last resort.

WaterPrepared makes a solid 160-gallon container that is stackable and doesn't take up too much space (29″W x 36″D x 42″). I have one in my garage. With AquaMira drops it's good for like 5-years.

That's just ~53-gallons each for my three person household.

It's $400 but seems like a reasonable investment in the case things go awry.

Some of us live places where storing water in the garage doesn't work for part of the year :-) I could store large quantities of water but I'm not in a seismically active area and I'm not sure what the scenario is where I need water specifically. (I'm also near a river so water probably isn't a particular issue.)

Why doesn't it work for part of the year? Freezing temperatures? In that case, you can just move it into your basement or other climate controlled space.

Even if you're near a river, having clean, treated water is still useful. It's one less activity you need to concern yourself with in the case of disaster. No need to go out and get water and treat it.

That said, I'm in a seismically active area, in a tsunami zone and pretty much surrounded by salt water so there is value in my situation

Yes absolutely. Don't count on any utilities functioning.

There are many long-term water storage solutions. The simplest is a large package of bottled water.

Also I highly recommended supplementing your water supply with a LifeStraw or similar device that can filter water.

LifeStraw is only rated for 250 gallons. Whereas you can get similar products for roughly the same price rated for 1,000,000 gallons, e.g.:

https://www.amazon.com/Sawyer-Products-SP129-Filtration-Sque...

(FWIW I haven't used either.)

Funny enough that's actually the one I normally carry but couldn't think of the name!

You are right the Sawyer is better in general.

1 gallon of water per person per day is recommended. This may seem excessive, but it factors in water for cooking and cleaning.

Yes/no/maybe. It never hurts to stock up on drinking water, but... water is very heavy and takes up a lot of space. This limits the quantity that most people can realistically store.

But what you can do, if you live in an area where any source of freshwater (lake, creek, stream, river, pond, etc.) is available within a reasonable distance (a day's hike?) is learn how to purify water and stock up on the supplies necessary to do so. There are different ways to purify water, but one of the easiest and most effective is still good old fashioned boiling. So if you have a decent vessel for boiling water in, and a means of starting a fire, and some supply of flammable materials, you can boil quite a bit of water.

If you only live near a supply of salt water, or if you live near water sources that are especially dirty / polluted, distilling the water is a step beyond boiling. It's more complicated, slower, and requires more up front prep, but it's not completely outrageous to think of building / buying a distilling unit in advance of a possible failure of the public water system.

The downside of this, of course, is that it requires you have a good supply of firewood or other burnable material, and a place to light a fire where you won't kill yourself with carbon monoxide poisoning.

Chemical purification is another option... and in a pinch, you can get by with plain old (unscented) household bleach.

And, of course, as others have mentioned, there are filtration options. If you go this route, it might not hurt to pre-filter your water (depending on what state it's in) with plain cotton cloth, a coffee filter, etc., to help preserve the life of your filter. The idea is the prefilter step removes the bigger particulates so the "real" filter never sees them.

I assume you live in a suburban house in the US? The majority of people live in places where it would be hard to stock up for a week without running out of space.

I hear this sentiment often when it comes to bulk purchases, but I don't think I've ever seen someone verify it. Even when I was living in college dorms I had enough space to stock up on a dozen of gallons of water and dozens of jars of peanut butter or similar calorie dense food. It wouldn't have been hidden away from view and wouldn't have looked pleasant but it was possible.

There are many emergency food options that can work for people in even the smallest studio apartment. For example, here is a 30 day supply of non-perishable food that fits into an 8.5 gallon bucket: https://www.amazon.com/Augason-Farms-30-Day-Emergency-Storag...

It will suck eating that everyday, but it will keep you alive.

And if you can't fit a months supply, at least try a weeks supply or more. A case of MREs and a large package of bottled water stashed away in the back of a closet will go a long way in a crisis.

Water. This assumes a plentiful supply of water for 30 days. If you consider storing water for “at least a month” as in your original comment, it takes an enormous amount of space even for a family of two/three.

10kg of rice will last you 2 months.

Respiratory viruses have a much harder time spreading in summer. If we can substantially slow the spread until then our odds of this having major impact in every country are much lower.

Should note that it's pretty warm in Singapore and they are definitely dealing with COVID-19.

Most Singapore buildings have A/C. The local clusters so far include two churches, a Chinese medicine store, and the Servomex business conference at Grand Hyatt Singapore.

There's a good infographic of all reported Singapore cases in this article: https://www.channelnewsasia.com/news/singapore/coronavirus-c...

They should shut their ACs off.

Most Americans also have a/c, so the point still stands.

There's some evidence out right now based on the current spread to suggest this won't fix things.

http://www.people.fas.harvard.edu/~msantill/Mauricio_Santill...

Is it just me or do COVID-19 stories get buried here much faster than their upvotes would justify? Flagging?

At this rate the Tokyo olympics might be cancelled.

Wasn't there something similar in Brazil few years ago ?

Zika. This is very much on a different level.

Thanks, yeah I assume it's biologically comparable, I was just curious about the massive social event side of things

Will the entire 2020 olympics be cancelled in that case? Or would it be moved or postponed?

It's too late to move it. The run up to hosting an Olympics lasts years and even recent hosts like Rio (2016) would have to do a lot of work to refresh facilities. [0]

[0] As soon as a year after they were already just sitting empty and falling into disrepair. https://www.youtube.com/watch?v=jMgPEz29abI

If it gets serious enough for Japan to cancel, nobody else is going to be able to host it either. It's supposed to be a worldwide competition, there's no point having it if half the world can't attend and the other half really, really doesn't want to.

If national quarantine's were holding in theory they could maybe move it if another venue were possible.

It'd be shocking to say the least, the only Olympics that have been skipped in the modern era were '16, '40 and '44 and that's because there were the World Wars going on at the time. The closest I think we've gotten to a similar scare would be SARS on 2002 but that was just starting iirc when the winter games in Salt Lake City started.

Would it be fair to assume Japan may be downplaying the outbreak so that they do not risk losing the 2020 Olympics? It's quite a large investment that would get no return if it were to be cancelled.

Meanwhile a man from the Westerdam cruise ship, where one passenger already tested positive, escapes quarantine, books ubers, and multiple flights, is arriving back in Seattle:

https://komonews.com/news/local/man-stranded-on-coronavirus-...

Some people can't get more selfish. Also, what a colossal failure on the part of customs and immigration.

It's not about "just people" - look at those people at cruise ship, abandoned by Japan, abandoned by cruise company and their countries. Little knowledge needed to predict what would happen if those people were left on the ship under what japanese officials called "quarantine".

What is it if not selfishness of the whole nations? So are we to blame this single passenger?

Show HN: I made an open-source COVID-19 coronavirus tracker for Japan

https://COVID19Japan.com

There is a useful daily updated dashboard that tracks all the cases, recoveries, death, geographical data and analytics about all that:

http://avatorl.org/covid-19/

Here is an alternative from John Hopkins https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...

Those numbers are likely at least an order of magnitude underreported. They mirror the figures out of China, and there are a number of issues:

1. They follow a quadratic distribution over time with a regression coefficient of >.99. that's now how epidemics spread

2. China ran out of testing kits weeks ago.

3. Half of the population is on lockdown, and according to Chinese reports, even those who are sick and need to go to the hospital are not allowed to travel. So cases are not being counted

4. Even if they were able to do so, hospitals have been overwhelmed for weeks and have been turning cases away

In addition to other reasons, the authoritarian CCP has shown a willingness to punish anyone who speaks toward how severe this infection actually is and their numbers absolutely cannot be trusted. Just look at the unprecedented response - 700 million people, 10% of the world's population, is under lockdown.

Can't speak to 2-4, but on 1., there seems to be research suggesting early epidemic growth can actually be quadratic: https://www.ncbi.nlm.nih.gov/pubmed/27266847

Specifically, it notes that "Sub-exponential growth profiles may result from heterogeneity in contact structures or risk groups, reactive behavior changes, or the early onset of interventions strategies, and consideration of "deceleration parameters" may be useful to refine existing mathematical transmission models and improve disease forecasts."

Not sure if there are more striking examples of "reactionary behavior change" than a massive lockdown.

The problem is really the regression coefficient rather than the fact that it's quadratic. Nothing is that clean in real life.

A quadractic is also a second order approximation. On a short enough time scale it will fit any smooth function well.

For 2, China has been reporting clinically diagnosed for a few days now. (as mentioned in another comment above, source: https://www.who.int/docs/default-source/coronaviruse/situati...).

Even clinical diagnosis is unreliable. It's based on indicators like fever and pathologic lung scans. Bear in mind this is in combination with strong top down pressure to underreport.

The natural and societal circumstances surrounding this epidemic feel like a perfect storm.

Is it possible that disease density increases chances of fatality for a particular person? The fatality rate seems so low outside of China, compared to China.

Chinese air quality is godawful, and this is a respiratory disease, so the large fatality rate makes sense. It is more important to look at ages of those who die and so far it appears to be far more fatal to those over 50.

Individually the fatality rate won't change, but as more individuals are infected the amount of people who are older will also go up and some of those cases will become fatal.

I came across someone else talking about "viral load" yesterday - I wonder if that is actually a factor.

>Avoiding unprotected contact with farm or wild animals.

Well, that's a nice way of saying it.

I've heard it mentioned by an unreliable source that perhaps the Asian phenotype has more of a tendancy to succumb to the virus. I won't how true this is as the majority of the infections seem to be based in Asian countries so far. I wonder how strong the correlation is.

There's a lot of travel within those regions, so can't say much, but one theory is the difference is ACE2 receptors amongst asians.

From what I know there is a single study with 1 east asian patient. I would not conclude anything from that.

There is definitively different phenotypes https://www.medsci.org/v14p0639.htm

What that means for the coronavirus is hard to say.

Ideally we would know the composition of the cruise ship in japan of ethnicity (illness in each group, and outcome) and location on the ship so one can control for likelihood of being infected (I would guess having a room with a terrace might mean less chance of infection as you would not be only relying on AC air, but its a complete guess).

Seems like a jump to a conclusion that can be explained much more simply: the virus has started in China, and the neighboring countries are the next hardest hit. Seems to me like this would be the case for any novel disease for any region of the world. There seem to be plenty of non-Asians whom come in contact with the sick who in turn get sick. Its just that there are many fewer non-Asians coming into contact with the disease than Asians, for the time being.

Men and smokers are definitely more susceptible from the data right now.

Could you link a source providing the argument that men and smokers are more susceptible to COVID-19?

I don't have a source for the claim about men, but the idea that smokers are susceptible comes from what we know about SARS, which is that it is a respiratory disease. COVID-19 is very similar to SARS so we can say with confidence that it is also a respiratory disease.

Logically, if this virus attacks your lungs, and your lungs are damaged from years of severe smoking, then the virus will hit you harder and you may take longer to recover / die more quickly.

Right, so it's less about smoking and more about previous damage to the lungs. That makes sense.

I thought there was something specific about smoking that was linked somehow to COVID-19, but seems like you're making a more general claim. All good!

Hopefully the pandemic has been delayed long enough to find effective treatments: https://www.pharmaceutical-technology.com/news/china-approve...

One month ago, on 2020-01-17, there were 62 confirmed COVID-19 cases in China. Now Singapore, Hong Kong, Japan without the Diamond Princess, and the Diamond Princess itself each independently have 62 or more confirmed cases.

The rate of contagion within China has dropped dramatically, down from the neighborhood of 30% per day to the neighborhood of 3% per day. If a similar improvement plays out in Japan, Singapore — and countries like Indonesia, Malaysia, Vietnam, and Australia, which probably have a lot more cases than those they've caught — it would take more than a year for the pandemic to reach its peak (log(7.7 billion / 73437)/log(1.03) ≈ 391), rather than the two months we've been predicting so far. That could provide enough time even for vaccination campaigns.

There are people claiming that the slowdown in China is due to underreporting, but as far as I can tell that's pure speculation. It seems more likely that it's due to the Chinese health authorities putting 10% of the world population under near house arrest.

----

Some news about the Diamond Princess, though, from https://www.japantimes.co.jp/news/2020/02/19/national/diamon...

> All passengers aboard the cruise ship who have tested negative for the virus will be allowed to start disembarking Wednesday, health minister Katsunobu Kato said Tuesday, with the ministry having finished taking test samples from all passengers. ...

> A group of 328 American passengers from the vessel left for home early Monday on planes chartered by the U.S. government. Over a dozen had tested positive for the virus.

So the number of COVID-19 cases in the US has just gone from 15 to somewhere between 27 and 343, and the number in Japan is going from 74 to somewhere between 500 and 4000 today. Those repatriated to the US are subject to a 14-day quarantine, and I think Japan is taking similar measures, so maybe this won't fast-forward Japan from China's January 17 to China's January 26, in terms of spread of the disease.

This is going to be very interesting, in the same way that oncoming headlights are very interesting to a deer.

Note that this comment was originally voted down to -1. The anti-intellectual scum are out in force on HN today, it seems.

>> There are people claiming that the slowdown in China is due to underreporting, but as far as I can tell that's pure speculation.

Occams razor is useful here.

Regardless whether there is underreporting. Placing ppl in house arrest and avoid any public gather will massively cut down the infection rate. I am not sure whether such action can be taken by other countries if the disease becomes full on outbreak in other nations. I really hope we dont have another wuhan-like outbreak in another city.

Sure, but will it cut the infection rate from 30% per day to 20% or to 3%? I think it's most likely that the Chinese figures are correct, but there is of course the possibility that they are not.

Has anyone seen this video yet? Apparently the government is so BAD about handling this. Sadly, not a surprise.

https://www.youtube.com/watch?v=vtHYZkLuKcI&t=265s

Has the origin of this been discovered/ agreed upon by now?

I don't follow this too closely but I remember discussions on here about the origin. It seemed very contentious at the time because it started in the same city as a research facility so there was questions of it being accidentally released vs appearing organically in the market.

Slightly of-topic, but idk where else to ask about this.

A recent paper suggested that there is strong evidence that SARS-CoV-2 is not the product of genetic engineering.

source: http://virological.org/t/the-proximal-origin-of-sars-cov-2/3...

Thanks for the link.

Some cherry picked excerpts from the paper.

> It is improbable that SARS-CoV-2 emerged through laboratory manipulation of an existing SARS-related coronavirus. As noted above, the RBD of SARS-CoV-2 is optimized for human ACE2 receptor binding with an efficient binding solution different to that which would have been predicted. Further, if genetic manipulation had been performed, one would expect that one of the several reverse genetic systems available for betacoronaviruses would have been used. However, this is not the case as the genetic data shows that SARS-CoV-2 is not derived from any previously used virus backbone17. Instead, we propose two scenarios that can plausibly explain the origin of SARS-CoV-2: (i) natural selection in a non-human animal host prior to zoonotic transfer, and (ii) natural selection in humans following zoonotic transfer. We also discuss whether selection during passage in culture could have given rise to the same observed features.

> Although genomic evidence does not support the idea that SARS-CoV-2 is a laboratory construct, it is currently impossible to prove or disprove the other theories of its origin described here, and it is unclear whether future data will help resolve this issue. Identifying the immediate non-human animal source and obtaining virus sequences from it would be the most definitive way of revealing virus origins.

It can still be released from a lab without being genetically engineered. It is possible that they had a sample retrieved from a cave somewhere, and that is what somehow escaped. That would explain the unprecedented response.

I think the conspiracy theorists are hoping for something more impressive other than "it was a lab accident." History has taught us that lab accidents are a bit more likely than we'd like to admit - see "Biohazard" by Ken Alibek. The Soviet Union (and China) had several accidental release incidents during his time in Biopreparat.

https://en.wikipedia.org/wiki/Ken_Alibek

As it stands, we have no way of knowing if it came from an animal or this lab unless they tell us. Either is possible.

Tokyo will become the next Wuhan, except they won’t be able to quarantaine anyone.

What's your basis for that statement? Japanese social norms are quite communitarian, especially around contagious diseases.

It all depends on the companies and institutions. If there are no special holidays or orders, people will go to work no matter what and the epidemic will spread. On the other hand, if the government or companies imposes a quarantine, it will be respected.

Japan is a much much cleaner country than China, with better health infrastructure. So I highly doubt your assessment.

The problem is that as far as we know about 15% of the people who get infected with covid-19 require intensive care. Combine that with the fact that covid-19 is very easily transmissible (even from people who show no symptoms) plus the size of a megalopolis such as Tokyo and things could get really ugly really, really fast. No government has tens of thousands or even hundreds of thousands of hospital beds at the ready in order to handle such a scenario (and this is also why the Chinese had to resort to putting sick people in sports halls and the like).

There’s also the very ugly fact that most probably half of the health workers directly involved will also get infected in the first 3 or 4 weeks, at which point you’d need to have a fresh batch of new doctors and nurses easily available from the outside.

For that matter, Tokyo may be one of the best places to be. I think the number of hospital beds per person in Japan is ridiculously high[0] at 13.1 per 1000, as opposed to 4.3 per 1000 for China.

0: https://www.statista.com/statistics/283273/oecd-countries--h...

There’s (probably) also way more people together. I doubt having a clean country helps if the virus is transmitted person to person.

I’m not saying the same number of people will die (because better and more prepared healthcare), but it’s a fantastic place for another outbreak.

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