Public Health Officials Offer Scant Details On U.S. Coronavirus Patients

Yves here. I’ve kept the original headline to this Kaiser Health News piece even though it focuses attention away from issues that the article raises that seem more important.

It is important to protect patient privacy to the extent possible. It’s a generally accepted principle of care plus having the identity of coronavirus victims get out would be a deterrent to getting treatment. Not only could the victim be subject to hostility even after he’d recovered, but uninfected relatives and contacts could be shunned and abused, such as fired from their jobs.

However, the piece points out that where the victims have been is also being kept under wraps. This strikes me as a mistake. Given that there is some evidence that the coronovirus can survive on surfaces, it would seem prudent for the CDC to recommend cleaning measures for establishments that infected people visited in the US before being hospitalized. Again, there’s the perverse issue that members of the public would happily and unknowingly visit, say a drugstore that an infected person had stopped in before seeking care, but would shun one that had been notified by the CDC of the need for special cleaning and would presumably be safe after that.

I just happened to visit a chain drugstore and it didn’t even register until now that it was impossible to check out without putting my hands on a touchscreen (you had to accept or reject getting text messages, the prompt comes up for every friggin’ transaction). Now I am well away from any area where cases have been reported. But it’s documented that touch screens are disease vectors. And to be more graphic, feces are suspected to be a transmission path for the novel coronavirus. So consider this cause for pause:

From self-check-in, at airports to self-checkout at grocery stores, touch-screen technology is increasingly becoming an integral part of our daily lives. Touted as time saving and efficient these surfaces are touched by countless people every single day steadily collecting germs and bacteria from users. Much of the bacteria found on surfaces in public areas originates from people’s intestines, gut, nose, mouth, throat, and feces and is a result of poor hand hygiene….

o help put it into perspective the Hartsfield-Jackson International Airport in Atlanta is the busiest airport in the world handling over 2,500 flights and 275,000 passengers a day. When you think about the staggering number of people passing through the terminals every day and that 34% of Americans do not wash their hands after using the restroom, avoiding germs is an impossible task. According to research done by Insurance Quotes, the average self-check-in screen contained 253,857 colony-forming unit (CFU) that’s over 13 times more than the average of an airport water fountain button. One check-in screen recorded over 1 million CFU. In comparison, on average only 172 CFU are found on toilet seats.

Even though touchscreen technology is providing consumers with the convenience they want, it is undeniable that many touchscreens are dirty and unhygienic. Tests conducted by the Microbiology department at London Metropolitan University in 2018 found that touchscreens in McDonald’s restaurants in London and Birmingham all carried traces of feces. More often than not customers eat immediately after placing their order not stopping to wash off the germs they have just picked up.

The second basis for concern is what looks to be overconfidence of US officials in our “public health system,” as if we have one. The fact that, depending on how the study was conducted, between 44% and 64% of Americans say they skip or delay medical treatment alone says we have huge gaps in our “system”. And remember, in the early stages, the cornoavirus symptoms seem like those of a winter flu until they progress to pneumonia in severe cases.

For instance, if you go to the CDC website, you have to go three clicks from the landing page (2019 Novel Coronavirus > What You Need to Know About 2019 Novel Coronavirus > Prevention and Treatment) to find out what to do to keep from getting infected. That’s not easy to find, particularly since for two of the three clicks, you also need to scroll down the page to find further links. Or at least if the CDC thinks conveying that sort of information is important.

Perhaps much more is happening behind the scenes, but what has kept infection numbers and therefore risk in the US low so far is the (admittedly a bit late) lockdown of Wuhan and other key cities in Hubei, the halting of passenger flights to the US, and putting evacuees in quarantine.

But while the potential for transmission from China has been throttled down to close to nil, enough people left Hubei before the lockdown to allow for infection through other countries, and we may see those avenues become meaningful risks. Thailand admitted a full week ago that it can’t stop the spread of the coronavirus. Kerkala just announced that the coronavirus was a “state emergency” although it is not clear what that means.

Epidemiologists are concerned that airlines were slow to cut off flights from China to Africa. Another issue is that while passenger transportation can be shut down fairly quickly, freight is another matter. Readers have no doubt seem much gnashing of teeth over the damage the coronavirus poses to global supply chains, both due to restrictions on transport as well as restrictions on movements of people, which will have knock-on effects to production. But there’s also the disease transmission issue. China has land transport routes though Asia to the Middle East; truckers may have taken infection with them.

Needless to say, disease containment measures could have even more severe knock-on effects, as sometimes discussed in comments. From Transport Geography:

  • Food. Contemporary food production and distribution rely on low levels of inventory, particularly to avoid wastes of perishable products on store shelves. On average, supermarkets have between 2 to 5 days of inventory of perishable goods (dairy, produce, meat) and about 1 to 2 weeks for other goods (pasta, canned goods, etc.). It is worth underlining that these figures are for a normal and stable demand. In the case of a pandemic, available food supplies could quickly be exhausted through hoarding behavior. Such behavior is commonly observed during an acute weather event such as a hurricane where store shelves are quickly emptied. Food security is therefore defined by the ability of the transportation workers to move food from producers to the bulk-storage facilities, to the processor and lastly to the grocer.
  • Energy. The provision and distribution of energy are critical to the functioning of a modern economy and society. For instance, about 40% of the world’s supply of electricity is generated by burning coal (50% for the United States). Coal power plants maintain a fairly low stockpile, about 30 days, and rely on a constant supply from major coal mining regions, which tend to be far away. While a pandemic would not directly damage energy systems, many energy distribution systems could be threatened through the removal of essential personnel from the workplace for weeks or months and impaired transportation capabilities to supply power plants.
  • Medical supplies. A pandemic is obviously associated with a surge in the use of medical facilities, equipment and pharmaceutical products. Global drug production is controlled by a few large conglomerates that maintain a limited number of facilities at selected locations. Commonly, a single drug is produced at a single plant. If global distribution systems were impaired during a pandemic, many essential drugs would have difficulties to reach patients while limited stockpiles maintained at medical facilities would quickly run out. For instance, over 95% of all generic drugs used in the United States are made offshore, primarily in China and India. A similar pattern applies to critical medical equipment such as ventilators. Even simple respiratory masks could quickly run out. In 2017, Hurricane Maria hit Puerto Rico and substantially damaged infrastructures, particularly the power generation system. In the aftermath, a shortage of saline solutions was felt because Puerto Rico was a major supplier of these solutions to hospitals across the Americas. All these shortages are likely to result in additional deaths.

In other words, the US may continue to be lucky. But I wouldn’t bet on our ability to respond well to a real crisis.

By Anna Maria Barry-Jester and Anna Almendrala. This KHN story first published on California Healthline, a service of the California Health Care Foundation

Disclosure this week of multiple cases in the United States of a new viral infection emerging from China — including the first confirmed cases of the virus passing from person to person in this country — is fueling public concerns about how easily the deadly virus can spread.

It is also raising pointed questions about why authorities aren’t disclosing more information about the risk of exposure.

The first person-to-person case, announced Thursday, involves a man in his 60s with underlying health issues who is married to a Chicago-area woman who contracted the virus while traveling in Wuhan, China, and was diagnosed upon her return. During a news briefing, state and federal health officials said they believe the threat from the virus remains low within the United States and remained cautious about sharing details about patients and their movements.

Unlike the more detailed accounting of patients’ movements released during measles outbreaks, public health departments are not sharing precise timelines of people’s activities and locations in the days before they were diagnosed with the new coronavirus. The Centers for Disease Control and Prevention has said that while there’s a risk for everyone who comes in contact with a person with the virus, it appears minimal for those with only casual contact, such as being in the same grocery store or movie theater.

On Thursday, health officials declined to name the hospital where the infected couple are being treated, saying the patients are isolated and the risk to others in the hospital remains low. Health care workers who are caring for them and at a higher risk of contracting the virus are being monitored. Jennifer Layden, an epidemiologist with the state of Illinois, told reporters that the wife is doing well and the husband’s condition is stable.

In Orange County, California, where a traveler from Wuhan was confirmed on Jan. 25 to have the virus, Health Care Agency officials said they have received questions from concerned community members about why the agency has not released a precise timeline with the patient’s whereabouts. Jessica Good, spokesperson for the agency, said given what public health officials understand at this point about how the virus spreads, no additional precautions are recommended for the public.

“Our residents should go about their daily lives with no changes to planned activities,” Good said.

Dr. Robert Kim-Farley, an epidemiology professor with the Fielding School of Public Health at UCLA, is among the experts endorsing calm. The new coronavirus appears to be spreading through respiratory droplets, expelled by a sneeze or cough, that do not remain airborne for long and would require close contact for transmission, Kim-Farley said. Given that, he said, publishing a list of locations infected patients had visited would unnecessarily stigmatize businesses and public places.

“There’s no reason to stigmatize a place if there’s no public health action to be taken,” he said.

But he also noted that public health officials could quickly shift strategies pending key developments; for example, if they find the viral particles can remain airborne for long periods, similar to the highly contagious measles virus.

Not everyone agrees with the cautious approach. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said that if public health officials have found that patients were in public spaces, they should make that information public. “There is every reason to inform people if they were exposed.”

Most of the people confirmed to have caught the coronavirus outside of China are believed to have had prolonged contact with people who picked it up in China, like the man in Illinois. But the medical community’s understanding of the virus is still evolving, and the CDC emphasized its recommendations may change.

The Chinese National Health Commission minister has reported that the virus appears capable of being transmitted by an infected person without symptoms. On Thursday, German researchers documented such a case involving German workers who contracted the virus while attending a workshop with a female colleague who had recently been in China, according to news reports.

On Friday, citing the new research and expanded outbreak in China, the CDC took the rare step of ordering a two-week quarantine for 195 Americans flown back to the U.S. from Wuhan by the State Department. The federal government later expanded that quarantine to all Americans who have been in Hubei Province, where Wuhan is located, during the last 14 days. Additionally, all foreign nationals who have traveled in China in the past 14 days will temporarily be prevented from entering the U.S., with the exception of immediate family members of U.S. citizens and permanent residents. Those measures took effect on Sunday at 5 p.m. ET.

While the CDC has cautioned against panic in the U.S., it has expressed concern about the situation in China, where more than 17,000 people have tested positive for the disease and more than 360 have died. The majority of people infected are experiencing mild cases of illness that resemble the flu or a bad cold. But more serious cases can result in pneumonia and respiratory failure.

Despite unprecedented travel restrictions in China, which have prevented the movement of tens of millions of people, the virus has spread to every major city, and the number of cases is sure to grow substantially.

The risk that large outbreaks could spring up in other countries, including the U.S., is also real. The World Health Organization declared the virus a global health emergency on Thursday, precisely because of that risk, WHO Director-General Tedros Adhanom Ghebreyesus said during a news conference. There likely will be more cases confirmed in the U.S., and it is likely that people in close contact with those patients could contract the disease, said Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the CDC.

Still, the risk to the American public remains low, officials stressed. That’s partly because public health departments around the country are on high alert and preparing for additional cases.

“We have a really good public health system that’s really good at detecting disease,” said Anne Rimoin, an epidemiologist and director of UCLA’s Center for Global and Immigrant Health. “We’ve been preparing for this kind of a thing.”

The CDC is reminding the public to take the usual precautions during flu season: Wash hands regularly; cover your mouth when you cough; avoid touching your eyes, nose and mouth with unwashed hands; and avoid contact with people who are sick.

Local health departments also are monitoring close contacts of people who have tested positive for the virus, and sometimes running diagnostic tests even when they have no symptoms.

Despite these assurances, rumors are circulating broadly via text and social media, particularly in Chinese immigrant communities, about people who recently traveled to China and might be infected.

Los Angeles resident Rachel Lee Morales, who was born in China, is anxious because her young daughter is in China with her grandparents to celebrate the new year. Morales is closely following news on the epidemic and has seen messages on social media making unverified claims about people who have recently traveled to Wuhan, including sharing their address and where their children attend school.

“Information gets spread so widely these days, and it could seriously hurt people’s lives,” Morales said. “I don’t want anyone to get into trouble because of this.”

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  1. jeremyharrison

    “Avoid contact with people who are sick.”

    That misses the larger imperative of “Avoid people who have no symptoms but have the virus and are currently in the 14 month asymptomatic phase, during which they’re perfectly capable of giving you the virus if wander down a store aisle where they happened to cough 15 minutes ago.”

      1. jeremyharrison

        Yes. The incubation period is between 2 and 14 days between exposure to the virus and the onset of symptoms. During this period, one can transmit the virus to others, including via droplets of moisture from a sneeze or cough:

        I read one source (which I cannot find again) which said that the virus can remain alive and airborne after a cough or sneeze for up to 45 minutes – I used 15 minutes as a conservative figure.

        Funny how authorities are not yet recommending that the general public wear masks when around crowds of people (or indoors where people gather – stores, etc) – yet insist that any caretaker of an infected person should wear a mask.

        Me? I’ll be wearing a mask whenever out shopping until I see more info on how this starts to play out….

        1. General Jinjur

          Yes. I have a supply of disposable n95 masks and surgical masks, gloves and alcohol based wipes. Luckily, I very seldom need to go anywhere there are crowds.

  2. Stephen The Tech Critic

    I have a question and related concern about the mortality. In the 1/29 coronavirus article, it is stated that the mortality is between 2 and 3%. I have also seen “2.7%” and similar numbers given here and on places like Wikipedia (when I checked yesterday). Does anyone here know of an original source for those numbers, or perhaps more specifically, what method was used to arrive at them?

    Here is my concern. If I perform a very naive calculation by taking the current headline numbers from the John’s Hopkins mapping tool of 20661 for “confirmed cases” and 427 for “deaths” and divide them, I get 2.0%. IIRC, I got closer to 2.7% when I did it yesterday. That sounds pretty close to the numbers that are being quoted, and that may be a problem.

    The problem is that such a naive calculation doesn’t take into account that it might take quite a while for newly “confirmed cases” to become fatal when and if that happens. Meanwhile, the “confirmed cases” are rising very rapidly, maybe even exponentially. This means that this naive calculation is likely to grossly underestimate mortality.

    Suppose instead I calculate mortality by dividing the “deaths” by the sum of “deaths” and “recoveries” (now 695), then I get a mortality of 32%. Wozers! That’s basically apocalyptic, but don’t despair yet. For one thing, I don’t know how recoveries are accounted for. Maybe a lot of recoveries are missed because they never reported back after the test. Perhaps a bigger issue is that someone may not be declared “recovered” until they’ve been free of symptoms for a long time. As such, I wouldn’t attach any significance to this number.

    What we really need to know is how long it takes for people to die after their cases were first “confirmed”. It will be different for different people, and an accurate picture of mortality would require distributional data of how long it took for each terminally ill patient to die. Lacking this data, we can try making something up just to get a feel for the possibilities:

    I’ll assume that every patient that dies does so exactly one-week after their case is confirmed, give or take a day. I’m assuming that patients don’t usually get confirmed until they are already having significant but not necessarily life-threatening symptoms. To do these calculations, I look at the data to see how many “confirmed cases” there were one-week ago, give or take a day, and I divide each of those numbers into the number of deaths today to arrive at the following mortality estimates: 5.5%, 6.1, and 9.7%. Note this variation is huge considering we’re only “giving or taking” a day in our assumed “average time-to-death”. What if patients all took 10 days to die instead? That’d indicate mortality of 20%.

    The point of my illustration is that the mortality could be quite a bit higher than 2-3%, but figuring out the actual number with any reasonable accuracy may be difficult without a lot more granular data. This whole analysis also ignores the many other potential data quality issues already mentioned on this site like the many people who may have the disease but who haven’t been “confirmed” yet. I hope this analysis is helpful.

    1. Yves Smith Post author

      I agree that the naive calculation of reported cases v. deaths is crude and there’s all sorts of reasons to question its accuracy as a metric (staring with problems with the data). What it does say at least is this disease is far more serious than a seasonal flu.

      Most commentary on “this isn’t the best/right way to do this” usually argues in the direction that the number of infected is underreported but deaths aren’t, so the naive calculation is a serious exaggeration. But even that vein of argument ignores that the number of infected is rising quickly (WHO anticipates the disease will peak in China in April) and with deaths occurring after an incubation period and typically late in an active infection phase, the timing mismatch means we pretty much can’t know until the disease stabilizes.

      Your argument for a higher mortality rate is interesting and worrisome.

    2. Ignacio

      “This means that this naive calculation is likely to grossly underestimate mortality”

      It may well be the contrary. My guess is that this overestimates mortality because “confirmed cases” are almost certainly (many) less than infected individuals. Unless you believe there are many unreported coronavirus-associated deaths, but I don’t believe this is the case.

      1. Ignacio

        In other words: there is a strong sampling bias towards more severe cases that results in mortality overestimation.

      2. Monty

        I imagine there will be elderly, who live alone, who will only turn up deceased once the smell in the quarantined apartment block gets too bad.

    3. Kevin C. Smith

      Also consider that deaths are likely to be grossly understated, deliberately and accidentally.

    4. MLTPB

      I was thinking the same about the dead and survived number columns in Wikipedia’s Timeline entry, which has one column that shows dead over (dead plus survived) oat oer 40% since Jan 23, 2020.

      Your recalculation using cases from one week before, as you say, assumes 7 days to die. If it’s longer, those numbers will go up.

      1. MLTPB

        I should add that, in the same Wiki article, there is a footnote for that particular column of numbers, and it should help clear with clearing up some of confusions here and elsewhere – ‘This number should only be considered final once every person diagnosed with the disease has been either dead or recovered.’

  3. Ignacio

    It is next to impossible to control this virus. Infected people may show little or no symptoms in many cases and this means that lots of “reservoirs” can go undetected until the virus infects a susceptible person that becomes seriously ill. I find it striking that for today only about 200 cases have been confirmed out of China (doubling in a week), particularly striking given that even with few reported cases, person-to-person transmission have been reported in many countries. This guy transmits easily! Seven countries have reported now a dozen or more cases diagnosed and IMO this means there are several many more unreported recipients around the world. Australia is now in mid summer (not high season for respiratory viruses) and has reported 12 cases. I guess air-conditioning in airports and many other places helps virus spread. Thailand has reported only a modest increase in detected cases and it may be heat what contains de virus. No cases reported in Laos (in Vientiane private schools have been closed) or Myanmar sounds incredible given the repatriation of many workers but again, these countries are hot and may show limited spread and virulence. South Korea and Japan (North Korea as if it doesn’t exist) might be our canaries in the mine.

    I guess there is an incentive to try to keep an aura of control for as long as possible but the pandemic looks unavoidable.

    1. PlutoniumKun

      Yes, its hard to see it being controlled, although there are all sorts of curious elements to its spread which indicates I think that it won’t expand in a straightforward way. Its been noted that few of the victims are children, which may mean that they are only getting bad colds – which could be good or bad – they may be unwittingly infecting their parents, or it may mean that only a specific segment of the population is vulnerable. As you say, its also possible that it doesn’t like hot weather which is good news for India and Africa.

      I’m very sceptical about the type of response all over the world – there seems to be a lot of virtue signalling actions (stopping flights), without really addressing the modes of contagion, specifically contact via hard surfaces. So many of the emergency plans I’ve read are all based on an assumption of a flu virus – this one seems to be significantly different in how it spreads, which could lead to a lot of trouble. In reality, governments will have to be prepared to close down all non-essential work, close schools and colleges and empty out public transport in order to slow its spread – and I don’t see many being willing to do that for weeks or even months on end.

      1. Ignacio

        A difference with flu that I find important is the apereance of ‘superspreaders’ and this is particularly important now for 1) airlines and airport personnel & passengers – transport hubs in general and 2) hospital and clinic personnel. Particularly the latter group needs special safety measures. I think these are being applied where confirmed cases have been identified but at some point (now?) it should be applied in all hospitals.

    2. Larry Y

      I’ve been following Taiwan, as there are hundreds of thousands of expats working in the mainland who normally travel back for the Lunar New Year.

      On the other hand, the huge decrease in Chinese tourism to Taiwan, as the CCP has discouraged it to punish Taiwan’s DemocratIc Progressive Party, has helped slow down spread of the corona virus.

  4. Tom Doak

    Hmmm … I’m flying today, and after reading your note it occurred to me that one of the perks of premium class travel is personalized check-in. No touchscreens.

    1. Anders K

      OTOH, you do get much more up-close and personal attention from the disease-riddled meatbags that roam the haunted corridors of the airports and airplanes, so it may even out. :)

      Personally, I recommend trying to get healthy amounts of sleep, and don’t pre-stress your body and nervous system with too many frantic internet searches late at night (I know, I know, do as I say, not as I do, but…).

  5. ObjectiveFunction

    Meanwhile, in a country with a properly functioning government:

    Six more cases of nCoV infection in Singapore, bringing the total number to 24.

    This includes four cases of human-to-human transmission. Three of them can be traced to contact with recent travellers from Mainland China, while the fourth was a close contact of one of the other three. These cases were identified as a result of enhanced surveillance at our hospitals.

    – Case 19 and 20 are Singapore residents who both work at a shop where they had prolonged interactions with travellers from China. At least two of these travellers had since been confirmed with the 2019-nCoV infection….


    Notice that this hard info is not left to the corporate news media to spin up for ratings or to dilute out of some diffident urge not to offend mainland Chinese.

  6. Brooklin Bridge

    One wonders, can the virus transfer over short distances without physical contact, say from a pair of reading glasses to the nose or eyes? Of course there is already actual physical contact between glasses and the bridge of the nose, and from there hitching a ride to the eyes, nostrils or mouth via the fingers would be fairly easy if not also likely, but could contagion occur without help of the fingers or sneezing, from simple currents of air, say between the glasses and the eyes?

    1. rd

      You can just buy cheap small stylus pens that easily fit in your pocket or purse that you can use on touchscreens or to press buttons.

    2. False Solace

      During flu season I routinely wear gloves when touching doorknobs at work or whenever I go to the store. Shopping carts, touch screens… Leather gloves tend to work for touchscreens as well. I think this accounts for how rarely I get sick these days. Before I started doing this, I joked that every time I used the lunchroom I came back with a cold.

      The idea rd posted of using a stylus is interesting, but I have no idea what you’re supposed to do with the stylus after you use it. Wouldn’t you potentially contaminate yourself later if the stylus goes into your pocket or purse and you need to fish it out? Gloves give you a layer of protection and you can swap between pairs. And if you live in a cold weather area it doesn’t look strange to anyone if you wear them.

    3. Wisdom Seeker

      In a pinch, just tap the screen using the corner of a credit/debit card or other plastic ID card.

      If you’re worried about the corner too, could scrounge up a card-size bit of copper to carry in the wallet or purse. Business idea? (Better than gloves since not disposable, won’t need washing, won’t get touched to your face, won’t contaminate you.)

      Next wave would be to for an enterprising business to incorporate copper corners (or other anti-germ technology) on new bank cards?

      1. oaf

        …or a stylus that stores in a housing with bleach and U.V lamp…
        Sometimes you can get a store *associate* to do the screen contact for you…if not; ask them to provide sani-wipes, hand gel, or similar…( not readily available at checkout in the local orange box store)

  7. Brooklin Bridge

    Regarding touch screens, I simply won’t use them except in an emergency where I have absolutely no choice. This since they first came out. I’ve found in supermarkets that the cashier will often offer to poke in what little info is required (such as do you want cash back). This stubborn if inadvertently healthy habit came more from tinfoil like assumptions about bio-metric data than from concerns about germs, but I’ll take what ever advantages from my paranoia I can get… Of course now I wonder about the transmission potential of my debit card itself, not to mention the food items the cashier touched when passing them through the scanner, or the bagger come to think of it.

    1. Brooklin Bridge

      Clarification: Simply won’t use them with my fingers, that is. No problem with a stylus as long as it works (for some reason it always seems to fail on the question of cash back).

      1. anon in so cal

        How about sitting in a college classroom with 40 students who work part- or full-time in various off-site locations, with the windows shut, poor ventilation….

        Stanford University apparently issued an advisory for any campus personnel who may have visited China to remain off campus for some number of days. Have not seen this for other campuses.

        Reposting this: are Asian males more genetically predisposed to contract the virus, due to having higher Angiotensin-converting enzyme 2 (ACE2) expressing cell ratios than females?

        “A comparison between eight individual samples demonstrated that the Asian male one has an extremely large number of ACE2-expressing cells in the lung. This study provides a biological background for the epidemic investigation of the 2019-nCov infection disease, and could be informative for future anti-ACE2 therapeutic strategy development.”

        Suggestive, but difficult to achieve validity with such a small sample size.

    2. polecat

      So, you’re instead relying on a cashier, perhaps ?? .. who may happen to be a phomite magnet un to themselves, along with the the customer items they scan, the register keys they press .. while they chat you up in the process of experiencing the Un-selfcheckout ?? Ok, pull the other one .. with a gloved hand, of course ! …. Oh, and lets not forget the Bagger, who runnith from one possibly infectious checkout lane, to another ! See where this virally crowned rabbit-hole leads ?

      Look, when it gets down to it, we’re ALL just tumbling the dice here. Some will roll snake eyes, others will roll sixes .. but what it all is is a planetary crap shoot, where some novel microscopic critter gets to come out and play !
      It’s our global civ. .. with it’s long-reach supply chains + ubiquitous, and often superfluous tech × the undaunted hubris of the human animal, in all it’s, uh, clustered glory .. that will determine our various, and individual fates.

  8. carycat

    I don’t do well with touch screens, my skin is probably too dry as the response is much better if I moisten my finger tips (no, I never lick them). I use a stylus that has a rubbery conductive tip with my phone. In the age of 2019-nCoV, maybe we all should carry our own stylus to deal with those (family blogging) touch screens, the other (hard) end could be used to poke real buttons. And sanitize the tip when possible for the same reason as washing our hands. Somebody has also suggested that you carry and use your own pen. The less direct skin contact, the better off we all will be until this dies down.

  9. Alternate Delegate

    > “it was impossible to check out without putting my hands on a touchscreen (you had to accept or reject getting text messages, the prompt comes up for every friggin’ transaction)”

    This is a real-world dark pattern that has started to come up more often.

    I always object. I state that I do not work for the retail outlet and I refuse to do free work for them. I will “push the button to decline the (whatever)” for a paycheck of one million dollars. I will not do it for free. They can do it, or they can call a manager, I will not do it.

    Generally the poor clerk rolls their eyes and pushes the button themselves.

    Not proud of giving the clerk a hard time, but there’s a line, and this is it. Maybe they’ll stop doing it if it costs enough manager’s time. Unfortunately they’re not seeing this in their metrics but – I’ve stopped going to all of those places. I’ve got to make sure it doesn’t become every place.

    1. Shiloh1

      Good that you don’t give the clerk / cashier a hard time. These decisions and set-ups are made at the six, seven and eight figure salary corporate management level to add to bottom line.

  10. Susan the other

    Just curious, does the corona virus migrate into pharma labs and get into the ingredients – because we know recently India was not very fastidious in its compounding practices.

  11. David Carl Grimes

    Isn’t the virus dying down? The number of confirmed cases is increasing at a decreasing rate, even outside China.

    1. Samuel Conner

      It’s hard to make sense (other than “OMG”) of the trajectory of reported new cases within mainland China as the medical infrastructure within the worst-affected province may be strained beyond its capacity to deal with the situation.

      The “outside of China” cases might be a better metric, simply because there are fewer of them and the reporting rate is likely to be closer to 100%. Unfortunately, there is an alarming jump in the last 24 hrs, after what appeared to me to be encouraging moderation in the geometrical growth rate in prior days.

      I don’t know what it means.

  12. Ignacio

    I am leaving here a link on a paper published by the NSR that provides good and brief background on the natural history of human coronavirus and then provides some data on the Wuhan CoV and its evolution in humans.

    PERSPECTIVE: Evolutionary Perspectives on Novel Coronaviruses Identified in Pneumonia Cases in China

    I believe that identifying the hypothetical intermediate host (pigs? rats?) is very important to adopt measures against new CoV infecting humans. Three novel coronavirus species from bats in less that 20 years is something to be noticed by the WHO… and do something about it.

    1. polecat

      Almost like the British Hulks of old .. except that the only crime those cruise ship passengers committed .. was going on holiday ! Unfortunately, the Antipodes are all spoken for. Antarctica better warm up, quick-like !

      I predict that after this is all over, hollywood .. and by extention it’s competitors, are going to be cranking out the horror/terror flicks … should a film industry survive this plague of seething ‘loci’.

  13. MLTPB

    In Hospital Ship, Wikipedia, it says the US has 2 such ships, with 1,000 beds each.

    Russia also has, with fewer beds.

    Two are operational in the People’ Liberation Army. Are they being used, or have they been in use, even before the 2 new hospitals in Wuhan were completed?

    1. khat

      Surprised by the info on how filthy touchscreens are! Recently had to get bloodwork. Required by insurance to go to LAB CORP. They have disposed of a receptionist entirely and all are forced to touchscreens. These are very difficult to use for the elderly.

      Even my GP stuck a touch screen check-in on the counter. Everyone complains about it. Corporate medicine is a danger to our health.

  14. smoker

    I find my self thinking it’s likely that all of the Silicon Valley Oligarchs, are currently well out of the area.

    There has been no transparency on why Silicon Valley/San Jose’s Mineta International that had the direct flights in from Beijing (and at least one, or more, other Chinese Cities outside of Wuhan), and likely numerous privately owned jets (see below) which have yet to be discussed, flying in and out of it (and Google/Moffett/NASA for that matter) and is the most likely Airport that the Santa Clara County and San Benito County cases arrived through is still not on the list of Airports being screened (though San Francisco International [SFO] has been since at least January 18th, according to this 01/20/20 piece, At San Francisco International Airport, a travel advisory has been in effect since last week, requiring all fliers coming directly from or connecting from Wuhan to undergo screening.). San Jose’s Mineta International Airport has been verified as the Airport flown through for the first Santa Clara County Case.

    Wasn’t surprised at all to find I’m not the only one with this sentiment.

    01/20/20 San Jose [Mineta] International Airport, emphasis mine:

    Fly into Mineta San Jose International Airport with JetOptions Private Jets. Second only to SFO for passenger traffic, SJC sees 20% of its daily runway use by private jets and general aviation. This popular airport is 3 miles from downtown San Jose and is considered the gateway to Silicon Valley.

    San Francisco 49ers Levis Stadium is 10 minutes from SJC, and it offers nearby access to U.S. 101, Interstate 880 & S.R. 87, all major Bay Area connectors.

    Mineta San Jose International Airport Private Jets

    This airport has two parallel runways of 11,000 feet for the largest long-range jets. There are two standalone FBO terminals to welcome private jets and passengers, with a full complement of hanger and maintenance services available. KSJC provides comprehensive FBO services at its two fixed-base locations. The SJC airfield covers more than 1,050 acres, and it has two runways of 11,000 feet in length.

    1. smoker

      020419 5:34PM Pacific Standard Time San Jose UPDATE Regarding that January 24th Un-scanned flight virus case, through Mineta International:

      Good Samaritan Hospital sends home 5 workers exposed to coronavirus-Patient with first confirmed case initially sought treatment at facility in San Jose

      No mention of whether they’ll be paid, or how many other members of their 5 households will be quarantined, possibly without pay, or far worse – job loss..

      Since that person was noted to have pretty much immediately felt sick upon arrival on the 24th

      The man arrived in the Bay Area, at Mineta San Jose International Airport, on Jan. 24 and isolated himself at home from that day on.

      CDC scanning may have mitigated that domino effect on those five people and those they might live with.

  15. John k

    Known cases up 25% to 16;600.
    12627 in hospital, of which1809 1/7, or 14%,, are critical.
    If half the critical ones don’t make it mortality would be 7% of those in hospital.
    Given none of the not critical cases become critical.
    But maybe some cases not considered important enough to hospitalize?
    Or maybe not enough beds, so sick people turned away?
    2-3% seems too low.

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