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Officials: Dozens at WA nursing facility show possible coronavirus symptoms (kiro7.com)
77 points by anigbrowl 8 months ago | hide | past | favorite | 104 comments



From another story on the nursing home outbreak:

> "If we had the ability to test earlier, I'm sure we would have identified patients earlier," he [a Washington State health official] said.

https://thehill.com/policy/healthcare/485302-officials-annou...

This is a pattern playing out with striking regularity:

1. Local authorities can't test for themselves.

2. CDC adjudicates testing requests, rejects many (most) of them.

3. People likely infected with COVID-19 are sent back home, to infect others.

Consider this case, posted to HN today:

https://abc7ny.com/5974999/

This pattern of apparently deliberate suppression of information can only fan the flames of what looks like a rapidly escalating problem.


We had so long to mobilize a lot of resources for this, and test every person with flu-like illnesses, and isolate them. CDC releasing broken testing kits and limiting use of testing. And then the President calling it a hoax made up to make him look bad, and forcing all statements from federal health authorities to go through the VP.

Isn't this exactly how the situation got so bad in Wuhan in the first place? Authorities not releasing information and preparing fast enough because it can make them look bad. China was able to limit the spread somewhat because they took the drastic step of cordoning off Hubei, shutting down all travel. If there was a big outbreak in WA, do you think the US, as a democracy, could shutdown all airports, roads and rail at the state border?


> If there was a big outbreak in WA, do you think the US, as a democracy, could shutdown all airports, roads and rail at the state border?

This is why the WA governor called a state of emergency. With that action, the state level government gains some pretty un-Democratic powers, such as mobilizing the National Guard for martial actions. I think that it would take them a while, and not be perfect, but eventually they could shut down most external transportation.


> apparently deliberate suppression of information

There's an alternative explanation: that the CDC massively dropped the ball on making enough test kits available.

The CDC comes off looking pretty bad regardless of whether it's deceit or incompetence, but they're pretty different things.

Hanlon's Razor (https://en.wikipedia.org/wiki/Hanlon%27s_razor) would tell us which to prefer, although it's not always right.


I'm sure this is the reason. Not being honest about it is a problem.


Why didn’t they buy working kits from other countries though? They had weeks to do that.


Probably because there's absolutely no reason to do so? It's not like the US has a shortage of labs that can produce these kits. Supposedly, the problem was that the CDC lab tasked with mass producing the testing kits wasn't competent to do so and didn't realise it - if the government had known what the problem was, they could've contracted production out to another US lab sooner. With the benefit of hindsight we of course know that getting kits from somewhere else would've been better, but imagine how much harder this problem would be to diagnose if the kits were sourced from some foreign lab the FDA didn't have access to.


I wouldn't be at all surprised if it's just bad project management.

You know how, when you really need to something accomplished without delay, you pursue two paths in parallel, so that by the time phase 1 comes to a close, you've got things ready for phase 2? Well, maybe the CDC doesn't.

Obviously they do on some level because they did develop kits (which had problems, which delayed them). But it's one thing to give lip service to getting started on stuff you're going to need in the near future, and it's another thing to commit to it and follow through with it and make sure it happens.

Also, I'm sure they were super busy and had other priorities, but lack of testing means the country is flying blind, so this should have made the short list of priorities.


And even worse, I believe they banned buying foreign test kits, so local authorities, hospitals, etc. had no ability to take matters into their own hands.


My guess is that lead time for the volumes they'd need is about a month if buying from overseas - and that's assuming a foreign supplier could absorb the extra kit volume.


Without being derogatory (only ironic); Made in China. That said it is a pandemic, those other countries are going to need their kits as much as anyone will.


I think the CDC comes off looking like the victim here. Years ago, Trump fired the pandemic response team [1] with a cited reason to 'cut costs'. Clearly there must have been some other reason, because firing a pandemic response team is guaranteed to increase costs, not reduce them.

Either way, the CDC has been intentionally handicapped by the Trump administration who specifically and intentionally reduced their ability to respond to crises like this one.

I certainly do not blame the CDC for their issues this time around, they are generally an incredible organization employing truly top minds and very high tech. If there is blame to go around here, it is with those who think that science is fake and that no money needs to be spent on community healthcare or prevention.

[1] https://www.snopes.com/fact-check/trump-fire-pandemic-team/


I think you hit the nail on the head. This seems like a testing issue, the real numbers are not known yet.


Look at the timeline of the outbreak in China: https://en.wikipedia.org/wiki/Timeline_of_the_2019%E2%80%932...

- Patient 0 falls ill on December 1, 2019.

- Patient 1 falls ill on December 8.

- 8 total cases by December 18.

- 45 cases by January 16, 2020.

- 121 cases by January 18.

- 1,287 cases by January 24.

- 11,791 cases by January 31.

- 24,324 cases by February 4.

- 44,653 cases by February 11.

- 70,548 cases by February 16.

- 79,251 cases by today.

Right now, South Korea and Italy are basically where China was in late January and the US and most of the rest of the world reporting their first infections are where China was in mid January. The next few weeks are not going to be pleasant.

It's important to note that the Hubei lockdown started on January 23, and China is only recently seeing new cases plateau as a result. It's hard to imagine what the stats would be had they not taken such aggressive action to contain the spread, but we may find out given that the US, Europe, and most of the rest of the world seems to be taking a wait and see approach as opposed to prompt action.


This is accumulated stats, please include the number of active cases too.

And the most of the accumulated cases are from Hubei. I agree the quarantine seems to be effective.


I’m starting to take some precautionary measures even here in Virginia. Stocking up on food and other emergency supplies, avoiding public transit and walking everywhere, wiping down all surfaces I come in contact with with Clorox wipes I keep in my backpack. Hopefully I’m just going insane and there’s no reason to panic, but a respiratory illness with no treatment protocol besides quarantine, an r nought of probably no less than 2 given lack of testing, and untraceable infection paths for new cases domestically sounds concerning to me. This isn’t Ebola or Zika. This doesn’t even look like SARS. It looks more like the first wave of Spanish flu. Second wave of Spanish flu made it land in the history books.

I really, really hope I’m just going insane and nothing will happen.


Definitely sounds insane to me. Stop reading the news mate.

>80% of cases are mild symptoms. A mild cold. Under 50 has a fatality rate of less than 0.5%. Almost all fatalities are over 70 or people who are already severely ill. You are about 25x more likely to die of the seasonal flu at this point.

This is media hysteria in a post fact world where all information from all sources is equally valid. Everyone is trying to be heard to make their case.

If you are 70+ or severely ill this IS pretty bad because, unlike the flu, their is literally no defense. If you don’t fit that profile it’s just a bunch of FUD.


Even if you are of an age where the risk of fatality or becoming very ill is minimal, consider this: if you have it for a few weeks even in a minor way, you are actively spreading it.

You don’t self isolate for yourself, you do it for all the people you can spread it to.


> If you are 70+ or severely ill this IS pretty bad because, unlike the flu, their is literally no defense. If you don’t fit that profile it’s just a bunch of FUD.

The 34 year old Chinese doctor who spoke up about the virus died.

https://www.bbc.com/news/world-asia-china-51403795


I’ve heard symptoms relate less with age and more with viral load. The sicker other people are and the more frequently you come in contact with them, the more lethal it becomes.

I’m checking reddit r/COVID19, which is a science based discussion forum with cited academic papers and flaired scientists. It started turning into a prepper forum but I think the mods are shutting that down pretty quickly. I go there for my news.


Would not trust /r/COVID19 for anything. There's been a lot of criticism on how they are applying censorship, and no transparency around it.

https://www.reddit.com/r/conspiracy/comments/f2jiyz/uclo_jun...


>> I’ve heard symptoms relate less with age and more with viral load. The sicker other people are and the more frequently you come in contact with them, the more lethal it becomes.

Are you sure that's accurate? I'm not disputing that as viral load increases, so do symptoms, and ability to infect others.

However, I'm finding it hard to model a scenario in which a virus is already replicating in one's system and external exposure to comparitively infinitesimal amounts of the same virus has an impact. Do you have any actual evidence to present which backs up your claims?


> However, I'm finding it hard to model a scenario in which a virus is already replicating in one's system and external exposure to comparitively infinitesimal amounts of the same virus has an impact. Do you have any actual evidence to present which backs up your claims?

Who really knows, but there are genetic diversity effects in other diseases. We also know that being exposed to a tiny initial viral load has a better prognosis with many diseases than a massive one (including with past SARS).

Doctors could be facing a "quadruple whammy"-- a disproportionate share of the worst strains (because they're meeting the most ill patients; exposure to greater viral loads; exposure to many patients with many slight variants of the disease; and sleep deprivation and overwork causing minor immune suppression.

But in the end, this is all speculation.


Here's the reddit post I looked at: https://www.reddit.com/r/COVID19/comments/f8lofv/why_are_so_...

Here's the full text of the post:

"""text Recently there have been several tragic deaths of young doctors in Wuhan from covid19, including the 29-year-old Dr. Xia Sisi, the 29-year-old Dr. Peng Yin Hua, the 42-year-old Dr. Huang Wenjun, and of course the 34-year-old Dr. Li Wenliang. This is at some odds with general population data showing that deaths of covid19 tend to be highly concentrated in the elderly. It could be a statistical anomaly, but it does seem like death rates may be higher in young doctors than would be expected in the population.

As an explanation, many of the most upvoted comments on these posts suggest that their immune systems might be suppressed due to overwork, poor sleep, and stress. To me, this seems to be an extremely unlikely explanation for many reasons, including the fact that doctors don't seem to die at relatively higher rates of other infectious illnesses such as influenza.

However, some people have mentioned higher viral load as a possibility, which seemed more likely. I did some research and I found this 2005 study on the role of viral load in SARS (which is, of course, very similar to covid19): https://wwwnc.cdc.gov/eid/article/11/12/pdfs/04-0949.pdf

The study looked at an outbreak of sars in a particular housing area in Hong Kong. They found that people who had closer contact with the index patient had a higher nasopharyngeal viral load on admission as measured by RT-PCR. Crucially, they also found that people in this area were also the most likely to die. Some quotes:

"The median nasopharyngeal viral load in E block patients (5.09 log10 copies/mL) was much higher than in non-E block patients (0 log10 copies/mL) on admission (p<0.001)... The overall case death rate among the 79 patients was 24.1%. The highest rate was in block E, which accounted for 79% of all deaths, while the death rate in patients living in E7 (the same block as the index patient) was 70% (7 patients). This rate is significantly higher than in other units (p = 0.001 by χ2 test). The index patient was one of the few patients from E7 who survived the disease."

"Severity of illness did not differ between block E patients and non-E block patients when they were first seen at the hospital, despite higher viral load in block E patients. However, the death rate was higher in block E. We have previously demonstrated that patients with high initial and peak viral loads in nasopharyngeal samples were more likely to show a less favorable disease course and lower survival rate (8,18). Patients living in E7 who had highest nasopharyngeal viral loads explains why their death rate was higher than for those living in other units. The dilution effect resulted in a decreased viral load as the disease spread to other units and in a lower death rate."

This data corroborates the viral load theory. It's not perfect evidence, but the theory also makes basic physiologic sense. A higher viral load on initial infection means that the virus will be able to do more damage and suppress the host's immune system further (lymphopenia) before the host can mount an immune response against the virus.

Hospital workers are likely to be exposed to especially high viral loads of covid19. People who are hospitalized with covid19 infections are likely to cough more and require close contact for procedures such as IV placement and intubation. It is hard to know for sure, but healthcare transmission risk may have been especially high in the early stages of the epidemic in Wuhan, when people were not as aware of the high mortality rates of this disease.

If viral load upon initial infection correlates with disease severity, this may also help to explain why some local clusters seem to have more severe disease, such as the family who all died of the disease. For some reason, people in these clusters may have been exposed to an especially high viral load. Ideally, we could measure the viral load of infected people with RT-PCR to test this, although it's hard enough to get basic yes/no tests for covid19 at this point.

The viral load theory is not rock solid. It may not explain a large percentage of the variance in disease severity - certainly age seems to be a larger factor. But to me, it is clearly the leading theory why a disproportionate number of young doctors without apparent pre-existing health problems have died of covid19 in Wuhan.

Healthcare workers putting themselves at risk to care for the sick during this pandemic are heroes. It is an urgent priority to have sufficient PPE available to our healthcare staff. We also need to have adequate space available to allow for the adequate distancing of staff and possibly infected patients. The viral load theory suggests that PPE and distancing are not only important for preventing healthcare workers from getting the illness but also decreasing the likelihood that they will die of the illness if they are infected. """


I'm an active poster there.

It's worth noting this is only a hypothesis. Yes, in general, across viral illnesses, people have a worse course of disease with high viral load. Whether that's a primary cause of differences in prognosis-- who knows. It would help explain why medical practitioners seem to do so badly.


Thank you very much for the clarification and for posting there! Yes, it is but one explanation and one possible reason out of many. I think others there have mentioned stress (I believe I read one 27 y/o doctor sadly dropped dead after working 10 days straight) and contexts such as existing immune system health (I've read a good number of stories of outbreaks in hospitals in addition to this nursing home story).


Yup. I'm not really involved in medicine (I've done a couple of things on the periphery), but one thing I've learned from reading lots of papers is just because something seems to make perfect sense doesn't mean it's what is actually happening.

Another factor beyond just viral load is viral diversity. People that are exposed to high viral loads also tend to be exposed to a genetically diverse population of viruses with a range of virulence and there's more likely to be virus that is particularly adapted to grow in that person and virulent. Also, there is almost certainly genetic variance in 2019-nCoV virulence and lethality, and the nastier strains are probably more concentrated in hospitals.


That’s called an outlier.


This hospital as about midway between Microsoft and Amazon headquarters.

The governor just declared a state of emergency and authorized use of the national guard:

https://www.kiro7.com/news/local/department-health-confirms-...


Google has a sizable Kirkland office. A good chunk of Google Cloud is there.

Also, rather ironically, Costco is headquartered there.

EDIT: Costco was founded there, but current hq is a few miles away in Issaquah.


People are panic shopping. I think even though the president is downplaying it, seeing how fast it spread in China and Italy, people are preparing for it to be really bad here.


>Health officials said that additional positive cases are not expected.

What does this mean? That everyone who could have got exposed are already sick? Or that two weeks have passed with no more new flu-like illnesses?


That’s a misquotation. The original source says “additional positive cases are expected”:

https://www.kingcounty.gov/depts/health/news/2020/February/2...


That's a pretty fucked up misquotation


KIRO has fixed the typo in the article.


A third option is that the statement simply isn't true / that it was said to attempt to reduce panic.

I think pretty much everyone expects additional positive cases. The statement is so vague, with no definitions of when, where or by what metric they mean "expected".

There has been significant misinformation around coronavirus, especially from US gov't officials - although not so much at the state level yet, from what I can tell.

Whoever is doing the 'expecting' on how there will be no future positive cases (whatever that means...I give it a couple hours/days before news breaks of an additional positive case near this location) is either intentionally misleading people, or the quote was taken out of context, or something.

I would certainly expect 'additional positive cases' to appear.


I'm starting to get the impression that most countries are dealing with this outbreak professionally. Except for Iran and the US. Ironic.


Mine (Italy) did not react professionally at all, in particular in the crucial first days, where there was a huge confusion and contrasts between local and central government (a paralyzed government who was mostly concerned about a majority party leaving or not leaving until up to this crisis).

Communication also was handled pretty poorly on all levels (central government, local government, and media). Strong measures (likely necessary) were not communicated properly ("do not panic" followed by restrictive measures), and the news are basically happy to provide sensationalist headlines ("coronavirus nightmare", "war bulletin", etc.). Lastly, the incompetent PM (he is: he's only there because he was "honest") blaming the hospital where the crisis started. This might be true (personally I think not, it is a failure in the chain of command as far as I can see), but you don't come out with these statements. What example are you giving to the country, the citizens, and everywhere in the world? That you don't even know how things are run in the country you are serving as part of the executive branch.

Also the experts (I do not use quotes, they are, or at least should be) providing explanations for the general public often coming up with contradictory statements (because of the various unknowns surrounding this virus and its behavior outside China). And the general public, which is unequipped to understand, gets even more confused.

This also led to the mass hysteria from the last weekend, with people raiding pharmacies and supermarkets. And the press from abroad (in Spain and at least in Colombia, from what I've seen) sensationalized that even more, up to the point that an acquaintance of mine (Colombian) got a worried phone call from her father because he was worried she'd starve.

"Professional"? Not by any means.


Doesn't seem that way looking at the numbers regarding the US.

The US has and is handling it the best.

The administration shut down travel earlier than any other country.

There are much fewer cases than other countries even though we have a larger population, economic trade, and travel.

There was already a travel ban from Iran to the US. This morning they just banned travel if you've ever been in Iran, so they don't come through Canada.

Maybe Canada should shut down flights from Iran.


Numbers don't mean much. You don't have confirmed cases if you don't test. The same is true pretty much everywhere however, not only the US. You'd have thought we would systematically test people from at-risk region, but apparently not.


> Numbers don't mean much.

Really?

> You don't have confirmed cases if you don't test.

There's appropriate testing. You and some media outlets are just fear mongering.

There's less testing overall because there's less risk because the US government quarantined it so well.

Other countries did and have not. Yes there have been some blunders, but that's human.

I don't think blanket statements politicizing the situation helps.


> there's less risk because the US government quarantined it so well.

Can you elaborate on that? Up to now everything shows that US government did not quarantine it very well, the chances for early testing and isolation of early cases were missed because of too restricted testing, and now we're getting severe patients who did not have any travel history, so they've been infected somewhere on US soil a week or two ago from sources who haven't been identified (possibly because they themselves have only mild symptoms and don't need hospitalization) and presumably have infected others. These "surprise patients" are evidence that community spread in USA has started some time ago already.

From what I see, countries like Singapore and South Korea are some examples of implementing somewhat effective quarantine measures, and USA has quarantined it much worse than other countries, it's just that it's been hidden due to lack of testing and the time delay of severe symptoms, so we're just starting to see the consequences of that.


The total number of cases in each country indicates otherwise.

Currently compared to every other country on Earth, we have quarantined it the best.

Even if you assume there are some undetected cases in the US (which is likely), it's still not even close.

It WILL spread across America, it's just a matter of time.

You are speculating that the CDC will not be able to handle it.

Take a step back and calm down. Maybe evaluate where you get your news and why they are trying to fear monger.


> The total number of cases in each country indicates otherwise.

The number of cases in the US is wrong. We know it's wrong because if it was right, we wouldn't have cases stemming from unknown sources.

> Currently compared to every other country on Earth, we have quarantined it the best.

No. We've put our collective heads in the sand, and hidden from testing any significant number of people.

> It WILL spread across America, it's just a matter of time.

This is the outcome of a bad quarantine.

> You are speculating that the CDC will not be able to handle it.

The CDC has already mishandled it. They created red tape making the criteria for administering testing very narrow. They coerced medical establishments to only use their test kits, rather than being able to pick from known working kits proven elsewhere in the world. Then, the kits they issued were flawed, and they forbade medical professionals from administering them. They have literally done nothing right yet. Have you seen their official webpage on Covid-19? It doesn't even describe the common chain of symptoms; instead it has multiple bullet points about Covid-19 Stigma... You get better and more complete information from reddit.


> The number of cases in the US is wrong. We know it's wrong because if it was right, we wouldn't have cases stemming from unknown sources.

We know they are from other countries that weren't able to get their quarantine under control. Iran and South Korea. Flights from SK were banned this Saturday morning. Flights from Iran were already banned, but now those coming from Canada and other countries that have been in Iran can no longer enter either.

> This is the outcome of a bad quarantine.

So you agree that case numbers matter and the US has dealt with it the best so far, because it's spread across the world much more prevalent than here.

> You get better and more complete information from reddit.

Your reaction makes a lot of sense now.


> > The number of cases in the US is wrong. We know it's wrong because if it was right, we wouldn't have cases stemming from unknown sources.

> We know they are from other countries that weren't able to get their quarantine under control. Iran and South Korea. Flights from SK were banned this Saturday morning. Flights from Iran were already banned, but now those coming from Canada and other countries that have been in Iran can no longer enter either.

No shit Sherlock. Unknown sources, as in none of the people that we suspected of being exposed could've come into contact with people who later tested positive.

> > This is the outcome of a bad quarantine.

> So you agree that case numbers matter and the US has dealt with it the best so far, because it's spread across the world much more prevalent than here.

I'm really not sure why you think "bad quarantine = we're #1!", but no, there are many other countries that did a better job of the US, and now it's likely a good number of us will die from it.

> > You get better and more complete information from reddit.

> Your reaction makes a lot of sense now.

Yes, I'm wholly willing to vet sources by the quality of the information they provide, and the CDC is putting out platitudes and vague happy-go-lucky information, while a number of informal channels are putting out the highest quality information available.

Check out: https://www.reddit.com/r/COVID19/comments/fakavo/compilation...

Compare it to: https://www.cdc.gov/coronavirus/2019-ncov/index.html

I know at this point you're just trolling, but this really isn't the right place for it.


Your Reddit post links to the CDC. All of that information you can basically find on the CDC website.

You're very misinformed and you seem to have angst against the administration for little reason.

Get off the internet and stop trying to scare people. Go stock up on germ-x and spend time with your family. Stop politicizing a very serious situation, it's dangerous and tacky.

Good night.


> Your Reddit post links to the CDC. All of that information you can basically find on the CDC website.

Before you edited your comment, you said that half of the links linked to the CDC. The other half linked elsewhere, where useful information was to be had.

> You're very misinformed and you seem to have angst against the administration for little reason.

Gee thanks, nice to see you aren't above personal attacks. Having been a Marine for nearly a decade, I have quite a lot of experience with the US government.

> Get off the internet and stop trying to scare people. Go stock up on germ-x and spend time with your family. Stop politicizing a very serious situation, it's dangerous and tacky.

> Good night.

Truly a poet.


>> Take a step back and calm down. Maybe evaluate where you get your news and why they are trying to fear monger.

Press conferences held by US leadership seem to indicate that they're not well prepared for an actual crisis, but are prepared to play politics with one. This does not bode well.


I guess we haven't been watching the same press conferences.

Care to elaborate what you had issue with?


You assert that numbers mean a lot. You also state that appropriate testing is being done. What number of tests need to be administered to attain an appropriately sized population for statistical analysis? The answer to this is a LOT MORE than the ~3500 tests that have been conducted in the US over the last month.

We already have people testing positive who have not travelled overseas and have not come into contact with known carriers. The CDC has labeled those cases as community acquired cases. That means we KNOW that we don't have accurate numbers, and we KNOW that there are more people sick than our data suggests. It also means that some population of carriers are both not in quarantine, and are activity transmitting to others.

So the quarantine in the US has failed, and we have no idea how badly. Paranoia is warranted at this point.


> So the quarantine in the US has failed, and we have no idea how badly.

No one ever suggested it was never going to spread in America. The quarantine was to TRY to prevent it from getting here, but you can only do so much.

Once it is here we will treat it. There are plenty procedures in place since 9/11 to handle these things properly.

The longer we held the quarantine the more time we had to prepare. We've done really well thanks to the early travel bans that the media was against.

> Paranoia is warranted at this point.

Stop fear mongering.


> No one ever suggested it was never going to spread in America. The quarantine was to TRY to prevent it from getting here, but you can only do so much.

In an earlier post you wrote, "There's less testing overall because there's less risk because the US government quarantined it so well." If the US government did so well at quarantine that they didn't need to do any surveillance testing, how is it now spreading outside of quarantine? Your statement is an assertion that the government has stopped it from spreading, by the logic that they wouldn't need to test outside of quarantine. So yeah, you did suggest it.

> Once it is here we will treat it. There are plenty procedures in place since 9/11 to handle these things properly.

There is no treatment that is known to work. There are four or five that are, or are approaching, clinical trials. The one that looks most promising to me is being used in a trial in Wuhan.

> The longer we held the quarantine the more time we had to prepare. We've done really well thanks to the early travel bans that the media was against.

We have no idea when the quarantine broke. We just know we've had several cases of people in hospitals who were sick and had no clue who they got it from. It could have been a single carrier, or they could be representing a thousand people who are just beginning to develop flu-like symptoms... We just don't know. Not enough data.

> > Paranoia is warranted at this point.

> Stop fear mongering.

I will monger fear when I think it's necessary; an illness that doubles the number of infected every 6 days, has no cure or treatment, has a death rate higher than swine flu, and takes a median of 4.5 days to even show symptoms scares the hell out of me, and it should scare the hell out of you too. And if you think the government "has this under control", you've obviously never worked for them. I did for nearly a decade, and they take months to get their heads out of their asses.


>> Stop fear mongering.

You might have the best of intentions, but you're not really helping anyone.

The US appears to be mirroring China's missteps quite well, and we all know how things turned out there. Unfounded optimism is as dangerous as fearmongering.


I don't think it's been quarantined well. In fact, I'd say the quarantine here in the US was handled very badly. Workers were exposed to quarantined individuals without proper equipment or training[0]. The virus has a long period before people show symptoms so the current number of people infected is probably larger and more widespread than we know.

[0] https://www.usnews.com/news/health-news/articles/2020-02-29/...


Based on the limited supply of test kits, and ability to use them in an rapid manner, I believe we are entering a phase where symptoms should warrant an immediate self-quarantine.

Waiting for a negative, or declaring that only those that may have traveled or contacted someone who was in china is test worthy is foolhardy. This thing dies after 9+ days in the environment, if we reduce exposure of those who may be infected; It is possible we can wait this out.

Companies without work from home policies should revisit them immediately. Forcing someone who is under the weather or feeling off to come into your office is risking your whole company site.

Also tell your co-workers to go home when they are sick! An office is not an ambulatory pneumonia wing of the local hospital. Sick people should be home!


HN is really buying into the media hysteria on this one. I would have expected more.


Personally I think the media is downplaying this, if anything. I hope you are right though, honestly.


I wish the admins would put a ban on these stories over here to be honest. I haven't seen anything interesting come out of these threads, just the same surface level fear-mongering you can find on reddit and elsewhere. I don't really see how any of this "gratifies one's intellectual curiosity". "If they'd cover it on TV news, it's probably off-topic", well, about that...

I don't know if the hysteria is warranted or not, but at this point I'm convinced that it doesn't make for good HN discussions. People who want to discuss every development of this epidemic can find tons of places to do that already, including a plethora of subreddits focusing on various aspects of it.


Flag it and move on. The flagging system works pretty well for this kind of thing.


I think the attention is coming from the initial numbers reported by China about a month ago, went from 2k to 80k in about 3 weeks. Something about the numbers seem odd, along with large city quarantines. If you look at the confirmed cases, neighboring countries like Vietnam have 16 confirmed, but the US already has 69. Thailand and Taiwan have 30 confirmed cases each, but Iran already has 245.


don't know why you got downvoted. I have yet to see the opinion of a doctor explaining why this virus requires specific measures compared to other types of flu-like viruses ( hint: friend working in a hospital recently told me doctors there are amazed by the frenzy on this topic, that looks to them exactly the same as other kinds of flu).

It seems politics are forced to take the same kind of exceptional measures as in other countries for fear of being accused of not being responsible.

I won't mention the other topic, but it's the second time i've found HN lacking scientific rigor the same way the general public does. I guess it's the downside of being more popular..


Let's just say that doctors and nurses treating flu patients during the flu epidemic are generally not dying from flu, and quite a few doctors and nurses treating Covid-19 patients have died from Covid-19.


The King County press conference today included a Q&A where this very question was asked ("why this virus requires specific measures compared to other types of flu-like viruses"). According to Dr. Francis Riedo, Medical Director of Infection Control and Prevention at EvergreenHealth, to paraphrase, "The difference between this Novel Coronavirus and Influenza is (1) there is no innate immunity, it is a completely vulnerable population, (2) there is no vaccine to prevent it, and (3) there is no currently effective anti-viral therapy. It is a perfect storm for a novel virus to come out without a vaccine, population base protection, or an effective therapeutic agent."


I'm not even sure what this "no innate immunity" sentence means. Old and fragile people are getting vaccined for flu every year, because they aren't immuned to the new strain of the year.

Now it is true that old and fragile people should be worried about coronavirus, but judging from death rates, it doesn't seem more deadly than the flu. So why put fear in the whole population ?

also, most people only experience nothing more than a cold symptoms. Which means most people actually have an immune system able to fight this virus quite efficiently.


Where are you getting your information? According to the Chinese CDC it is 20 times more deadly than the flu. And why does "most people only experience nothing more than a cold symptoms" imply that they "have an immune system able to fight this virus quite efficiently"? Younger and non-vulnerable people have gotten extremely sick (and died), one theory being that the more of the actual virus you are exposed to the more severe your symptoms.


influenza has 650k death over 3-5 million cases per year, according to wikipedia, which is around 16% casuality.

according to https://www.worldometers.info/coronavirus/ coronavirus has 3k deaths over 86k, which is 3%. Or if you take the other metrics, which is 40k recovered, that's 3/43 around 7% death. still way lower than the flu.

as for my remark about immune system, my point is that the vast majority of people experience very mild symptoms. Which means that their body was perfectly able to fight back and produce the antibody, just like against the other flus.


Try again. That’s 3–5 million severe cases per year, not total cases.


i suppose the people that got diagnosed for the coronavirus at the moment are people that felt bad enough to go to the doctor or hospital. We probably don't know about most of the cases..



What do you suggest?


[flagged]


China has been shut down for weeks, Japan and South Korea are shutting down, and you're here saying talking about it is a political thing. Truly an idiocracy


How do you differentiate influenza from covid-19? These folks probably just have the flu. I live in WA state and I had the worst case of the flu I can remember about 3 weeks ago. Did I have covid-19? No way to really know.


>These folks probably just have the flu.

Perhaps you're missing the part of the article that says:

>There are also two confirmed cases associated with the nursing facility.

I'm not trying to say they definitely have it, but it's foolish to brush this aside as "probably just the flu" when they appear to have been exposed to the virus.


My response was largely from my own wondering about my situation. I live in WA state and I fly to CA every week. I was super sick -- fever, chills, respiratory issues, etc... I just came to the conclusion that it is far more likely I had the flu, but I really don't know.


You should consider telling your doctor.

edit: I now see you said 3 weeks ago, so that may not be helpful.


Bellevue, WA here; I had a very bad case of the flu in early Feb (worst I can remember) and it took 3+ weeks to fully recover. Many cow-orkers were also affected (some meetings with 30+ people were down to a handful of people . . . not a bad thing under the circumstances).

Our "patient zero" was a dev who came into work for a day with a cough.

If you're sick, please stay home.


There’s no way you can confirm it was the dev. Almost Everyone has had the flu this year basically regardless of flu shot status. I had a flu shot and got influenza A. It took a week to recover but the fever only lasted half a day. Tamiflu helped. My case corrresponded with a peak in cases in my state.


Most of my past flu "experiences" have been like that. Started of as a cold, two days of low fever, 8 hours of high fever (that waas the sucky part), and two to three days for everything to stabilize.


My whole family had that same bug in Feb (in So Cal). It was nasty.

I have never worked at a company where one could call in sick without consequences. My last employer (which was evil) had a policy of five sick days per year, and more than two days consecutively needed a doctors note.


That's crazy, my mom who lives in the Seattle area got sicker than she's ever gotten with that bug. I knew it was going around, but I had no idea it was THAT rampant.


A real bad influenza swept through here. I was laid out for at least a week with a 102 fever.


From the article: "There are also two confirmed cases associated with the nursing facility."

Also, there was recently a death from Coronavirus in Seattle, and there has been community transmission in the nearby neighborhood of Mill Creek.

So, what evidence do you have that that "these folks probably have the flu"? At best you are dismissing concerns, at worst you are making things worse by trying to convince people not to take this seriously.


Statistically it is still far more likely that they had the flu. I think it is dangerous to overstate the problem because then when it really does become an issue it will be dismissed because of all the previous folks "crying wolf."


You can test for influenza. In that article I didn't see, "tested positive for influenza". I did see "tested positive for coronavirus".

So no, I don't think it's statistically more likely that ill patients around a highly contagious disease randomly picked up something else.


The influenza test exists, bit it has a very high false negative rate. It is useful in epidemiology, because if you test large populations, you'll get enough positives to learn something -- but you learn virtually nothing from a negative influenza test.


At this point, it's much more likely that these residents and staff were exposed to Covid-19. We know of two confirmed cases at this facility, and no confirmed cases of influenza. Given our knowledge of the contagiousness of Covid-19, it would make little sense to assume this cluster of respiratory illnesses is not Covid-19.


I mean, there’s always wishful thinking. That seems to be the US’s current response.


"Statistically" means, in this case, based on data. The data we have right now is EXCEEDINGLY poor. The US just hasn't been testing many people, and the CDC has mandated that only people who travel abroad and those they contact should be tested. It's obvious based on these new cases that Covid-19 is being spread through communities, rather than by single carriers who've travelled abroad.

Statistics based on bad data (which we know is bad at this point) is analogous to guessing, and when guessing it's best to guess with the more cautious point of view. Is it still more likely, at this point in time, that a person with flu-like symptoms has flu? Probably.

Given the transmission rate from Chinese data (also bad data, but not as bad as ours), the US likely has more flu carriers than Covid-19 carriers. But how much more likely? No one knows, and no one can know, until we get a reasonable sample population tested.


Not to be too snarky, but your response could be seen as precisely the kind of dismissive response you’re trying to prevent.

Now is the time to be vigilant. I’d rather have too many people thinking they have this and self isolating/getting tested than too few.


> These folks probably just have the flu.

An update, ten days later: 26 people (nearly a quarter of the 120 residents of this facility) have died in the past three weeks. Most of those who died have already positive for the SARS-CoV-2 coronavirus. Post-mortem tests are still pending for a handful of the earlier cases.

More than half of the surviving residents have also tested positive for coronavirus so far. Most of them are serious cases and are currently hospitalized. More than a third of the staff have COVID-19 symptoms and are awaiting test results.


35 residents are now known to have died of COVID-19.


With a coronavirus test. The CDC screwed the pooch by shipping defective kits and restricting the criteria for getting tested.


Yes, but these folks were not tested correct?


I know this is a fast moving topic, but the kerfluffle from last Wednesday about the person not tested for 4 days has caused testing to become much broader. For example, on Thursday, Santa Clara County ran a local test that confirmed the community-spread patient that's in a hospital in Mountain View. So a lot more testing is going on than was the case Wednesday and earlier.


Again, from the article: Dr. Jeff Duchin with King County Public Health also said that an additional 27 residents and 25 staff members are reportedly ill with respiratory symptoms, hospitalized with pneumonia or are being tested for coronavirus.

And two people have confirmed cases and are currently hospitalized.


That is incorrect. At least some of the people were tested for coronavirus and the tests showed positive.


Yes, but the high number suggests that it may not be the flu, since immunity to flu lasts a few years, so people are unlikely to fall sick in high numbers like this, and also are in the same facility as people tested positive.


  immunity to flu lasts a few years
Immunity to that specific strain.


I saw on the news, they are now using CAT scans to detect as a first pass. Apparently the damage done to the lungs has a distinct popcorn like outline, easily seen on the scans.


Wouldn't this catch only those with the most severe sympthoms (the dreaded 20% often quoted, of which a part of that is fatal) and not the "dangerous" (because they can infect others more easily) people with mild to no sympthoms?


There’s an RNA based test procedure that can differentiate Covid-19 from the Flu, I think it’s what everyone is using.


The better thing is the new (not yet widely available) antibody test, which can determine if you had it even after you recover.

Useless in a clinical setting, of course, but highly useful for epidemiology


most elderly are vaccinated against seasonal influenza, particularly those in a managed home like that.




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