Coronavirus Sars-CoV-2/Covid-19 Megathread

[Eddie Teach]

Your system sucks.

[jimmy olsen]

New York Times says China is fucking it up

https://www.nytimes.com/2020/02/02/world/asia/china-coronavirus-wuhan.html

Coronavirus Pummels Wuhan, a City Short of Supplies and Overwhelmed

It is nearly impossible to get the care they need to treat, or even diagnose, the coronavirus, say residents at the crisis' center.


By Amy Qin
Feb. 2, 2020
Updated 8:45 p.m. ET

WUHAN, China — Weak with fever, An Jianhua waited in line for seven hours outside the hospital in the cold, hoping to get tested for the new coronavirus, which doctors suspected she had contracted.

Ms. An, 67, needed an official diagnosis from a hospital to qualify for treatment, but the one she and her son raced to last week had no space, even to test her. The next hospital they were referred to here in Wuhan, the  city of 11 million people at the center of the outbreak, was full, too, they said. They finally got an intravenous drip for Ms. An's fever, but that was all.

Since then, Ms. An has quarantined herself at home. She and her son eat separately, wear masks at home and are constantly disinfecting their apartment. Ms. An's health is declining rapidly, and even keeping water down is a struggle.

"I can't let my mom die at home," said her son, He Jun. "Every day I want to cry, but when I cry there are no tears. There is no hope."

As countries race to deal with an outbreak that has begun spreading around the world, inciting panic and disrupting the global economy, the residents of Wuhan are waging a daily battle to survive an illness that has sickened more than 4,100 people and killed 224 in their city alone.

Last month, the government put Wuhan in a virtual lockdown, sealing off the city and banning most public transportation and private cars from its streets in a desperate effort to contain the outbreak. Now, many residents say it is nearly impossible to get the health care they need to treat — or even diagnose — the coronavirus.

Expressing exasperation, doctors say there is a shortage of testing kits and other medical supplies, and it is not clear why more are not available. The ban on transportation means some residents have to walk for hours to get to hospitals — if they are well enough to make the journey. Layers of bureaucracy stand between residents and help. And the long lines outside hospitals for testing and treatment suggest that the outbreak is spreading far beyond the official count of cases.

Ambulances, too, are hard to come by, residents say. In recent days, some say they have called 120, China's equivalent of the emergency number 911, only to be told that there were already hundreds of people in the queue.

Those who do make it to the hospital say they are squeezed together for hours in waiting rooms, where infections are easily spread. But the shortages have meant that many are ultimately turned away and sent home to self-quarantine, potentially compounding the outbreak by exposing their families.

Many doctors and residents are putting their hopes on the two new coronavirus hospitals that China has been racing to build in Wuhan in just a matter of days. One of them spans about eight acres, has 1,000 beds and is scheduled to open on Monday. The government says 1,400 military medical workers will be deployed to work there, potentially helping with the shortage of health professionals on hand to combat the outbreak.

On Sunday, city officials announced plans to set up quarantine stations around Wuhan for people with symptoms of pneumonia and close contacts among coronavirus patients. But just over a week into the lockdown, many residents believe the virus has already spread much further than the official numbers suggest.

"The situation that we've seen is much worse than what has been officially reported," Long Jian, 32, said outside a hospital where his elderly father was being treated. Mr. Long said his father had to go to six hospitals and wait seven days before he could even be tested for the coronavirus.

Just steps from where Mr. Long spoke, beds could be seen lining both sides of a narrow corridor in the emergency room. One man was getting an intravenous drip outside in his car.

"Those who can get diagnosed and treated are the lucky ones," Mr. Long said. "In our neighborhood, many who weren't able to get diagnosed ended up dying at home."

Getting treatment for the coronavirus in a hospital requires jumping through a number of hoops.

According to official guidelines, patients are encouraged to go to their local hospitals first for initial assessments and sometimes prescriptions. Then patients are to deliver the results to their local neighborhood committees, which are responsible for communicating with the hospitals and coordinating resources for the households in their areas. There are about 1,000 neighborhood committees in Wuhan, for a population of 11 million.

Patients with mild symptoms are typically told to go home and self-quarantine, according to a Jan. 24 notice by city officials. Those who have more severe symptoms are flagged by the neighborhood committees, which arrange for transportation by ambulance to one of the two dozen or so hospitals designated for treating the coronavirus.

But in practice, patients and their relatives say that the process takes far too long, and that the bar for what constitutes "severe symptoms" has been set too high — so they give up and try waiting in long lines at hospitals instead.

Amy Hu said her 64-year-old mother went to the doctor after experiencing a fever, cough, shortness of breath and diarrhea about 10 days ago. Based on the initial assessment, the doctor told Ms. Hu's mother that she had contracted the coronavirus. But the test needed to confirm the diagnosis was not available, the doctor said.

Without the test, her mother couldn't be admitted to a hospital. Since then, Ms. Hu said, they have been waiting at home to hear back from the hospital about when her mother can be tested. In recent days Ms. Hu, who has been visiting her parents for the Lunar New Year holiday, took precautions herself: She checked into a hostel with her two children.

"I'm very dissatisfied with the government," Ms. Hu said. "It's like only when the patients are close to death can they be admitted to a hospital."

Tong Yixuan, 31, said Sunday that he panicked last week when he learned that in just a few days, his father's cold had escalated into a full-blown illness that doctors said was almost certainly the coronavirus.

But neither his father, who had a 104-degree fever and was slipping in and out of consciousness, nor his mother, who was starting to show similar symptoms, could get tested. Hospitals said that there was no space, and that their symptoms were not severe enough, Mr. Tong said. His parents were sent home to quarantine themselves.

There was no way for Mr. Tong to help. He was more than 60 miles away in Huangshi, which days ago had been locked down by the government along with many other cities in Hubei Province. The roads out of Huangshi and into Wuhan had all been sealed off. For days, Mr. Tong was stuck. Only Saturday, after hours of negotiation with local officials, was he able to make it to his parents' bedside, he said. They have since been tested for the coronavirus, and his father has been admitted to a hospital. The process took 10 days.

"All I want to do is take care of my parents," Mr. Tong said. "I don't even care if I get infected."

For some people, like Gan Hanjiang, the new hospitals cannot be built fast enough.

Last month, his father came down with a severe fever and cough. He was tested for the coronavirus, but the results were negative. Ten days after the onset of symptoms, however, his father died, Mr. Gan said.

The hospital classified the cause as "severe pneumonia," Mr. Gan said, but he believes it was the coronavirus. Several experts have recently conceded that several rounds of testing may be needed for an accurate diagnosis of the virus.

On the day his father died, Mr. Gan began to show the same symptoms, he said. But without a car, he has not been able to go to one of the designated hospitals to get tested for the coronavirus.

"Getting treatment is so difficult," he whispered slowly by telephone from a small hospital near his home where he was being treated for viral pneumonia. "We can't get admitted to the hospitals. And there's not enough medicine."

Elsie Chen contributed reporting.

Amy Qin is a China correspondent for The New York Times in Beijing covering the intersection of culture, politics and society. @amyyqin

[DGuller]

At least that will stem the tide of new diagnoses.

[Legbiter]

The virus has to have originated in November for Wuhan to be overwhelmed this early.

[DGuller]

I seem to recall reading a story sometime in December about how some outbreak of a diseases was tamped down in China, and how it was a sign of effectiveness of Chinese health policy.  I need to find it to make sure I remember the details correctly.

[Legbiter]

I'm offically paranoid now. R0 close to 3 and 2% mortality rate and more infectious than the flu but with a long asymptomatic incubation period? This will be hell once it starts spreading in countries like India and Bangladesh if containment in China fails.

[DGuller]

This is the earliest mention I found on the Internet: http://www.cidrap.umn.edu/news-perspective/2019/12/news-scan-dec-31-2019.

[Admiral Yi]

Do we officially know yet if it's contagious during the incubation period?

Does the incubation period remind anyone else of Alien?

[Legbiter]

The German infection was from an asymptomatic Chinese colleague according to the NEJM report I linked to earlier.

Before the onset of symptoms, he had attended meetings with a Chinese business partner at his company near Munich on January 20 and 21. The business partner, a Shanghai resident, had visited Germany between Jan. 19 and 22. During her stay, she had been well with no signs or symptoms of infection but had become ill on her flight back to China, where she tested positive for 2019-nCoV on January 26 (index patient in Figure 1).

On January 27, she informed the company about her illness. Contact tracing was started, and the above-mentioned colleague was sent to the Division of Infectious Diseases and Tropical Medicine in Munich for further assessment. At presentation, he was afebrile and well. He reported no previous or chronic illnesses and had no history of foreign travel within 14 days before the onset of symptoms.

https://www.nejm.org/doi/full/10.1056/NEJMc2001468?query=featured_coronavirus

[jimmy olsen]

The virus has to have originated in November for Wuhan to be overwhelmed this early.

The genetic analysis pointed to that IIRC

[Monoriu]

Do we officially know yet if it's contagious during the incubation period?

I am not sure if it is official, but all signs point to yes. 

[Admiral Yi]

Well I'm fucked then.  Thousands of Chinese students at U of I, a couple must have gotten out of the forbidden zone before they sealed the blast doors.  Oh well.

[DGuller]

Well I'm fucked then.  Thousands of Chinese students at U of I, a couple must have gotten out of the forbidden zone before they sealed the blast doors.  Oh well.

Do you remember if you owe me any money from our past bets?

[Eddie Teach]

His sig says you owe him.

[DGuller]

His sig says you owe him.

Oh, I see, I have those turned off. Would these receivables be considered part of the estate?