Saul Leiter Man with flowers, NY 1950s
A few days ago, I was thinking of writing another corona article, focusing on two things: 1) the ease and speed with which the virus spreads -because I think that is hugely underestimated-, and 2) testing. But then the situation with the two cruise ships started going berserk.
I had intended to use the Diamond Princess as a case for the ease and speed of infection, but it became clear quite rapidly that you can’t use the ship to prove any case, other than that people are completely nuts. But we already knew that. And while Dostoyevsky wrote some great books on the topic, it’s not a great framework for a piece on a virus. Unless perhaps if it infects the brain.
Not that I don’t think the ship is still a good example to make the point, but too much plain bonkers stuff has been going on with and around it. The quarantine, the evacuations, the infection numbers, you name it. I’ll get to the testing later, that was/is a whole other chapter.
A problem, if you’re me, with letting an essay simmer for a bit, is that ever more sources start accumulating, until there’s too many to either comprehend or use in an effective way. First thing to do is not to wait another day. Let’s start with 1) The ease and speed with which the virus spreads, aka transmissibility,, and see where we land.
1) The ease and speed with which the virus spreads
People continue to have this idea that COVID19 isn’t all that bad, yada yada, an “analysis” crowned by the comparisons to seasonal flu. Which make no more sense then to compare it to bovine flatulence. Stop it.
The way and extent the virus was spreading aboard the Diamond Princess became clear before the evacuation efforts. The US government, and others, were watching it happen, and pulled the plug. What the Japanese were doing and thinking is less clear. It’s sort of fun to see Washington refrain from calling Tokyo on it, best allies and all, but it makes you think at the same time.
So if using the Diamond Princess is not a good example, we need to look elsewhere. This Feb 16 Zero Hedge graph of infections outside China might be a good start. Whether it represents an exponential or a quadratic function is sort of an inside joke by now, but it’s clear enough in either case.
Even more obvious perhaps is this from the South China Morning Post (SCMP):
The deadly new coronavirus is up to 20 times more likely to bind to human cell receptors and cause infection than severe acute respiratory syndrome (Sars), a new study by researchers at the University of Texas at Austin has found. The novel coronavirus and Sars share the same functional host-cell receptor, called angiotensin-converting enzyme 2 (ACE2).
The report, published on the website bioRxiv on Saturday, said the new coronavirus had around 10 to 20-fold higher affinity – the degree to which a substance tends to combine with another – for human ACE2 compared with Sars. But the researchers added that further studies were needed to explore the human host-cell receptor’s role in helping the new virus to spread from person to person.
“Compared with SARS-CoV, 2019-nCoV appears to be more readily transmitted from human to human,” the report of the study said. “The high affinity of 2019-nCoV S for human ACE2 may contribute to the apparent ease with which 2019-nCoV can spread from human to human.”
The ACE2 receptor has already been reported as being much more prevalent among Asian people, but please don’t presume the buck stops there. Non-Asians have them as well, and we’re not even sure what role they play, or if fewer of them would protect you from being infected. Allegedly, smokers have more ACE2 enzymes as well. As do older people.
Another transmissibility example is the death of an entire family in Wuhan:
A Chinese film director and his entire family have died from the novel coronavirus in Wuhan, the epicenter of the outbreak. Chang Kai, a film director and an external communications officer at a Hubei Film Studio subsidiary, died in hospital on Feb. 14 from the virus now called COVID-19, according to a statement from the studio. He was 55.
But Chang’s death was not the first in his family—the Chinese media reported that Chang’s father and mother were infected and died one after the other. Chang and his sister, who looked after their parents at home, were both infected with the virus as a result. His sister died just hours later. Chang’s wife is also infected, still alive, and is still battling the virus in an intensive care unit.
But everything above loses most of its meaning compared to the following, also from the South China Morning Post. You might want to sit down for this one.
Until now, ‘accepted knowledge” is that the first death from COVID19 was registered on January 9 2020, a 61-year old man in Wuhan. And that the incubation time for the virus was maximum 14 days – hence the 2-week quarantines everywhere. No more.
The government of Xinxian county, in the city of Xinyang, on Sunday reported that one of its new cases had been confirmed 34 days after the patient returned from a mid-January visit to Wuhan.
He had been sent to hospital with suspected symptoms on January 28, but twice tested negative before testing positive on February 16. A further two people who attended family gatherings with the man in Xinxian were reported as infected, while three were suspected cases or under hospital quarantine.
The county government announced it would extend the home quarantine period from 14 to 21 days for residents who had been to Hubei or had contact with people who had been there.
It also reported a case that was confirmed 94 days after the patient’s contact with a relative from Hubei. The patient had taken care of his father-in-law, who arrived from Wuhan on November 13 and died days later.
The son-in-law continued to stay in the father-in-law’s house until January 31. However, the government statement said the origin of the son-in-law’s infection had yet to be identified. Zhuhai, in the southern Guangdong province, last week reported two cases with incubation periods longer than 14 days. Similar cases have also been reported in Anhui and Shandong provinces.
This potentially pushes back the first known case to November 13 2019 and the first known death to November 13 and change. “Died days later”. Shall we say 4-5 days? That means the first fatality was November 17-18. While incubation time may have been pushed forward to 94 days.
The most important term coming out of the coronavirus news, going forward, will be “false negative”. Closely followed by “asymptomatic”. There are tons of stories about people testing negative 2-3-4- times before testing positive. And also tons of stories about people with no symptoms infecting others. It’s all about the things you don’t see.
The Chinese had it about as wrong as can be early on, and knee-jerked into the Party deny and hide mode. They have it right now, though: the only way to keep the virus from spreading is to limit contact between people, even if that may seem to reach extreme proportions. If there is no vaccine, there is no other way. But if it’s just the Chinese that do isolation, that solves nothing.
When I first read that the passengers of the Holland-America Line cruise ship Westerdam had been allowed to leave the ship when it landed in Cambodia a week ago after, I think, 9 days of floating around aimlessly, I thought this was a “Go Forth and Multiply” message for the virus. Second thought was: who’s in charge here? Still wondering about that one.
The Westerdam had 2,257 people on board, 1,455 passengers and 802 crew. They were not allowed to dock anywhere after a man who had gone off board in Hong Kong tested positive. As we speak, some 255 passengers and 747 crew members are still being held on the ship while further testing was conducted. That means 1,200 passengers and 55 crew have left the ship. Cambodia let lots of them fly to Malaysia, and they flew all over from there.
And only then did they discover an 83-year old American woman who had already flown to Malaysia had tested positive. The ship had a lot of Americans (400?) , Canadians and Dutch people on board. Where did they go? Mostly home, of course. And now all those countries are scrambling to locate these people. Even if they do, who have they infected in the meantime? They’ve been in close proximity to others, like on planes.
And, again, who’s in charge? Did the Holland-America people, and the Cambodian government, keep in constant touch with the WHO and the Chinese? Would it have made any difference if they did? Or is it as bad as it seems, a Wild East sort of set-up with everyone fending for themselves?
What are the odds that someone in the Cambodian government now has a new offshore bank account with $10 million in it, in a deal made before the 83-year old American woman tested positive, in exchange for letting the ship dock and making sure the passengers would leave ASAP?
Hard as it may seem to imagine, the Diamond Princess may be, and have been, even more of a mess than the Westerdam. Someone said: “it was a mess on board, and the mess is now moving off board”. And now we have the first 2 fatalities from the ship.
Diamond Princess: everyone confined to their cabins, little interaction, but still in the past week numbers of new infections have exploded, with many dozens of new cases every day. So now we have a total of what, 500-600 new infections ever since the US said: enough!
Why were they, why were larger numbers, not discovered earlier? Well… There were 3,711 people on board. 5-6 days ago, 10-12 days after the first positive test, 1,219 had been tested. Which means that after 10+ days of quarantine, less than a third had actually been tested. As of Monday, 2,404 passengers and crew, out of the 3,711, had been tested. That still left 1,300. Many of whom are now gone.
The remaining 61 American passengers on the Diamond Princess who opted not to join the evacuation will not be allowed to return to the US until March 4, according to the American embassy in Tokyo.
Undoubtedly some logic behind the lack of testing until recently will be offered by Tokyo, but you must wonder how many of the 542 new cases of the last four days had been tested at all, and how long some of them had been infected, probably without showing any signs. For instance, the 14 cases on the flights to the US this week were all asymptomatic virus carriers. All of them, according to official channels.
And now we read that Japan has no intentions of quarantining its citizens who were on board the Diamond Princess:
Earlier in the week, the United States evacuated more than 300 nationals on two chartered flights. A State Department official said there were still about 45 US citizens on board the cruise ship as of Thursday. Americans flown back will have to complete another 14 days quarantine, as will returning Hong Kong residents. Disembarked Japanese passengers, however, face no such restrictions, a decision that has sparked concern.
One more thing, then I’ll stop. Zero Hedge a few days ago quoted a Taiwan Times article saying people can be infected multiple times. And be worse off for it. A first infection leaves your immune system ravaged, and combined with the damage caused by the medication taken, can make you helpless against a second attack.
Doctors working on the front lines of the novel coronavirus (COVID-19) outbreak have told the Taiwan Times that it’s possible to become reinfected by the virus, leading to death from sudden heart failure in some cases. “It’s highly possible to get infected a second time. A few people recovered from the first time by their own immune system, but the meds they use are damaging their heart tissue, and when they get it the second time, the antibody doesn’t help but makes it worse, and they die a sudden death from heart failure.. ”
“The source also said the virus has “outsmarted all of us..” [..] “It can fool the test kit – there were cases that they found, the CT scan shows both lungs are fully infected but the test came back negative four times. The fifth test came back positive.” -Taiwan Times
We will now start to see the economic effects (you haven’t seen anything yet in that regard). More on that later. Rule of thumb: companies have 1-2 weeks of supplies in stock. Just-in-Time. Then they need more delivered. But the Chinese economy is on its last legs. Please don’t think it’s about Apple or some other major company. This is about a million smaller companies and (chain) stores in the west. What was it, 80% of US drugs come from China? Or was that just antibiotics?
There are ways to minimize the damage a virus can do. Mankind as a whole, in the places where the proverbial chain literally is as strong as the weakest link, has not minimized it. Instead it has told the virus: “Go Forth and Multiply”. Prepare accordingly. If we’re lucky, this will die down and pass. But that’s the problem: it’ll happen only if we’re lucky, not because we’ve done all we know we could.