
Scientist decries ‘chaotic’ conditions on cruise ship after viral outbreak - yskchu
https://www.sciencemag.org/news/2020/02/scientist-decries-completely-chaotic-conditions-cruise-ship-japan-quarantined-after
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paranoidrobot
The German Public Broadcaster DW has a short video[1] covering this, including
some of Kentaro Iwata's video statement.

The mention that the Japanese government is allowing it's citizens to leave
and use public transit seems like a very risky and foolhardy move.

While I'm certainly no expert, and I'd definitely hate to be stuck on that
ship - I think Japan could surely have set up some kind of field isolation
area in the last few weeks and get passengers off and isolated using proper
quarantine protocols. The statement by Kentaro Iwata makes it clear that
nobody with a background in infectious diseases was involved in setting up
proper quarantine procedures onboard the ship.

[1]
[https://www.youtube.com/watch?v=iPpAsRJJ14E](https://www.youtube.com/watch?v=iPpAsRJJ14E)

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bencollier49
If the tests are as unreliable as has been reported (and a lot of rubbish gets
reported) then those released passengers travelling around Japan seem like a
bit of a risk.

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galacticaactual
Effective crisis management of this nature requires rehearsal and drilling,
even if just an administrative / tabletop exercise. The chaos described is a
classic symptom of not doing so.

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catalogia
I'm under the impression the Japanese government received some withering
criticism for their bureaucratic mismanaged response to the Tōhoku earthquake
and tsunami; I expected they would have revisited their emergency response
procedures after that, but I guess not?

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chrisco255
If anyone's interested this is a good breakdown of the cases so far, by region
and country: [https://bnonews.com/index.php/2020/02/the-latest-
coronavirus...](https://bnonews.com/index.php/2020/02/the-latest-coronavirus-
cases/)

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justlexi93
A Japanese infectious disease specialist who visited the quarantined Diamond
Princess decried "chaotic" and "scary" conditions on the cruise liner that
gave the coronavirus more opportunity to spread.

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qtplatypus
Can someone fix this headline? ‘... cruise ship Japan” reads like it is a
cruise ship called “Japan” rather then the full headline “... cruise ship
Japan quarantined”

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ackbar03
I don't think any country is really fully prepared to handle outbreaks on this
level tbh

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sdinsn
> outbreaks on this level

An isolated outbreak on a cruise ship? That should be the bare minimum a
country should handle. Note that Japan doesn't have any organization like the
CDC- they aren't prepared for anything.

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NotSammyHagar
Japan or rather their govt screwed it up. But it's very hard to deal with
thousands of sick people, no doubt they had no facility big enough. They
should have seen this as an extreme emergency and either used a military base
or taken over (renting) a large hotel. These are emergency situations.

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morpheuskafka
That's kind of odd for Science Magazine to use a conspiracy theory YouTube
channel as their source...

~~~
allovernow
Much of the information floating around regarding 2019-ncov has hallmarks of
"conspiracy theory" because it is all happening in real time and legitimate
media is unwilling to publish anything without confirmation from "official"
sources...who in turn are not willing to confirm anything because anecdotal
reports and pending peer review journal articles do not meet (understandable)
verifiability standards. This unfortunately relegates any news to unnofficial
"conspiracy" channels and gives people a dangerous justification for
dismissing potentially legitimate reports.

If you've been paying attention for the last month or two, there are hundreds
of anecdotal reports and videos all pointing toward the same grave conclusions
- not to mention dozens of published (awaiting review) papers at this point
and, increasingly, many if not most of the rumors from 1-2 months ago are
gradually being confirmed. Look no further than China's unprecedented response
to this outbreak - 700 million people are under lockdown and their GDP is
effectively shut down.

Frankly, the modern media establishment's standards for proof are too high to
adequately cover such a rapidly unfolding catastrophy when the majority of
information has to come from unofficial leaks because ground zero is an
authoritarian regime which controls what it's citizens can say amongst
themselves and to the rest of the world. This epidemic is far worse than
westerners currently seem to understand, and if it is not contained, the chaos
that will grip the rest of the world will be truly awesome to behold. This is
a virus which is at least as deadly as the infamous 1918 flu, likely more
virulent (R0 estimates anywhere from 3 to 6+), and there is _still_ no cure,
though a paper was published on the 4th with chloroquine as a potential
candidate. Plus, based on autoimmune reactions induced by all previously
developed viable vaccine candidates for SARS and MERS, there is unlikely to be
a vaccine for this coronavirus as well.

As I've been saying for a month now, we should not be panicking, but there's
no excuse at this point not to be prepared. WSJ announced 5400 people in
California are under quarantine today. 700 people in WA under supervision from
authorities. Personally I'm moving to minimize my reliance on the government
in the case that this pandemic spreads to the U.S. at large, based on the rank
incompetence that we see in government activities on a frequent basis.

Honestly watching so many average people dismiss 2019-ncov has been a
fascinating exposé on the potential for centralized information control in
free speech societies - if you're a 3 letter agency and you want something to
disappear from public consciousness, just preemptively leak the story to
"questionable" sources and suddenly the media won't report on it and people
will balk at you for posting junk sources. What a world we live in!

~~~
chrisco255
I've followed it closely but the death toll outside of China is really low.
Some reports are that this disease binds to specific receptors in the lungs
that are especially prominent in Asian males:

"The result indicates that the ACE2 virus receptor expression is concentrated
in a small population of type II alveolar cells (AT2). Surprisingly, we found
that this population of ACE2-expressing AT2 also highly expressed many other
genes that positively regulating viral reproduction and transmission. A
comparison between eight individual samples demonstrated that the Asian male
one has an extremely large number of ACE2-expressing cells in the lung."

Which is disturbing all the same, but it means the fatality rate will be lower
among non-Asians, unless the disease mutates further, which is very possible.

[https://www.biorxiv.org/content/10.1101/2020.01.26.919985v1](https://www.biorxiv.org/content/10.1101/2020.01.26.919985v1)

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icegreentea2
It's worth reading the paper, which calls out its own limitations:

* It is unknown if ACE2 is the only important receptor * Study doesn't actually count the amount of ACE2 receptors, just the amount of RNA expression (ok, you can probably hand wave this limitation away) * Study also shows a difference of expression ratio of 1.6% vs 0.4% in males vs females (n=2 vs n=6) * There was a SINGLE asian male in the data set

Given these limitations of the original paper, at the very least, I would say
that you should shy away from definitive statements until stronger evidence
appears.

The top comment on biorxiv ran with some of the ideas from the paper, and
looked at a more general and larger data set and found no statistically
significant difference between Asian and Caucasian lung tissue samples in
terms of ACE2 expression when measured in bulk (see
[https://uploads.disquscdn.com/images/5cb4b2c5e1ae3cf8454e870...](https://uploads.disquscdn.com/images/5cb4b2c5e1ae3cf8454e870f139b03b987614b28052f899aec0ee160c32ff548.png))

That said, it's certainly a cool paper.

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chrisco255
From that link above, "there are eight and 436 putative Asians and Caucasians,
respectively (imputed from the first two principal components" so its
comparing a sample size of 8 Asians with a sample size of 436 Caucasians. I'd
say the jury is still out on whether there is a racial difference in ACE2
expression, but good call out either way.

