
Coronavirus outbreak likely now ‘gathering steam’ - chmaynard
https://news.harvard.edu/gazette/story/2020/02/harvard-expert-says-coronavirus-likely-just-gathering-steam/
======
joeyspn
Yesterday I submitted this but it didn't get many upvotes..

[https://towardsdatascience.com/modelling-the-coronavirus-
epi...](https://towardsdatascience.com/modelling-the-coronavirus-epidemic-
spreading-in-a-city-with-python-babd14d82fa2)

I think that reached this point is obvious that in our hyperconnected cities a
containment is going to be very difficult if the R0 is 3+ and we don't
shutdown commuting

PS: for those interested in real-time info from experts I recommended
following:

    
    
      https://twitter.com/DrEricDing
      https://twitter.com/MackayIM
      https://twitter.com/trvrb

~~~
Fomite
__Please __don 't follow Eric Ding. He's not particularly qualified, and his
statements to date have betrayed that he's not actually all that good at
infectious disease epidemiology.

I'd suggest, in place, Maia Majumder (@maiamajumder) and Tara Smith
(@aetiology).

~~~
jdhendrickson
Could you please flesh out your comment on Ding's skill in regard to
infectious disease epidemiology ? I don't doubt you, I just like to know why
people say things.

~~~
Fomite
Sure thing.

First, note that Eric Feigl-Ding is a nutritional epidemiologist, _not_ an
infectious disease epidemiologist. Infectious diseases are weird for a lot of
reasons, and require something of a different skillset.

For example, in a Tweet of his he has now deleted: "never seen an actual
virality coefficient outside of Twitter in my entire career." about the
estimate for R0 for this novel coronavirus.

Similar R0 estimates existed for SARS, and MERS. Measles, Rubella and a number
of other diseases have _vastly_ higher R0s.

He also messed up some things like conflating R0 with secondary attack rates,
and was generally _very_ sensationalistic. Basically, the things that boosted
him to prominence in this epidemic built on fairly sloppy reasoning from
someone outside the field.

He's calmed down now, but one might as well go to sources for people who are
both good at science communication and actual outbreak scientists.

~~~
ixtli
Thank you for making the effort required to put all this together.

~~~
Fomite
My pleasure.

~~~
ortusdux
Any sources that you do recommend?

~~~
RandomBacon
Maybe the person you asked edited their comment after you asked, but he/she
listed their recommendations here:

[https://news.ycombinator.com/item?id=22304794](https://news.ycombinator.com/item?id=22304794)

------
haunter
>But there is some evidence — and we’re working on quantifying it — that
coronaviruses do transmit less efficiently in the warmer weather. So it’s
possible that we will get some help from that, but I don’t think that will
solve the problem, as evidenced by the fact that there’s transmission in
Singapore, on the equator.

There have been several research about seasonal influenza and how it
correlates with weather, like temperature but especially humidity

[https://journals.plos.org/plosbiology/article?id=10.1371/jou...](https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1000316)

[https://www.sciencedirect.com/science/article/abs/pii/S01634...](https://www.sciencedirect.com/science/article/abs/pii/S0163445315001061)

[https://academic.oup.com/aje/article/173/2/127/99316](https://academic.oup.com/aje/article/173/2/127/99316)

~~~
joeyspn
Singapore is having 30ºC days, yet the epidemic is progressing and the city is
already bracing for the worse...

~~~
catalogia
Singapore also has a lot of air conditioning. Perhaps the transmission is
occurring primarily indoors, away from the 30ºC heat.

~~~
nutjob2
Exactly. The comparison with Indonesia is interesting, which has a similar
climate, but isn't as rich or developed as Singapore.

Air conditioning is actually very conducive to colds and the like. When you go
from outside to inside you're usually sweaty and the air conditioning tends to
make you too cold until you dry out. I've caught way more sniffles in the
tropics than in the freezing climates.

~~~
tim333
Anecdotally, I flew from Bali to Singapore today and there seemed to be a lot
more sniffles and coughing in Singapore. In Bali the architecture is very open
with lots of fresh air, scooters being popular for transport whereas in
Singapore they tend more to sitting together in air conditioned boxes of
various types (buildings, busses etc).

------
ourmandave
It's now officially named COVID-19 by the WHO.

~~~
teeray
Despite that, I think it’s too late to rename this virus. People have called
it “coronavirus” for weeks now and the name will likely stick, correct or not.

~~~
crazygringo
What's super-weird in all that coronaviruses are already an entire class of
viruses that are the _second most popular cause of the common cold_ , behind
rhinoviruses:

> "The common cold is a viral infection of the upper respiratory tract. The
> most commonly implicated virus is a rhinovirus (30–80%), a type of
> picornavirus with 99 known serotypes. Other commonly implicated viruses
> include _human coronavirus (≈ 15%),_ influenza viruses (10–15%),
> adenoviruses (5%)..." [1]

Someone you know probably has a coronavirus right now -- just not the one in
the news.

But somehow this basic fact has barely been mentioned in the media.

Seriously, calling the new disease "coronavirus" is as silly as a chef calling
their new very specific recipe "soup". Like... you've gotta come up with
something more specific...

[1]
[https://en.wikipedia.org/wiki/Common_cold](https://en.wikipedia.org/wiki/Common_cold)

~~~
auspex
If a chef came up with a super delicious recipe that was taking the world by
storm and happened to be soup... I could see people using the generic
encompassing term to identify it. By nature of popularity people would know
what you were referring to.

------
eyegor
Today the cdc had a press conference announcing the quarantine release of 195
people who flew into the US from Wuhan, based on the assumption that being
asymptomatic for 14 days is good enough [0]. Last I heard, WHO is calling the
upper limit on incubation 24 days. This release is being done without any
actual testing.

Edit: seems all I can find from WHO is 14 days, the 24 day estimate was from
this paper:
[https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v...](https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1)
(thanks to u/pmorici below)

[0] [https://youtu.be/JW1ntWFiZNI](https://youtu.be/JW1ntWFiZNI)

~~~
viraptor
Have you got a link for the 24 days? The best I could find is that we're
totally guessing things at this point. CDC says:

> CDC believes at this time that symptoms of 2019-nCoV may appear in as few as
> 2 days or as long as 14 after exposure. This is based on what has been seen
> previously as the incubation period of MERS viruses.

~~~
eyegor
Apologies, I'm not sure if I misremembered, misattributed, or if that was an
actual previous estimate from WHO. Everything I can find now seems to be
around 14 days, with the Japanese govt using 16 as a lower bound for the
cruise ship. I swear WHO was publishing 24 in a sitrep last week, maybe I just
haven't found it yet.

From the WHO Q&A page,

> Current estimates of the incubation period range from 1-12.5 days with
> median estimates of 5-6 days. These estimates will be refined as more data
> become available. Based on information from other coronavirus diseases, such
> as MERS and SARS, the incubation period of 2019-nCoV could be up to 14 days.
> WHO recommends that the follow-up of contacts of confirmed cases is 14 days.

[https://www.who.int/news-room/q-a-detail/q-a-
coronaviruses](https://www.who.int/news-room/q-a-detail/q-a-coronaviruses)

~~~
remote_phone
WHO never reported a 24 day incubation period.

There was a paper that talked about 24 days but that was a single patient and
the more likely scenario is that the person was wrong about the timing or got
infected at a later time period.

------
devit
Is there any betting market that is taking bets and has good volume on whether
there is going to be a novel coronavirus pandemic?

That seems like the only way to get some clarity on this.

~~~
foota
I bought some put options on the S&P index a couple weeks ago.

~~~
pjkundert
Won’t help, if response is infinite QE and monetization of government debt:
Dow 1,000,000, here we come!

I was thinking deep out of the money gold calls...

~~~
dcolkitt
QE and monetary stimulus is primarily effective at counteracting _demand_
shocks. For example productive capacity, like empty storefront or unemployed
workers, sits unused because liquidity has dried up.

A worldwide pandemic would primarily exert its economic effect through
_supply_ shocks. The productive capacity of the economy genuinely shrinks.
Stores can't open during a quarantine. Sick workers can't show up at the
office.

A pandemic might have second-order demand shocks, particularly if panicking
investors flee to quality. But there'd still be a genuine contraction in real
and potential GDP, most of which would get absorbed by contracting corporate
profits. Monetary stimulus can't route around those constraints.

~~~
jshaqaw
Very clearly put. Thank you.

------
nemonemo
It appears US is better than Indonesia in reporting, but worse than Singapore,
according to their preprint [1].

AFAIK, the coronavirus test is not being conducted for people who have no
history of visiting China or traveling outside, and the virus can be
transmitted before symptoms could appear. Based on the article, it is
conceivable that the virus could soon be found from a person who has no travel
history outside US, but only when the person gets dangerously sick.

[1]
[https://www.medrxiv.org/content/10.1101/2020.02.04.20020495v...](https://www.medrxiv.org/content/10.1101/2020.02.04.20020495v2.full.pdf)

~~~
hurrdurr2
In the US they also are not testing people who came from China even if they
have mild symptoms.

Unless you have a fever and a cough they won't test you. According to the
latest research out of China there are many people who when admitted to the
hospital had no fever but tested positive.

Frankly a lot of cases are likely not being caught in the US and elsewhere.

------
tim333
It's interesting that chloroquine, an old anti malarial drug is "highly
effective in the control of 2019-nCoV infection in vitro". I wonder if
anyone's doing a study to see if that stops it spreading in the real world? I
almost thought I could do a double blind study myself with a website and a
bunch of chloroquine pills and aspirins and randomly post volunteers one or
the other. Dunno if the post works in Wuhan though.
[https://www.nature.com/articles/s41422-020-0282-0.pdf](https://www.nature.com/articles/s41422-020-0282-0.pdf)

~~~
ipsum2
Not a biologist, but "in vitro" isn't really that informative. Many things,
including fire, are highly effective in stopping diseases in vitro.

~~~
tim333
>Chloroquine is widely distributed in the whole body, including lung, after
oral administration.

Can't say that about fire.

~~~
ipsum2
You could say that about vodka though. It'll definitely kill the virus are in
a petri dish, but maybe won't work as well in the body.

~~~
tim333
But it probably won't kill the virus in the petri dish at the same
concentrations found in the body. The chloroquine did.

------
kragen
“worst flu season in modern times” — would that be when
[https://en.m.wikipedia.org/wiki/Spanish_flu](https://en.m.wikipedia.org/wiki/Spanish_flu)
killed one out of every 15 to 30 people then living, mostly within a period of
two months? That sounds pretty bad.

~~~
bdcravens
For purposes of discussion, I think they consider 102 years outside the range
of “modern times”

~~~
kragen
Really? Early modern Britain is roughly the 16th to 18th century.
_Postmodernism and Other Essays_ was published in 1926.
[https://en.m.wikipedia.org/wiki/Modern_era](https://en.m.wikipedia.org/wiki/Modern_era)
is 1500 CE and later. If they intended to refer to such a nonstandard
definition, don't you think they'd have been explicit about it rather than
leaving readers to argue about it? Either they meant specifically that
pandemic or they were just bullshitting with no concern for the truth-value of
their utterance.

Note that the mortality figures they're bandying about do intersect with the
1918 flu pandemic mortality rates at the high end.

~~~
samatman
Alternately, when they said "worst flu season in modern times", they said it
specifically to exclude the Spanish Flu.

It's not a well-defined phrase, I think this is the more likely
interpretation.

------
asdfasgasdgasdg
How does this jive w/ the totals counted on this site:

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

? I guess the source data could be fudged but surely China realizes by now
that faking things is only going to make them look worse in the long run?
Maybe I'm too optimistic.

~~~
reustle
That data looks quite delayed, I'd check this one out

[https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...](https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6)

~~~
asdfasgasdgasdg
This is the data for mainland China, and it looks to be of an order with the
data you cite. I think the main risk is whether the China data is accurate. I
read the article subsequent to my comment and I realized that this interview
accounts for the downward second derivative. The answer is: perhaps controls
are working, or perhaps China is unable to test so many new cases. I'm
inclined to believe the first hypothesis because apparently they were able to
test 4.5k new cases in a day a few weeks ago. It doesn't really make sense to
me that they would subsequently be able to test only 2.5k.

~~~
droithomme
Numbers went down because they changed the method of counting.

[https://www.taiwannews.com.tw/en/news/3874490](https://www.taiwannews.com.tw/en/news/3874490)

 _> In a notice issued by China's National Health Commission (NHC) on Feb. 6,
it wrote that the classification of new Wuhan virus infections will be divided
into four categories: "suspected cases," "clinically diagnosed cases,"
"confirmed cases," and "positive tests." Among these, "positive tests" refers
to "asymptomatic infected patients" who test positive for the disease but have
no symptoms.

> There is also a clear stipulation in the official document stating that "If
> the reported 'asymptomatic infected patient' has clinical manifestations,
> their status shall be revised to 'confirmed case' in a timely manner"
> (highlighted text in Tweet below). This indicates that even if a person
> tests positive for the disease but does not exhibit any symptoms, they will
> no longer be included in the daily infection reports._

(the notice cited:
[http://www.gov.cn/zhengce/zhengceku/2020-02/07/content_54758...](http://www.gov.cn/zhengce/zhengceku/2020-02/07/content_5475813.htm))

------
m3kw9
The last I heard from Reuter, China was trumpeting an April date for this to
end. I don’t know why they would pin a date when you are just extrapolating a
graph that was in itself wildly inaccurate due to testing limits

~~~
eric-hu
China is looking at major economic damage from the quarantines. I think their
concern is about people staying in, cancelling travel and other economic
activity far past the end of the epidemic. I can see a logic to it, but I
share your disapproval.

------
dghughes
>But there is some evidence — and we’re working on quantifying it — that
coronaviruses do transmit less efficiently in the warmer weather. So it’s
possible that we will get some help from that, but I don’t think that will
solve the problem, as evidenced by the fact that there’s transmission in
Singapore, on the equator.

The temperature of a human body is 37ºC it's odd a virus would be
incapacitated or slowed by "warmer" weather. I know to kill viruses a fever is
what our bodies use along with the immune system. And I know this is referring
to it outside a body but it seems odd. I would have expected warm, moist
weather to make transmission easier like an incubator.

~~~
AnotherGoodName
Viruses don't survive at all in open air due to uv. They need some protection,
usually in the form of a water droplet. If that evaporates sunlight will kill
it.

