
Whistleblower Dr. Li Wenliang confirmed dead of coronavirus at 34 - danso
https://www.scmp.com/news/china/society/article/3049411/coronavirus-li-wenliang-doctor-who-alerted-authorities-outbreak
======
nkurz
You know how we look back at the state of medical knowledge from a couple
hundred years ago, and it all seems so primitive? Contagion was explained by
miasma rather than germs, leeches and trepans were best practices, and even
basic surgical sanitation was an uphill battle. From our point of view, they
didn't even understand the basics! Easily cured diseases were just left to run
their course!

Events like this are a reminder that there is still so much that is beyond the
abilities of current medicine. As a prominent doctor, he almost certainly got
the best care that is currently available, and yet he still died from a simple
virus. Our ability to treat viruses today is where our ability to treat
bacterial infections was 100 years ago. We knew that germs existed, but
penicillin was still a decade away. The standard of care was to keep the
patient well hydrated and hope that they don't die.

Similarly, we know today that viruses exist, but in most cases the best care
we can offer is to keep the patient hydrated and hope that they don't die.
With sufficient luck, in a hundred years we'll have progressed to the point
that people look at us and marvel: "They didn't even know the basics! When
people contracted a virus, there was nothing they could do but let the disease
run its course!"

~~~
koheripbal
...and yet, we are still so much further ahead than we were even only 20 years
ago.

This virus was caught by the early detection mechanisms setup after SARS, and
it was DNA sequenced from samples taken from some of the first victims within
a couple of weeks - pointing to a near match with a sample collected in 2014
in a cave from bat poop as part of a "preparatory program" also setup after
SARS.

New sequencing tech has allowed the global distribution of test kits, allowing
us to have thousands of confirmed cases shown to us in real time - globally.

Vaccines are already in development and the FDA is prepared to fast-track
their testing under procedures, you guessed it, updated after SARS.

...and yet, this turned into a global outbreak that we're desperately trying
to stop from becoming a global pandemic. Sadly, Chinese prosperity has meant
prolific Chinese tourist industries which helped spread the disease robustly
throughout South-east Asia. And so there's a very real possibility that,
unlike SARS, this new Coronavirus will become endemic and return each year
like the seasonal flu, possibly causing hundreds of thousands of dead per year
until a vaccine is deployed. Based on projected numbers, it seems like it has
spread far beyond our ability to contain it.

So while it certainly could have been worse, had we not been as prepared - I
like to think that when this happens again 20 years from now, we'll be far
better prepared. I'll have to learn to use those three sea shells.

~~~
nate_meurer
How the hell _do_ you use the three sea shells?

~~~
sslayer
John Spartan, you have been fined 1 credit...

------
divbzero
First, condolences to Dr. Li’s family. As we speak of epidemiology and
statistics, let’s not forget that every single “case” is an individual with
family and friends, and behind each individual are doctors, nurses, and
caretakers who risk their own health to help another.

Second, as noted by nkurz the contrast between bacterial and viral treatments
is striking. Whereas we expect bacterial infections to be treatable and are
alarmed when they aren’t (MRSA), we expect viral infections to simply run
their course except for the few instances where they’re treatable (HIV,
influenza) or even (gasp!) curable (HCV). We explain away the sad state of
antivirals by pointing to the inherent biochemical challenges of fighting
viruses [1] but maybe what we really need is a breakthrough — perhaps a
miraculous fortuitous “penicillin” moment — so 100 years from now antivirals
will also be a matter of course.

[1]:
[https://en.wikipedia.org/wiki/Antiviral_drug#Approaches_by_l...](https://en.wikipedia.org/wiki/Antiviral_drug#Approaches_by_life_cycle_stage)

------
hanoz
I'm concerned about this virus. Most people I talk to (in the UK) think it's
being over-hyped but I can't help but think it's being under-played.

The virus seems, in my completely inexpert assessment, to occupy a sort of
sweet spot in a terms of virulence, mortality and incubation period, for
wreaking maximum damage.

Based on its current trajectory I can't see any reason to believe the whole of
the world won't be affected on the same scale as Wuhan at some point this
year.

Am I right to be concerned, and if so what should I be doing about it?

~~~
hatenberg
The biggest concern is health care capacities being overwhelmed. He died in a
place under severe resource constraints, basically a warzone. Fatality inside
Wuhan is 5%, the rest of china 0.17% and even lower outside the country.
Regardless of how correct the numbers are at this point - available ICU
capacity is probably the largest factor for fatality rates for the disease at
this point.

Just like the flu, this virus causes number of very serious cases that require
intensive care but care capacities in most countries are barely able to cope
with a bad flu season before bed appear on hallways - and this year had a
particularly bad flu season still ongoing. There are only so many ventilators
and artificial lungs available in hospitals and there is limited capacity in
the world to deal with a new, highly infectious pathogen hitting a population
without any preexisting immunities and people requiring weeks care to recover
and become non infectious

China has, for better or worse, sacrificed Wuhan to buy the rest of the
country and the world time to shore up capacities and enact procedures to
stagger the load that will hit healthcare systems if the virus becomes broadly
entrenched. I don't think there is any healthcare system on the planet that
won't severely strain if hit by the sudden load of a new, highly infectious
virus with long, invisible incubation period.

~~~
richard78459
> China has, for better or worse, sacrificed Wuhan to buy the rest of the
> country and the world

The point is centralized authority is worse. In a democratic country he would
have had warned quicker and his life sacrifice would have made more
meaningful.

~~~
hatenberg
Well it's a good thing then we have a president who is held to account by the
people's representatives and firmly rejects autocratic tendencies.

------
koheripbal
I think what triggers an enormous amount of panic are the stories from Chinese
social media - contradicting official Chinese reports. I cannot tell what's
true and what's hyperbole... The government numbers don't seem so bad - but
then some of the quarantine measures seem oddly harsh if the numbers were
true.

Stories of Tencent "accidentally" leaking numbers online that are 10x what the
government is reporting - stories of crematoriums being inundated with corpses
- pictures of death certificates omitting the cause - the banning of funerals
- videos of women being pulled off the street to be forcibly transported to a
quarantine center (that one was particularly concerning) - etc...

The numbers from China are suspect of course - it's statistically hard to
imagine such a global contagion last week with the small number of confirmed
cases the Chinese gov't was publishing.

I don't want to _over_ react... but I also don't want to _under_ react.

~~~
zozbot234
I'm not really seeing the "global" aspect to this. A huge majority of the
numbers are in Wuhan or Hubei, and then much of the rest is just elsewhere in
mainland China. Cases abroad are almost a rounding error by comparison. It's
quite weird actually, it's like there's some factor we don't quite understand
that has been limiting the virus's spread even before protective measures were
taken.

~~~
koheripbal
If you look at the maps of infections there are some areas, frequented by
Chinese tourists, that are not reporting data.

Thailand, Laos, Vietnam, Cambodia - none have been reporting data because they
know that a panic will wreck their tourist industry. The Thai government even
admitted that publicly - that they would not release data on the disease.

The "good" news is that Coronaviruses are not great survivors in tropical
climates, so when summer comes, the infections will abate - BUT we are still 8
weeks away from warmer weather (with a doubling every 5 days).

The bad news is that if governments do not also stop flights out of Southeast
Asia, then there will be a secondary wave of Coronavirus, and it will likely
hit the Southern Hemisphere over the summer, and then the entire Northern
Hemisphere this winter.

------
ashwinaj
> Chinese social media has been awash with anger over the death of the
> whistle-blower

How about going out to protest? Oh wait, you can't...bravo for your virtue
signalling.

------
anonytrary
The fact that the hospital lied about Dr. Li Wenliang dying goes to show you
how absolutely dystopian China is. How afraid (or corrupt) do you have to be
to continue to claim someone who died was alive?

~~~
Jommi
Are you referring to this part?

>The announcement capped several chaotic hours in which Chinese media first
reported Li’s death, only for the hospital to respond that Li was alive,
though in critical condition.

>Li Wenliang has died, Wuhan Central Hospital confirmed early Friday morning,
hours after it initially denied reports of his death.

Where here do you see clear evidence or even indication of deceit?

If someone is in critical condition, that does not mean they are dead.
Announcing someone dead just hours after saying someone is in critical
condition is, actually, super super logical.

I fear your comment might be quite guided by your unfamiliarity with China and
xenophobic touch. Please do take some more time to reflect before posting
similar comments again. Thank you.

~~~
s_y_n_t_a_x
It's pretty clear the side of history the CPC is on.

You only have to look to their concentration camps and what's been happening
in Hong Kong.

They can't be compared to Western democracies, they are closer to Nazi
Germany.

~~~
Jommi
Not sure what you are aiming for with this response, what part of my comment
did you try to respond to? I'm just trying to wrap my head around this comment
and see how I could respond. Thanks!

~~~
s_y_n_t_a_x
I was addressing your accusation against the GP.

> your unfamiliarity with China and xenophobic touch.

I would argue that he is very familiar with China and his views are not
xenophobic but purely rooted in philosophical differences with the Communist
Party of China.

------
RcouF1uZ4gsC
The coronavirus is devastating for the Chinese Communist Party.

Basically, the deal with the populace was people gave up their freedom in
exchange for competent government and economic growth. In the last several
decades, this was seen as a good deal, by a lot of people both inside and
outside China. China had massive economic growth and modernization.

Now, however, the handling of coronavirus was a huge blow to the perception of
competency of the government, and is likely to have big economic implications
as well, thereby threatening the foundations of this deal.

~~~
koheripbal
I'm not so sure. Could a western country initiate entire city-wide quarantines
at the drop of a hat? Could a western country pull sick people off the streets
and forcibly put them into quarantine centers? Unilaterally shut down schools,
factories, and transportation at a whim?

Maybe. ...but, to be honest, despite their clear dishonestly about the number
of infected/dying, they are also clearly taking some definitive actions to
contain this.

~~~
tal8d
The propensity for lying, in order to protect the power structure, results in
a major constraint on future options - requiring more lies. It is a vicious
cycle that completely obliterates any potential strong-arm advantage a single
party system may have. If for no other reason: this is why you don't lie, you
have no idea how badly you screw your future self. Also, and I'm looking at
you World Health Organization, anyone trying to soften the blowback from lying
suffers major damage to their credibility.

~~~
beamatronic
The WHO fucked everyone. “No alarm” from WHO is my new “red flag”.

~~~
DarthGhandi
People who think the WHO is somehow corrupted scare me.

They are easily one of the most honest and forthright global organisations
around, made up of competing professionals in their field from around the
globe. They would be the first to be ringing alarm bells if there was a
problem.

The onus is on you to prove they are being dishonest, not the other way around
friendly internet commentator.

~~~
tal8d
Unlike the WHO, this friendly internet commentator hasn't appointed Robert
Mugabe as a goodwill ambassador. So you'd be better served appealing to my
authority, not theirs.

~~~
DarthGhandi
It was honestly a good move, with all upside and no downside, influence moves
in subtle ways. The rabid internet mobs who move from one issue to the next
with no concern for the bigger picture made quick work of it though.

I truly wonder if these people reflect on what they did, was it in the
interest of human suffering or simply petty signalling?

Was nothing more than a title, much like the CEO's and Senior engineers in
startups. Saying this as a code artisan.

Please read the statement on the matter:

[https://www.who.int/news-room/detail/22-10-2017-director-
gen...](https://www.who.int/news-room/detail/22-10-2017-director-general-
rescinds-goodwill-ambassador-appointment)

~~~
tal8d
And snap goes the bear trap. I was a little concerned that the parallels
between their political maneuvering with Mugabe and Jinping would be too
obvious, but you've clearly missed it. They have a history of this sort of
behavior.

> They are easily one of the most honest and forthright global organisations
> around, made up of competing professionals in their field from around the
> globe.

They are political actors. You may, most charitably, say that they are
pragmatic in pursuit of a great good - but there are two problems with that:
loss of trust and misaligned objectives.

> They would be the first to be ringing alarm bells if there was a problem.

Would they? You just admitted that their motives can't be examined without
considering the political dimension. This is why you shouldn't lie.

------
sillysaurusx
567 deaths, 1,341 recovered, 28,403 cases.

It's remarkable that humanity can globally track such things.

He was only a few years older than me.

How does the coronavirus kill? I tried searching, but the first five results
were all paywalled. I'm curious about what specifically makes the coronavirus
deadly compared to the flu.

~~~
keanzu
Studies from patients who died from SARS coronavirus showed the virus caused
damage to not only the lungs, but also other organs in the body. Early
research suggests the Wuhan coronavirus can also damage other organs,
including the kidneys.

The Wuhan coronavirus appears to cause pneumonia in two ways: when the virus
takes hold in the lungs, and through secondary bacterial infections, however,
the first way appears to be more common.

Although it can be difficult to determine whether organ damage from the Wuhan
coronavirus is a result of direct viral infection or indirect “collateral
damage” from the immune system, initial reports suggested around 11% of people
severely ill with the Wuhan coronavirus experienced sepsis with multi-organ
failure.

[https://theconversation.com/how-does-the-wuhan-
coronavirus-c...](https://theconversation.com/how-does-the-wuhan-coronavirus-
cause-severe-illness-130864)

I am not a medical practitioner nor researcher and have no understanding of
the virus. I make no representation as to the veracity of this source lacking
the means to independently verify it.

~~~
jnwatson
It is hard to square 11% “sepsis with multiple organ failure” with only 2%
reported fatality rate.

Somebody isn’t telling the truth, and I’d bet it is the Chinese government.

~~~
RcouF1uZ4gsC
> Of the first 99 people with severe infection, three-quarters had pneumonia
> involving both lungs. Around 14% appeared to have lung damage caused by the
> immune system, while 11% suffered from multi-organ system failure, or
> sepsis.

The 11% with multiple organ failure is referring to the first 99 people with
severe infection.

The 2% reported fatality rate is for everyone that acquires the virus.

~~~
koheripbal
No - 2% is only for those sick enough to have the test administered. Many are
not even being checked because their symptoms don't warrant hospitalization.

------
whoevercares
Interestingly and rarely, instead of covering up or Force deleting the posts,
this time the Central government treat this seriously with several
investigation announced and official mourning. This news does go viral among
Chinese internet and triggered huge criticism of the government so it might be
impractical to censor it. All in all, it could be a good thing to CCP since
they showed iron hand in the right way this time

------
monadic2
Why does this media make such a big deal about a virus with such a low
mortality rate?

~~~
keanzu
National mortality rate is 2.1% of confirmed cases.

[https://www.worldometers.info/coronavirus/coronavirus-
death-...](https://www.worldometers.info/coronavirus/coronavirus-death-rate/)

What would you consider a high mortality rate? 2% lethality in healthy
patients is significant and it is "so far". We don't know the true rate yet.

~~~
cjhopman
The swine flu of 2009 had up to a 5% mortality rate in confirmed cases
([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809029/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809029/)).

SARS was 10%
([https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...](https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome))

MERS is 35% ([https://www.cdc.gov/coronavirus/mers/clinical-
features.html](https://www.cdc.gov/coronavirus/mers/clinical-features.html))

The bird flu is 60%
([https://en.wikipedia.org/wiki/Avian_influenza](https://en.wikipedia.org/wiki/Avian_influenza)),
though there's few cases and estimates of what it would actually be are lower,
but still >15%
([https://jech.bmj.com/content/62/6/555](https://jech.bmj.com/content/62/6/555))

~~~
beerandt
The denominator currently has a multi day head start vs the numerator.
Exponential growth means the fraction will grow.

Not to mention limits of testing and reporting at this point. Regardless,
we're not at a point where your method of comparison is meaningful yet.

If we want to err the other way, you could look at deaths over deaths+
recoveries:

638/(638+1341)=32.2%

That, combined with the growth/spread rate and the fact that otherwise healthy
30-somethings are dying, means a potentially nasty outbreak. And that's based
on taking the Chinese government at their word.

