
Coronavirus: Five Brits in French ski chalet catch virus - kgwgk
https://www.bbc.com/news/uk-51425702
======
themgt
I started following this outbreak about two weeks ago, when confirmed number
of cases was still below 300 and 17 people had died. The confirmed cases were
almost wholly contained in China, primarily just Wuhan province. At the time
there was a lot of debate about the seriousness of the virus and the risk of a
pandemic, and I was mostly sitting on the fence, looking back to SARS/Ebola
and figuring a quarantine might be able to burn it out.

Today confirmed cases stand at 34,964, with 725 dead, and the virus spread to
nearly 30 countries. I'd highly recommend this interview from a couple days
ago with Neil Ferguson, director of the Institute for Disease and Emergency
Analytics at Imperial College London's School of Public Health[1]

Some highlights I'll quote, based on his team's modeling of the true situation
vs. the necessarily incomplete confirmed cases:

\- China: estimated 10% of total cases detected

\- International: estimated 25% of total cases detected

\- estimated 50,000 new infections per day in China

\- Doubling every 5 days

\- Onset to death can take up to 20 days (in fact I think we've seen deaths up
to 30 days post-infection now)

The NYT today[2] also quotes leading experts that this virus is almost certain
to become a pandemic, and no one can with certainty predict the consequences.
All of which is just to say, I think it's time to stop the hot takes about how
unseriously you're taking the situation. There seems to now be unanimity among
global experts, who are taking it very very seriously indeed. The actions of
widespread border closures, travel and economic shutdowns and China forcefully
quarantining 500 million citizens also ought to suggest that governments are
treating this far differently than the flu or in fact any sort of viral
outbreak in perhaps modern history.

[1] [https://youtu.be/ALQTdCYGISw](https://youtu.be/ALQTdCYGISw) [2]
[https://www.nytimes.com/2020/02/02/health/coronavirus-
pandem...](https://www.nytimes.com/2020/02/02/health/coronavirus-pandemic-
china.html)

~~~
JauntTrooper
Very good point.

When the 2009 H1N1 flu virus hit, it infected 11% to 21% of the world's
population. The mortality rate was low, at just 0.02%, but because of the
number of people it infected it resulted in 284,000 deaths.

When a novel disease hits the population for the first time, it often spreads
faster and wider than diseases for which we've developed some immunity.

The coronavirus mortality rate so far is alarmingly high. It is highly
uncertain and very preliminary, but it could go in either direction. Early
estimates of SARS were that it had a fatality rate of <3%. It was eventually
revised upward to 9.6%.

~~~
lamontcg
It looks a lot more like viral pneumonia than 2009 H1N1. Healthy younger
adults largely don't get infected or don't suffer very severe symptoms. In one
study in the lancet no patients under 40 were admitted to the ICU. The MuLBSTA
score of a patient for predicting fatality from viral pneumonia (which
considers comorbidities like diabetes, heart disease, smoking, etc) is
predictive of fatal outcomes with nCoV-2019. Everyone on the internet doing
the math on this thing loves to assume it will naturally be as broadly
infectious as influenza and will ultimately infect 1/3 of the planet (with the
usually quoted 2% fatality rate). More likely the number of infections will be
lower than that by an order of magnitude at least (even though it will still
be a global pandemic). If you look at the quarantined cruise ship only 63 out
of 3700 people have been confirmed as cases. At 1.7% (and of course still
growing) that is still very far off from 33%.

It is still troubling because if you assume the impact is like viral pneumonia
then the impact of effectively doubling the number of cases of that worldwide
will stress our health care systems, and it will increase mortality in
vulnerable populations (very young and older people with comorbidities). I'm a
bit worried about my mom and dad who are pushing 80 now, I'm not much worried
about myself (48 with no other issues). Healthy 25 year olds probably won't
catch this at all, and if they do they'll just get a bad cold.

~~~
kgwgk
Are you refering to this paper:
[https://www.thelancet.com/journals/lancet/article/PIIS0140-6...](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(20\)30183-5/fulltext)
?

"We report the epidemiological, clinical, laboratory, and radiological
characteristics, treatment, and clinical outcomes of 41 laboratory-confirmed
cases infected with 2019-nCoV. The median age of patients was 49·0 years (IQR
41·0–58·0), and 13 (32%) patients had underlying disease. All patients had
pneumonia. A third of patients were admitted to intensive care units, and six
died."

Looking at Fig 1 one-third of patients in the 25-49 age group needed intensive
care. Maybe the were all above 40, but anyway I don't think that looks like
the usual influenza-related pneumonia.

[https://marlin-
prod.literatumonline.com/cms/attachment/f86df...](https://marlin-
prod.literatumonline.com/cms/attachment/f86df21c-bbb2-4922-975a-14a067deb0e9/gr1.jpg)

------
Cantbekhan
So, today we're learning about 5 infections from a man coming from Singapore
(not China) staying there in Contamines-Montjoie from 01/27 to 01/28\. So
we're now learning about infections from almost 2 weeks ago, almost a week
before the last major airlines stopped their regular flight to/from China. And
flights from/to Singapore are still going to this day. Makes you wonder how
many people slipped through since then ... (sorry for my broken non native
English)

~~~
cs702
Personally, I'm assuming this new virus has already gone global, with the
scale of the outbreak in most major metropolitan areas a few weeks behind
Wuhan. For practical purposes, I'm already lumping this new virus in my mind
with the "seasonal flu," variants of which travel around the globe every year,
requiring annual shots. It seems that most people who get infected have only
mild symptoms.

Consider: Many major cities in China already have infected populations in the
hundreds or thousands, and growing:
[https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...](https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6)
\-- these are official, confirmed figures.

See also
[https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820...](https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930260-9)
for maximum-likelihood estimates of the size of the outbreak as of month-end.

~~~
Cantbekhan
Personally I'm not afraid of the sanitary aspect of this virus. I don't think
the mortality is extremely alarming per se. What I'm afraid of is the
emotional population reaction and the practical impact on daily services
fueled by FUD and sensationalist media coverage. Schools closing unnecessarily
forcing many working people to stay home to babysit their kids.
Teachers/Drivers/Cashiers going on strike to avoid risks while there is a now
globally confirmed shortage of face masks (which might or might not be very
useful anyway but it will keep people working if they feel it helps). It's
virtually impossible to find a useless face mask where I am in the EU (at a
normal non 10x inflated price from opportunistic vendors) and even less
possible to find a useful one (N95/FFP2/FFP3 rating). Interesting times for
sure.

~~~
mantap
The mortality rate is unknown. The best estimate is on the order of 1%, but it
could be a factor of 10 either way.

The mortality rate will be _different_ depending on the health system, since a
significant number of people with this virus require either supplementary
oxygen or more seriously ICU care.

If this were to become an epidemic in India for example, a higher mortality
rate would be expected. In Africa it could be severely bad due to the large
numbers of people with AIDS and the tendency of this virus to suppress the
immune system.

~~~
Cantbekhan
Also Sub Saharan Africa only has 2 labs (South Africa and Senegal) capable of
technically confirming cases. Which might be a reason there aren't any
confirmed cases on the continent.

~~~
krn
> Which might be a reason there aren't any confirmed cases on the continent.

There is not a single confirmed case of coronavirus in the entire Central and
Eastern Europe, yet[1]. Most likely because there are almost no direct flights
from Asia to this region, since it lacks major international metropolitan
areas and global tourist attractions.

[1] [https://ig.ft.com/autograph/graphics/coronavirus-
map.svg](https://ig.ft.com/autograph/graphics/coronavirus-map.svg)

~~~
biztos
Hungary has a pretty big Chinese community mostly in Budapest, plus plenty of
Chinese tourists, and I would assume there was a lot travel around the New
Year.

If we are guessing about why (and whether) there is no Coronavirus in CE
Europe, “no Chinese” is probably not a good guess.

~~~
riffraff
but the amount of traveling chinese is still much much smaller than to larger
western european countries.

Consider that Italy has had 3 cases to date: a chinese couple from Wuhan and
an italian who was repatriated from Wuhan and is in quarantine.

There are 300k chinese nationals in Italy and about 20k in Hungary, and while
I love Budapest the amount of chinese tourists is nothing compared to those in
Rome.

------
speedgoose
For the record, the name of the place "Contamines-Montjoie" can mean
"Contaminated-JoyMountain" in French.

~~~
hef19898
Contamines comes, in that case, from Contamina which comes from Condominium
(roughly co-administered property). But "Contaminated" sounds _soooo_ much
cooler right now, doesn't it?

------
hedora
In case there was any doubt, the numbers coming from China are being faked.
Infections and deaths are quadratic with an R^2 value of 0.9995:

[https://news.ycombinator.com/item?id=22275092](https://news.ycombinator.com/item?id=22275092)

~~~
jobigoud
I've read this several times. Could someone shed some light on this? Are the
reported numbers impossible because they are too close to the curve? Or
because the numbers should follow another curve? Could there be a hidden
mechanism in the speed at which the virus is tested for that could explain the
quadratic?

~~~
mtreis86
Something like a hospital opening, and suddenly having a pile of patients to
test, should result in a small spike in that graph. A quarantine being enacted
in a city should cause a change in angle of the curve.

~~~
yorwba
The list of spikes is available, e.g. from Tencent News:
[https://xw.qq.com/act/qgfeiyan](https://xw.qq.com/act/qgfeiyan)

Most recent update right now:

上海新增5例新型冠状病毒感染的肺炎确诊病例

 _Shanghai adds 5 confirmed cases of pneumonia caused by novel coronavirus
infection_

2020年2月8日0—12时，上海市排除新型冠状病毒感染的肺炎疑似病例11例；新增治愈出院11例；新增确诊病例5例，其中2例为外地来沪人员，3例为本市常住人口。

 _On 2020-02-08 from 0 to 12, Shanghai handled 11 suspected cases of pneumonia
caused by novel coronavirus infection, added 11 cases released from hospital
after treatment, added 5 confirmed cases, 2 of which are not originally from
Shanghai and 3 are residents._

截至2月8日12时，上海市已累计排除疑似病例877例，发现确诊病例286例。

 _Until 02-08 at 12 o 'clock, Shanghai has already handled a total of 877
suspected cases and discovered 286 confirmed cases._

健康上海12320 _Healthy Shanghai 12320_

Lots of small spikes can still add up to a smooth curve overall.

------
ryanobjc
This seems to suggest, in addition to another case, that nCOV is in the wild
in Singapore?

~~~
Nursie
Certainly looks like it, two brits, each of whom attended business meetings
there, are now confirmed.

I am worrying as I returned to the UK from Singapore a week ago and now have
cold-like symptoms. No coughing, no raised temperature, lungs OK so far... but
it's a worry.

(--edit-- actually it looks like one Brit, I had thought the new cases were
related to a separate traveller, but it looks like it was the same guy)

~~~
praveenster
I would go to the doctors office and get myself checked, if I were in your
situation. Let’s hope and pray that you test negative and if not you can take
immediate action.

~~~
jtaft
Call ahead before you go to a doctor’s office or emergency room. Tell them
about your recent travel and your symptoms.

[https://www.cdc.gov/coronavirus/2019-ncov/faq.html](https://www.cdc.gov/coronavirus/2019-ncov/faq.html)

~~~
yongjik
Seconded. This is very important - if you just walk into a hospital and later
it turns out you had the virus, now they have to _close the hospital_ and
quarantine hundreds of patients who are already sick (and hence in higher
risk).

------
DayDollar
A worldwide shutdown of airports for two weeks is out of the question, why
exactly? This is a honest question.. Its obviously one of the most potent
travel vectors of the virus. When the plague struck, harbours where closed,
and gates where manned on both sides. It seems quite logical, to enforce
quarantine this way.

~~~
eropple
Because that would be an eye-poppingly ridiculous response?

Seriously, this breathless "plague!" nonsense absolutely must stop and its
purveyors should feel bad for doing so. Bubonic plague has an untreated
mortality rate of _fifty percent_! This, on the other hand, is a nontrivial
though increasingly global outbreak of a disease that is unlikely to seriously
harm healthy people--CFR rate of mortality seems to be about three percent--
and is predominantly a threat to the very young and the elderly.

If this sounds familiar that should be because it maps rather closely to the
flu. There are 650,000 deaths per year from the flu--who's suggesting closing
the airports over such a Threat To Humanity?

Turn the news off. If you have a brain predisposed to low-information panic it
is bad for you.

~~~
abootstrapper
I’m not for stopping the world, but Coronavirus gets brushed off as no big
deal a lot online. I feel like the big issue will be Coronavirus bogarting
medical resources. Pneumonia in a healthy individual is treatable given proper
treatment and resources, but if everyone has pneumonia, then we have a
resource problem.

Additionally, a lot of people care for the very young and the very old, and
they’re not comforted with the sentiment, “well, if you’re healthy you’ll
live,”

~~~
eropple
It gets brushed off as "not a big deal" because...right now, we don't really
have a reason to think it is one. It _could become one_. It merits state and
international attention. It does not merit panic and there is absolutely no
reason to think that "everyone" will get it or will develop pneumonic symptoms
from it in a way that strains medical resources in developed countries
(indeed, the biggest threat is likely if it becomes a thing in less-developed
countries--but it seems to be less communicable than SARS or H1N1 right now,
too). It is an important issue at the levels of government and international
organizations that manage things like this. But it's silly to obsess over it
and it's downright immoral to shit-stir with comparisons to _bubonic
civilization-wrecking plague_ as the OP to whom I replied decided to do.

And I'm going to be frank: the very young and very old could just as easily
die of influenza and the people who care for the very young and very old are
not, for the most part, even screening for flu shots. I have trouble mustering
the emotional energy to care for their fear of the scary black swan when
they're standing in a flock of white ones that are themselves dangerous.

~~~
wolco
Less communicable than SARS?

No, it is more because SARS was only communicable when the patient was at
their worst. This can spread during all phases.

The mortality is lower than SARS but much higher than the flu.

To put it in real terms. If you take the number of people you ever met in your
life and gave them a bad flu you might find one who dies. Compare that to
taking your mother/father/brothers and immediate families and giving them
corona where at least one would die. Compared to SARS where someone in your
immediate family would die or ebola where either you or your wife would die.

~~~
pmoriarty
_" This can spread during all phases."_

There is evidence that the study claiming the virus can be transmitted by
people without symptoms was flawed.[1]

Also, according to that article, even if asymptomatic people transmit the
virus _" asymptomatic transmission likely plays a minor role in the epidemic
overall, WHO says. People who cough or sneeze are more likely to spread the
virus, the agency wrote in a situation report on Saturday."_

[1] - [https://www.sciencemag.org/news/2020/02/paper-non-
symptomati...](https://www.sciencemag.org/news/2020/02/paper-non-symptomatic-
patient-transmitting-coronavirus-wrong)

