Current Wuhan Situation
twitter.com
twitter.com
The lockdown is in effect and the moment it's taken down, we'll see a second wave. No?
[1] flattenthecurve.com
If that doesn't work, restart the lockdown.
The big risk my be re-importing it back from other parts of the world who've been much less successful at containing this.
But... hospital and testing capabilities are building day by day, the quarantine is buying time
It comes back, but the second time around we can isolate the right people due to ubiquitous testing, have more hospital beds and more knowledge on how to treat the sick, and are that much closer to a vaccine
Who knows, I think they have no idea and are just keeping things as they are to avoid having Wuhan in the news. Would make awful press to admit to any new cases in Wuhan.
Are other major metropolises locked down similarly? Beijing, Shanghai?
In general, is it credible that China has had no new cases other than those so called "imported from outside"? Sounds like propaganda to me.
Kuala Lumpur has all unessential services and schools closed. Supermarkets are open.
People aren't allowed outside apart from going to work or the shops. Police are enforcing this and they've brought in the Army to help stop people spending time in parks.
Nanjing is a city of 8M people so roughly the size of Wuhan. I came away from it thinking that the numbers coming out of China could very well be credible given how strict movement/social distancing/etc is/has been. Of course that is not Wuhan, which is why the stricter lockdown still going on in Wuhan would seem to make sense (but I can't vouch for the authenticity of any of this).
Evidence from China and Italy is that they don't actually work. It's been three months, and China still can't let people leave their front door or the virus will return full force, with no expectations that another month or even another year of lockdown will help.
In Italy, with two weeks of lockdown, the exponential growth of new infections hasn't even slowed. Now they are predicting that "just three more weeks" and the exponential growth might start to slightly decline.
Wealth and freedom are declining around the world, but it doesn't even slow the virus' spread.
Meanwhile, places like Korea have no trouble stopping the virus without the authoritarianism.
And yet, all people here call for is ever-more economic destruction, and ever more authoritarian controls, all to no detectable effect. Except, of course, the end of our free and prosperous societies.
Don’t work for what purpose? They work well at shutting down the virus in the short term. In Wuhan the reproductive number of the virus is estimated to have dropped from above 3 to ~0.3 after the lockdown.
> In Italy, with two weeks of lockdown, the exponential growth of new infections hasn't even slowed
This is definitely not true. If you plot Italian cases or deaths on a logarithmic scale it’s easy to see the curve slowly bending down. Keep in mind it takes ~2 weeks for public health interventions to start showing up in data about identified cases, and ~3 weeks for them to show up in data about deaths.
> places like Korea have no trouble stopping the virus without the authoritarianism
Places like South Korea have had plenty of “trouble”, but have stopped transmission through nationwide testing, contact tracing, isolation, and quarantine, along with early school closures and a mass social distancing effort among the public, pervasive use of face masks, etc.
The South Korean public health response (and we might add also Taiwan, Hong Kong, Singapore) was much faster and more decisive than the response in the US or Europe. As a result they have avoided the situation of widespread community spread, and not needed to undertake a total societal shutdown as became necessary in Hubei or Italy.
What other countries should be learning from South Korea is to act quickly and stay on top of the virus before it gets out of control.
The common goal is to survive and to pursue the quest for happiness, I doubt it is better set by a central government.
As for the approach (the way to tackle the problem), having groups choosing various ways is a way to discover what works or not, and which new challenges are raised by each approach. When everybody everywhere applies the same approach, everything may break simultaneously if it is not the perfect approach (perfect approaches are pretty rare), and progress towards new solutions is slow.
You're responding to something else. The point I made is that you WANT to coerce people into vaccinating their kids, into educating their kids, etc, etc. Those should not be things where one crosses their fingers and hopes that people get convinced into doing that.
>The common goal is to survive and to pursue the quest for happiness, I doubt it is better set by a central government.
Sorry, are we even talking about the same thing here? I thought the conversation was about healthcare/vaccination/infectious diseases/.
>As for the approach (the way to tackle the problem), having groups choosing various ways is a way to discover what works or not, and which new challenges are raised by each approach. When everybody everywhere applies the same approach, everything may break simultaneously if it is not the perfect approach (perfect approaches are pretty rare), and progress towards new solutions is slow.
Okay, but nothing about having a central government precludes you from running local experiments w.r.t new policy. I believe RCT economics received a nobel prize either last year or the year before that.
My skepticism will wane when I see videos of hospitals all across the country with patients in the halls. Until than, we really have no clue what happens next.
There was no lockdown.
Everyone wears a mask in public places, this is mandatory. Before entering many/most buildings (private or public) your body temperature is measured. In most private compounds non-resident people cannot enter without a solid reason. Schools are closed. A gym I know was closed for weeks and restarted at the beginning of March in restricted mode (no group class, simultaneous private courses are under quota, masks are mandatory at all times...), and restrictions are progressively lifted (reduced group classes will soon restart...).
And current expert consensus is in line with that, putting the odds at 73% for a 2nd wave in the fall:
https://fivethirtyeight.com/features/infectious-disease-expe...
R0 goes down with rising temps and humidity. Covid has a pretty high R0 to begin with, so unlike flu and colds that almost disappear in summer, covid will most likely be slightly less contagious than in winter (people being more outdoors helps too). That’s not enough to make it not spread in warm countries now, but it will likely help some bad areas in colder climates such as New York or Germany.
Until there is a vaccine or the entire remaining population develops some immunity, the disease is still around and lockdown will have to be lifted gradually to keep the number of new cases low enough that the cases that need intense care can get it.
Japan still has a growth rate that's doubling roughly monthly. Better, and a much flattened curve, but still concerning.
That said, if the 5 days is true, then you wouldn't expect them to remove the lockdown until they know they've starved the virus for the incubation period (I think it's generally accepted that 14 days is the number, but that there are potentially longer outliers). By that logic, you wouldn't expect them to lift the lockdown materially for another 9 days and even then you would expect them to only gradually lift restrictions while they ensure no new cases emerge.
I'm sure there are media outlets saying China has "defeated" the virus, but from what I've read they've contained it, kept new infections to a minimum (attributing all at this point to imported cases) and are still on varying degrees of lockdown. And this is hardly reputable, but I follow people on Instagram who are in Shanghai and folks there still talk as if things are far from normal... There are still restrictions on what you can do, where you can go.
On the positive side, it shows that Wuhan now have enough testing capacity to test almost every single one who walked in a hospital even they are seeking medical help for completely different issues.
Off-topic I know, but this is a pretty good description of the Sim City “donut” shape that was essential to building a megalopolis and winning the game. You built residential units around a park center, and with the right conditions that developed into white high-rises like those in her linked picture.
For years experts have warned that another SARS-like virus is going to come out of China, due to their animal husbandry practices and culture of eating certain animals.
Then this disease appears, and China initially tries to suppress news of it. They deny it's an issue. Wasting valuable time and allowing it spread unchecked to the rest of the world.
Then, about three months ago they lock down Wuhan to contain it (an area with millions of people I think?) This means, based on this Twitter thread, that residents can't even walk outside. So, like being incarcerated?
And, people's wages are getting paid still, but as loans they'll owe when this is all over. So, like debt?
What boggles my mind is all the positive news coverage of this. Why are people fawning over this?
e.g.
“China has used draconian measures to contain the spread of the virus, including locking down Hubei province and more recently stepping up measures to screen and quarantine overseas arrivals.” Reuters (NYTimes?) https://www.nytimes.com/reuters/2020/03/21/world/asia/21reut...
Truth is nonideological.
As much as China squandered weeks, possibly months of advanced warning, we've seen precisely that script repeated around the world, across a wide range of cultures, governmental systems, economic systems, and ideologies.
With a few notable exceptions: Hong Kong, Singapore, Taiwan RoC, and South Korea most notably.
This epidemic is unprecedented since WWII, and everyone is making up their response (including numerous ineffective ones) as it develops. Most often there are no good options, only least bad ones.
Speaking of that:
- Hongkong and Palau has much worse eating wild animal habit than Wuhan.
- Hundreds of Wuhan gov officials got punished due to inefficient response, more investigation is still continuing.
- First case reported at end of Dec, China CDC shared out coronavirus gen sequence in Jan, Wuhan locked down in Jan, but the most of the world simply did nothing in the upcoming 3 months and keep spreading unchecked globally even today.
- "Incarcerated" or die, you make the choice.
- Loan payments are postponed as well.
If the shutdowns/lockdowns go for more than 4 weeks, I think we'd have been better off just letting the disease run wild. More people will die from the economic issues at that point. Might be too late already.
> "The case fatality rate (CFR) depends on the availability of healthcare, the typical age and health problems within the population, and the number of undiagnosed cases. Preliminary research has yielded case fatality rate numbers between 2% and 3%; in January 2020 the WHO suggested that the case fatality rate was approximately 3%, and 2% in February 2020 in Hubei. Other CFR numbers, which adjust for differences in time of confirmation, death or remission but are not peer reviewed, are respectively 7% and 33% for people in Wuhan 31 January. An unreviewed preprint of 55 deaths noted that early estimates of mortality may be too high as asymptomatic infections are missed. They estimated a mean infection fatality ratio (IFR, the mortality among infected) ranging from 0.8% to 0.9%. A peer-reviewed article published on 19 March estimated the overall symptomatic case fatality risk as 1.4% (IQR 0.9–2.1%). The outbreak in 2019–2020 has caused at least 335,974 confirmed infections and 14,641 deaths."
Current predictions are that letting the disease run wild would result in millions or tens of millions of deaths, and on top of that another large number of people walking around (slowly) with serious lung damage. Consider this:
> "The Hong Kong Hospital Authority found a drop of 20% to 30% in lung capacity in some people who recovered from the disease, and lung scans suggested organ damage."
But in any case, the CFR estimates are also changing as a function of learning more about how to treat, and hospital capacity relative to caseload.
I was replying about the "let it rip through the population" scenario, without slowing it down, which basically means don't treat the majority of severe cases in hospital (because the hospitals would be totally overwhelmed in that scenario). The CFR would be higher.
Curious how you get this impression, do you have specific examples in mind? For example, bats, wolves and civet cats are consumed in Wuhan, which is not the case in Hong Kong.
> - Hundreds of Wuhan gov officials got punished due to inefficient response, more investigation is still continuing.
On the flip side, I wonder how the cases for the eight whistleblowers reprimanded by local authorities, including Li Wenliang, are being investigated. More importantly, the real question is: does it actually solve the problem? Replacing officials (especially the local ones) is easy, solving the root cause (lack of accountability) is hard.
There you go. Even in Guam. https://en.wikipedia.org/wiki/Bat_as_food
Australians eat crocodiles and kangaroos. https://www.cnn.com/travel/article/australian-food/index.htm...
Our world would be better with more accountability. And in this case there is one specific party who fucked up worse than all the rest, particularly given their 20 year notice.
All very difficult stuff to get international accountability on, they’ve really joined the super power ‘I-do-whatever-I-want’ club nicely.
Moving forward, we can criticize the reasons in the post mortem. However, if we are looking to find the truth, we cannot start with blame. We all know how blame causes people to cover their ass and inhibits learning.
Wuhan medical community recognized a new pneumonia of unclear cause in late December during winter and the height of influenza season. The novel Corona Virus was identified, WHO was notified, the genome was sequenced. This took roughly 1 week. Then it took 3 more weeks of "stability management" before central government quarantined WuHan and essentially shutdown the entire country right before the most important holiday of the year and the largest annual human migration.
4 weeks for identification to evaluation to 3 months of aggressive techno-authoritarian quarantine, and assuming 2nd wave and import cases can be managed until the vaccine - China just demonstrated the first civilization model in human history to be able to suppress a virus of this magnitude in large countries. Other countries are only recently adopting the war analogy, China executed it on a dime. How they'll fair in rebooting society is unknown.
Was there missteps? Yes. Could they have done better? Not by much IMO. Every misstep with Chinese characteristics is being repeated just as worst in other countries with their cultural characteristics. The overall response as been not as agile (if there a response at all), despite having ample notice and more information.
The retrospect of this global health crisis is going to be interesting, China and a handful of islands managed to successful crush the curve, complacent developed countries may or may not successful spread the curve, and all the developing countries get rapid herd immunity because like the Spanish flu, they have no other choice. 1.4 billion people without herd immunity among a globalized world with immunity is going to be a conundrum though.
But for herd immunity to occur, a very large portion of the herd needs to get infected. And I would assume that proportion is greater, the more infectious a disease is.
The idea with the lockdowns is to keep the rate of infection slow enough that hospitals can handle the influx of cases.
Many considerations in a region of 60million, i.e Jan 17th was the regional two sessions meeting. The early migration and WuHan being regional hub no doubt precipitated the decision to lock-down that fast. China locked down most of the country after ~30 days. Outside of a few city-states or island nations, we have ample counter-examples that no other country has responded as agile as China. Many don't even have a meaning response plan in place.
The earliest known case was 1 Dec.
There were suspected cases going back at least as mid-November.
Do you doubt that health officials in Wuhan were - to put it mildly, incurious about the novel flu like sickness?
The doctors who saw these cases are certainly curious, but unless one sees a number of related cases with similar symptoms, "novel infectious disease" would not be among the first few explanations one turns to. There are simply too many other possible reasons (and more probable in routines) for flu-like symptoms. Unfortunately due to the nature of this virus early cases are indeed pretty isolated.
From what I read, the virus was first detected by an mNGS run in late Dec, which as far is still a "fuck I believe this must be caused by microbe but I'm seriously out of idea what could this be"-thing to Chinese doctors.
The mNGS run itself happened around Dec 26 if you look at the original photo Dr. Li posted.
Could you please highlight where in this news article a date earlier than late December (like, Dec 1 or Dec 8 as you said) was mentioned? It brings a valid point, that China government sat on the problem for three weeks, but the timeline does not match yours.
How is this any different from what China did?
At-least China has gotten things under control, the west is on fire. Italy is being decimated and being overwhelmed.
So how are the workers going to pay it back? I presume it's going to be a pay cut for the next n months until it's all made up for. While that's better than not getting paid at all, the unexpected pay cut might be problematic for households that live paycheck to paycheck (not sure how prevalent that is in china), and for the consumer economy. Also, are what happens if the employee simply quits? Are those debts legal debts?
If there were a community consensus that threadreaderapp.com links are better than the equivalent twitter.com links, we could maybe override that, but there's no such consensus.
> Our CSRF protection mechanism for POST requests checks that the origin and referer headers of the request are sourced from Twitter. Since we knew this to be effective for POSTs, we considered how we could implement this for GET requests.
> This proved effective in addressing the vulnerability, but it prevented this initial load of the website. You might load Twitter from a Google search result or by typing the url into the browser. To address this case, we created a blank page on twitter.com which did nothing but reload itself. Upon reload, the referer would be set to twitter.com, and so it would load correctly.
https://blog.twitter.com/engineering/en_us/topics/insights/2...
Not sure how they disinfect the taxi afterwards though. Anyone more knowledgable on this?
From Wikipedia ..
> Coronavirus research In 2005, a group including researchers from the Wuhan Institute of Virology published research into the origin of the SARS coronavirus, finding that China's horseshoe bats are natural reservoirs of SARS-like coronaviruses.[6] Continuing this work over a period of years, researchers from the Institute sampled thousands of horseshoe bats in locations across China, isolating over 300 bat coronavirus sequences.[7]
In 2015, the Institute published successful research on whether a bat coronavirus could be made to infect HeLa. A team from the Institute engineered a hybrid virus, combining a bat coronavirus with a SARS virus that had been adapted to grow in mice and mimic human disease. The hybrid virus was able to infect human cells.[8][9]
There is evidence that there virus was not engineered. The spike protein is completely novel and existing techniques for finding bonding proteins do not see this virus as a good binding candidate.
It is conceivable that the lab was studying bat coronavirus and accidentally released it, but Occam's razor suggests that the market where most early patients contacted the virus, similar to the market where SARS evolved, is the actual source.
(Even those that say it started from the U.S. https://www.nytimes.com/2019/08/05/health/germs-fort-detrick...)
There is absolutely no evidence showing the virus started from a lab, regardless of Chinese or American.
https://nplusonemag.com/online-only/online-only/chinese-viru...