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The Korean Clusters: How coronavirus cases exploded in Korean churches/hospitals (reuters.com)
56 points by lawrenceyan on Feb 29, 2020 | hide | past | favorite | 42 comments



It's crazy to think that SK might have stamped this thing out if it weren't for the selfish and shortsighted actions of one person. It reminds me of a book series I read called the Second Apocalypse by R. Scott Bakker. One of the themes of the series is how (at least in his story) history often turns on the seemingly minor, self-interested actions of important people. I don't know if that's generally true in the real world, but it certainly seems true in this case.


Commonly known as the butterfly effect or a sliding door https://en.wikipedia.org/wiki/Sliding_doors_moment

Watch the Sliding Doors movie. A curious movie where you can see how one little change dramatically alters the course of (Gwyneth Paltrow's) life in a vivid way.

https://www.imdb.com/title/tt0120148/


It’s crazy that the doctors could not force her to get tested and/or quarantine her. If this is the way we’re going to approach it in the west we’re screwed.


> it weren't for the selfish and shortsighted actions of one person

Very unlikely. This thing’s R0 is high enough that it was never getting stopped.


If stopping is not an option, delaying (or decreasing the speed of spreading) is the next best thing. Who is to say we won’t have a vaccine or some other treatment soon?

Delaying means reducing potential deaths, suffering and economic impact.


The sheer contagiousness of COVID19 means that any quarantine measures would only slow down, but not stop the spread. If they stamped it out in SK this month, in a few months it would be back. Most health experts believe it's inevitable it spreads around the globe.


I don't think they could avoided the virus, realistically speaking. What this one person did was to bring mass contagion in SK maybe 3-4 weeks closer in time.

Mass contagion is inevitable at a global scale at this point.


experience in Singapore with a similar level of active surveillance argues that they would have been able to contain it except for getting unlucky with "patient 31."


Singapore is excellent at this game. Most western (or asian) countries aren't even in the same league.


That's because they'll tie you up and beat you with a stick if you don't obey the rules.

https://en.wikipedia.org/wiki/Caning_in_Singapore


I think there is a chance that's true. But there's also a decent chance it is still containable. All depends on whether China's numbers are accurate.


> But there's also a decent chance it is still containable

I mean; I understand why national governments communicate this way; they (sort of) correctly want to avoid "panics", disrupting critical supply chains (food, fuel, medicine, etc).

But seriously speaking.. do you really see a way of this being contained at this point? I simply don't.


The reason I referenced China's numbers is that the number of active infections there is trending down. When that's the case, absent an excursion from the trend, a virus would eventually be wiped out. So, yes, if China's numbers are accurate (big if, but plausible if not probable), it does seem possible to stamp it out given sufficient application of resources and effort.

There is also precedent for stamping out new viruses before they manage to take hold in the last two decades. That doesn't mean we'll be able to do it this time, but it's another bit of evidence that makes me suspect it's possible this time as well.

The question is how long it will take before western governments get serious about stopping this thing. I do not believe the Chinese or Singaporeans are inherently better at this stuff than us. They're just more serious. If we get serious, we can accomplish similar feats.


The question is also how many governments are going to go with full lock down like the Chinese government has gone.


No doubt no doubt. Again, I'm not saying it's more likely than not at this point that we'll stamp it out. If we continue with our current behavior, we certainly won't. But I think there's a decent chance that as western countries are more and more affected by this disease, we will start changing our behavior. Hopefully it will not be too little too late.


Something seems strange. The woman was in a traffic accident on the 6th. She attended church services on the 9th and 16th. On the 17th she was confirmed to have the virus. Then "days later" "hundreds of people" become ill at the church. I'm under the impression that the virus has a long incubation period. As it isn't clear where she got the virus, isn't it likely that she isn't the original carrier, but contracted it from some other connection to the church? I mean it seems like the first opportunity to infect people was the 9th and something like 10 days later hundreds of people are ill.


Median incubation time 4 days and interquartile range 2-7 in this study in the New England Journal of Medicine, https://www.nejm.org/doi/full/10.1056/NEJMoa2002032


> Then "days later" "hundreds of people" become ill at the church.

Days later, South Korean health officials tested people thought to have been in contact with the patient, and hundreds of those tests came back positive. The article doesn't say whether any of those tested showed symptoms (of any illness); the incubation period really isn't relevant.


The time to having it/transmitting it is quick, like 2 or 3 days. Symptoms come later, on average 6 days after that. If you're dealing with a big group of people, 10 days is sort of a smoking gun here.


Just some context too, that church isn't really representative of the "average" church there, but like a cult.

Look up shincheonji.

I feel their beliefs + how they conduct mass is contributing to this crazy increase. Something like 80% of the new cases today are linked to their members... and they have like 200k of them.


Take this with a _huge_ grain of salt, but this article neglects to discuss the role of the Shincheonji followers - who have an interesting view on diseases and illness - in potentially spreading this disease.

https://foreignpolicy.com/2020/02/27/coronavirus-south-korea...


How do you infect 600 people during a 2 hr service if it's only transmitted through droplets and prolonged close contact.


Transmission doesn’t occur only via droplets. The virus is supposed to survive for up to 9 days on surfaces/objects in normal conditions, and for up to 28-29 days at low temperatures:

“Droplets transmitting coronaviruses only stay suspended in the air for a short time. Details for SARS-CoV-2 are not available as of 26 February 2020, and it is assumed that they are similar to other coronaviruses,[64] which may stay viable and contagious on a metal, glass or plastic surface for up to nine days at room temperature.[65] Disinfection of surfaces is possible with substances such as 62–71% ethanol applied for one minute.[65]“ — source: Wikipedia [0]

What sort of rituals do these people follow? Do they have mass? Do they share maybe something like a spoon? Or touch the same objects on entering or leaving the place of prayer?

References: [0]: https://en.wikipedia.org/wiki/2019%E2%80%9320_coronavirus_ou...


I just opened the NYTimes front page and counted the number of occurrences of "coronavirus". I counted 15 total.

The biggest winners from coronavirus are going to be those who sell fear (i.e., mainstream media). I also suppose anyone who was astute enough to open a large short position against the market in the past week or two will profit. I think we're only going to see an increase in panic and fear before things settle down. What real impact there will be on the world remains to be seen, I think it's too early to tell.

Worst case, it seems like the virus will mostly harm those who are at risk of death, but healthy people will probably be okay.


> Worst case, it seems like the virus will mostly harm those who are at risk of death, but healthy people will probably be okay.

Plenty of healthy people have died, and it seems the disease is so aggressive that it can cause significant organ damage in survivors. Most healthy people are likely to be ok, but not all.


There has been no credible evidence of “organ damage” in survivors.

These are unsubstantiated rumors. Stop repeating them.


I’m glad you asked, skepticism can be a healthy attitude in moderations and there is a lot of FUD around, but here’s an article from the Lancet. These were 99 patients, 11 of whom ultimately died. That means from the stats below a significant number of the patients with organ damage, possibly most of them, must have survived. Also the stats below were on admission, it’s likely even more of the patients may have suffered organ damage by the time they were discharged.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736...

>Many patients presented with organ function damage, including 17 (17%) with ARDS, eight (8%) with acute respiratory injury, three (3%) with acute renal injury, four (4%) with septic shock, and one (1%) with venti­ lator­associatedpneumonia(table2).


These conditions are listed as “comorbidities”, which means that they’re illnesses they already had, in addition to the virus.

In no way is this paper saying that the virus caused the listed conditions.


If you know what comorbidity means, you must know perfectly well that it includes secondary conditions, such as organ function damage, caused by the primary condition.

At these levels of prevalence, I think that comfortably clears the bar for having some pretty credible evidence.


??????? This is way too critical of an approach to this issue. Coronavirus affects supply chains, schools and many other facets of our lives. If mainstream media didn’t report heavily on the risks that would be negligent.

There have been many people who were healthy and have been infected, and also just because some people are at the risk of death; doesn’t means we should just cast off Coronavirus as a minor concern.


A lot of people die every year for a lot of reasons. Have a look at the CDC's death statistics[1]. One interesting thing to note is that flu vaccines are widely available and quite affordable, and yet many people die every year from the flu.

Yes, the virus may increase the total number of deaths overall, but my armchair hypothesis is that fear and panic will do more long term damage than the virus itself.

[1]: https://www.cdc.gov/nchs/fastats/deaths.htm


China has a flu every year, their reaction to the current outbreak is vastly different from a flu. That suggests that they consider it a bigger threat than the flu.


The US death rate is about 0.83%. The current raw death rate of COVID-19 is 2.6%. A quadrupling of the US death rate in a year is likely to cause concern. Consider all the concern over the far smaller number of firearm deaths.


we can't yet conclusively determine overall death rate, let alone for the US, of covid-19 (or alternatively speaking, the error bars of our current estmates are very large), so throwing out numbers with decimals insinuates a level of knowledge we don't yet have.

note that we've had single-digit number of deaths (one?) in the US so far.

34K people die of gun violence per year in the US, not a small number. what's insignificant is the number (tens to low hundreds per year) who die in mass shootings or from terrorism in the US.


Aren’t these comparisons a bit like saying that the pipes in Flynt Michigan are already toxic, so what’s another toxin added in to the mix?

Yes, we have zero deaths in America today. But like the grains of rice on the chessboard in the old fable, exponential growth can take people by surprise.


not at all. the point is that we really don't know enough yet to draw definitive conclusions either way, and it's erroneous to make (strong) assertions otherwise.

a reasonable response for individuals is to keep monitoring the situation and taking basic precautions (e.g., washing hands) but not becoming paranoid/spreading paranoia.

if you live with elderly or immune-compromised people, you might be a little more cautious, but there's no need to barricade yourself in your house with a stockpile of n95 masks at this point.

(btw, 1 american death was reported this morning)


If this was a new strand of the flu then I could understand what you are saying, but now we will have the flu which as you said many people die from, and we will have a new virus (nobody has immunity to) which many people will die as well, especially once this virus fully spreads across the globe.

Now I don't think extreme panic is a good, but fear on a certain level could help. I am in a major city and I have seen a lot better hygiene practices from civilians and businesses in the last couple of weeks.


You sound just like this super spreader missionary who shouted "It's not a big deal, we are all going to heaven."


I’m a bit bored of these ‘it’s just flu’ arguments.

Even though not everyone is vaccinated, flu vaccine does a good job of preventing flu going too far through the population. People are immunised against it and that helps stop it spread.

Also, even at the bottom end of fatality rate it’s 10X deadlier then flu.

I’m also bored of people saying it is OK because it only effects old people - so you don’t have any old people you care about?


My dad is 60 years old and just barely survived a bought of pancreatitis a few years ago. He’s got every single complicating health issue. According to the statistics that means he has like a 1 in 4 or 1 in 3 chance of dying if he catches this. That’s way worse than his odds with the flu or a cold. Maybe my dad doesn’t matter to you, but he’s kind of important to me.


That sucks. Both my parents have cancer (breast & prostate). I hope your dad lives many more good years.


I guess you just don’t know or care about anyone old or with a health condition, or who’s young and a bit unlucky. Or about potential panic buying, shortages of things made in China, and economic depression.

In this case, sure everything will be fine.




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