Dr. Victor Shih: Coronavirus MUCH Worse Than SARS

Yves here. MacroBusiness has enough of a very important article on the “novel coronavirus” outside its paywall for the great unwashed public to get the drift of the gist (and if you want to read the whole thing, they courteously provide for a 14 day free trial, with no credit card required, as you can see here). The analysis is persuasive and needless to say, not cheery.

I am kicking myself for having had the nagging sense that the combination of new coronavirus’ the assumed to be pretty long incubation period, high contagiousness, and moderately high fatality rate (at 2 to 2.5%, much worse than seasonal flu but less bad than SARS at 10%) was in a virulence sweet spot, but not being able to work out as to why.

Shih gets to the critical point: the mortality rate of the coronovirus isn’t so high as to deter many who might have it from taking risks, like getting on planes or trains or seeing family and co-workers. SARS was so dangerous that anyone who thought they had it would very likely seek treatment pronto and try to stay away from others out of concern for their well being.

By David Llewellyn-Smith, founding publisher and former editor-in-chief of The Diplomat magazine, now the Asia Pacific’s leading geo-politics website. Originally published at MacroBusiness

Via our friends at GLJ Research LLC in the US, comes an exclusive interview with China expert Dr Victor Shih who, in my experience, knows what he talking about.

Fireside Chat w/ China Economist, Victor Shih, Sheds Light on the True Extent of Coronavirus “Threat”. In short, after our conference call this morning with Harvardeducated Chinese economist & former principal for the Carlyle Group in its hedge fund arm in New York City, Victor Shih, we believe the market is grossly underestimating the potential negative knock-on effects from the coronavirus outbreak in China.

By way of background, we remind our readers that over the Nov. 2002-to-Jun. 2003 timeframe which defined the China SARS outbreak and agreed-upon month the pandemic was under control, 8K people were infected & around 800 died (i.e., a ~10% mortality rate over the 8 months). However, according to Mr. Shih, taking the confirmed number of coronavirus cases (i.e., 4.690K [as of 6:52pm EST] – Ex. 1) and adding in the ~6K suspected cases (of which Mr. Shih believes the lion’s share will convert into confirmed cases, given a near 1:1 conversion of suspected to confirmed SARS cases in 2003) the coronavirus pandemic is already larger, in just roughly one week’s time, than the SARS pandemic was over the entirety of its lifecycle.

Other takeaways, according to Mr. Shih, associated w/ the coronavirus center on: (a) a lower mortality rate of 2-3% (vs. ~10% for SARS), which leads to it spreading faster as the fear of death is lower (which, due to the harsh quarantine regiment, also emboldens carriers to hide it to get through airport scanners by taking Tylenol to lower their fever levels), (b) the virus being asymptomatic (meaning one can carry it without any noticeable symptoms), (c) 5mn people who were allowed to leave Wuhan (link) before China quarantined the city to contain the coronavirus outbreak, (d) Dr. Eric Daniels of Harvard, who believes the virus is mutating faster than SARS (link), (e) 7 provinces w/ over 100 confirmed cases, (f) the epidemiologists Mr. Shih has been briefed by both in the US and in China who say we are only in the early stages of the outbreak, & (g) the coronavirus outbreak will likely be much worse than the SARS pandemic given SARS was contained to 3 provinces (Guangdoung, Hong Kong, & Beijing), while the coronavirus has already spread to 25 provinces [link]) – air travel within China is ~8x more today vs. where it was during the SARS outbreak.

In short, in Mr. Shih’s view, based on his work suggesting “hundreds of thousands” of potentially infected Wuhan residents left for Shanghai & Guangdong, the number of cases being reported in these economically important provinces (66 and 207, respectively) are likely “grossly” understated, suggesting the impact to growth, globally, will be much worse than currently implied by market valuations.

Now for those of us outside China, the selfish question is: and what might its disease path be outside China and Asia? As of this hour, British Airways has cancelled all flights to and from China, but the US is holding off from doing so. If the incubation period really is typically close to 14 days (this is one of those frustrating important unknowns), aggressive measures are warranted. Reducing the inflow of potentially infected people and putting in place measures to track them could dampen the propagation.

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110 comments

  1. vlade

    I have pretty much no belief in the lockdowns. They are, short of depilying the army on 24/7 basis, really not viable, and we could see that they were at best dubiously enforced first. Now’s way too late – I believe it’s pretty safe to assume that just about any continent now has enough carriers to produce an epidemic, so the efforts should be at how to prepare for it.

    The timing is really bad because the seasonal flu epidemic in Europe is in full swing already, which means both strain on healtcare resources, and a lot of people who will be weakened by just having gone through that flu.

    Reply
    1. PlutoniumKun

      Yup, its far too late for a lockdown, certainly in Asia. Huge numbers of people have been moving to and from the infected area to and from the US, Oz, and Europe.

      Reply
    2. Bill Smith

      What is the difference between a lockdown / lockout or quarantine? if done soon enough, such measures would slow down the spread. That may be key to buying time to come up with effective countermeasures.

      Even at this point, they may still be effective in some places. For example, the spread in the US or UK is so far pretty small. So bringing home a few hundred people from Wuhan seems foolish without a stop for them in a quarantine for a few weeks. Other relatively isolated places such as Iceland, Greenland, New Zealand, perhaps even Australia might benefit from a dramatic slowdown in international arrivals for a few weeks.

      Reply
  2. vlade

    Just thinking aloud:
    In the UK, if it does turn into an epidemic, it could have some massive political consequences. Basically, with Cummings in the process of ripping apart the civil service (even more than it is now), with the UK ministers having not enough brain cells between all of them to make a noise in s shaker, NHS losing people and capacity by the day, this could turn out to be waaay worse than May’s Grenfell. Because Johnson can’t talk coronavirus around, and any impact would be mostly felt by 55+, a cohort that decisively voted Tories.

    No idea about the US potential politics impact, but again, badly handled epidemics could throw all sort of wrenches into Trump’s reelection campaign.

    Reply
    1. Colonel Smithers

      Thank you and well said, Vlade.

      I can think of a dozen doctors, including my father and godfather and some of their former RAF comrades, who stayed on well beyond retirement age and have left the NHS in disgust over the past couple of years. At Stoke Mandeville in Buckinghamshire and the John Radcliffe and Warneford Churchill in Oxford, not just wise old head doctors and nurses, but younger EU27 staff, too. In some units, most, if not all, staff are from the EU27.

      Almost daily, one comes across Chinese visitors heading from Marylebone, my London terminus, to Oxford, Bicester Village and Stratford upon Avon in the morning and back in the evening.

      Further to the weakening of the Civil Service, readers may read https://members.tortoisemedia.com/2019/12/20/camerons-legacy/content.html and weep.

      See you soon. Hope that all’s well.

      Reply
    2. PlutoniumKun

      As for the US, it wouldn’t surprise me if Trumps team were wargaming the electoral/trade benefits of cutting off all movements to and from China. A major outbreak in the middle of an election campaign is bound to have a very serious impact, but I’ve no idea who would, or would not, benefit from this.

      I don’t really know about the UK either – its possible of course that the Tories could play this as a “see? we told you that securing our borders was a good idea” type of event. I also wouldn’t put it past them to start wolf whistling about immigrants and diseases.

      Reply
      1. Joe Well

        Who would be hurt by an outbreak midcampaign? Maybe the candidate who is locked out by the media and depends on door to door canvassing and in-person events?

        Reply
        1. epynonymous

          I was thinking that a global outbreak, or even the real potential for one, is as good an argument for universal healthcare as you could care to ask for. Particularly here in the US. If people were rational and impartial, of course they would already be for public health services.

          Reply
            1. Oregoncharles

              Actually, under single payer, the “medical establishment” WOULD profit off it (at a more reasonable level of payment), and the insurance co.’s would have dodged a bullet. But the epidemic would be less extensive, as fewer people would go around infecting others.

              Reply
        2. allan

          Never misunderestimate the cynical use of public health crises for political gain.
          A blast from the past (2014):

          Ebola Coverage On TV News Plummeted After Midterms [Media Matters]

          In early October, the GOP developed a plan to make the federal government’s response to Ebola a central part of its midterm elections strategy. …

          Of course, this time it will be: any criticism of the government response is borderline treason.
          As a great man once said, people need to watch what they say.

          Reply
      2. John k

        Probably true that the reason we haven’t stopped flights from China is political… but with brits doing it now, trump will look really bad if us cases expand. Apparently students are returning from holidays, they’re known to get into close contact with others.
        Repat our citizens, put them into quarantine, for two weeks, wait for it to run its course.
        Otherwise everybody gets it.

        Reply
    3. TimOfEngland

      Cummings is still dreaming about/planning the evisceration (some say improvement) of the civil service. So far he has a few CVs from his bright sparks & weirdos. Plus I don’t see how anyone can blame Boris for an epidemic that originated in an animal market in China! Just a black swan and no country is really ever ready for those.

      The sky isn’t going to fall on the 1st Feb [I’ve been checking it for cracks :) ] SARS2 or not.

      And, The UK is getting its people to sign a contract agreeing to 2 weeks quarantine if they want to get on a plane home.

      Reply
    4. drumlin woodchuckles

      On the other hand, the casualties from such an outcome could be a part of Jackpot Design Engineering.

      First, destroy the capacity of the Epidemic Containment Institutions, then stand by helplessly as the “next epidemic” rips and roars.

      Reply
  3. Thomas P

    One should also consider what happens if the virus reaches conflict areas where there is little health care or ability to contain the disease available. Afghanistan, large parts of Africa etc. This is especially bad if it is mutating as it will give the virus lots of hosts to optimize infection of humans.

    Reply
        1. Yves Smith Post author

          Yes, I’ve been saying privately, but admittedly not as much as I should on the site, that I cannot fathom how short-sighted our supposed elites are about public health risks. Poverty and no access to health care is a prescription for epidemics. And they are delusional if they think they can escape them. Among other things, their help uses transportation (public transportation, an Uber) which is a disease vector. In a worst case scenario, they go see a doctor or a hospital, which has as much risk of exposing them as helping them.

          Reply
          1. Tony Wright

            Competence at fleecing the great unwashed does not necessarily translate into great understanding of epidemiology, or any other aspect of biological understanding.
            However it can lead to an excess of hubris.

            Reply
      1. Thomas P

        Gaza is so cut off from the rest of the world that it will be reasonably safe from an outbreak, but if one happen, yes, that could be really bad. I’m more worried about Africa where they have lots of trade with China and Chinese workers. Some of the remote areas in Pakistan would also be scary, especially since they are suspicius of doctors after the fake vaccination program used to catch Bin Laden.

        Reply
        1. Bill Smith

          My first thought was the tunnels into Egypt, some of which still operate. Plus the official entry point with Egypt and now about 5,000 people a day enter Israel for work.

          My bigger concern is once it got in there given the conditions there is no way it could be stopped.

          I agree with your other places.

          Reply
  4. rfdawn

    The link is missing but point (d) about possibly high mutation rate may be important. Combined with the other factors mentioned it becomes more possible for this to become perpetual, like colds and flu which are always around somewhere in the human population. The normal expectation then is that mutation would tend to make it less lethal but that is just a norm and it could take a while. Acquired immunity would be temporary because limited to the strain experienced.

    Reply
    1. Ignacio

      Regarding the mortality rates it is too soon to say how it will evolve. The theory of pandemics says that “selection for pathogen virulence and horizontal transmission is highest at the onset of an epidemic but decreases thereafter, as the epidemic depletes the pool of susceptible hosts“. We can say that now the pool of hosts is highly succeptible to the new disease and this favours the spread of the most virulent variants. Also, the most virulent variants are prevalent at the front line of spreading epidemics. These insights tell us that the observed mortality rates in China (that might be somehow high considering health services are overwhelmed in China) might (hopefully) represent that of the “front line” more virulent variants and thus might represent the highest values during this epidemic and will therefore be lower once a pandemic is set. These statements are specially designed for viruses with high variability and mutation rates such as RNA virus (like CoV).

      I wonder if by trying to keep it contained in Asia we could inadvertedly select in other countries for the most virulent strains. One has to be careful with bottlenecks!

      Reply
      1. Ignacio

        Today El Pais published news saying that one “superspreader” patient had already been identified. This means that hospitals will need special safety measures!

        Reply
        1. Eustache de Saint Pierre

          According to this very interesting article which features the effects of Spanish flu ( sorry Ignacio it was of course French flu to the Spanish ), which occurred about the same time as US forces were being mowed down on the Western Front resulting in around 27,000 fatalities, that form came in 4 waves, the 2nd & 3rd being the most virulent & it killed more Americans than the Germans during the Meusse-Argonne offensive.

          Obviously this is a different strain & I am hopelessly out of my depth, but as the present one has no prior precedent – is it possible that it could act in a similar fashion or do something else that is totally unexpected ? I suppose that the fact is that there is no way of knowing beforehand.

          I also read an article on the 140,000 Chinese Coolies who worked as labourers on the front lines & were treated unbelievably badly & to this day they are blamed by some for pandemic.

          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181817/

          Reply
          1. Ignacio

            How the ‘Spanish flu’ appeared and why those waves may probably be something specific of the peculiar flu genetics and immunology (particularly the ability of flu for fast and unpredictable antigenic change of the immune targets, so this mustn’t necessarily apply for coronavirus. Oh and don’t worry about it being called Spanish, it doesn’t bother me.

            Reply
            1. Ignacio

              The trenches in WWI were probably the best culture broth ever for flu and that might explain those so many waves. But this again raises the question on how probable would be the emergence of another new CoV. We know too little about this. First it was supposedly originated in the wet market but now it is known it was originated in other place (probably a farm with a close bat population) but the propagation exploded in the market (a superspreader there?).

              Reply
                  1. phichibe

                    And I’ve heard estimates that R0 for the Wuhan CoV2019 may be as high as 3.5 That is a spectacularly bad number.

                    Reply
            2. The Rev Kev

              The Spanish flu. What a misnomer of a name. The only reason that it got called that was that during the war the continent was under heavy censorship but neutral Spain wasn’t . So they were reporting their cases whereas the rest of Europe was not hence the idea that the flu originated from there. The books that I have read indicate that the flu originated in the United States which is kinda unexpected.

              But troop movements also helped spread this flu. One time President Wilson had to decide to send a convoy of American troops to Europe, knowing that many would die due to enclosed quarters and the flu, or holding them back until they were all cleared. But the troops were needed in Europe so he ordered them sent and many ended up over the side.

              Reply
  5. Bugs Bunny

    Won’t a flu virus normally burn out after winter? If people follow the basic recommendations, I don’t see that this gets too out of hand. Probably “famous last words” :(

    Pasteur Institute is working on a DNA-based vaccine but reports (French) say it will take about a year to complete.

    CEPI says that they might be able to have one ready in 4 months.

    Reply
    1. PlutoniumKun

      Coronavirus is not a flu virus – its more associated with the common cold and forms of bronchitis. Some coronaviral diseases are persistent.

      Reply
  6. john bougearel

    OMG, have none of you bright people considered the anecdotal stories rolling in that deaths are being underreported. As in, confirmed Coronavirus cases that lead to death, the cause of death is being reported as viral pneumonia generally rather than Coronavirus specifically.

    This improves the optics, manages fears that lead to panics, etc. And clearly managing fears and irrational behaviors is clearly on the mind of the officialdom in China, as much of yd’s rally in the market was precipitated by China promising “liquidity” and vowing to “paper” over the virus to investors, and then telling them to act “rationally.”

    It’s the old “Move along folks, nothing to see here” type of response from officialdom in China.

    Reply
    1. Bill Smith

      For how long did the mayor of Wuhan say that the news had been sat on while the central government decided what to do? The Lancet article says this likely started back in October/November, with it likely seen as early as December 1st.

      If one looks at the charts showing the growth, how do they look if one moves the start back a month?

      Reply
      1. Sam Adams

        Genetic traceback based on mutation suggested that the virus crossed species no earlier than October 28-29th. The Chinese lost control and are now doing a lot of fear management.

        Reply
    2. fajensen

      Yes. People I know, who know people inside of China, say that there are really thousands of dead people with many rumours (and some grainy potato-cam footage) of people keeling over in the streets. Who Knows? Why not also run an information attack on top of the disaster, like, if anyone was having a beef with China or something?

      Thing is, there is not much to *do* either way, other than hoping for the best, that anyone that one knows or cares about will not get the infection and that the medial scientists will manage to cook up something.

      We all have it coming, as the song goes.

      Reply
      1. vlade

        Thousands of deaths would be pretty hard to hide for three+ months, in a region which was, until fairly recently full of foreigners (remember, Wuhan is a university city, with both foreign students and teachers).

        Reply
        1. PlutoniumKun

          While I’m very sceptical that the death rate is substantially above that already reported (although its possible that local authorities have an incentive to hide facts from Beijing), its quite feasible that they could keep it quiet if this was the case, even in Wuhan.

          As an example, there is a lot of evidence that knife crime is rampant across China, with a very high associated murder rate, but the authorities have managed to persuade everyone, including most Chinese people, that the rate of murders in the country is very low.

          Reply
          1. vlade

            I’d be the first to say that the lower level officials in China will misreport the numbers. But families and friends won’t.

            I don’t know how it’s with murders, but if just about everyone knows somone who had a murder in the family, it’s hard to suppress it. Unlike murder, virus is catching, so if there was a massive outbreak of flu-like ilness (even w/o deaths) before December, I’d think that _some_ of the westerners in the province would have known, and by now, would have pointed it out.

            People generally tend to know when there’s a flu epidemic going on – colleagues don’t show up for work (or show visibly sick), etc. etc. It’s hard to supress that.

            Reply
            1. Isotope_C14

              According to a Chinese MD that I work with, she says if a patient dies under a particular Doctor’s care, they are at a pretty high risk from being killed by the deceased patient’s family.

              I’d never heard this before, but it appears to be well known within the MD community there, and is utterly frightening. Why would you kill the person that tried to save your loved one? Totally nuts.

              Reply
              1. Foy

                This is definitely a thing, although how big, not sure. The guy who runs the Serpentza and ADVChina channels on youtube did a video on patients murdering doctors about 3 weeks ago, saying that it is a real and under reported risk to doctors there.

                He lived in China 15 years, is fluent in Chinese, married a local who is also a doctor, and he taught medical students there himself, so has some credence. He has done excellent videos on his life in China for years. He recently moved to the USA so is now speaking more openly about the situation there.

                Reply
                1. Monty

                  “He taught medical students” He was a TEFL teacher. You don’t need any qualification other than being able to speak English and being willing to travel to China to do that. He’s no expert. He is an opportunistic troll, catering to “a certain crowd”.

                  Check out his older videos and see what he says about South Africa, and see how you feel about him afterwards.

                  Reply
                  1. Foy

                    Ok Monty, will do, I could tell he was South African but I hadn’t seen any South African videos of his. I lived in South Africa and Mozambique for 8 years and enjoyed my time when I lived there. I’ll be interested to see what he says, but I think I can guess now based on your comments. Thanks for the heads up!

                    Reply
            1. Bill Smith

              Nobody believes the Chinese economic statistics, why should we believe the Chinese health statistics?

              And even if not officially adjusted, given the size of the mess it would seem that reporting may well sloppy and / or be running behind.

              Reply
    3. Ignacio

      You should read an article published this week by P. Cockburn at the Guardian on how people react to public information on virus outbreaks.

      Reply
      1. Old Jake

        I think you mean Counterpunch. I searched the Guardian and found nothing by Cockburn, but quickly found his column dated 1/28 at Counterpunch describing the Irish (Cork) polio epidemic in 1956.

        Reply
  7. katiebird

    How likely is it that people will mistake this virus for a cold and go on about business as usual? The symptoms seem so similar up to pneumonia. Is there something that would distinguish it? I know it is early to know these answers. But it seems like people could be walking around even with symptoms for some days before they become aware of how serious their condition is.

    Reply
      1. katiebird

        Right. But I am thinking that the symptoms are so normal …. like a cold. Not like having spots or something that screams, I am sick. 2 weeks for symptoms. But how sick do people feel with onset of symptoms? Sick enough to stay home? So many people push on even when sick.

        Reply
        1. The Historian

          I think how people react to this virus is kind of like how they react to the flu viruses going around. They only go to the doctor when the symptoms become unmanageable with OTC drugs. It wouldn’t surprise me if most of the people who get this new virus aren’t being counted since they aren’t ill enough to seek medical intervention. Since this new virus only has a mortality rate of possibly – really too soon to tell yet – around 2.8%, that means that 97.2% of the people who are treated survive as well as all those who get it but aren’t sick enough to seek medical assistance. I would assume those people who don’t seek medical assistance would go about their lives as usual, just as people do when they get light cases of the flu.

          It doesn’t help that we still don’t have comprehensive paid sick leave in our service industries, i.e., those people who are most around the public, so I am sure that many people who are sick still go to work because they have to, and therefore, can be a vector in spreading this disease since, right now, it appears to be travelling faster than the flu.

          Reply
          1. Phemfrog

            I think this is really important. People (especially those who dont follow the news) may not realize they have coronavirus. The top symptoms are FEVER, COUGH, and SHORTNESS OF BREATH. These are all things that one can feel from colds, flu, asthma, allergies, or a combination. Everyone has a different response to a virus. Think about how one can spread in your own family. For example, mom can have a mild fever and runny nose, while dad has a high fever and cough. The kids are bedridden with aches and fever. All the same cold.

            There will be many people who have and spread coronavirus because they assume they cant get it.

            And dont get me started on all the sick people coming to school and work. ugh…

            Reply
            1. redleg

              If one’s contagious before they’re symptomatic, staying home after the symptoms appear won’t stop transmission of the virus. It might slow it down, best case.

              Reply
          2. Pym of Nantucket

            This is important. It also means some developed herd immunity and preexisting herd immunity because the virus is so similar to other viruses which most humans have fought off.

            Another factor is if people intentionally stay away from hospitals for countless reasons.

            Reply
            1. The Rev Kev

              It has been suggested that a reason why so many old people did not die during the 1919 flu pandemic was that many had caught a flu in the 1890s that had a similar genetic makeup.

              Reply
              1. Tony Wright

                Similarly, I read somewhere that people like myself old enough to have been exposed to the 1956 Hong Kong strain of flu were partially resistent to the recent flu strain of 2015, due to a high level of antigenic similarity between the two strains.

                Reply
  8. Louis Fyne

    There really should be a travel ban on passenger flights to/from the PRC. in my opinion.

    Precautionary principle: better safe than sorry.

    Just saying.

    Reply
  9. The Rev Kev

    Taking a different slant on possible developments, you can bet that the Pentagon are gaming out the possibilities of this virus cutting loose. For example, suppose that cases turn up at Fort Bragg or Quantico and the whole base has to be quarantined? How can troops be sent overseas? Can troops stationed overseas be brought back safely home?

    What if it spreads to places like Afghanistan or Iraq? Do the troops there just stay behind the wire? Consider the hundreds of US military flights all around the world? Will countries just allow them to land in their countries and disembark if they are not sure if there are no infected troops. Think Okinawa or Germany here.

    What if groups like the Taliban or al-Qaeda use infected people to spread it to US troops either directly or infecting allied troops first? Not the first time that that has been done. And finally, if a vaccine is found and is starting to be produced, does the Pentagon claim a large share of these vaccines for their own use first on the grounds of military necessity? General officers first of course.

    Reply
      1. The Rev Kev

        Thanks for that link. Reading between the lines you can see lots of stories and anecdotes from which this material was based on.

        Reply
    1. The Historian

      There is a lot of fear-mongering going on about 2019 n-Cov and that is NOT helpful. We really don’t need another ebola panic – remember Chris Christie’s behavior at the time?

      I’ll just take the usual precautions – it is flu season after all – and wait for more information. Yes, I did get my flu shot, but as my daughter’s family found out – that flu shot is not 100% effective against all flu viruses going around.

      Reply
    2. PlutoniumKun

      Shih may be an economist and a hedge fundie, but he is also known as one of the most astute and well connected independent commentators on Chinese policy. He is probably one of the most reliable sources available on what really goes on in China.

      Reply
      1. Synoia

        Yes but the article discusses the spread of a disease, which is not commentary on Chinese policy, but a commentary on public health.

        With the byline at the beginning of the article one is mislead as the the nature of the Doctorate, and his expertise.

        Disingenuous at best, dishonest in an editorial senses as click bate.

        Reply
        1. PlutoniumKun

          I emphasised that he is ‘well connected’. He has access to significant amount of formal and informal sources of information in China – this is his job. And he is not someone who is selling his book – he has an excellent reputation and wouldn’t be writing something like this if he wasn’t quite confident that his information is correct.

          Reply
        2. Yves Smith Post author

          Epidemiological data is data.

          It does not require special expertise to interpret it. It requires having good sources of the estimates and understanding the limits of the information.

          Shih is not doing anything that requires specific medical expertise. In fact, I have to point out that a Chinese Harvard-connected epidemiologist has been providing hysterical commentary on Twitter and we mistakenly propagated some of it. Credentials don’t necessarily translate into sound analysis. For instance, I am not an economist yet I regularly comment on economics….

          Reply
        3. drumlin woodchuckles

          Maybe in some countries having a PhD automatically gets its holder addressed or referred to with the honorific title of Doctor. Maybe in other countries where that is NOT the custom, calling someone with a PhD “Doctor” from withIN a country where it IS the custom would sound to people in countries where it is NOT the custom as if it were some kind of misleading fraud. But it would not have been intended as such.

          Reply
      1. drumlin woodchuckles

        Maybe a catchy name will get a disease more thought about and communicated about and discussed. Maybe ” wuhan pneumonia” could be just the catchy name this disease needs.

        Reply
  10. George Phillies

    On one hand, the mortality rate needs to be estimated in terms of the people who caught it two weeks ago, not the people who just caught it and haven’t had a chance to die yet. That change gives a much higher mortality rate. On the other hand, the ‘year to a vaccine’ assumes the full anti-litigation protocol rather than skipping steps.

    Reply
  11. funemployed

    Given that universities around the US just started or are just starting their semesters, and the size of the two way traffic between China and the US during January for that reason, and the relative privilege of those who do go back and forth, and the, um, less than stellar reputation of foreign undergraduates regarding integrity and prosocial behavior,* I’d not be surprised if it’s already hit a few campuses, and we don’t learn about them til it’s too late to contain.

    *I’m not making some blanket statement about Chinese people or foreigners – the most privileged students of all backgrounds are frequently dishonest, incompetent, entitled, jerks – and foreign undergraduates at US universities are, for the most part, extremely privileged people. So don’t woke at me, please, unless you feel the need to defend the honor of the adult children of rich people in the neoliberal age, against whom I am indeed quite biased.

    Reply
    1. savebyirony

      Miami University of Ohio (not too far from where I live) just cancelled 2 ncaa basketball games because a recently returned from visiting China student is showing mild symptoms of the coronavirus. They have isolated the student and a traveling companion in off campus housing and are taking other steps to help inform the local public and prevent spreading the virus.

      Reply
    2. drumlin woodchuckles

      One wonders if the last places to be reached by this disease would be the little places, the isolated places, the places that time and economics have forgotten.

      Maybe places like Medicine Hat, Broken Bow, Buck Snort, Blodgett Mills, etc. will be the last to get it. Or not ever get it at all.

      Reply
  12. Reify99

    Wuhan Coronavirus
    Audio of Henry L Niman, PhD, important figure in monoclonal antibody development, early advocate for recombination as a predominate mechanism of viral mutation. (Ihaven’t found a transcript.) Niman followed avian flu, (flock by flock!), H1N1, in granular detail on his website recombinomics.com, which he seems to have dropped now in favor of this format. (There are still some links to the very stale Website http://www.recombinomics.com/founder.html)

    I confess I am still listening but he makes two important points early on in the 1/27 interview that I want to share. One, that the number of of suspected corona virus cases (in China) will continue to rise faster than the number of confirmed cases because, although they have been tested PCR positive ( a highly accurate DNA test), they are still waiting for the gov’t to perform the second confirmatory test. And they are back logged.

    Given the accuracy of PCR he therefore contends
    that 1/27/2020’s confirmed and suspected cases,
    6K and 9K, respectively, should be combined. 15K then.

    Second point is that so far, up to the time of the interview, in China, there had been 103 recovered and released cases, and 132 deaths. So around 50% mortality so far.

    http://recombinomics.co/topic/4352-interviews-on-novel-2019-ncov-coronavirus-in-wuhan/?tab=comments#comment-15347

    Reply
  13. Expat2uruguay

    I know we’ve been looking for a new nickname for the coronavirus and I think I’ll have a winner, The Medicare For All virus!

    Reply
  14. Wyoming

    Think how many people this guy infected.

    On the morning of January 18th, a seventy-nine-year-old resident of the central Chinese city of Wuhan, whom I’ll call Li, eagerly awaited the arrival of his daughter and her family, who were travelling from Shanghai to join him for the most important holiday on the Chinese calendar: the Lunar New Year. The festivities revolve around family meals, and, that afternoon, according to Phoenix Weekly, a political and cultural weekly magazine based in Hong Kong, Li rode his bicycle to the store to buy groceries. Halfway there, he began to feel weak, and fell off his bike. He was taken to a district clinic, where, owing to a lack of medical equipment—only X-ray machines were available—it was recommended that he go to a larger hospital. Around 5 p.m., he arrived with his daughter at the Wuhan Central hospital, where he waited five hours to see a doctor, who told him that he needed a CT scan of his lungs, for which there was a four-hour wait. Li went home, and, when he returned later, he was told to wait to see someone in the pulmonology department, where he finally got a scan. A pulmonologist said that the scan was worrying and told him to go to the emergency room, but there was a six-hour wait there, so Li went home again. The next day, a report showed an infection in sixty per cent of his lungs. Doctors suspected that he had contracted the new coronavirus, known as 2019-nCoV, the first cases of which had been reportedly identified in December, but they could not perform the tests to confirm it. The hospital was not an infectious-disease hospital, and, furthermore, Li’s family was told, staff members didn’t have the authority to make diagnoses themselves; they had to report cases to superiors and seek further consultation. Nor were there any quarantine rooms available.

    Thus, according to Phoenix Weekly, began an ordeal, during which Li was bounced from one medical institution to another without being given a diagnosis or a bed. One night, when his fever had climbed and he had trouble breathing, Li’s daughter called the equivalent of 911—in China, the number is 120—for an ambulance. The dispatcher told her that, without confirmation of a diagnosis from a receiving hospital, he could not help her. Finally, an ambulance was sent, but Li was turned away from a couple of hospitals, which were already full. One told him that he should go back to Wuhan Central and insist on being admitted there, or get a transfer notice from it. Finally, at the fourth hospital the family tried, Li’s daughter and her husband, despondent and frustrated, started shouting in the E.R. waiting room. “If you don’t take my father,” she said, “he will die.” The family camped out in the waiting room, along with a crowd of other people.

    https://www.newyorker.com/news/daily-comment/what-its-like-to-try-to-get-treatment-for-the-coronavirus-in-china

    Reply
  15. skk

    Being fond of “off-the-wall” ideas like “cigarette smokers DO NOT cost the NHS in totality-when netted out over time” or “doctors strikes REDUCED mortality during the strike period” – netting out the auto-accident deaths reduction (reduction from 700 a day in China ) due to people staying at home versus deaths due the nCOR virus versus change in suicides/ family murders versus kitchen fire deaths versus …. is a thought provoking exercise.

    Conditional and sums of independent and non-independent Statistics / Probability of random variables is a strange beast. One CAN reason with it though – its worth having a bash at :

    Jaynes’ book, Probability Theory: The Logic of Science (2003) gathers various threads of modern thinking about Bayesian probability and statistical inference, develops the notion of probability theory as extended logic, and contrasts the advantages of Bayesian techniques with the results of other approaches. This book was published posthumously in 2003

    Reply
        1. Eustache de Saint Pierre

          It appears he backtracked to a certain extent afterwards which I missed due to having to go out.

          Reply
        2. MBP

          Current estimate is that ~20% of cases become hospitized i.e. “severe”. Of those ~11% are terminal. This gives the current mortality rate of ~2%

          Reply
          1. Eustache de Saint Pierre

            I hope you are correct but looking at this report from Chinanews.com I imagine that the present level of mortality depends on the fate of the 37 listed as being in a severe condition who are I assume are receiving good medical care, which is about 9.5% of the total – unless of course I am missing something from the equation.

            As it is a constantly changing picture it must be like herding cats in trying to get a handle on it.

            ” Langzhong Xinnet, January 30th. According to the official website of the Guangdong Health Commission, as of 12:00 on January 30th, Guangdong had reported a total of 354 confirmed cases of pneumonia due to new coronavirus infection. At 02:00 on the 30th, 43 new cases were confirmed and 2 were discharged from the province. Among the newly confirmed cases, 15 were in Guangzhou, 12 in Shenzhen, 8 in Zhuhai, 4 in Dongguan, 2 in Zhongshan, and 2 in Zhanjiang. 1,514 close contacts are under medical observation.

            Of the confirmed cases, 94 were in Guangzhou, 98 in Shenzhen, 26 in Zhuhai, 12 in Shantou, 25 in Foshan, 4 in Shaoguan, 1 in Heyuan, 5 in Meizhou, 17 in Huizhou, and Shanwei. There were 1 case in Shenzhen, 11 cases in Dongguan, 18 cases in Zhongshan City, 1 case in Jiangmen City, 10 cases in Yangjiang City, 11 cases in Zhanjiang City, 3 cases in Maoming City, 5 cases in Zhaoqing City, 6 cases in Qingyuan City, and 6 cases in Jieyang City. There were 176 males and 178 females, aged between 11 months and 85 years.

            At present, there are 37 cases of severe illness, 13 cases of critical illness, no deaths, and a total of 8 patients have been discharged “.

            Reply
  16. Oregoncharles

    Does someone have a source with a description of the distinctive symptoms? I’ve yet to to see one. Since one case is only a few hours away in Everett, WA, it might be nice to know what to watch for.

    Reply
    1. Nat

      Everything I have seen claims similar symptoms to flu. There haven’t been any reported symptoms that are obvious stand outs from more common flu and flu-like illnesses unfortunately.

      Reply
  17. rtah100

    The coronavirus will prove to be fizzle (many sick, possible wide disruption / consequential losses, few dead) unless:

    – its propensity for mutation sees it acquires sequences for SARS-like mortality;
    Or
    – the reports that the Canadian level 4 containment facility in Manitoba that had shipped pandemic virus samples (Ebola, SARS, West Nile etc) to China and has dismissed Chinese research group leaders suspected of inappropriate links to Chinese military bioweapons programme based in Wuhan, China’s level 4 containment facility, turn out to be than coincidence….

    As the epidemiology already disproves the seafood market story (13 of initial cluster had no contacts there and who who heard of a snake virus anyway!), the anthropogenic origin in Wuhan is starting to look plausible. Remember, we live in a world where Skripal and Douma are reported with a straight face and MK Ultra and Tuskegee, to say nothing of the Japanese unit in Harbin and other programmes, took place….

    Reply
    1. campbeln

      Very well put!

      The Chinese JUMPED on this pretty hard, which makes me wonder what they know about the virus. They’ve shut down their Disneyland and other high profile locations and been very vocal on “closing” cities (never mind how effective that’s actually been), all during the largest human migration (Lunar New Year).

      Tinfoil hat aside, the Chinese seem far too vocal about their actions to not have more info or some form of ulterior motive. Be it they know what it is, or are using it to cover up something else (cough, unavoidable economic slowdown, cough) there’s SOMETHING going on behind the curtain…

      Reply
  18. phichibe

    A thought just occurred to me while reading the true-to-form excellent comments of the NC commentariat. It is this: the Chinese authorities have access to the search statistics the Chinese equivalent of Google (I can’t keep track of them – is it WeiBu? Baidu? ). Google’s data scientists published some peer-reviewed papers at least a decade ago (I think) that indicated the search history of Google searches on keywords related to flu symptoms could be used as both an early warning system and a way of tracking the progress of its spread spatially throughout the United States.
    ..
    Given the almost obsessive way Chinese tech folks track and copy the Western tech companies I can not believe that they are not doing this. The fact that we aren’t hearing any reassuring statistics based on these methods is in itself alarming to me. ,That, coupled with articles I’ve read today (NYT? WP? Guardian?) that the Chinese authorties have their cyber minions working overtime to remove critical posts from the Chinese Facebook, makes me think that the information gleaned from user-generated content (search terms, etc) is not encouraging. To paraphrase Sherlock Holmes, somewhere there is a dog not barking in the night.

    Phichibe

    Reply
  19. Synoia

    I do wonder about the timing Coronavirus epidemic, specifically if there were any man made assistance in creating the virus as a weapon.

    Or is that only a question from a lunatic?

    Reply

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