China Coronavirus Watch: Updated – Another Chinese City Locked Down to Prevent Spread

It isn’t yet clear how serious a health threat China’s new coronavirus outbreak will be. The 17 deaths attributed to it so far pales in comparison to annual winter flu mortality. [See update at end: Chinese authorities clearly very worried…and per the theme of the post, do they know more than they are letting on, or is this the public health version of fog of war?]

Note that as of now, the WHO has not declared this coronavirus outbreak to be a global health emergency. But the speed and severity of China’s reaction, taking the unprecedented step of cordoning the city of Wuhan, is enough to lead worry-warts to think officials might know something they haven’t yet ‘fessed up to.

Even though Wuhan is a provincial capital, it has a population of 11 million and 600 to 800 daily flights, including direct flights to San Francisco, Tokyo, London, New York, Paris, and Moscow. The Chinese measures are on the order of halting air, train, and other public transport travel from New York City right before Christmas.

However, the “lockdown” wasn’t absolute:

But other images suggest that getting out by car is difficult:

And this suggests road exits are being shut down:

Input from readers who can read Chinese and provide more intel would be very much appreciated. For instance, it would be useful to know if other sources confirm that locals are concerned that the travel limits will affect daily life, or if this is what Lambert likes to deride as “Web evidence”:

Note the figure of 554 cases is confirmed infections; many press reports now estimate the number of infections as in the thousands. There have also been confirmed cases in the US, Macau, Hong Kong, Taiwan, and Thailand.

This tweet gives more confirmation of the strictness of measures within Wuhan:

Recall that the coronavirus is believed to have started at a market for exotic meat; researchers believe it might have originated with snakes. Chinese don’t like eating formerly frozen meat, so these foods are regularly transported in trucks unfrozen; only the bourgeois shop at stores with refrigerator cases. When I visited Bali in the early 1990s, I was disconcerted by similar norms: local markets, with the food market the big draw and stalls with clothing and crafts on the periphery, with vegetables and (hopefully slaughtered that day nearby) raw chicken parts piled up in baskets in the equatorial heat.

This gives an idea of the much more modern, urban version of that type of market in Wuhan:

The Chinese response could come out of post mortems of the 2002 SARS (“severe acute respiratory syndrome”) outbreak. I could easily see that if you are dealing with a new disease that has proven itself to be a killer, an aggressive response early on would be a more prudent approach than waiting to have better data about communicability, vulnerability, and infection modes. In other words, the potential for this outbreak to be SARS 2.0 is ample reason for caution. From Wikipedia:

…an outbreak of SARS in southern China caused an eventual 8,098 cases, resulting in 774 deaths reported in 37 countries, with the majority of cases in China and Hong Kong (9.6% fatality rate) according to the World Health Organization (WHO). No cases of SARS have been reported worldwide since 2004.

A 10% death rate is enough to focus the mind. And again, based on the data out of China so far, it does not yet appear that this new coronavirus is that lethal.

Nevertheless, Mr. Market didn’t like the look of medics in hazmat suits attending the sick and inspecting planes.

The ban on travel out of Wuhan, a city of 11 million, triggered a drop in the Shanghai index of 2% and Hong Kong, 3%. The Nikkei and the ASE also fell.

Bloomberg has some detail on the fatalities:

At least nine victims had pre-existing conditions such as diabetes, coronary artery disease and Parkinson’s disease, the National Health Commission said. Eight were aged 80 or over, two were in their seventies, five in their sixties and one in his fifties. The youngest was a 48-year-old woman with a pre-existing condition. Four of the victims were women and the rest were men.

Causes for concern:

One expert thinks the extent of this coronovirus spread could be much worse than SARS. From Shanghaiist:

In an interview with Caixin, Guan Yi, a Hong Kong University professor specializing in infectious diseases, feared that the scale of the Wuhan virus may be 10 times greater than that of SARS, adding that the situation left him feeling “powerless.”

”I’ve experienced so much. I’ve never felt scared, most of them are controllable, but this time, I’m scared,” he told the news outlet on Thursday in regards to his recent trip to Wuhan to help discern the source of the virus.

Arriving in the city on January 21, Guan was critical of what he saw there including the alarming uncleanliness of local wet markets and the airport, even as the city was on high alert. After only a day in Wuhan, he decided that he needed to get out. He has since put himself into isolation.

When asked for his opinion, Guan was skeptical about how much good the Wuhan lockdown would do, noting that many residents had already left the city for the Spring Festival holiday and that the optimal time for quarantine had already passed.

He also explained that this new virus may prove more difficult to trace than SARS, which was chiefly transmitted by so-called “superspreaders.” So far, health authorities haven’t been able to trace the spread of the virus.

Some of the people who died did not exhibit a fever. This is particularly troubling since it would make it well nigh impossible to determine who has been infected. Again from Bloomberg:

Several people who’ve died from a new virus in China didn’t display symptoms of fever, potentially complicating global efforts to check for infected travelers as they arrive at airports and other travel hubs.

Details released by China’s National Health Commission show five of the 17 people who died after being infected with novel coronavirus displayed other symptoms such as breathing difficulty, chest tightness and coughing. The joint-oldest victim, an 89-year-old male, was suffering from drowsiness and incontinence, as well as a fever. He sought medical help on Jan. 5 and died on Jan. 18. He had pre-existing conditions, including hypertension.

There are rumors of new cases in Hong Kong (note one has been confirmed so far):

And the greater extent of air travel in and out of China greatly increases the risk if this coronavirus proves to be as deadly as SARS:

However, Chinese officials really are not messing around:

But what about people with no fever in China and abroad?

Update 6:00 AM: Via a Wall Street Journal news alert:

On Thursday, authorities in Huanggang—a city of 7.5 million people—said they won’t let long-distance trains and buses run from the urban center and will shut its public transportation system in the lockdown zone, effective midnight Friday local time. Ezhou, another neighboring city with just over a million residents, said it would enact similar restrictions.

Huanggang is about 35 miles east of Wuhan, a city of 11 million and a major hub for travel, where the new pneumonia-causing coronavirus originated. Wuhan just hours earlier halted outbound trains and flights and shut down its public-transportation system.

The Huanggang local government also said movie theaters, internet cafes and other entertainment and cultural facilities in the city center would temporarily halt operations and a central market would be shut down for an indefinite period.

Starting Thursday, the local government said it would inspect every person and car entering and exiting the urban center.

The new restrictions and shutdowns effectively represent a doubling down by Chinese authorities of a high-stakes strategy that experts describe as an untested approach to dealing with infectious diseases.

The BBC is running a live blog.

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91 comments

    1. JohnnySacks

      And here we are thinking an impossible green new deal was needed to curb global warming. There’s such balance in nature.

      Reply
      1. MyLessThanPrimeBeef

        Regarding the Green New Deal and Climate Change, it appears, for now, that suburban (or rural) sprawl is better than high density urban living, and public transportation can be lethal, in this case.

        Reply
  1. bwilli123

    Via Chinahand (@chinahand)
    “Professor Yi Guan, Director of the State Key Laboratory of Emerging Infectious Diseases, @HKUniversity – We can’t control the source of infection. I’m pessimistic, the scale of infection of #nCoV2019 would be 10 folds of SARS.”
    From Google translate

    …”Caixin Reporter: What have you observed in Wuhan recently?

    Guan Yi: I arrived in Wuhan on the 21st and arrived at a local vegetable market called Xiaodongmen Market at 3 pm. The scene was peaceful and many people were still busy buying New Year’s goods. I was extremely surprised. Because this time Wuhan pneumonia originated from the South China seafood market, the source of animal infections has not yet been found, and other vegetable markets appear to be unsatisfactory. The Xiaodongmen market is humid, the hygiene is very poor, and the ventilation equipment is poor. I observe that less than 10% of the people in the market wear masks.
    After that, I met some local departments again. At night, I judged that the epidemic situation was out of control in Wuhan. Even people like me who have been “struggled in battle” have to be deserters, so I quickly settled on the 22nd. Out-of-city tickets.
    At the airport the next day, I was surprised again that I dropped my chin. The airport’s passenger flow has dropped significantly, and the airport actually has individual tours.
    What’s even more puzzling is that the ground of the airport is not disinfected, and only the thermometer is used to monitor the body temperature. I observed that in the Wuhan terminal, only sporadic places such as Starbucks put disinfectant.
    When I passed the security check, the little security girl holding the luggage box was wearing only the simplest disposable mask. I said: Girl, the quality of your mask is not good, and you are in contact with so many passengers every day. She said that she was not allowed to wear it because she was worried about affecting the image, which was prepared by herself.
    This shows that even though the central authorities have spoken highly in the past two days, the local health protection has not been upgraded at all. I thought at the time that this was going to be a “state of war.” Why hadn’t the alarm been raised? The people were so pitiful that they were still preparing for the New Year with peace of mind and had no sense of the epidemic.

    Caixin Reporter: What progress have you made in finding animal sources in Wuhan?

    Guan Yi: I ate a lot behind closed doors, and there were not many scientific research institutions willing to cooperate. They are inertia in management and may consider themselves more capable.
    But the key point I want to point out was that the South China Seafood Market was closed, the floor was washed, and the “crime scene” was gone. How can we solve the case without evidence? Tracing the source of an animal is a relatively complicated process. I cannot easily find an animal with a virus and blame it as the culprit. It requires scientific analysis such as scale and system.

    Caixin Reporter: How to treat Wuhan ’s closure?
    Guan Yi: Evaluating a measure depends on the time and effect. At the time, I feel that the golden prevention and control period has been missed, and I am not optimistic about the effect. According to my observations, the flow of people on the streets of Wuhan City has significantly decreased on the 21st, the Spring Festival tide is almost over, and many young people or hometowns have returned home for the Chinese New Year. They may have come into contact with patients in the community and left the city It is still in the incubation period, and it is likely to be mobile viruses. When these people returned to their hometowns, they took the virus to all parts of the country. Starting from their departure on the 17th and 18th, people on the 25th and 26th may need to pay more attention.
    In addition, those who have left the city will not or do not understand how to isolate themselves. I don’t think the local government has done anything, and even a quarantine guide has not been given to those who have left the city.
    On January 20th, the National Health and Medical Commission has issued a document to include Wuhan pneumonia into the legal management of Class B infectious diseases, and adopted measures for the prevention and control of Class A infectious diseases. However, according to my observations and investigations, I still have Wuhan Undefended city.

    Caixin Reporter: How to determine the trend of the next epidemic?
    Guan Yi: The outbreak is certain. “Wuhan’s nine provinces are all connected”, coupled with missing the gold prevention and control period, and the tide of the Spring Festival, some people do nothing.
    I have also counted hundreds of battles and experienced bird flu, SARS, H5N1, swine fever and so on. But for this pneumonia in Wuhan, I really feel extremely weak. There is simply no comparison with the SARS epidemic. At that time, SARS first developed in several cities in the Pearl River Delta, followed by Beijing and Hong Kong.
    60% -70% of the SARS infected people are from individual super communicators, and the transmission chain is very clear, as long as the contacts of those people are blocked. But this time, the source of transmission has been fully spread, and epidemiological investigations are no longer possible. And to control costs, you should use a geometric digital meter.
    It is conservatively estimated that the scale of the infection may eventually take off 10 times that of SARS. I’ve experienced so much, I’ve never felt scared, most of them are controllable, but this time I’m scared.

    more at the original (in Chinese)
    https://www.caixin.com/2020-01-23/101507670.html

    Reply
    1. Susan the other

      Thanks bwilli. This sounds like pure chaos. They scoured the market so nobody can find cues to the origin of the virus. And it has surely already escaped into the wider world. Not much news this morning on the radio. I don’t like it when things go quiet. Xi did warn the Chinese authorities that if they tried to hide the problem they would be “nailed to a pillar of shame.” I guess they can use virus DNA and other indicators; and vaccines can follow pretty fast – but not fast enough to stem this first terrifying round of infections. Wild meat markets sound like they should have been banned long ago.

      Reply
    2. MyLessThanPrimeBeef

      It would seem that Hong Kong is still needed by China, if not for financial reasons, brain power.

      Thank you, prof. Yi Guan of Hong Kong Univsersity.

      I think there were some who suggested that China no longer had use for HK.

      Reply
        1. MyLessThanPrimeBeef

          Instead of spending all that money on One Belt One Road, people in China might ask the leadership to invest in China and the people of China.

          Hardware like infrastructure is nice, but it should not be mothers wanting to give birth in the US or buying baby formula abroad.

          Spend some to sanitize markets, for example, would be a good start.

          Reply
    3. Krystyn Walentka

      I have a feeling the horrible air pollution in Wuhan is not helping any of this:

      Exposure to diesel exhaust particles linked to pneumococcal disease susceptibility

      Dr Rebecca Shears, who is first author, added: “Our study shows that exposure to DEPs, which is a major airborne particulate pollutant both here in the UK and abroad, may be one of the key factors involved in the switch from harmless pneumococcal colonisation of the nasal tissues to severe disease, such as pneumonia.”

      “Our data provides further insight to support previous observations of increased pneumonia hospital admissions in countries such as China, where airborne pollution levels are highest.”

      And here is Wuhan Air Quality

      Reply
      1. Math is Your Friend

        This is likely irrelevant. Pneumococcal pneumonia is caused by a bacterium that is normally resident in a large fraction of the population.

        The Wuhan virus appears to be a totally new thing, and quite different from a bacterium.

        Living where the air quality is higher is not likely to reduce your chance of contracting the virus.

        Reply
          1. epynonymous

            So it’s not just “Swine flu” or “avian flu”? Or H1N1, or…

            Some marketing team these diseases have these days. And the media seems to have no taste for reporting this in the context of all the die off of pork in China. I don’t know what’s true, but it’s terrifying either way that these might be related or that they are really 2 separate outbreaks.

            https://www.nytimes.com/2020/01/01/opinion/china-swine-fever.html

            1/4 of the world’s pigs died off in a year. 40% of China’s total population. This article calls it “African Swine Flu” (seems unlikely to me…) and says it started in NE China. The cause authors theory? “in April 2016 the central government mapped out a strategy called ‘nanzhu beiyang’: ‘raising pigs in the North for consumption in the South.’ ” (Might be time for him to check his social credit score and GTFO IMO) This checks out if the north central origin checks out for the origin of the human outbreak.

            “Pig speculators (“chao zhu tuan”) — yes, there is a specific term for them — traveled to various households and villages to collect these pigs and ship them to other localities, enabling the disease to cross administrative borders and disseminate. In northern and central China, some speculators even deliberately tried to spread the disease by using drones to drop contaminated pork products into farms. After causing an outbreak, or at least sparking fears about one, speculators could buy pigs for cheap — then stockpile the animals for a time to create shortages locally and sell them only after the prices had gone back up.”

            There’s more, but it’s getting long winded here. Worth hitting cntl-a cntl-c and throwing the article in a word doc so you can browse around the pay-wall.

            Reply
        1. ewmayer

          “Living where the air quality is higher is not likely to reduce your chance of contracting the virus.” — That is far from obvious, especially given the bit in the article KW linked, about “the switch from harmless pneumococcal colonisation of the nasal tissues to severe disease, such as pneumonia.” Note the “such as” – that implies more broadly increased susceptibility to all manner of respiratory diseases, which quite plausibly follows from the kind of generic inflammation cascade and tissue damage associated with exposure to air pollution. And Henry Moon Pie below also notes the compromised-immunity-and-overall-health effects of living in highly polluted air.

          Harking back to just over 100 years ago, one of the key factors that helped make the ‘Spanish’ flu pandemic so widespread and deadly was its ability to induce a Cytokine storm in its victims … one of the known predisposers to that is noted as being “systemic inflammatory response syndrome (SIRS)” … the associated page does not specifically mention chronic pollution exposure, but it seems quite possible to me.

          Reply
  2. Ignacio

    Yes, I think it may be a bit too late for quarantine. The rate of spread is yet unknown though it looks like relatively easily given how fast has spread so far. If many infected people remain largely asymptomatic but can spread the virus it will be extremely difficult to control. It doesn’t seem to be very virulent except in people that have conditions making them vulnerable.

    Regarding the source, potentially snakes and bats, it has been described before that some bat CoV species identified in Guandong use for cell entry the same receptor that human MERS-CoV and that could explain why bats can be a reservoir for new CoV infecting humans and human-to-human spread. The article linked in the post speculates that bat and snakes CoV migth have combined in the market. The solution is easy: force sanitary measures in those markets, please!

    When I was young I worked in a lab that focused a big part of its work in the evolution of plant RNA virus and I participated in a paper that showed (through a relatively large sample of isolates taken in a field study in Spain) how natural recombination had an important role on the evolution of Watermelon Mosaic Virus (Potyviridae) and i find it somehow rewarding to find, if you can forgive me for this, that natural recombination is also important in animal RNA viruses like CoV.

    Reply
    1. OpenThePodBayDoorsHAL

      My son works in the unit of the Australian government responsible for containing this, they met the 11:15 flight from Wuhan to Sydney and snatched a potential carrier, whisked him off to hazmat suit land. They already had the genome from the Chinese and WHO so now they’re testing

      Reply
      1. Ignacio

        Australia has an experience on epizootic virus outbreaks. If I remember well, in the nineties there was one from horses though not sure if the original reservoirs were also bats. In that case it was limited because there wasn’t human to human spread.

        Reply
            1. The Rev Kev

              Ah, you must be talking about Hendra which is an absolute mongrel of a virus and has killed people from time to time-

              https://en.wikipedia.org/wiki/Henipavirus#Hendra_virus

              The government got together with a drug company to push a vaccine a coupla years ago and more or less made it mandatory for your horse to have it if you took it to a show or something. Trouble is that the vaccine has been devastating to so many horses due to side effects and we know of so many stories of this happening to good horses as well as horse deaths-

              https://www.abc.net.au/news/rural/2018-03-21/classs-action-launched-against-hendra-vaccine-makers/9572480

              https://vetpracticemag.com.au/inside-the-hendra-vaccine-debate/

              Reply
              1. Tony Wright

                Yes. My wife ran a vet practice in northern NSW for 14 years until 2018. She has now retired due to autoimmune arthritis.
                Her practice gave up all horse work back in 2015( I think) due to the huge (>40%) mortality rate in humans unlucky to be infected via exposure to horses, which had acquired the virus from exposure to infected fruit bats.
                Many human diseases originated in other species. Even the virus that I spent many years working on in Public Health, Ross River virus, exists in natural zoonotic cycles between some mosquito species and wildlife ( mainly macropods and possums). Humans are then infected via the bites of mosquitoes which have acquired the virus from said wildlife.
                Other arboviruses affecting humans elsewhere in the world similarly occur in natural zoonotic cycles causing no apparent morbidity in their natural hosts. Not dengue though, which occurs in a human/mosquito cycle, largely involving the domestic, container breeding species Aedes aegypti.
                The point is that these various pathogens of animal origin are going to be an increasing risk as human population numbers continue to rise unsustainably, and humans encroach further into remaining natural habitats and are exposed to previously sequestered animal pathogens. Ebola is a recent such example.

                Reply
                1. anon in so cal

                  “human population numbers continue to rise unsustainably, and humans encroach further into remaining natural habitats”

                  Biodiversity versus human demographic growth.

                  Reply
      2. Dikiaos Logos

        Isn’t Australia the world’s gold standard in border control? I’m talking goods, especially non-native species, not about human migration. It sounds like they’re always ready to pounce.

        Reply
        1. Wukchumni

          Used to be back in the 80’s & 90’s when you arrived in Auckland on an international flight before disembarking, you were greeted with an aerosol spray of insect killer or something like that, a couple of NZ Ag officials in uniform would walk through aisles with both arms raised high with spray cans, fingers pushed down on the trigger and there you were in your seat, the ersatz object of the spray’s desire.

          Reply
  3. The Rev Kev

    Rather remarkable that a virus crossed from a reptilian species over to mammals but those with more knowledge on this will probably weigh in. A plane landed from Wuhan today in Sydney, Australia and nobody was kidding around. The passenger were taking their own precautions while in flight and one guy was saying that he cut short his trip early so as not to be stuck in Wuhan-

    https://www.abc.net.au/news/2020-01-23/coronavirus-warning-as-wuhan-flight-lands-in-sydney/11892018

    Reply
    1. skippy

      Lmmao it must screw some head on the wrong way to think a non connotative organism screw with religious destiny unless you could pro actively ascribe the results to reflect the aforementioned prophecy.

      Till then for your enjoyment – fixing the economist blog Philip Pilkington

      Reply
    2. Ignacio

      Yes it is quite remarkable, even surprising. I believe that so far the study done relies on sequences from only part of the virus genome so it still might be the case, when all the sequence is known, that the virus is a recombinant with parts of it from, for instance, bat origin, particularly the epitope that links with the cell receptor for entry. This is speculated in the link that Yves posted.

      Reply
        1. Ignacio

          This is consistent with bankers ability to erase their prints. Originated in a bank but passed to a market to avoid conjectures.

          Reply
      1. Susan the other

        They finally came up with an effective ebola vaccine. That was good news. But it turns out that they didn’t create it in the virus lab – instead they took blood from a healthy survivor and did a replication of his immunity (can’t remember the process); that then became the basis of the vaccine.

        Reply
    3. Tony Wright

      Arboviruses occur in cycles between blood sucking invertebrates (mosquitoes, ticks,biting midges etc) and vertebrates. Historically they are thought to have crossed over from their invertebrate vectors to the vertebrate hosts along with the evolution of blood feeding many millions of years ago. Blood feeding provides female mosquitoes with a huge protein hit to enable them to lay greater numbers of eggs. All mosquitoes, both male and female, feed on plant necter for energy for flight. Some mosquitoes e.g. Toxorhynchites species still do not blood feed – even the Australian saltmarsh mosquito Aedes vigilax retains the historical ability to lay a small first egg batch without blood feeding, despite being a wide ranging and viciously biting major vector of Ross River virus.
      Point being that if a virus can adapt from surviving and replicating in mosquito salivary gland tissues and haemolymph (which is fundamentally very different to vertebrate blood and tissues) , then almost anything is possible when it comes to viruses crossing over species. Bear in mind also the replication rates (i.e.generation times) of viruses are usually measured in minutes or hours, so the potential for the rapid evolution and proliferation of any characteristic which enhances their survival is much greater.

      Reply
  4. rfdawn

    The Independent has a live blog mentioning “official” announcement that another N million people in nearby Huanggang city are being warned not to leave town.

    Reply
      1. vlade

        Worse than that – 11m in Wuhan, 6m in Huanggang.

        I believe Wuhan has quite a few universities, and students there would have already left for CNY.
        So we won’t see the full impact until at least a few weeks, more likely month or two.

        Reply
        1. PlutoniumKun

          Wuhan is a major University centre in China and a huge hub for students. The academic year in China tends to end just before Christmas, with January being exam time for students, with the major break being Spring Festival (just starting). I know two university teachers of English in Wuhan who came back to Europe just before Christmas for a 6 week break before going back after Spring Festival (presumably, this is now unlikely).

          So while most students and teachers would still be in the city for exams, presumably a very significant number would have gone home in late December. Disastrous timing.

          Reply
          1. Dikaios Logos

            Wuhan University is among China’s most prestigious. Its ties to elites across China have to make this especially demanding for Xi, an overwhelming response seems more likely than an underwhelming one.

            Reply
            1. MyLessThanPrimeBeef

              It is a traditional Chinese belief, and mentioned quite often in the book, “Nine Sloughs,’ that natural disasters occur when the ruler has displeased Heaven.

              Logically, it is easy to see how that could have checked the worst of most emperors.

              Though China is aiming for scientific communism, it is hard, even after the Cultural Revolution, for people to stop believing completely in thousand year old ideas.

              And if many of the same mistakes from before are found to have been repeated again this time, Xi is going to look very bad, with or without Trump.

              Reply
              1. Massinissa

                I guess we will see in the handling of this crisis whether or not Xi has lost Heavens Mandate…

                If he does lose it, hopefully it won’t trigger a civil war AGAIN… It hasn’t even been a full century since the end of the last one.

                Reply
                1. Tony Wright

                  Human overpopulation will be curtailed by natural ecological constraints as apply to any species sooner or later i.e. Conflict, disease and famine. Oh, and I forgot that uniquely human generated constraint, anthropogenic climate change – just to add fuel to the fires, so to speak…

                  Reply
          2. rd

            They may be able to set up a semester of remote course work for classroom work so that students that aren’t in the city don’t go back in but can still attend lectures and do assignments remotely. Lab work etc. would be an issue, but they can creatively restructure things for this semester.

            Reply
          3. MyLessThanPrimeBeef

            Over at Rail Transport in China, Wikipedia, there is a rail map for the Middle Kingdom.

            (One can search for similar maps elsewhere).

            It shows the major route, likely the only major route, from Guangdong to Beijing is through Wuhan. The other north-south route connects the coast provinces like Zhejiang and Fujian to Beijing, through Shangrao (in Jiangxi province).

            There are a few hubs east-west-wise, and again, Wuhan is one of them.

            Reply
            1. Janie

              Wuhan is the head of navigation on the Yangtze and the home of the Yellow Crane Pagoda – and Mao. Lots of international and national tourists.

              Reply
  5. PlutoniumKun

    I’ve read reports that a significantly more people have died than has been admitted – there seems at the early stage to have been a reluctance from medical authorities to diagnose this as anything but a generic pneumonia unless they’ve had to (this is unsurprising to anyone familiar with the Chinese health system). I find it inconceivable that it could have appeared so rapidly to Japan and other countries unless its been brewing away for some months already in Wuhan, with lots of carriers. I know a few European English teachers in Wuhan who left for home in December for a long Christmas/New Year break, and they are already getting used to the jokes (and will no doubt have to go for checkups soon).

    This means its already dispersed widely, so quarantining the city is too little, too late. With the huge population movements at New Year, this is the worst possible time for it to happen.

    Reply
    1. vlade

      China being China, you’d increase any bad numbers reported by at least one order of magnitude.

      And they would hate to quarantine the city before CNY until the last moment.

      Reply
      1. PlutoniumKun

        I would have hoped they’d learned their lesson from SARS, but it seems not. The huge problem in China is that even if the will is there for better identification and action in the face of new diseases, there are huge cultural and institutional barriers to early identification. Quite simply, nobody likes being the bearer of bad news, so there is constant pressure to ensure that its someone else’s problem. Add this up to the low status and poor training of doctors in China and you have a recipe for slow reaction times at local/city level.

        Reply
        1. Goat Farmers of the CIA

          “…huge cultural and institutional barriers to early identification.”

          Are you saying the US or the UK, with its oh so efficient, increasingly privatized health system would be better able to cope with it? If it turns out it doesn’t I am sure their governments wouldn’t resort to armed force, since they have very high “cultural and institutional” barriers to attacks on the human rights of non-WASP people. Sad that here one should run across the kind of comments that wouldn’t be out of place in Murdoch’s Times or the WSJ…

          Reply
          1. MyLessThanPrimeBeef

            I think ‘better able to cope with it’ is a lot broader than ‘early identification.’

            And you have a point about coping with it, but PK is referring to only the ‘early id’ part.

            Reply
          2. PlutoniumKun

            No I didn’t say that the US or the UK would be better. Or worse for that matter. I just don’t know.

            I do know however that China has a very poor record of systematic identification and reaction to diseases such as this – just read up any source on SARS. The evidence we’ve seen so far is that while the national government has a strong centralised response, the local level health and sanitary systems are chaotic with far too many institutionalised incentives against speedy reporting and reaction.

            Reply
        2. curlydan

          Should one lesson of SARS been not to eat a bunch of weird [bleep]? I’ve been to China often, and when it’s party time, there is a remarkable trend to try to eat some really weird, odd animal. For me, it’s mainly been “alligators!” or something like that, but civets were linked to SARS, and still these animal markets are open offering up everything under the sun.

          Reply
          1. MyLessThanPrimeBeef

            Eating exotic animals (though it would be wise to avoid civets) could be that (though I am not sure) has a lot to do with the practice of traditional Chinese medicine.

            For example, It is said in Bencao Gangmu, Wikipedia:

            The Compendium of Materia Medica is regarded as the most complete and comprehensive medical book ever written in the history of traditional Chinese medicine. It lists all the plants, animals, minerals, and other items that were believed to have medicinal properties.

            Further down, this:

            Compendium of Materia Medica also contains information that has since been proven to be erroneous due to the contemporary limited scientific and technical knowledge. For example, it is claimed that lead is not toxic. It is also claimed that otters are “always male”, and that the Moupin langur is ten feet tall, has backwards feet and can be caught when it draws its upper lip over its eyes.[5]

            Presumably, the Moupin langur was believed to be of some medicinal value, if mistakenly.

            Reply
          2. Yves Smith Post author

            To be precise, I doubt the issue is eating the meat if it is fully cooked. I believe normal cooking temperatures for meats ‘inactivate” viruses.

            But they get handed by the vendor and cooks raw. I believe that is the transmission vector. Get pathogen on your hand, put hand to mouth or nose…

            Reply
        3. flora

          Any idea how many or what percentage of the Chinese who prefer traditional Chinese medicine to allopathic “western” medicine? Any reports coming from traditional Chinese medicine practices/hospitals about this new virus ?

          Reply
          1. PlutoniumKun

            I don’t know about percentages, but certainly a huge proportion of Chinese people will opt for traditional medicine – in many respects Chinese don’t really make a distinction between the two. I think most Chinese are sensible enough to know that when it comes to infectious viral infections, you need to go to a hospital.

            Reply
  6. allan

    Who could possibly have predicted that ubiquitous touch screens for check in at airports and train stations
    and meal ordering in their food courts would be a bad idea?

    Reply
    1. MyLessThanPrimeBeef

      I assume this refers to the 5:48 am comment above by Vlade, and it sounds like it’s about that person and his/her ‘special arguments.’

      Reply
      1. Massinissa

        I’m familiar with Vlade’s comments to some extent but not these ‘special arguments’, what are they about? I seem to have not noticed.

        Reply
  7. notabanktoadie

    Recall that the coronavirus is believed to have started at a market for exotic meat; researchers believe it might have originated with snakes. Yves

    Score 1 for the Old Testament and the distinction between “clean” (kosher) and “unclean” foods.

    The New Testament ends that distinction but apparently it’s still a concept to be respected (e.g. Trichinosis from pig, dog and bear meat).

    I’ve also read that Jewish communities, due to an emphasis on cleanliness, etc, were often spared the plagues of Medieval Europe.

    Reply
    1. Wukchumni

      I haven’t been to Asia since the 90’s, and was always astounded by how meat was out in the open, upside down plein air ducks in a row @ some butcher on Queen’s Rd in HK, that sort of thing.

      Considering how China has modernized to a great degree, how did they keep with the old unsanitary ways, one wonders?

      Reply
      1. PlutoniumKun

        Its very much a cultural thing – even very middle class educated Chinese that I know prefer ‘fresh’ meat, they consider it cleaner and healthier. They associated it with freshly killed animals and consider frozen food to be more likely contaminated.

        For a reason I don’t really know, here in Ireland Chinese will nearly always buy meat in Chinese owned butchers, but will also insist on it being Irish meat, as they assume that Irish meat is superior to imports. So you will have the anomaly of a Chinese butcher, serving only Chinese clients, with a sign in the shop saying (in English and Mandarin) ‘all our beef and pork is Irish’.

        Reply
      2. Larry Y

        Culturally speaking, there’s a huge emphasis on fresh. Go to Chinatown in lower Manhattan, and some of the restaurants and larger grocery stores and will have tanks of live seafood, including frogs and turtles.

        Open air wet markets are still very much a thing in Taiwan and Hong Kong. I went to one where you can pick which live silkie chicken you want, and they’ll pluck, clean, butcher it to bring home to cook (not in the same area though).

        The local governments modernized many of the traditional markets into public multi-story buildings, adding ventilation, sanitation drains, etc. Usually bottom floor is the wet market, above that fresh fruit, fresh vegetables and prepared foods, then sometimes household goods, then a food court above that.

        Reply
      3. Massinissa

        The same way India has modernized and ALSO has kept many unsanitary ways, even in urban centers. If anything it may be worse off than China in that regard, though I suppose that could be chalked up to India having modernized to a lesser degree.

        Reply
    2. rd

      Kosher and halal have a lot of overlap and it is largely basic food hygiene in warm to temperate climates. Turning it into religious instruction was an effective way of having it become embedded in the culture without needing an FDA and local health department. The rabbi or imam would supervise instead with the overhanging threat of offending God instead of some government bureaucrat thereby providing a higher level of compliance.

      Reply
      1. notabanktoadie

        But where did the knowledge come from? Or were the ancient Hebrews smarter than the Chinese are today?

        So your theory has a major hole in it, imo.

        Reply
        1. Janie

          From observation i suppose. How did people find out that foxglove helped heart problems, hemlock was poisonous, etc? Much of that knowledge and observational power has been lost. Example: i buy milk that is pasteurized but not homogenized. It’s in glass and several people have warned me that something is wrong with it, bless their hearts.

          Reply
  8. Ping

    Sooner or later the horrific practices of industrial raising of animals will produce an international biological catastrophe. It’s basic science. China may be the worst in the rogues gallery of these cruel, polluting, unnatural practices.

    Reply
    1. MT_Bill

      I think you have this backwards. While there are many horrible parts to industrial animal production, the creation of novel zoonotic diseases are not likely.

      Most of our production is single species from birth to packaging, and does not provide the opportunity for cross-species spillover. Moreover, animals like chicken and pigs often spend their entire lives quarantined indoors with minimal contact with the environment.

      It’s the open-air, backyard, multi-species production of livestock that serve as petri dishes. Throw in live wild animals from around the globe, stack them in cages to the ceiling, and then put them in a city of 11 million people and it’s surprising this doesn’t happen more often. All that animal waste and fluid gets washed down the same drain at the end of the day, it’s like an accidental bioweapon production line.

      Reply
      1. PlutoniumKun

        Yes – industrial meat production is an abomination, but it does have the virtue of being less likely to produce a disease like this. In China and Vietnam you have an unhappy mix of small mixed farms which tend to sell live animals to huge markets in gigantic, densely populated urban areas. That’s the perfect environment for diseases to jump the species barrier.

        Reply
        1. rd

          Those small farms with lots of interaction between people and critters are perfect laboratories for creating diseases with the ability to be transferred between humans. In the old days, those small family farms had very limited interactions with the outside world, so if something really bad developed, they would just die before it could spread. If a ship carried disease, people were on it long enough to figure that out and it could be easily quarantined in port if the crew and passengers hadn’t already died. Modern motorized ground transport and air travel means these diseases can spread very quickly nationally and globally once they get into a city.

          Industrial animal production has very limited human interaction, so the opportunity for diseases to learn how to interact with human cells is very low. So it is very fundamental diseases with things like prions in Mad Cow Disease or evolution of antibiotic-resistant diseases that are the challenge there. Also, introduction of hormones etc. cause other health challenges. But it is very unlikely that the next Spanish Flu or ebola will come from a US feed lot.

          Reply
          1. notabanktoadie

            But it is very unlikely that the next Spanish Flu or ebola will come from a US feed lot. rd

            But so what? The industrial abuse of animals (supposedly safe) and grossly bloated international trade (now proven to be unsafe) have the same root cause: an unjust finance system.

            And neither will be abolished except by fundamental reform based on ethics, not unprincipled pragmatism.

            And are we to take comfort that our feedlots are not the proximate cause of our deaths while an unjust finance system is the root cause? When we are just as dead?

            Apparently God is not successfully mocked. But let’s keep trying, huh? /sarc

            Reply
        2. Eclair

          I would not be so sanguine about the safety of industrial meat production. Crowded conditions for egg-laying chickens fosters the spread of the salmonella bacterium, which then is transferred into the eggs. And, there is evidence that the corn diet of feed lot cattle, by changing the acidity of their stomachs (they did not evolve to eat corn), results in the development of a more virulent acid-resistant strain of E. coli. Human stomach acids destroy most E. coli, but not the acid-resistant one. Resulting in death-by-Romaine.

          And, let’s not forget that many of our ‘common’ diseases are caused by bacteria and viruses that have crossed over from animals. Measles, brought by the settlers, ravaged the Indigenous inhabitants of North America (although it was not as effective as small pox.) And, then there are the venereal diseases, whose method of transmission to humans we really don’t want to discuss in a family blog.

          Reply
      2. Sweet.Kumara

        A cross-species virus may not come from a single species feedlot but an antibiotic-resistant superbacteria could. E.g., the antibiotic (tylosin) that is used to treat liver abscesses in grain-fed cows in feedlots is similar to erythromycin. Its use can cause bacteria to become erythromycin-resistant. Erythromycin is an important broad spectrum antibiotic for treating many human infections.

        Reply
  9. Ana in Sacramento

    As a youngster I lived in southern Taiwan and Japan way out in the boonies. I can remember going with my mother to the local markets. No refrigeration, tropical temps, high humidity, everything hanging on hooks or laid out on an unsealed wooden or bamboo table.

    The market was a series of stalls on one side of the dirt road with the open “benjo” on the opposite side. Benjo is a polite term in Japanese for open sewer. Kids and random animals, particularly chickens and dogs, roaming around, dust from pedicabs and crowds of people moving up and down the street, and absolute clouds of black flies traversing the road between benjo and whatever was for sale across the street. The smell cannot be described.

    I realize that was then and this is now but the rural areas may still have similar markets which mix all manner of bacteria and viruses which can then be taken into the cities. From the reading, it may be that a very casual approach to contamination is still the norm in wet markets even in cities.

    Reply
    1. anon in so cal

      Even now, wet markets abound throughout Asia, including KL, Singapore (city-state), etc. They’re all over Central and South America. Many smaller towns still have aguas negras, or raw sewage, flowing through drainage ditches along the sides of the roads.

      Reply
  10. phichibe

    I was in China twice back in the 90s, and saw the wet markets talked about here in Hong Kong and on the mainland. I took a train from Beijing to Wuhan and caught a boat to Chungking from there to see the 3 Gorges before the dam was built and they were flooded. Just to add my two cents, I remember waiting in one of the then new main train stations in Beijing in a large hall with rows of wooden benches, seating in total maybe 5,000 people. I watched as multiple individuals around me would spit copious amounts of phlegm and sputum on the floor, including one guy who took a large sip of tea from one of the large plastic tea bottles everybody seemed to be toting, and then turn his head and spit it out between the rows of wooden benches. As I saw this I remember thinking that this is how plagues get started.

    I’ve been in numerous historic temples, pagodas, and castles around the Far East and they all had signs in multiple languages listing prohibited activities, notably anything with an open flame (all the pre-Western buildings were all wood, it was a point of pride to fashion amazingly intricate joints that needed no nails to keep a multistory building up) and spitting. I believe that Chinese medicine holds that phlegm and mucous are toxic, so in many Asian cultures it is the norm to expectorate.

    In addition, I recall as the train went through the countryside passing countless farms where there were paddies, pigs, and ducks in profusion. It’s almost a tailor made environment for the cross-infection of the 3 species that carry the influenza virus. No wonder most of the new variants come out of Asia.

    As for the reliability of the reported cases, I second the comment about a 10x factor to get at the real numbers. The same phenomenon applies to production statistics, which are notoriously unreliable in China because each party functionary multiplies the numbers they get from their subordinates by at least 20% so that after five or ten levels it’s totally divorced from reality. The fact that they’ve quarantined Wuhan and its nearby cities speaks volumes: it’s like Chicago, ie a critical juncture for rail, river, and now air links.

    I recall watching a PBS travel show years ago where the host was in a bar cum apothecary that specialized in cocktails compounded from spirits and the blood of freshly killed animals. They showed the decapitation of a cobra and the mixing of its blood with whisky, the mixture served to a group of wealthy Asians who prized its effects on their virility. Between that and the variety of animals they consume cooked it’s little wonder that these epidemics happen. The real mystery is why they don’t happen more frequently.

    Reply
  11. Roxan

    I lived in India for awhile. It was beyond filthy! In Goa, we encountered the ‘pig toilet system’, which I’m told is common in Southeast Asia. The pigs were, literally, the toilet. The guy we were renting a cottage from, proudly exclaimed “Mem Sahib very happy here! Pig no can touch!” I had no idea what he meant until I was told to inspect the outhouse–looked like a regular old-fashioned outhouse-until I saw the pig eyeing me from the hole. The landlord meant it was built high enough that it couldn’t nudge me to hurry up! They ate those pigs, too, but we did not eat pork in Goa. And to top it off, their well was just downhill from the toilet and pig stye. It was not a deep well, either. We hauled water out by hand quite easily, and did our laundry on a nearby rock.

    Reply

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