Coronavirus Sars-CoV-2/Covid-19 Megathread

[merithyn]

Quite honestly, I am reaching fast my breaking point about living in the US...

Me, too.

[Sheilbh]

Reading this piece and feeling like it's probably time to teach my 70 something dad how to facetime - the psychological impact on those involved of this sort of measure, I think, could be very significant. I feel like communities might need to do more to support and be in touch with their elderly if social distancing has to apply to families:

The most important fact about coronavirus that the government does not know, writes Robert Peston

I understand a bit more than I did about what the prime minister, the chief medical officer Chris Whitty and the chief scientific adviser Sir Patrick Vallance are trying to achieve with their Covid-19 policy, what that policy actually is, what they actually know about the illness and - importantly - what they don't know.

Let's start with the most important thing they don't know. This is the proportion of people who will get the virus but will show no symptoms.

It is a hugely important ratio, because it conditions how far the government should take measures to restrict our ability to move around and socialise.

The point is that the more people who get the illness without showing any symptoms, the fewer people will need hospitalisation - which in turn means that the fewer actions the PM would need to take to curb our precious freedoms to be with who we want, where we want and when we want.

But the more people who would have symptoms when ill with the virus as a proportion of the population, the more urgent it is to delay its spread - because a massive surge of seriously sick people would overwhelm our healthcare system.

Just to explain with notional numbers, based on one statistic that Whitty and Vallance seem to have some confidence in, namely that 5% of those with symptoms will need hospitalisation. On that basis, if 30m people got Covid19, but half of those were asymptomatic (with no symptoms), then 750,000 of us would require help in a hospital during the epidemic's duration. But if the asymptomatic ratio were just 20%, then the Coronavirus burden on the health service would be a near impossible 1.2m newly sick people.

So as I hope you can now gather, a massively important statistic is this ratio of asymptomatic sufferers to those showing any kind of symptom. But Whitty and co have little idea what it is, and the problem is that there is no available serological test, or test for the viral antibodies in our blood, that would conclusively show who has had the virus, whether or not they ever manifested symptoms.

Huge amounts of work are going on to establish such a test. But it almost certainly won't be ready in time to inform the decision of Whitty, Vallance and Johnson about how much so-called "social distancing" - staying away from people - to enforce on all of us.

If you are with me so far, let us now examine what Whitty and Johnson want to achieve with social distancing.

Now I understand Whitty has not been instructed by Johnson or the health secretary to restrict his advice to policies that are affordable or do less damage to the economy. That may happen at some point, but so far Whitty has given the advice he believes is best for our health and has encountered no push back.

Which then brings us to his core ambition.

It is, as far as possible, to manage the rate of infection through the population so that it is not so rapid that the NHS can't cope at all, such that far too many people die of the virus in a short time because the NHS can't cope, but is not so slow that the ability of the NHS to help people with other illnesses and life-threatening conditions is impaired for months and even years.

To put this in the grimmest possible terms, Whitty's primary function is to minimise deaths from coronavirus, though these deaths may not be directly from the virus itself but also from the inability to treat those who suffer strokes, cancer, heart attacks and so on.

Calibrating all this is spectacularly hard, not just because the government does not know the asymptomatic ratio, but it also doesn't know whether the virus will automatically calm down in summer, only to rear up again next winter, nor does it know whether those who suffer it are likely to acquire immunity for a short while or a long time.

For what it's worth, Whitty's central planning assumption is that this virus will have a spike in numbers soon, and then come back - probably less aggressively - in the winter.

He makes another important assumption - which is that the probability of there being an effective vaccine within 18 months is less than 50% (largely because no vaccination for any form of coronavirus has ever been made yet).

Where is this leading the government?

Given that the government has been widely criticised for not taking dramatic enough prophylactic action, surprisingly it will - I think - lead Whitty to pretty soon recommend measures that will feel severe and unkind, namely that older people and those with chronic illness should be barred from any but essential physical contact with people.

Which in crude terms means the elderly being prevented from mixing with their children, grandchildren and younger friends.

Why?

Because the statistics are clear that the likely need for hospitalisation as result of catching Covid-19 rises very sharply over the age of 70.

Now you may feel this is common sense.

But for those who are old, and may in any case have not much longer to live, it is miserable to be cut off from those they love.

In fact it is worse than that. For some old and infirm, ending contact for an extended period with their loved ones can lead to chronic depression, and cause some to give up the will to live.

So the cost of this sort of social distancing would be big - if, in the view of many, necessary.

As for other forms of social distancing, I would be surprised if at some point there were not temporary closures of pubs and restaurants, because Whitty and Vallance believe the risk of transmitting the virus is much greater in smaller social venues than in giant ones like stadia.

And at some point, probably at the peak of the epidemic, schools are likely be closed for a couple of weeks.

All of which is to make one simple and depressing caveat about Johnson's repeated statement, and that of his health secretary, that they are being guided always by the science: which is that Whitty and Vallance would admit that what they don't know about this virus is probably as significant as what they do know.
Last updated Fri 13 Mar 2020

Edit: On my point about the media earlier - apparently the government will be announcing a ban on large gatherings from next weekend. The Guardian headline is about Johnson's "U-Turn" and I'm seeing journalists talk about him being "forced to backtrack in 24 hours". The government's been flagging this might happen and is something they're looking at, but they want to do it at what they consider is the right time based on the advice. But the media is reporting it like any other bit of politics and so it's a "U-turn" or a "backtrack" or a "flip-flop".

I'm not sure which is true but I'm not sure this approach to reporting it is really suitable for responding to a pandemic, especially when you flag the situation is rapidly changing and youradvice to people will evolve

Edit: Good lord - legislation to give government emergency powers for two years:

EXCLUSIVE:
Ministers to unveil emergency Coronavirus powers:
* Police allowed to detain infected
* Care standards could be lowered for elderly
* Ministers allowed to close ports
* 'Trains, vessels & aircraft' can be halted
* Schools can be directed to close or remain open

The emergency powers, which will be in place for two years, will enable police and immigration officers across UK to detain anyone with suspected Coronavirus
They will be able to detain them for a 'limited period' so they can be screened

The level of care for elderly could be stripped down as pandemic grips Britain
Local authorities will be relieved of statutory duty to meet 'assessed needs'
It could mean people only receive support with washing and cooking once rather than twice a day

Ministers will be allowed to close ports if there are 'insufficient resources' to maintain border security because too many border staff are sick
The Government will be given the power to halt 'any vehicle, train, vessel or aircraft' under the legislation

Measures to speed up funerals among most bleak:
'In a reasonable worst-case scenario the death management industry will be rapidly overwhelmed
'There is a significant gap in body storage requirements to ensure we are prepared for the reasonable worst-case scenario'
Measures to speed up funerals include:
* Removing need for jury inquests
* Enabling health professionals other than doctors to sign off cause of death certificates
* Doctors will not be required to see body of deceased

[Admiral Yi]

The weakest societal link IMO is food retail.  They're not paid a ton of money, and they come in contact with hundreds or thousands of people a day.  If one guy in a store gets C19, what's to prevent the other employees from skipping out?

[Sheilbh]

For Syt, Marina Hyde has been reading Daniel Defoe's A Journal of the Plague Year (tempted to get a copy myself):

Yes, it's grim. And the British way with contagion has barely changed since 1665
Marina Hyde
From ye olde panicke buying to quack cures, conspiracy theories and imbeciles with public platforms, the plague had it all
@MarinaHyde
Fri 13 Mar 2020 16.33 GMT
Last modified on Fri 13 Mar 2020 18.20 GMT

Having had a temperature and a dry cough for some days now – don't worry, I'm not going to write That Column – I've been doing the reading equivalent of shopping in my closet. And, ever a sucker for a theme, this has turned out to be that rare occasion where I've ended up going: "Ooh, I must have some more Fruit & Nut and get Daniel Defoe's A Journal of the Plague Year down off the shelves". Forgive me; that was unclear. Fruit & Nut is a hugely frequent occurrence; a need for historical accounts of mass distemper less so.

Obviously I'm slightly put out to discover that what follows might not be the first review of the work. I understand Defoe's fascinating account of the 1665-66 London plague season received very favourable notices when it came out (the year 1722). I myself found it a brilliant curiosity of a book when I read it first time round (the year 1995). But from the particular vantage point of the year 2020, I can only say: guys, it really is all there. Ye olde panicke buying, ye olde refusal to self-isolate – "they did not take the least care or make any scruple of infecting others" – ye olde wittering and twittering of conspiracy theories. "The error of the times," as Defoe optimistically judges them.

Nor were our plague-plagued 17th-century forebears short of famous imbeciles with a public platform. Defoe's narrator marvels at the pitiable foolishness of one noted idiot who spent his time going about the city spouting deranged pronouncements and doomy surmise, the occupation of breakfast television presenter not existing at the time. Nor, indeed, the occupation of former leader of the Brexit party.

There are suddenly familiar tales of the rich taking flight (in the 1665 version, to the countryside, as opposed to the sort of bunker complex where one might have to know Mark Zuckerberg socially). The narrator voices huge admiration for the poorest workers and those on the frontline of fighting the pestilence, who "went about their employment with a sort of brutal courage". I thought of this when Jenny Vaughan of the Doctor's Association told Thursday's Channel 4 News: "We will lose our colleagues – we will be burying our colleagues.".

Others in 1665 London behave absolutely appallingly, of course – worse even than you might see in the 2020 supermarket bog roll aisle. Then again, it's still early days for us.

Speaking of shopping, it's striking how 350 years of retail innovation don't amount to a hill of beans. Like many of my friends right now, Defoe's narrator is sufficiently disorganised to have very little stuff in, when the plague gets serious. "I was one of those thoughtless ones ..." Thereafter, his stockpiling necessities are flour, malt to brew "as much beer as all the casks I had would hold", salted butter and Cheshire cheese (the components of a much more agreeable supper than pasta, surely). Most ominous is his realisation that regular panic-buying sorties were likely the occasions on which many people ended up catching the distemper.

So everything changes, and nothing changes. Almost 50 years after the plague, Defoe comes to write the book in what he regards as a media explosion. Newspapers and periodicals and pamphlets were now everywhere, meaning that reports, accurate or otherwise, "spread instantly over the whole nation". This is the only thing on which we might pull rank on Defoe, with a friendly "Dude: it gets SO much worse. Wait till they get school parents WhatsApp groups, and uncles on Facebook."

And yet, it's surely the 1722-ers who should be pulling rank on us. After all, you'd hope that in three and a half centuries of supposed progress, we might just have moved beyond virally disseminated quack cures and "hearing that the virus is a bioweapon invented by the US / China???" But we haven't, presidents and politburo officials included. We remain, as Defoe put it, "addicted to prophecies and astrological conjurations, dreams, and old wives tales".

Most resonantly for the contemporary UK, perhaps, the infectious disease Defoe is writing about comes to an already divided nation – barely five years after the Restoration, not a whole lot more after the civil war, and with ideological and religious arguments positively frothing. The narrator rather hopes it will end up uniting people. "Another plague year would reconcile all these differences," he idealises. "A close conversing with death ... would scum off the gall from our tempers, remove the animosities among us ..."

Yup, well, SPOILERS: it doesn't. "As the terror of the infection abated, those things all returned to their less desirable channel," the narrator laments. "There did not cease the spirit of strife and contention, slander and reproach, which was really the great troubler of the nation's peace before." Likewise. Perhaps we'll make a better fist of it.

For now, there is a distinct war-by-other-means to what we might euphemise as "the discourse" around coronavirus, on social media and beyond. People have been very used to entrenching on leave and remain lines; now we seem to have almost reflexively self-split into Panickers and Deniers. These two categories don't mirror their immediate forerunners, of course – you can be a hard remainer and a hard panicker, for instance, or a hard leaver and a hard panicker and so on. Some people who'd had enough of this lot having had enough of experts have now had enough of this lot deferring to experts.

Still, we polarise about everything else – why not this? Maybe there is something of the comfort of the familiar in fighting pitched online battles about whether Boris Johnson is or isn't telling the truth about a matter. It's all we've known for years. It's just the stakes are suddenly rather higher.

Wishing the prime minister anything but the absolute best in his stewardship of this crisis is psychopathic. But it does feel a little late in the day for Johnson to set himself against whipped-up hysteria and dodgy fake news. In an era of rumour and superstition, Defoe laments that the government of 1665 didn't do more to clamp down on popular falsehoods, putting this down to their "being unwilling to exasperate the people". Our current government seems markedly more willing to exasperate the people, with its coronavirus response atypically cavalier compared with that of so many other countries. This ... might be a good thing? Then again it ... might be up there with the very worst things? After four years which have upended so many of the certainties, it's rather difficult to get any bearings. But wherever we really are, and whoever Boris Johnson really is, we finally are all in this together.

• Marina Hyde is a Guardian columnist

[mongers]

Useful summation of coronavirus daily info, taken from Reuters:

Factbox: Latest on the spread of coronavirus around the world
8 MIN READ
(Reuters) - U.S. President Donald Trump on Friday declared a national emergency over the fast-spreading coronavirus to free up $50 billion in federal aid to combat a disease that has infected over 138,000 people worldwide and left more than 5,000 dead.

A man wearing a protective face mask is seen following an outbreak of coronavirus (COVID-19), at Lujiazui financial district in Shanghai, China March 13, 2020. REUTERS/Aly Song
(Interactive graphic tracking global spread of coronavirus: open tmsnrt.rs/3aIRuz7 in an external browser)

DEATHS/INFECTIONS

** More than 138,000 people have been infected globally and over 5,000 have died, according to a Reuters tally of government announcements.

** The Chinese city of Wuhan, the epicenter of the outbreak, reported just five new cases on Friday, the second day in a row the tally has been less than 10. That brings the total number of infections in mainland China to 80,813. The death toll is more than 3,000.

EUROPE

** British cases of coronavirus rose 35% to 798 over the past 24 hours. There have been 10 deaths so far.

** Major Spanish regions shut shops, bars and restaurants and Easter parades were cancelled as Spain prepared to enter a 15-day state of emergency on Friday. The number of infections rose to 4,231, up about 1,000 cases from Thursday. About 120 people have died.

** Russia, which has so far recorded 45 cases, will limit passenger flights to and from the European Union, Switzerland and Norway, starting March 16.

** Greece reported its first fatality, a 66-year-old man who had returned from a religious pilgrimage to Israel and Egypt at the end of February.

** The death toll from coronavirus in Italy has jumped in the last 24 hours by 250 to 1,266, a rise of 25%. The total number of infections rose to 17,660.

** The number of confirmed cases in Germany has risen by 671 to reach 3,062, the Robert Koch Institute for infectious diseases said on Friday. It said five people had died after testing positive for the virus.

** A second patient has been diagnosed with coronavirus in Turkey, its Health Minister said on Friday.

** The Bulgarian parliament voted unanimously on Friday to declare a state of emergency until April 13 as the number of confirmed cases in the country more than tripled to 23.

AMERICAS

** U.S. President Donald Trump said on Friday morning that coronavirus testing in the United States will soon be carried out on a large scale.

** Mexico could consider measures at its northern border to slow the spread of the coronavirus into its relatively unaffected territory. It has confirmed 16 cases, with no deaths.

ASIA

** Kazakhstan confirmed first coronavirus cases.

** South Korea reported more recoveries than new infections on Friday for the first time since its outbreak emerged in January. The country recorded 110 new cases, compared with 114 a day earlier, taking the national tally to 7,979, with the death toll rising by five to 72 as of late Friday.

** India, with 82 confirmed cases and two deaths, ordered the closure of public buildings, malls, cinemas and bars in several major cities on Friday.

** An 80-year-old man became the fourth patient in Hong Kong to die from coronavirus. The country has so far confirmed around 130 coronavirus cases.

** Thailand reported five new coronavirus cases, bringing the total to 75.

MIDDLE EAST AND AFRICA

**Kenya confirmed East Africa's first case of coronavirus, a woman who had returned to the capital Nairobi from the United States.

**Ethiopia has confirmed its first case.

**Saudi Arabia detected 24 new cases, 14 of whom were Egyptians. This brings the total in the kingdom to 86.

**In Iran the total number of deaths from the outbreak has risen by 85 to 514, a Health Ministry official said on state TV on Friday, while total infections had increased by more than 1,000 in the past 24 hours to 11,364.

AUSTRALIA

**One of Australia's highest-profile ministers, Peter Dutton, who is in charge of home affairs, said he had tested positive for coronavirus on Friday. The country has recorded 156 infections and three deaths.

ECONOMIC FALLOUT

**Switzerland will make 10 billion Swiss francs ($10.52 billion) available in immediate aid to mitigate the economic impact of the coronavirus outbreak.

ADVERTISEMENT


**The Indonesian government has prepared a 120-trillion-rupiah ($8.1 billion) stimulus package to support its economy as the spread of coronavirus disrupts global activities.

**Japan's government is expected to cut its assessment of the economy in a monthly report due later this month.

**Norway's central bank said on Friday it had offered the first in a series of extraordinary loans to the banking industry, along with a surprise half-point cut in its key policy interest rate.

**France will help all companies in which the French state has a stake to weather the coronavirus crisis, its finance minister said on Friday, putting the growing cost of measures to soften the economic fallout at "dozens of billions".

**Germany's KfW state development bank has roughly half a trillion euros in support available to help support Europe's largest economy, which risks being stricken by the coronavirus epidemic, the Economy Minister said on Friday.

**Sweden's central bank said on Friday it would lend up to 500 billion crowns ($51 billion) to Swedish companies via banks

**China's central bank cut the cash that banks must hold as reserves on Friday for the second time this year, releasing 550 billion yuan ($79 billion) to help its coronavirus-hit economy.

**Kazakh President Kassym-Jomart Tokayev ordered his government on Friday to allocate 300 billion tenge ($740 million) towards measures to boost employment through infrastructure maintenance projects.

....

Full item here:
https://www.reuters.com/article/us-health-coronavirus-latest-factbox/factbox-latest-on-the-spread-of-coronavirus-around-the-world-idUSKBN2100OM?feedType=RSS&feedName=worldNews&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Reuters%2FworldNews+%28Reuters+World+News%29

[Berkut]

Does this mean the epidemic is burning itself out in China already? That seems hard to believe....

[mongers]

Does this mean the epidemic is burning itself out in China already? That seems hard to believe....

Now I don't think so, as burning itself out as a phrase implies letting it have a freer hand than the draconian measures China took. So they seemed to have hammered down on the Wuhan centred outbreak, but they now risk new infectious outbreaks from abroad and possibly elsewhere in China.

Incidentally the UK 'government' plan most resembles letting the infection burn itself out, rather than locking down the population or following the WHOs four point program.

[Josephus]

Holy shit...Italy. 250 deaths in the past 24 hours. WTF?

[mongers]

Holy shit...Italy. 250 deaths in the past 24 hours. WTF?

Yes, more than 10 Italians dying an hour.

Did you see the shocking film of the Italians patients on camp beds in what looked like a hospital garage/warehouse?

[Fate]

Things aren't looking good in Lombardy - 75% ICU bed utilization and rising fast. They'll be able to go over 100% because make-shift ICU beds can be created from post-op care beds and operating theaters, but you can't create 110% ICU doctors.

[Eddie Teach]

Can't they throw GPs or Cardiologists in there?

[Fate]

Can't they throw GPs or Cardiologists in there?

You need people experienced in running ventilators/intubation, ECMO, sepsis, acute respiratory failure, etc. These aren't skills you teach everyone in training. Anesthesiologists, cardiovascular surgeons, and some other specialists could defintely be conscripted as make shift ICU managers. But GPs would be largely useless for managing the critically ill. I'm also dead weight - I'll read your chest CT scan and diagnose the viral pneumonia but I wouldn't have a clue on how to keep that person alive when they present in acute respiratory distress.

[Barrister]

Do you remember when Fate was the biggest fucking troll we had?

And now he consistently gives good, solid, informed posts?

[jimmy olsen]

But we did some up with 1.5 trillion dollars to help the stock market. I guess that shows where Washington thinks the priorities are.

I mean yes millions of people's lives are impacted by the stock market but surely a few dollars can find their way to the common people trying to weather this storm.

We're an oligarchy.

Saw that student debt in 2008 was $1.47 trillion.

Would have been a much better use of that money.

[Richard Hakluyt]

But we did some up with 1.5 trillion dollars to help the stock market. I guess that shows where Washington thinks the priorities are.

I mean yes millions of people's lives are impacted by the stock market but surely a few dollars can find their way to the common people trying to weather this storm.

We're an oligarchy.

Saw that student debt in 2008 was $1.47 trillion.

Would have been a much better use of that money.

In the financial crisis the net effect of government aid was a bung to the rich and asset price inflation. The poor took most of the blame (and the pain) and the architects of the problem were bailed out. Then we wonder why the people start voting for populist cunts throughout the West.

This time we need the financial stimulus to benefit the poor; apart from anything else they will spend a high proportion of anything extra they get; unlike the beneficiaries of the last stimuli who just increased their assets.